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Analysis on Demand and Supply-side Responses during the Expansion of Health Insurance Coverage in Vietnam: Challenges and Policy Implications toward Universal Health Coverage

Author

Listed:
  • Midori Matsushima

    (Faculty of Business Administration, Osaka University of Commerce)

  • Hiroyuki Yamada

    (Faculty of Economics, Keio University)

  • Yasuharu Shimamura

    (Graduate School of International Cooperation Studies, Kobe University)

Abstract

Vietnam is one of the leading countries moving towards universal health coverage (UHC) among developing and emerging countries. This paper examines how utilisation and the supply side have responded to the expansion of health insurance coverage. In the analysis, we use provincial panel data of 2006 to 2012 for every two years, which is constructed from several data sources. The results show that the utilisation has only slightly responded to the expansion of health insurance coverage, and nearly no positive supply-side response has been observed during the expansion. Also, the results of detailed analysis of health workers imply that there has been an unbalanced allocation of health workers between provincial hospitals and commune health stations despite the importance of commune health stations in providing primary healthcare. Our further analysis also reveals that the out-of-pocket (OOP) burden has not decreased and the affordability of healthcare services has not changed in response to health insurance coverage. Based on our findings, we argue that supply-side factors might have constrained utilisation, and that health insurance has hardly eased liquidity constraints.

Suggested Citation

  • Midori Matsushima & Hiroyuki Yamada & Yasuharu Shimamura, 2016. "Analysis on Demand and Supply-side Responses during the Expansion of Health Insurance Coverage in Vietnam: Challenges and Policy Implications toward Universal Health Coverage," Keio-IES Discussion Paper Series 2016-013, Institute for Economics Studies, Keio University.
    • Handle: RePEc:keo:dpaper:2016-013
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    References listed on IDEAS

    as
    1. 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, February.
    2. Wagstaff, Adam & Pradhan, Menno, 2005. "Health insurance impacts on health and nonmedical consumption in a developing country," Policy Research Working Paper Series 3563, The World Bank.
    3. Nguyen, Ha Thi Hong & Bales, Sarah & Wagstaff, Adam & Dao, Huyen, 2013. "Getting incentives right : an impact evaluation of district hospital capitation payment in Vietnam," Policy Research Working Paper Series 6709, The World Bank.
    4. Jonathan Gruber & Nathaniel Hendren & Robert Townsend, 2012. "Demand and Reimbursement Effects of Healthcare Reform: Health Care Utilization and Infant Mortality in Thailand," NBER Working Papers 17739, National Bureau of Economic Research, Inc.
    5. Guindon, G. Emmanuel, 2014. "The impact of health insurance on health services utilization and health outcomes in Vietnam," Health Economics, Policy and Law, Cambridge University Press, vol. 9(4), pages 359-382, October.
    6. Kondo, Ayako & Shigeoka, Hitoshi, 2013. "Effects of universal health insurance on health care utilization, and supply-side responses: Evidence from Japan," Journal of Public Economics, Elsevier, vol. 99(C), pages 1-23.
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    Cited by:

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    2. Shrestha, Vinish & Jung, Juergen, 2023. "Healthcare reform and gender specific infant mortality in rural Nepal," World Development, Elsevier, vol. 161(C).

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    Keywords

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    JEL classification:

    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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