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The impact of health insurance for children under age 6 in Vietnam: A regression discontinuity approach

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  • Palmer, Michael
  • Mitra, Sophie
  • Mont, Daniel
  • Groce, Nora
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.

Suggested Citation

  • Palmer, Michael & Mitra, Sophie & Mont, Daniel & Groce, Nora, 2015. "The impact of health insurance for children under age 6 in Vietnam: A regression discontinuity approach," Social Science & Medicine, Elsevier, vol. 145(C), pages 217-226.
    • Handle: RePEc:eee:socmed:v:145:y:2015:i:c:p:217-226
    DOI: 10.1016/j.socscimed.2014.08.012
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    3. Nolan, Anne & Layte, Richard, 2017. "The impact of transitions in insurance coverage on GP visiting among children in Ireland," Social Science & Medicine, Elsevier, vol. 180(C), pages 94-100.
    4. Sophie Mitra & Michael Palmer & Shannon Pullaro & Daniel Mont & Nora Groce, 2017. "Health Insurance and Children in Low- and Middle-income Countries: A Review," The Economic Record, The Economic Society of Australia, vol. 93(302), pages 484-500, September.
    5. Cuong Nguyen, 2016. "The impact of health insurance programs for children: evidence from Vietnam," Health Economics Review, Springer, vol. 6(1), pages 1-15, December.
    6. Dang, Thang, 2017. "The Multiple Effects of Child Health Insurance in Vietnam," MPRA Paper 78614, University Library of Munich, Germany.
    7. Huang, Wei & Liu, Hong, 2023. "Early childhood exposure to health insurance and adolescent outcomes: Evidence from rural China," Journal of Development Economics, Elsevier, vol. 160(C).
    8. Phuong Huu Khiem & Yu-Chen Kuo, 2022. "Health insurance reform impact on children’s educational attainment: evidence from Vietnam," Review of Economics of the Household, Springer, vol. 20(4), pages 1255-1285, December.
    9. Minh T. Nguyen, 2020. "Re‐examining the effects of public health insurance: The case of nonpoor children in Vietnam," Health Economics, John Wiley & Sons, Ltd., vol. 29(3), pages 294-305, March.
    10. Axel Demenet, 2016. "Health Shocks and Permanent Income Loss: the Household Business Channel," Working Papers DT/2016/11, DIAL (Développement, Institutions et Mondialisation).
    11. Lau, Siew Yee & Parinduri, Rasyad & Lee, Yoong Hon, 2019. "Does Social Health Insurance Help Owners of Micro- and Small Firms Cope with Family Hardships? Evidence from Indonesia," MPRA Paper 95295, University Library of Munich, Germany.
    12. Axel Demenet, 2016. "Can Insurance Mitigate Household Businesses’ Vulnerability to Health Shocks?," Working Papers DT/2016/10, DIAL (Développement, Institutions et Mondialisation).
    13. Michael Palmer & Nora Groce & Daniel Mont & Oanh Hong Nguyen & Sophie Mitra, 2015. "The Economic Lives of People with Disabilities in Vietnam," PLOS ONE, Public Library of Science, vol. 10(7), pages 1-16, July.
    14. Le, Nga T.Q. & Groot, Wim & Tomini, Sonila & Tomini, Florian, 2017. "Effects of health insurance on labour supply: Evidence from the health care fund for the poor in Viet Nam," MERIT Working Papers 2017-050, United Nations University - Maastricht Economic and Social Research Institute on Innovation and Technology (MERIT).
    15. Miyawaki, Atsushi & Noguchi, Haruko & Kobayashi, Yasuki, 2017. "Impact of medical subsidy disqualification on children's healthcare utilization: A difference-in-differences analysis from Japan," Social Science & Medicine, Elsevier, vol. 191(C), pages 89-98.
    16. Le, Nga & Groot, Wim & Tomini, Sonila & Tomini, Florian, 2018. "Health insurance and patient satisfaction: Evidence from the poorest regions of Vietnam," MERIT Working Papers 2018-040, United Nations University - Maastricht Economic and Social Research Institute on Innovation and Technology (MERIT).
    17. Paqueo, Vicente B. & Abrigo, Michael Ralph M., 2017. "Social Protection and Access to Health Care among Children in the Philippines," Discussion Papers DP 2017-36, Philippine Institute for Development Studies.
    18. Darius Erlangga & Marc Suhrcke & Shehzad Ali & Karen Bloor, 2019. "The impact of public health insurance on health care utilisation, financial protection and health status in low- and middle-income countries: A systematic review," PLOS ONE, Public Library of Science, vol. 14(8), pages 1-20, August.

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