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医疗保险对越南医疗服务利用和健康结果的影响。

The impact of health insurance on health services utilization and health outcomes in Vietnam.

作者信息

Guindon G Emmanuel

机构信息

1Centre for Health Economics and Policy Analysis,McMaster University,Hamilton,ON,Canada.

出版信息

Health Econ Policy Law. 2014 Oct;9(4):359-82. doi: 10.1017/S174413311400005X. Epub 2014 Mar 25.

Abstract

In recent years, a number of low- and middle-income country governments have introduced health insurance schemes. Yet not a great deal is known about the impact of such policy shifts. Vietnam's recent health insurance experience including a health insurance scheme for the poor in 2003 and a compulsory scheme that provides health insurance to all children under six years of age combined with Vietnam's commitment to universal coverage calls for research that examines the impact of health insurance. Taking advantage of Vietnam's unique policy environment, data from the 2002, 2004 and 2006 waves of the Vietnam Household Living Standard Survey and single-difference and difference-in-differences approaches are used to assess whether access to health insurance--for the poor, for children and for students--impacts on health services utilization and health outcomes in Vietnam. For the poor and for students, results suggest health insurance increased the use of inpatient services but not of outpatient services or health outcomes. For young children, results suggest health insurance increased the use of outpatient services (including the use of preventive health services such as vaccination and check-up) but not of inpatient services.

摘要

近年来,一些中低收入国家的政府推出了医疗保险计划。然而,对于此类政策转变的影响,人们了解得并不多。越南近期的医疗保险经历,包括2003年为贫困人口推出的医疗保险计划,以及一项为所有六岁以下儿童提供医疗保险的强制计划,再加上越南对全民覆盖的承诺,都需要开展研究来考察医疗保险的影响。利用越南独特的政策环境,采用2002年、2004年和2006年越南家庭生活水平调查的数据以及单差法和双重差分法,来评估获得医疗保险(针对贫困人口、儿童和学生)是否会对越南的医疗服务利用和健康结果产生影响。对于贫困人口和学生,结果表明医疗保险增加了住院服务的使用,但未增加门诊服务的使用或改善健康结果。对于幼儿,结果表明医疗保险增加了门诊服务的使用(包括预防保健服务如疫苗接种和体检的使用),但未增加住院服务的使用。

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