Department of Health Economics & Center for Health System Research, Hanoi Medical University, No 1 Ton That Tung, Ha Noi, Viet Nam.
Soc Sci Med. 2013 Nov;96:258-63. doi: 10.1016/j.socscimed.2012.11.028. Epub 2012 Dec 1.
In Viet Nam, household direct out-of-pocket (OOP) health expenditure as a share of the total health expenditure has been always high, ranging from 50% to 70%. The high share of OOP expenditure has been linked to different inequity problems such as catastrophic health expenditure (households must reduce their expenditure on other necessities) and impoverishment. This paper aims to examine catastrophic and poverty impacts of household out-of-pocket health expenditure in Viet Nam over time and identify socio-economic indicators associated with them. Data used in this research were obtained from a nationally representative household survey, Viet Nam Living Standard Survey 2002, 2004, 2006, 2008 and 2010. The findings revealed that there were problems in health care financing in Viet Nam - many households encountered catastrophic health expenditure and/or were pushed into poverty due to health care payments. The issues were pervasive over time. Catastrophic expenditure and impoverishment problems were more common among the households who had more elderly people and those located in rural areas. Importantly, the financial protection aspect of the national health insurance schemes was still modest. Given these findings, more attention is needed on developing methods of financial protection in Viet Nam.
在越南，家庭直接自付（OOP）卫生支出占总卫生支出的比例一直很高，范围在 50%至 70%之间。OOP 支出的高比例与不同的不平等问题有关，如灾难性卫生支出（家庭必须减少在其他必需品上的支出）和贫困。本文旨在考察越南家庭自付卫生支出在时间上的灾难性和贫困影响，并确定与之相关的社会经济指标。本研究使用的数据来自具有全国代表性的家庭调查——越南生活水平调查 2002、2004、2006、2008 和 2010 年的数据。研究结果表明，越南的医疗保健融资存在问题——许多家庭因医疗保健支出而遭遇灾难性的卫生支出和/或陷入贫困。这些问题随着时间的推移而普遍存在。在老年人较多和农村地区的家庭中，灾难性支出和贫困问题更为常见。重要的是，国家健康保险计划的财务保障方面仍然有限。鉴于这些发现，需要更加关注在越南发展财务保护方法。
