title: The impact of health insurance for children under age 6 in Vietnam: A regression discontinuity approach.
abstract: Accessing health services at an early age is important to future health and life outcomes. Yet, little is currently known on the role of health insurance in facilitating access to care for children. Exploiting a regression discontinuity design made possible through a policy to provide health insurance to pre-school aged children in Vietnam, this paper evaluates the impact of health insurance on the health care utilization outcomes of children at the eligibility threshold of six years. Using three rounds of the Vietnam Household Living Standards Survey, the study finds a positive impact on inpatient and outpatient visits and no significant impact on expenditures per visit at public facilities. We find moderately high use of private outpatient services and no evidence of a switch from private to covered public facilities under insurance. Results suggest that adopting public health insurance programs for children under age 6 may be an important vehicle to improving service utilization in a low- and middle-income country context. Challenges remain in providing adequate protections from the costs and other barriers to care.
authors.affiliation: The University of Melbourne, Australia. Electronic address: michael.palmer@unimelb.edu.au.
authors.forename: Michael
authors.initials: M
authors.lastname: Palmer
authors.affiliation: Fordham University, United States.
authors.forename: Sophie
authors.initials: S
authors.lastname: Mitra
authors.affiliation: University College of London, United Kingdom.
authors.forename: Daniel
authors.initials: D
authors.lastname: Mont
authors.affiliation: University College of London, United Kingdom.
authors.forename: Nora
authors.initials: N
authors.lastname: Groce
mesh_terms: D000553:Ambulatory Care / Q000191:economics; D002648:Child; D002662:Child Health Services / Q000191:economics / Q000706:statistics & numerical data*; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D018166:Health Care Reform; D005102:Health Expenditures; D006297:Health Services Accessibility / Q000191:economics; D054625:Healthcare Disparities; D006801:Humans; D007223:Infant; D019458:Insurance Coverage / Q000331:legislation & jurisprudence*; D007348:Insurance, Health / Q000191:economics*; D016018:Least-Squares Analysis; D008297:Male; D014744:Vietnam
keywords: Children; Health care utilization; Health insurance; Regression discontinuity design; Vietnam