Impact of health insurance on health care treatment and cost in Vietnam: a health capability approach to financial protection.
We applied an alternative conceptual framework for analyzing health insurance and financial protection grounded in the health capability paradigm.  Through an original survey of 706 households in Dai Dong, Vietnam, we examined the impact of Vietnamese health insurance schemes on inpatient and outpatient health care access, costs, and health outcomes using bivariate and multivariable regression analyses. Insured respondents had lower outpatient and inpatient treatment costs and longer hospital stays but fewer days of missed work or school than the uninsured.  Insurance reform reduced household vulnerability to high health care costs through direct reduction of medical costs and indirect reduction of income lost to illness. However, from a normative perspective, out-of-pocket costs are still too high, and accessibility issues persist; a comprehensive insurance package and additional health system reforms are needed.
School of Medicine, Yale University, New Haven, CT 06510, USA.
Kim Thuy
KT
Nguyen
Oanh Thi Hai
OT
Khuat
Shuangge
S
Ma
Duc Cuong
DC
Pham
Giang Thi Hong
GT
Khuat
Jennifer Prah
JP
Ruger
D000293:Adolescent; D000368:Aged; D003625:Data Collection; D005191:Family Characteristics; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006297:Health Services Accessibility / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D007182:Income / Q000706:statistics & numerical data; D007348:Insurance, Health / Q000191:economics / Q000706:statistics & numerical data*; D017057:Medically Uninsured / Q000706:statistics & numerical data; D011203:Poverty / Q000191:economics / Q000706:statistics & numerical data*; D012424:Rural Population / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014744:Vietnam