Biomedical Research

All submissions of the EM system will be redirected to Online Manuscript Submission System. Authors are requested to submit articles directly to Online Manuscript Submission System of respective journal.

Research Article - Biomedical Research (2017) Volume 28, Issue 6

Health insurance thresholds and policy implications: A Vietnamese medical survey in 2015

Objective: Vietnam’s healthcare system has undergone numerous reforms while institutionalizing a market-based mechanism. Still the poor cite medical costs and inadequate insurance as the reason to destitution risks. The reality gives rise to evidence on: 1) Effects of residency status, socioeconomic status, medical costs, and insurance on patient satisfaction towards health insurance; 2) Existence of “psychological thresholds” toward cost and insurance coverage. The article addresses these two questions.

Materials and Method: A dataset containing 900 records was collected from a 2014-15 survey on Northern Vietnamese patients, 67% of which with insurance. Attributes include: a) medical expenditures; b) (in)eligibility for insurance coverage; c) dis/satisfaction with insurance; d) length of hospitalization; e) socioeconomic/residency status. The method of analysis is logistic regression techniques involving both discrete and continuous predictor/response variables. Estimations are then used to compute empirical probabilities and threshold values.

Results: Relations are found statistically significant at 5% level, suggesting that insurance coverage and medical expenditures contribute to higher probabilities of satisfaction. Insurance has a stronger influence. Threshold coverage and expenditures show that perceptions are heterogeneous. The poor and non-resident patients show lower threshold coverage of 63.4% (mean=58%).

Conclusions: An overemphasis on raising insurance coverage is unlikely to pay off. To promote the value of health insurance, the target group should be the poor and non-resident patients. It is better for policymakers to promote a diversity of insurance schemes, including micro-health insurance, and to lower medical costs for the target group. Thresholds can serve as a reference value for policy-making.

Author(s): Quan Hoang Vuong, Ha Nguyen, Thu-Trang Vuong

Abstract Full Text PDF