[health-vn] New paper on health insurance

[Ardeshir Sepehri]

Dear Vern,
The following article might be of interest to some. Thanks. 

Ardeshir Sepehri
Professor, Dept. of Economics
University of Manitoba
Winnipeg, Manitoba
Canada, R3T 5V5
Tel: (204) 474-6241
Fax: (204) 474-7681
e-mail: sepehri at cc.umanitoba.ca


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

Social Science & Medicine 73 (2011) 559-567


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 CHI and VHI schemes have 
little influence on out-of-pocket spending while HIP scheme reduces outof-
pocket spending by about 15%.

JEL classification:110; C13; C33
Key Words: Health care expenditures; health insurance; unobserved
heterogeneity; Vietnam
*Manuscript
Click here to view linked References


Social Science & Medicine 67 (2008) 1009“1017
On 13 Sep 2011 at 10:40, Ha Le Thu wrote: