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Health insurance and treatment seeking behaviour: evidence from a low-income country

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  • Matthew Jowett

    (Department of Health Sciences, University of York, UK)

  • Anil Deolalikar
  • Peter Martinsson

    (Department of Economics, Göteborg University, Sweden)

Abstract

This paper analyses the effect of being insured under the voluntary component of Vietnamese Health Insurance, on patterns of treatment seeking behaviour. A multinomial logit model is estimated using household survey data from three provinces in Vietnam. Decisions regarding both the type of provider sought and type of care received are analysed. Insurance status is treated as both exogenous and endogenous to account for potential selection bias. The results indicate that, overall, insured patients are more likely to use outpatient facilities, and public providers, an effect that is particularly strong at lower income levels. Copyright © 2004 John Wiley & Sons, Ltd.

Suggested Citation

  • 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.
  • Handle: RePEc:wly:hlthec:v:13:y:2004:i:9:p:845-857
    DOI: 10.1002/hec.862
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    Cited by:

    1. Vincent Z. Kuuire & Eric Y. Tenkorang & Andrea Rishworth & Isaac Luginaah & Alfred E. Yawson, 2017. "Is the Pro-Poor Premium Exemption Policy of Ghana’s NHIS Reducing Disparities Among the Elderly?," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 36(2), pages 231-249, April.
    2. Acharya, Arnab & Vellakkal, Sukumar & Taylor Fiona & Masset Edoardo & Satija, Ambika & Burke, Margaret & Ebrahim, Shah, 2013. "The impact of health insurance schemes for the informal sector in low- and middle-income countries : a systematic review," Policy Research Working Paper Series 6324, The World Bank.
    3. 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.
    4. El-Sayed, Abdulrahman M. & Palma, Anton & Freedman, Lynn P. & Kruk, Margaret E., 2015. "Does health insurance mitigate inequities in non-communicable disease treatment? Evidence from 48 low- and middle-income countries," Health Policy, Elsevier, vol. 119(9), pages 1164-1175.
    5. Samuel S. Lieberman & Adam Wagstaff, 2009. "Health Financing and Delivery in Vietnam : Looking Forward," World Bank Publications, The World Bank, number 2594.
    6. Galarrága, O & Sosa-Rubí, S. G & Salinas, A & Sesma, S, 2008. "The Impact of Universal Health Insurance on Catastrophic and Out-of-Pocket Health Expenditures in Mexico: a Model with an Endogoenous Treatment Variable," Health, Econometrics and Data Group (HEDG) Working Papers 08/12, HEDG, c/o Department of Economics, University of York.
    7. 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.
    8. Pablo Gottret & George J. Schieber & Hugh R. Waters, 2008. "Good Practices in Health Financing : Lessons from Reforms in Low and Middle-Income Countries," World Bank Publications, The World Bank, number 6442.
    9. 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.
    10. Pia Schneider & Kara Hanson, 2006. "Horizontal equity in utilisation of care and fairness of health financing: a comparison of micro-health insurance and user fees in Rwanda," Health Economics, John Wiley & Sons, Ltd., vol. 15(1), pages 19-31.
    11. Ha Trong Nguyen & Luke B Connelly, 2017. "Cost-sharing in health insurance and its impact in a developing country: evidence from a quasi-natural experiment," Bankwest Curtin Economics Centre Working Paper series WP1702, Bankwest Curtin Economics Centre (BCEC), Curtin Business School.
    12. Victoria Fan & Anup Karan & Ajay Mahal, 2012. "State health insurance and out-of-pocket health expenditures in Andhra Pradesh, India," International Journal of Health Economics and Management, Springer, vol. 12(3), pages 189-215, September.
    13. Victoria Fan, Anup Karan, and Anjay Mahal, 2012. "State Health Insurance and Out-of-Pocket Health Expenditures in Andhra Pradesh, India - Working Paper 298," Working Papers 298, Center for Global Development.
    14. Qian, Dongfu & Lucas, Henry & Chen, Jiaying & Xu, Ling & Zhang, Yaoguang, 2010. "Determinants of the use of different types of health care provider in urban China: A tracer illness study of URTI," Health Policy, Elsevier, vol. 98(2-3), pages 227-235, December.
    15. Silfverberg, Raymunda R., 2014. "The Sponsored Program of the Philippine National Health Insurance - Analyses of the Actual Coverage and Variations Across Regions and Provinces," Discussion Papers DP 2014-19, Philippine Institute for Development Studies.
    16. Amarakoon Bandara, 2005. "Emerging health isues in Asia and the Pacific: implications for public health policy," Asia-Pacific Development Journal, United Nations Economic and Social Commission for Asia and the Pacific (ESCAP), vol. 12(2), pages 33-58, December.
    17. 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.
    18. Palmer, Michael G., 2014. "Inequalities in Universal Health Coverage: Evidence from Vietnam," World Development, Elsevier, vol. 64(C), pages 384-394.
    19. Chaudhuri, Anoshua & Roy, Kakoli, 2008. "Changes in out-of-pocket payments for healthcare in Vietnam and its impact on equity in payments, 1992-2002," Health Policy, Elsevier, vol. 88(1), pages 38-48, October.
    20. Palmer, Michael G. & Nguyen, Thi Minh Thuy, 2012. "Mainstreaming health insurance for people with disabilities," Journal of Asian Economics, Elsevier, vol. 23(5), pages 600-613.
    21. Omar Galárraga & Sandra Sosa-Rubí & Aarón Salinas-Rodríguez & Sergio Sesma-Vázquez, 2010. "Health insurance for the poor: impact on catastrophic and out-of-pocket health expenditures in Mexico," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 11(5), pages 437-447, October.
    22. 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.
    23. Dutta, Mousumi & Husain, Zakir, 2012. "Use of hospital services and socio-economic status in urban India: Does health insurance ensure equitable outcomes?," MPRA Paper 40055, University Library of Munich, Germany.
    24. McBain, Florence, 2014. "Health insurance and health environment: India’s subsidized health insurance in a context of limited water and sanitation services," Working Papers 179200, University of Bonn, Center for Development Research (ZEF).
    25. Hidayat, Budi, 2007. "Are there differences between unconditional and conditional demand estimates? implications for future research and policy," MPRA Paper 30196, University Library of Munich, Germany.

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