Coverage of health insurance among the near-poor in rural Vietnam and associated factors

Thanh Duc Nguyen and Andrew Wilson ()
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Thanh Duc Nguyen: Hanoi School of Public Health
Andrew Wilson: University of Sydney

International Journal of Public Health, 2017, vol. 62, issue 1, No 9, 63-73

Abstract: Abstract Objectives The Vietnamese government is committed to universal health care largely through social health insurance. The near-poor population is entitled to subsidized but not free insurance under this scheme, but remains under-represented compared to other groups. The aims of this research were to estimate the health insurance coverage of the near-poor in rural Vietnam and identify the individual and household factors associated with health insurance status. Methods Rates of health insurance coverage were estimated from district-level administrative data. A cross-sectional survey was conducted in a representative sample of 2000 near-poor in Cao Lanh district, Dong Thap province, Vietnam. Face-to-face interviews were conducted with a standardized questionnaire. Multiple logistic regression was applied to identify the factors associated with insurance status. Results The insurance coverage of the near-poor in the selected communities was 20.3%. Enrollment in the health insurance scheme was significantly associated with poor health status (OR = 4.8, 95% CI = 2.4–9.8), good knowledge of health insurance (OR = 4.6, 95% CI = 3.4–6.2), interest in health insurance (OR = 30.1, 95% CI = 11.6–78.0), and the perceived cost of the insurance premium (OR = 2.4, 95% CI = 1.7–3.6). Conclusions The cost of insurance premiums is a barrier to enrollment. Information, education and communication campaigns together with modified insurance scheme for the near-poor are necessary to enhance insurance coverage in Vietnam.

Keywords: Health insurance; Near-poor; Universal health coverage (search for similar items in EconPapers)
Date: 2017
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DOI: 10.1007/s00038-016-0911-z

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