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Does health insurance matter in the hospital? New evidence from patient-level medical records in Vietnam

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Abstract
Vietnam has achieved several Millennium Development Goals of the United Nations including child mortality reduction and maternal health improvement. The government of Vietnam aims to further improve health in Vietnam by expanding its public health insurance system originally introduced in 1993. Since health insurance is an essential tool to prepare for unexpected health shocks, the government plans to provide a public insurance system to cover eighty percent of its population by 2020. However, whether having health insurance is beneficial remains unclear and controversial. Some recent studies find positive impact of health insurance, while others argue that the quality of its services has been low due to limited coverage. In contrast to previous papers on Vietnam's health policy that use data from nationwide Vietnam Household Living Standard Survey, this research uses more detailed, randomly-selected, patient-level medical records from Viet Duc University Hospital, the largest public surgical hospital in Vietnam. Using precise information on each patient's treatment history and usage of health insurance, this paper provides new empirical evidence on the effect of health insurance. Regression analysis shows that insurance helps patients stay 1.6 days longer in hospital and pay 48.6 percent less for their treatments than uninsured counterparts. This study also finds that financial burden between the insured and uninsured patients is larger in rural provinces than in the capital-city Hanoi, suggesting the significant advantages of health insurance for people in under-developed areas with fewer public hospitals. These new findings from patient-level information in Vietnam contribute to the growing literature on health insurance policies in developing countries and are particularly informative when governments plan to introduce nationwide public health-insurance systems.

Suggested Citation

  • Lan Thi Thu Phan & Yusuke Jinnai, 2018. "Does health insurance matter in the hospital? New evidence from patient-level medical records in Vietnam," Working Papers EMS_2018_01, Research Institute, International University of Japan.
    • Handle: RePEc:iuj:wpaper:ems_2018_01
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    File URL: https://www.iuj.ac.jp/research/workingpapers/EMS_2018_01.pdf
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    1. Wagstaff, Adam & Lindelow, Magnus & Jun, Gao & Ling, Xu & Juncheng, Qian, 2009. "Extending health insurance to the rural population: An impact evaluation of China's new cooperative medical scheme," Journal of Health Economics, Elsevier, vol. 28(1), pages 1-19, January.
    2. Matthew Jowett & Anil Deolalikar & Peter Martinsson, 2004. "Health insurance and treatment seeking behaviour: evidence from a low‐income country," Health Economics, John Wiley & Sons, Ltd., vol. 13(9), pages 845-857, September.
    3. Joseph J. Doyle Jr., 2005. "Health Insurance, Treatment and Outcomes: Using Auto Accidents as Health Shocks," NBER Working Papers 11099, National Bureau of Economic Research, Inc.
    4. Amy Finkelstein & Sarah Taubman & Bill Wright & Mira Bernstein & Jonathan Gruber & Joseph P. Newhouse & Heidi Allen & Katherine Baicker, 2012. "The Oregon Health Insurance Experiment: Evidence from the First Year," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 127(3), pages 1057-1106.
    5. Krueger, Alan B. & Kuziemko, Ilyana, 2013. "The demand for health insurance among uninsured Americans: Results of a survey experiment and implications for policy," Journal of Health Economics, Elsevier, vol. 32(5), pages 780-793.
    6. Ardeshir Sepehri & Sisira Sarma & Wayne Simpson, 2006. "Does non‐profit health insurance reduce financial burden? Evidence from the Vietnam living standards survey panel," Health Economics, John Wiley & Sons, Ltd., vol. 15(6), pages 603-616, June.
    7. Chunhuei Chi & Jwo‐Leun Lee & Shu‐Ling Tsai & Wen‐Yi Chen, 2008. "Out‐of‐pocket payment for medical care under Taiwan's National Health Insurance system," Health Economics, John Wiley & Sons, Ltd., vol. 17(8), pages 961-975, August.
    8. Palmer, Michael G., 2014. "Inequalities in Universal Health Coverage: Evidence from Vietnam," World Development, Elsevier, vol. 64(C), pages 384-394.
    9. Hamid, Syed Abdul & Roberts, Jennifer & Mosley, Paul, 2011. "Evaluating the Health Effects of Micro Health Insurance Placement: Evidence from Bangladesh," World Development, Elsevier, vol. 39(3), pages 399-411, March.
    10. Finkelstein, Amy & McKnight, Robin, 2008. "What did Medicare do? The initial impact of Medicare on mortality and out of pocket medical spending," Journal of Public Economics, Elsevier, vol. 92(7), pages 1644-1668, July.
    11. Fernando Ruiz & Liliana Amaya & Stella Venegas, 2007. "Progressive segmented health insurance: Colombian health reform and access to health services," Health Economics, John Wiley & Sons, Ltd., vol. 16(1), pages 3-18, January.
    12. Zhongliang Zhou & Jianmin Gao & Qinxiang Xue & Xiaowei Yang & Ju'e Yan, 2009. "Effects of Rural Mutual Health Care on outpatient service utilization in Chinese village medical institutions: evidence from panel data," Health Economics, John Wiley & Sons, Ltd., vol. 18(S2), pages 129-136, July.
    13. Gross, Tal & Notowidigdo, Matthew J., 2011. "Health insurance and the consumer bankruptcy decision: Evidence from expansions of Medicaid," Journal of Public Economics, Elsevier, vol. 95(7-8), pages 767-778, August.
    14. Joseph Mensah & Joseph R. Oppong & Christoph M. Schmidt, 2010. "Ghana's national health insurance scheme in the context of the health MDGs: an empirical evaluation using propensity score matching," Health Economics, John Wiley & Sons, Ltd., vol. 19(S1), pages 95-106, September.
    15. Fink, Günther & Robyn, Paul Jacob & Sié, Ali & Sauerborn, Rainer, 2013. "Does health insurance improve health?," Journal of Health Economics, Elsevier, vol. 32(6), pages 1043-1056.
    16. Joseph J. Doyle, 2005. "Health Insurance, Treatment and Outcomes: Using Auto Accidents as Health Shocks," The Review of Economics and Statistics, MIT Press, vol. 87(2), pages 256-270, May.
    17. Likwang Chen & Winnie Yip & Ming‐Cheng Chang & Hui‐Sheng Lin & Shyh‐Dye Lee & Ya‐Ling Chiu & Yu‐Hsuan Lin, 2007. "The effects of Taiwan's National Health Insurance on access and health status of the elderly," Health Economics, John Wiley & Sons, Ltd., vol. 16(3), pages 223-242, March.
    18. Shao‐Hsun Keng & Sheng‐Jang Sheu, 2013. "The Effect Of National Health Insurance On Mortality And The Ses–Health Gradient: Evidence From The Elderly In Taiwan," Health Economics, John Wiley & Sons, Ltd., vol. 22(1), pages 52-72, January.
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    More about this item

    Keywords

    Health insurance; treatment; length of stay; out-of-pocket payment;
    All these keywords.

    JEL classification:

    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I10 - Health, Education, and Welfare - - Health - - - General

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