IDEAS home Printed from https://ideas.repec.org/a/gam/jecomi/v12y2024i6p153-d1415800.html
   My bibliography  Save this article

Urbanization and Health Expenditure: An Empirical Investigation from Households in Vietnam

Author

Listed:
  • Hang Thu Nguyen-Phung

    (Research Division, Asian Growth Research Institute, Fukuoka 803-0814, Japan
    Faculty of Information Technology, Hanoi University, Hanoi 100000, Vietnam)

  • Hai Le

    (Department of Business, Swinburne Vietnam, FPT University, Hanoi 700000, Vietnam)

Abstract

This study examines the effects of urbanization on household health expenditure. Using a unique bi-annually household-level dataset from 2012–2016 from Vietnam, we obtain key findings as follows. To mitigate possible endogeneity concerns, we utilize a two-stage least squares regression (2SLS) approach, employing the development of information and communication (ICT) infrastructure at the province level as an instrumental variable (IV). The key findings can be summarized as follows. First, urbanization significantly reduces Vietnamese households’ inpatient and outpatient health expenses. Second, the self-treatment expenses of households increase as the process of urbanization advances. In addition, we perform various robustness checks, encompassing different measures of urbanization, the use of lag of urbanization as an additional IV, and the plausible exogenous IV. The outcomes derived from these rigorous sensitivity analyses substantiate the reliability and consistency of our key results. Finally, we propose different ways to explain these results, including health insurance expenses and household income.

Suggested Citation

  • Hang Thu Nguyen-Phung & Hai Le, 2024. "Urbanization and Health Expenditure: An Empirical Investigation from Households in Vietnam," Economies, MDPI, vol. 12(6), pages 1-17, June.
  • Handle: RePEc:gam:jecomi:v:12:y:2024:i:6:p:153-:d:1415800
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/2227-7099/12/6/153/pdf
    Download Restriction: no

