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The influence of health insurance on hospital admission and length of stay--The case of Vietnam

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  • Sepehri, Ardeshir
  • Simpson, Wayne
  • Sarma, Sisira

Abstract

Few studies analyze the effects of health insurance on inpatient care in low income countries. This paper provides an empirical assessment of the influence of Vietnam's health insurance schemes on both hospital admission and the length of stay (LOS) using the Vietnam National Health Survey 2001-2002 and an appropriate count data regression model. Our findings suggest that the influence of health insurance on hospital admission and the LOS varies across insurance schemes. The compulsory insurance scheme and the insurance scheme for the poor increase the expected LOS by factors of 1.18 and 1.39, respectively, while the voluntary insurance scheme has minimal effect on the expected LOS. Insurance also increases the likelihood of hospital admission far more for compulsory members than for members of the other two insurance schemes. The positive influence of insurance on hospital admission and the LOS also varies across income quintiles, regions and types of health facilities. While the compulsory and voluntary schemes increase the likelihood of hospital admission more for lower and middle income individuals, the influence of the compulsory scheme on the expected LOS is more pronounced for patients in the middle income groups. The influence of insurance on the LOS is also found to be stronger in the North than in the South and stronger for patients admitted to provincial hospitals rather than district hospitals.

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  • 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.
    • Handle: RePEc:eee:socmed:v:63:y:2006:i:7:p:1757-1770
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    1. 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.
    2. Cameron, A Colin & Trivedi, Pravin K, 1986. "Econometric Models Based on Count Data: Comparisons and Applications of Some Estimators and Tests," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 1(1), pages 29-53, January.
    3. Dafny, Leemore & Gruber, Jonathan, 2005. "Public insurance and child hospitalizations: access and efficiency effects," Journal of Public Economics, Elsevier, vol. 89(1), pages 109-129, January.
    4. Antonio J. Trujillo, 2003. "Medical care use and selection in a social health insurance with an equalization fund: evidence from Colombia," Health Economics, John Wiley & Sons, Ltd., vol. 12(3), pages 231-246, March.
    5. World Bank, 2001. "Growing Healthy : A Review of Vietnam's Health Sector," World Bank Publications - Reports 15512, The World Bank Group.
    6. Winnie Yip & Peter Berman, 2001. "Targeted health insurance in a low income country and its impact on access and equity in access: Egypt's school health insurance," Health Economics, John Wiley & Sons, Ltd., vol. 10(3), pages 207-220, April.
    7. Trivedi, Pravin K., 2002. "Patterns of health care utilization in Vietnam : analysis of 1997-98 Vietnam Living Standards Survey Data," Policy Research Working Paper Series 2775, The World Bank.
    8. A. C. Cameron & P. K. Trivedi & Frank Milne & J. Piggott, 1988. "A Microeconometric Model of the Demand for Health Care and Health Insurance in Australia," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 55(1), pages 85-106.
    9. Nyman, John A., 1999. "The value of health insurance: the access motive," Journal of Health Economics, Elsevier, vol. 18(2), pages 141-152, April.
    10. Manning, Willard G, et al, 1987. "Health Insurance and the Demand for Medical Care: Evidence from a Randomized Experiment," American Economic Review, American Economic Association, vol. 77(3), pages 251-277, June.
    11. Hunt-McCool, Janet & Kiker, B F & Ng, Ying Chu, 1994. "Estimates of the Demand for Medical Care under Different Functional Forms," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 9(2), pages 201-218, April-Jun.
    12. Sapelli, Claudio & Vial, Bernardita, 2003. "Self-selection and moral hazard in Chilean health insurance," Journal of Health Economics, Elsevier, vol. 22(3), pages 459-476, May.
    13. Meer, Jonathan & Rosen, Harvey S., 2004. "Insurance and the utilization of medical services," Social Science & Medicine, Elsevier, vol. 58(9), pages 1623-1632, May.
    14. Michael Grossman, 1972. "The Demand for Health: A Theoretical and Empirical Investigation," NBER Books, National Bureau of Economic Research, Inc, number gros72-1, March.
    15. Zweifel, Peter & Manning, Willard G., 2000. "Moral hazard and consumer incentives in health care," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 8, pages 409-459, Elsevier.
    16. Hugh R. Waters, 1999. "Measuring the impact of health insurance with a correction for selection bias-a case study of Ecuador," Health Economics, John Wiley & Sons, Ltd., vol. 8(5), pages 473-483.
    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.
    18. Yip, Winnie & Eggleston, Karen, 2004. "Addressing government and market failures with payment incentives: Hospital reimbursement reform in Hainan, China," Social Science & Medicine, Elsevier, vol. 58(2), pages 267-277, January.
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    3. 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.
    4. Dan Liu & Daniel Tsegai & David Litaker & Joachim Braun, 2015. "Under regional characteristics of rural China: a clearer view on the performance of the New Rural Cooperative Medical Scheme," International Journal of Health Economics and Management, Springer, vol. 15(4), pages 407-431, December.
    5. Peilu Zhang & Marco A. Palma, 2021. "Compulsory Versus Voluntary Insurance: An Online Experiment," American Journal of Agricultural Economics, John Wiley & Sons, vol. 103(1), pages 106-125, January.
    6. Liu, Dan & Tsegai, Daniel W., 2011. "The New Cooperative Medical Scheme (NCMS) and its implications for access to health care and medical expenditure: Evidence from rural China," Discussion Papers 116746, University of Bonn, Center for Development Research (ZEF).
    7. Luv Sharma & Deepa Goradia, 2023. "Will your insurance type influence clinical quality outcomes? An investigation of contributing factors, underlying mechanism, and consequences," Production and Operations Management, Production and Operations Management Society, vol. 32(7), pages 2207-2226, July.
    8. 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.
    9. Samuel S. Lieberman & Adam Wagstaff, 2009. "Health Financing and Delivery in Vietnam : Looking Forward," World Bank Publications - Books, The World Bank Group, number 2594, December.
    10. Philip H. Brown & Caroline Theoharides, 2009. "Health‐seeking behavior and hospital choice in China's New Cooperative Medical System," Health Economics, John Wiley & Sons, Ltd., vol. 18(S2), pages 47-64, July.
    11. London, Jonathan D., 2013. "The promises and perils of hospital autonomy," Social Science & Medicine, Elsevier, vol. 96(C), pages 232-240.

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