Catastrophic health expenditure and impoverishment in Vietnam: Evidence from national Household Living Standards Surveys 2008–2018

Nguyen Thi Thu Thuong

Economic Analysis and Policy, 2021, vol. 72, issue C, 668-684

Abstract: One of the strategic objectives of the Vietnamese government in achieving universal health coverage (UHC) is to develop a sustainable, equitable, and effective health financing system. This study aimed to examine the incidence and intensity of catastrophic health expenditure (CHE) and impoverishment in Vietnam at different thresholds of expenditure. The data were obtained from six national representative Household Living Standards Surveys from 2008 to 2018. We found that the incidence and intensity of CHE declined significantly over study years. Additionally, we found a substantial reduction in the incidence and intensity of medical impoverishment in Vietnam. The increase in the poverty gap in 2012 and 2014 was because non-poor households became poor after out-of-pocket (OOP) health payments. However, the rise in poverty gaps in 2008, 2010, 2016 and 2018 was attributable to the worsening state of existing poor households after healthcare payments. In addition, we found that the CHE rate and impoverishment were more concentrated in the poor quintile groups. Furthermore, we found that the Red River Delta had the highest CHE rate, whereas the Northern Midland region experienced the strongest poverty impact of OOP payments. Generally, in Vietnam, the health financing system has had no considerable success in reducing inequality across quintiles and regions. Finally, our findings revealed that health insurance showed positive impacts on households’ financial protection against CHE and impoverishment, after enacting both the first Health Insurance Law in 2009 and the Revised Health Insurance Law in 2015. The results suggest that the health insurance scheme should be reviewed to continue reducing CHE and impoverishment, promoting equity and enhancing the performance of the health financing system in Vietnam.

Keywords: Vietnam; Catastrophic health expenditure; Poverty; Equity; Health insurance (search for similar items in EconPapers)
JEL-codes: D31 D63 G52 H51 I14 I32 (search for similar items in EconPapers)
Date: 2021
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (2)

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Persistent link: https://EconPapers.repec.org/RePEc:eee:ecanpo:v:72:y:2021:i:c:p:668-684

DOI: 10.1016/j.eap.2021.10.009

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