Health Service Utilization and Out-of-Pocket Expenditure Associated with the Continuum of Disability in Vietnam

Liem Nguyen, John Tayu Lee, Emily S. G. Hulse, Minh Van Hoang, Giang Bao Kim and Duong Bach Le
Additional contact information
Liem Nguyen: Institute of Population, Health and Development, Hanoi 117222, Vietnam
John Tayu Lee: Nossal Institute for Global Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC 3000, Australia
Emily S. G. Hulse: Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Parkville, VIC 3010, Australia
Minh Van Hoang: Hanoi University of Public Health, Hanoi 11909, Vietnam
Giang Bao Kim: Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 116001, Vietnam
Duong Bach Le: The United Nations Population Fund (UNFPA), Hanoi 11109, Vietnam

IJERPH, 2021, vol. 18, issue 11, 1-11

Abstract: Reducing the burden of disability is key priority in many countries where the population is aging rapidly. The relationships between disability, health expenditure and economic burden are complex, particularly when disability is recognized as a continuum rather than a dichotomous phenomenon. However, these complex relationships are not adequately addressed in national health policy and management plans in Vietnam. This paper examines the economic consequences of disability across its continuum or levels of severity. Two-part regression models were applied to assess the relationships between disability, health service use and the out-of-pocket expenditure. We found that Vietnamese adults with disabilities had multiple characteristics of vulnerability, e.g., older, less likely to be employed, lower education, and poorer than adults without disabilities. These characteristics are associated with poorer health and higher need of healthcare utilization but, after controlling for these factors, disability still had an independent association with higher health expenditure and greater economic burden at their household ( p < 0.05). Our study provides empirical evidence of the economic burden associated across the continuum of disability in Vietnam. Decisive action is critical for protecting persons with disability from medical impoverishment, and such targeted interventions should include those with moderate disability rather than the current focus on severe disability.

Keywords: disability; continuum of disability; health utilization; out-of-pocket expenditure; Vietnam (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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