title: Coverage of health insurance among the near-poor in rural Vietnam and associated factors.
abstract: OBJECTIVE
  The Vietnamese government is committed to universal health care largely through social health insurance. The near-poor population is entitled to subsidized but not free insurance under this scheme, but remains under-represented compared to other groups. The aims of this research were to estimate the health insurance coverage of the near-poor in rural Vietnam and identify the individual and household factors associated with health insurance status.
  
  
  METHODS
  Rates of health insurance coverage were estimated from district-level administrative data. A cross-sectional survey was conducted in a representative sample of 2000 near-poor in Cao Lanh district, Dong Thap province, Vietnam. Face-to-face interviews were conducted with a standardized questionnaire. Multiple logistic regression was applied to identify the factors associated with insurance status.
  
  
  RESULTS
  The insurance coverage of the near-poor in the selected communities was 20.3%. Enrollment in the health insurance scheme was significantly associated with poor health status (OR = 4.8, 95% CI = 2.4-9.8), good knowledge of health insurance (OR = 4.6, 95% CI = 3.4-6.2), interest in health insurance (OR = 30.1, 95% CI = 11.6-78.0), and the perceived cost of the insurance premium (OR = 2.4, 95% CI = 1.7-3.6).
  
  
  CONCLUSIONS
  The cost of insurance premiums is a barrier to enrollment. Information, education and communication campaigns together with modified insurance scheme for the near-poor are necessary to enhance insurance coverage in Vietnam.
authors: Hanoi School of Public Health, Hanoi, Vietnam.
authors: Thanh Duc
authors: TD
authors: Nguyen
authors: School of Public Health, University of Sydney, Sydney, NSW, Australia. a.wilson@sydney.edu.au.
authors: Andrew
authors: A
authors: Wilson
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006304:Health Status; D006801:Humans; D019458:Insurance Coverage / Q000191:economics / Q000706:statistics & numerical data*; D007348:Insurance, Health / Q000191:economics / Q000706:statistics & numerical data*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012424:Rural Population / Q000706:statistics & numerical data*; D012923:Social Class; D011795:Surveys and Questionnaires; D014744:Vietnam
keywords: Health insurance; Near-poor; Universal health coverage