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Determinants of catastrophic health expenditure in Vietnam

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  • Nguyen Thi Thu Thuong
  • Yme Van Den Berg
  • Tran Quang Huy
  • Do Anh Tai
  • Bui Nu Hoang Anh

Abstract

Background The Government of Vietnam has set the goal of achieving universal health coverage (UHC) by 2025. Health insurance (HI) is being considered a tool to achieve this goal. However, out‐of‐pocket spending and catastrophic health expenditure (CHE) remain high. Research evidence on how to reduce these expenditures to achieve UHC is essential. Therefore, this study examines the determinants of CHE, especially the HI factor. Method To identify HI participation status and other factors associated with CHE, we use logistic regression on a dataset from the 2016 Vietnam Household Living Standards Survey. Results The study finds that HI is a protective factor against CHE, although this result is not always statistically significant across different subsamples. Moreover, the household head's age and employment status, household size, share of the elderly above 60 years, income, illness status, healthcare utilisation, availability of hospitals, commune health stations with medical doctors and place of residence all correlate with household CHE. Conclusion Although there has been a rise in HI coverage, the financial protection capacity of HI schemes in Vietnam remains inadequate, particularly for households living in rural areas. Further investigations of the causal effect of HI, other health system factors and CHE in rural settings are necessary to reduce the incidence of CHE. Additionally, policies aimed at groups vulnerable to CHE, such as those with higher incidences of severe illness or inpatient admissions, low income, and higher age, should be considered.

Suggested Citation

  • Nguyen Thi Thu Thuong & Yme Van Den Berg & Tran Quang Huy & Do Anh Tai & Bui Nu Hoang Anh, 2021. "Determinants of catastrophic health expenditure in Vietnam," International Journal of Health Planning and Management, Wiley Blackwell, vol. 36(2), pages 316-333, March.
    • Handle: RePEc:bla:ijhplm:v:36:y:2021:i:2:p:316-333
    DOI: 10.1002/hpm.3076
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    References listed on IDEAS

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    1. Uğur Ercan, 2021. "The Determinants of Turkey Household Catastrophic Health Expenditures: A Different Approach by Data Mining," Alphanumeric Journal, Bahadir Fatih Yildirim, vol. 9(2), pages 229-246, December.
    2. Kaiser, Andrea Hannah & Okorafor, Okore & Ekman, Björn & Chhim, Srean & Yem, Sokunthea & Sundewall, Jesper, 2023. "Assessing progress towards universal health coverage in Cambodia: Evidence using survey data from 2009 to 2019," Social Science & Medicine, Elsevier, vol. 321(C).
    3. Paulo Caldas & Miguel Varela, 2023. "The Portuguese Public Hospitals Performance Evolution before and during the SARS-CoV-2 Pandemic (2017–2022)," Sustainability, MDPI, vol. 15(15), pages 1-31, July.
    4. Thuong, Nguyen Thi Thu, 2021. "Catastrophic health expenditure and impoverishment in Vietnam: Evidence from national Household Living Standards Surveys 2008–2018," Economic Analysis and Policy, Elsevier, vol. 72(C), pages 668-684.

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