Determining the impacts of hospital cost-sharing on the uninsured near-poor households in Vietnam

dc.contributor.authorVuong, Duong Anhen
dc.contributor.authorFlessa, Steffenen
dc.contributor.authorMarschall, Paulen
dc.contributor.authorHa, Son Thaien
dc.contributor.authorLuong, Khue Ngocen
dc.contributor.authorBusse, Reinharden
dc.date.accessioned2015-11-21T00:56:43Z
dc.date.available2015-08-06T12:00:00Z
dc.date.issued2014
dc.date.submitted2015-08-05
dc.description.abstractObjectives: The study objective was to identify the size of different hospital financing sources for different hospital services and their impact on the uninsured. Methods: A panel dataset of 84 public general hospitals (2005–2008) with cross-section data on hospital activity and hospital revenue was created and used to calculate unit costs of different hospital services by applying multiple regression models. The resulting risk of catastrophic health expenditure (CHE) was estimated based on official income statistics. Results: Average user fees (UF) for outpatient visits and inpatient bed days were US$4.13 and US$20.27, while actual full costs (AFC) were US$8.41 and US$36.66, respectively. These unit costs were 2.5 times higher in hospitals at the central versus the provincial level. UF for surgical inpatient bed days were 3.6 times that of non-surgical treatments (US$47.50 vs. 12.87) and AFC 5.0 times (US$101.72 vs. 20.08). UF accounted for 44.6%-77.9% of the AFC, the rest (22.1%-55.4%) was provided by direct government support (DGS). One surgical inpatient treatment at either central or provincial hospital level and one non-surgical inpatient treatment at central hospital level, immediately pushed uninsured near-poor households at risk of CHE. Conclusions: Around 45% of hospital AFC was paid by DGS, the larger rest by UF. UF have become a great financial burden on the uninsured near-poor households, who have to pay for these out-of-pocket and therefore may not utilize even necessary services. If the rate of DGS were reduced, this would have the effect of increasing UF, but the savings to Government could be spent on subsidizing insurance to ensure that a larger part of the population can cover UF through insurance, especially the near-poor households.en
dc.identifier.eissn1475-9276
dc.identifier.uriurn:nbn:de:kobv:83-opus4-70081
dc.identifier.urihttp://depositonce.tu-berlin.de/handle/11303/4908
dc.identifier.urihttp://dx.doi.org/10.14279/depositonce-4611
dc.languageEnglishen
dc.language.isoenen
dc.rights.urihttps://creativecommons.org/licenses/by/2.0/en
dc.subject.ddc610 Medizin und Gesundheiten
dc.subject.otherCatastrophic health expenditureen
dc.subject.otherCost-sharingen
dc.subject.otherHospital unit costen
dc.subject.otherUser feeen
dc.subject.otherVietnamen
dc.titleDetermining the impacts of hospital cost-sharing on the uninsured near-poor households in Vietnamen
dc.typeArticleen
dc.type.versionpublishedVersionen
dcterms.bibliographicCitation.articlenumber40en
dcterms.bibliographicCitation.doi10.1186/1475-9276-13-40en
dcterms.bibliographicCitation.journaltitleInternational Journal for Equity in Healthen
dcterms.bibliographicCitation.originalpublishernameBioMed Centralen
dcterms.bibliographicCitation.originalpublisherplaceLondonen
dcterms.bibliographicCitation.volume13en
tub.accessrights.dnbfree*
tub.affiliationFak. 7 Wirtschaft und Management>Inst. Technologie und Management (ITM)de
tub.affiliation.facultyFak. 7 Wirtschaft und Managementde
tub.affiliation.instituteInst. Technologie und Management (ITM)de
tub.identifier.opus47008
tub.publisher.universityorinstitutionTechnische Universität Berlinen
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