IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v73y2011i4p559-567.html
   My bibliography  Save this article

Does the financial protection of health insurance vary across providers? Vietnam's experience

Author

Listed:
  • Sepehri, Ardeshir
  • Sarma, Sisira
  • Oguzoglu, Umut

Abstract

Using household panel data from Vietnam, this paper compares out-of-pocket health expenditures on outpatient care at a health facility between insured and uninsured patients as well as across various providers. In the random effects model, the estimated coefficient of the insurance status variable suggests that insurance reduces out-of-pocket spending by 24% for those with the compulsory and voluntary coverage and by about 15% for those with the health insurance for the poor coverage. However, the modest financial protection of the compulsory and voluntary schemes disappears once we control for time-invariant unobserved individual effects using the fixed effects model. Additional analysis of the interaction terms involving the type of insurance and health facility suggests that the overall insignificant reduction in out-of-pocket expenditures as a result of the insurance schemes masks wide variations in the reduction in out-of-pocket sending across various providers. Insurance reduces out-of-pocket expenditures more for those enrollees using district and higher level public health facilities than those using commune health centers. Compared to the uninsured patients using district hospitals, compulsory and voluntary insurance schemes reduce out-of-pocket expenditures by 40 and 32%, respectively. However, for contacts at the commune health centers, both the compulsory health scheme and the voluntary health insurance scheme schemes have little influence on out-of-pocket spending while the health insurance scheme for the poor reduces out-of-pocket spending by about 15%.

Suggested Citation

  • Sepehri, Ardeshir & Sarma, Sisira & Oguzoglu, Umut, 2011. "Does the financial protection of health insurance vary across providers? Vietnam's experience," Social Science & Medicine, Elsevier, vol. 73(4), pages 559-567, August.
  • Handle: RePEc:eee:socmed:v:73:y:2011:i:4:p:559-567
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277953611003546
    Download Restriction: Full text for ScienceDirect subscribers only

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. 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.
    2. 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.
    3. 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.
    4. Tin Su & Subhash Pokhrel & Adjima Gbangou & Steffen Flessa, 2006. "Determinants of household health expenditure on western institutional health care," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 7(3), pages 195-203, September.
    5. 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.
    6. Sepehri, Ardeshir & Sarma, Sisira & Serieux, John, 2009. "Who is giving up the free lunch? The insured patients' decision to access health insurance benefits and its determinants: Evidence from a low-income country," Health Policy, Elsevier, vol. 92(2-3), pages 250-258, October.
    7. Ardeshir Sepehri & Sisira Sarma & Wayne Simpson, 2006. "Does non-profit health insurance reduce financial burden? Evidence from the Vietnam living standards survey panel," Health Economics, John Wiley & Sons, Ltd., vol. 15(6), pages 603-616.
    8. Adam Wagstaff, 2010. "Estimating health insurance impacts under unobserved heterogeneity: the case of Vietnam's health care fund for the poor," Health Economics, John Wiley & Sons, Ltd., vol. 19(2), pages 189-208.
    9. Fwu-Ranq Chang & Pravin K. Trivedi, 2003. "Economics of self-medication: theory and evidence," Health Economics, John Wiley & Sons, Ltd., vol. 12(9), pages 721-739.
    10. Catharina Hjortsberg, 2003. "Why do the sick not utilise health care? The case of Zambia," Health Economics, John Wiley & Sons, Ltd., vol. 12(9), pages 755-770.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. repec:bla:asiaec:v:31:y:2017:i:2:p:139-164 is not listed on IDEAS
    2. Palmer, Michael G., 2014. "Inequalities in Universal Health Coverage: Evidence from Vietnam," World Development, Elsevier, vol. 64(C), pages 384-394.
    3. Ali, Shehzad & Cookson, Richard & Dusheiko, Mark, 2017. "Addressing care-seeking as well as insurance-seeking selection biases in estimating the impact of health insurance on out-of-pocket expenditure," Social Science & Medicine, Elsevier, vol. 177(C), pages 127-140.
    4. Giang Thanh Long, 2011. "Reaching a Universal Health Insurance in Viet Nam: Challenges and the Role of Government," Asia-Pacific Development Journal, United Nations Economic and Social Commission for Asia and the Pacific (ESCAP), vol. 18(1), pages 47-72, June.
    5. LeDang TRUNG, 2013. "Economic and Welfare Impacts of Disasters in East Asia and Policy ResponsesL The Case of Vietnam," Working Papers DP-2013-11, Economic Research Institute for ASEAN and East Asia (ERIA).
    6. Palmer, Michael & Mitra, Sophie & Mont, Daniel & Groce, Nora, 2015. "The impact of health insurance for children under age 6 in Vietnam: A regression discontinuity approach," Social Science & Medicine, Elsevier, vol. 145(C), pages 217-226.

    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:eee:socmed:v:73:y:2011:i:4:p:559-567. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Dana Niculescu). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    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 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.

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

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.