    File URL: https://www.mdpi.com/2227-7099/12/6/153/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Damian Clarke & Benjamín Matta, 2018. "Practical considerations for questionable IVs," Stata Journal, StataCorp LP, vol. 18(3), pages 663-691, September.
    2. Matthew Jowett & Anil Deolalikar & Peter Martinsson, 2004. "Health insurance and treatment seeking behaviour: evidence from a low‐income country," Health Economics, John Wiley & Sons, Ltd., vol. 13(9), pages 845-857, September.
    3. Guo, Shiqi, 2020. "The legacy effect of unexploded bombs on educational attainment in Laos," Journal of Development Economics, Elsevier, vol. 147(C).
    4. Wameq A. Raza & Ellen van de Poel & Arjun Bedi & Frans Rutten, 2016. "Impact of Community‐based Health Insurance on Access and Financial Protection: Evidence from Three Randomized Control Trials in Rural India," Health Economics, John Wiley & Sons, Ltd., vol. 25(6), pages 675-687, June.
    5. Thang Dang, 2018. "Do the more educated utilize more health care services? Evidence from Vietnam using a regression discontinuity design," International Journal of Health Economics and Management, Springer, vol. 18(3), pages 277-299, September.
    6. Douglas Gollin & Remi Jedwab & Dietrich Vollrath, 2016. "Urbanization with and without industrialization," Journal of Economic Growth, Springer, vol. 21(1), pages 35-70, March.
    7. Hang Thu Nguyen-Phung & Hai Le, 2024. "Energy Poverty and Health Expenditure: Empirical Evidence from Vietnam," Social Sciences, MDPI, vol. 13(5), pages 1-14, May.
    8. Meierrieks, Daniel & Renner, Laura, 2023. "Islamist terrorism and the status of women," European Journal of Political Economy, Elsevier, vol. 78(C).
    9. James Thornton & Jennifer Rice, 2008. "Determinants of healthcare spending: a state level analysis," Applied Economics, Taylor & Francis Journals, vol. 40(22), pages 2873-2889.
    10. Wagstaff, Adam & Lindelow, Magnus, 2008. "Can insurance increase financial risk?: The curious case of health insurance in China," Journal of Health Economics, Elsevier, vol. 27(4), pages 990-1005, July.
    11. Zijun Wang, 2009. "The determinants of health expenditures: evidence from US state-level data," Applied Economics, Taylor & Francis Journals, vol. 41(4), pages 429-435.
    12. Guo Chen & Amy K Glasmeier & Min Zhang & Yang Shao, 2016. "Urbanization and Income Inequality in Post-Reform China: A Causal Analysis Based on Time Series Data," PLOS ONE, Public Library of Science, vol. 11(7), pages 1-16, July.
    13. Yu Shen & Wenkai Sun, 2023. "From Villages to Urban Neighborhoods: Urbanization and Health," China & World Economy, Institute of World Economics and Politics, Chinese Academy of Social Sciences, vol. 31(2), pages 137-158, March.
    14. Waters, Hugh R. & Anderson, Gerard F. & Mays, Jim, 2004. "Measuring financial protection in health in the United States," Health Policy, Elsevier, vol. 69(3), pages 339-349, September.
    15. Zheng, Xiaoting & Wu, Anqi & Wei, Xuejing, 2023. "The social support returns to college education in China: Evidence from online medical crowdfunding," China Economic Review, Elsevier, vol. 79(C).
    16. Levine, David & Polimeni, Rachel & Ramage, Ian, 2016. "Insuring health or insuring wealth? An experimental evaluation of health insurance in rural Cambodia," Journal of Development Economics, Elsevier, vol. 119(C), pages 1-15.
    17. Colm Harmon & Brian Nolan, 2001. "Health insurance and health services utilization in Ireland," Health Economics, John Wiley & Sons, Ltd., vol. 10(2), pages 135-145, March.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Bukari, Chei & Broermann, Shanaz & Okai, Davidson, 2021. "Energy poverty and health expenditure: Evidence from Ghana," Energy Economics, Elsevier, vol. 103(C).
    2. Emily Gustafsson-Wright & Gosia Popławska & Zlata Tanović & Jacques Gaag, 2018. "The impact of subsidized private health insurance and health facility upgrades on healthcare utilization and spending in rural Nigeria," International Journal of Health Economics and Management, Springer, vol. 18(3), pages 221-276, September.
    3. Thang Dang, 2022. "Retirement and health services utilization in a low‐income country," Economics of Transition and Institutional Change, John Wiley & Sons, vol. 30(3), pages 597-620, July.
    4. Mohammad Abu-Zaineh & Habiba Romdhane & Bruno Ventelou & Jean-Paul Moatti & Arfa Chokri, 2013. "Appraising financial protection in health: the case of Tunisia," International Journal of Health Economics and Management, Springer, vol. 13(1), pages 73-93, March.
    5. Wagstaff, Adam & Lindelow, Magnus & Jun, Gao & Ling, Xu & Juncheng, Qian, 2009. "Extending health insurance to the rural population: An impact evaluation of China's new cooperative medical scheme," Journal of Health Economics, Elsevier, vol. 28(1), pages 1-19, January.
    6. Lau, Siew Yee & Parinduri, Rasyad & Lee, Yoong Hon, 2019. "Does Social Health Insurance Help Owners of Micro- and Small Firms Cope with Family Hardships? Evidence from Indonesia," MPRA Paper 95295, University Library of Munich, Germany.
    7. Grigorakis, Nikolaos & Floros, Christos & Tsangari, Haritini & Tsoukatos, Evangelos, 2016. "Out of pocket payments and social health insurance for private hospital care: Evidence from Greece," Health Policy, Elsevier, vol. 120(8), pages 948-959.
    8. Ibrahim Mohamed Ali Ali & Imed Attiaoui & Rabeh Khalfaoui & Aviral Kumar Tiwari, 2022. "The Effect of Urbanization and Industrialization on Income Inequality: An Analysis Based on the Method of Moments Quantile Regression," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 161(1), pages 29-50, May.
    9. Masayoshi Hayashi & Akiko Oyama, 2014. "Factor Decomposition of Inter-prefectural Health Care Expenditure Disparities in Japan," CIRJE F-Series CIRJE-F-948, CIRJE, Faculty of Economics, University of Tokyo.
    10. Macha, Raphael Rasiel, 2015. "Community Based Health Insurance Schemes and Protection of the Rural Poor: Empirical evidence from Tanzania," African Journal of Economic Review, African Journal of Economic Review, vol. 3(2), July.
    11. Darius Erlangga & Marc Suhrcke & Shehzad Ali & Karen Bloor, 2019. "The impact of public health insurance on health care utilisation, financial protection and health status in low- and middle-income countries: A systematic review," PLOS ONE, Public Library of Science, vol. 14(8), pages 1-20, August.
    12. Sepehri, Ardeshir & Simpson, Wayne & Sarma, Sisira, 2006. "The influence of health insurance on hospital admission and length of stay--The case of Vietnam," Social Science & Medicine, Elsevier, vol. 63(7), pages 1757-1770, October.
    13. Arnab Acharya & Sukumar Vellakkal & Fiona Taylor & Edoardo Masset & Ambika Satija & Margaret Burke & Shah Ebrahim, 2013. "The Impact of Health Insurance Schemes for the Informal Sector in Low- and Middle-Income Countries: A Systematic Review," The World Bank Research Observer, World Bank, vol. 28(2), pages 236-266, August.
    14. Owen (O.A.) O'Donnell, 2019. "Financial Protection Against Medical Expense," Tinbergen Institute Discussion Papers 19-010/V, Tinbergen Institute.
    15. Lingguo Cheng & Hong Liu & Ye Zhang & Ke Shen & Yi Zeng, 2015. "The Impact of Health Insurance on Health Outcomes and Spending of the Elderly: Evidence from China's New Cooperative Medical Scheme," Health Economics, John Wiley & Sons, Ltd., vol. 24(6), pages 672-691, June.
    16. Jeffrey E. Harris & Sandra G. Sosa-Rubi, 2009. "Impact of "Seguro Popular" on Prenatal Visits in Mexico, 2002-2005: Latent Class Model of Count Data with a Discrete Endogenous Variable," NBER Working Papers 14995, National Bureau of Economic Research, Inc.
    17. Richard Agbanyo & James Atta Peprah, 2021. "National health insurance and the choice of delivery facility among expectant mothers in Ghana," International Journal of Health Economics and Management, Springer, vol. 21(1), pages 27-49, March.
    18. Ramses H. Abul Naga & Karine Lamiraud, 2008. "Catastrophic Health ExpenditureandHousehold Well-Being," STICERD - Distributional Analysis Research Programme Papers 098, Suntory and Toyota International Centres for Economics and Related Disciplines, LSE.
    19. Juergen Jung & Jialu Liu Streeter, 2015. "Does health insurance decrease health expenditure risk in developing countries? The case of China," Southern Economic Journal, John Wiley & Sons, vol. 82(2), pages 361-384, October.
    20. Sheikh Aftaab Ul Maroof & Mohi-ud-Din Sangmi, 2021. "Assessing financial impact of a health intervention program and controlling spillover effects," DECISION: Official Journal of the Indian Institute of Management Calcutta, Springer;Indian Institute of Management Calcutta, vol. 48(1), pages 15-25, March.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jecomi:v:12:y:2024:i:6:p:153-:d:1415800. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.