Health insurance and public health care utilization in Vietnam

Abstract

Vietnam is in the process of improving health system. To achieve this goal, the Vietnam Government attempts to expend the coverage of public health insurance which is an effective tool in low and middle income countries to finance health care provision (WHO, 2000). Although the insurance coverage increases significantly over the last ten years, the private expenditure on health is still high. It only reduces 6%, particularly from 69.1% of total expenditure on health in 2000 to 62.9% in 2010 (WHO, 2013). This comes up with a question that whether health insurance improves access to care? To answer this question, this study will assess the impact of health insurance on health care utilization, particularly public health services through two purposes: medical examination and treatment. A binary probit model is used to estimate the impact of health insurance on public health care utilization. Then we investigate determinants of insurance enrollment to increase the number of insurance participators if insurance affects positively significant on health care use. Data are obtained from Vietnam Household Living Standard Surveys (VHLSS) in 2010. The empirical results indicate that insurance has a positively significant effect on public health care utilization. In other words, we can conclude that health insurance actually improve access to care. Moreover, the results of insurance participation show that insurance enrollment is affected strongly by income and interaction terms of frequency of illness. It is also remarked that demand for insurance is different between five income quintiles. Finally, household’s characteristics including household’s size, income and illness ratio affect significantly to insurance enrollment.