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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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    1. Rajani Pokharel & Pushkar Raj Silwal, 2018. "Social health insurance in Nepal: A health system departure toward the universal health coverage," International Journal of Health Planning and Management, Wiley Blackwell, vol. 33(3), pages 573-580, July.
    2. Sparrow, Robert & Suryahadi, Asep & Widyanti, Wenefrida, 2013. "Social health insurance for the poor: Targeting and impact of Indonesia's Askeskin programme," Social Science & Medicine, Elsevier, vol. 96(C), pages 264-271.
    3. Sisira Kumara, Ajantha & Samaratunge, Ramanie, 2019. "Relationship between healthcare utilization and household out-of-pocket healthcare expenditure: Evidence from an emerging economy with a free healthcare policy," Social Science & Medicine, Elsevier, vol. 235(C), pages 1-1.
    4. Aparnaa Somanathan & Ajay Tandon & Huong Lan Dao & Kari L. Hurt & Hernan L. Fuenzalida-Puelma, 2014. "Moving toward Universal Coverage of Social Health Insurance in Vietnam : Assessment and Options," World Bank Publications - Books, The World Bank Group, number 18885.
    5. Midori Matsushima & Hiroyuki Yamada, 2013. "Public Health Insurance in Vietnam towards Universal Coverage: Identifying the challenges, issues, and problems in its design and organizational practices," OSIPP Discussion Paper 13E003, Osaka School of International Public Policy, Osaka University.
    6. Yardim, Mahmut Saadi & Cilingiroglu, Nesrin & Yardim, Nazan, 2010. "Catastrophic health expenditure and impoverishment in Turkey," Health Policy, Elsevier, vol. 94(1), pages 26-33, January.
    7. Palmer, Michael G., 2014. "Inequalities in Universal Health Coverage: Evidence from Vietnam," World Development, Elsevier, vol. 64(C), pages 384-394.
    8. Cylus, Jonathan & Thomson, Sarah & Evetovits, Tamás, 2018. "Catastrophic health spending in Europe: equity and policy implications of different calculation methods," LSE Research Online Documents on Economics 89062, London School of Economics and Political Science, LSE Library.
    9. Diego Proaño Falconi & Eduardo Bernabé, 2018. "Determinants of catastrophic healthcare expenditure in Peru," International Journal of Health Economics and Management, Springer, vol. 18(4), pages 425-436, December.
    10. Asnakew Molla Mekonen & Measho Gebreslassie Gebregziabher & Alemayehu Shimeka Teferra, 2018. "The effect of community based health insurance on catastrophic health expenditure in Northeast Ethiopia: A cross sectional study," PLOS ONE, Public Library of Science, vol. 13(10), pages 1-13, October.
    11. Le, Nga & Groot, Wim & Tomini, Sonila & Tomini, Florian, 2018. "Health insurance and patient satisfaction: Evidence from the poorest regions of Vietnam," MERIT Working Papers 2018-040, United Nations University - Maastricht Economic and Social Research Institute on Innovation and Technology (MERIT).
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    4. 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.

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