Household out-of-pocket payments for illness: evidence from Vietnam.
BACKGROUND
In Vietnam, illnesses create high out-of-pocket health care expenditures for households. In this study, the burden of illness in the Bavi district, Vietnam is measured based upon individual household health expenditures for communicable and non-communicable illnesses. The focus of the paper is on the relative effect of different illnesses on the total economic burden of health care on households in general and on households that have catastrophic health care spending in particular.


METHODS
The study was performed by twelve monthly follow-up interviews of 621 randomly selected households. The households are part of the FilaBavi project sample--Health System Research Project. The heads of household were interviewed at monthly intervals from July 2001 to June 2002.


RESULTS
For the population in the Bavi district, communicable illnesses predominate among the episodes of illness and are the reason for most household health care expenditure. This is the case for almost all groups within the study and for the study population as a whole. However, communicable illnesses are more dominant in the poor population compared to the rich population, and are more dominant in households that have very large, or catastrophic, health care expenditure, compared to those without such expenditures.


CONCLUSIONS
The main findings indicate that catastrophic health care spending for a household is not usually the result of one single disastrous event, but rather a series of events and is related more to "every-day illnesses" in a developing country context than to more spectacular events such as injuries or heart illnesses.
Thuan
Nguyen Thi Bich
NT
Planning and Financing Department of Ministry of Health, Hanoi, Vietnam. ntbthuan2002@yahoo.com <ntbthuan2002@yahoo.com>
Lofgren
Curt
C
Chuc
Nguyen Thi Kim
NT
Janlert
Urban
U
Lindholm
Lars
L
D002388:Catastrophic Illness / Q000191:economics* / Q000453:epidemiology; D003141:Communicable Diseases / Q000191:economics* / Q000453:epidemiology; D017281:Cost of Illness; D003906:Developing Countries; D004194:Disease / Q000145:classification / Q000191:economics*; D017050:Episode of Care; D005191:Family Characteristics; D005382:Financing, Personal / Q000706:statistics & numerical data*; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006301:Health Services Needs and Demand / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D007182:Income; D017059:Models, Econometric; D011159:Population Surveillance; D012423:Rural Health / Q000706:statistics & numerical data*; D012923:Social Class; D011795:Surveys and Questionnaires; D014744:Vietnam