Health insurance and patient satisfaction: Evidence from the poorest regions of Vietnam

Even though health insurance is expanding rapidly in Vietnam, its coverage is not effective. There remain inefficiencies in the healthcare system with quality concerns, especially at primary care and in remote areas. However, very little is known about how health insurance is valued by people and whether health insurance coverage can translate into quality healthcare. This paper investigates the relationship between health insurance and patient satisfaction with medical care in the poorest regions of Vietnam. We use multi-level models for ordinal responses on a cross-sectional dataset of the poorest regions of Vietnam in 2012. We find that it is not health insurance coverage per se but the financial coverage that matters to improve patient satisfaction with medical care. Patient satisfaction depends on the breadth and depth of insurance coverage (i.e. services and medicines covered, co-payment rate for each service) and the ability to use health insurance to reduce medical costs via the co-payment mechanism.