1Independent Research Consultant,Mountain View,CA,USA.
2Professor,Health Policy and Administration Division,University of Illinois at Chicago,Chicago,IL,USA.
Health Econ Policy Law. 2019 Jul;14(3):299-314. doi: 10.1017/S1744133117000159. Epub 2017 May 9.
Our research investigates the effects of the 2005 universal health insurance program for children under age 6 in Vietnam on health care utilization, household out-of-pocket (OOP) spending and self-reported health outcomes using data from the Vietnam Household Living Standard Survey in 2002-2004-2006-2008. We use difference-in-differences to compare children eligible for the program to older children who are ineligible for the program. Results indicate that the program increased insurance coverage by 250% for children age 0-5 relative to the pre-policy period. We found large increases in both outpatient visits and hospital admissions. Health insurance availability also increased outpatient visits at both public and private facilities, suggesting that public and private health care services are complements. Although health insurance was associated with a decrease in inpatient OOP spending for children aged 3-5, it did not reduce outpatient OOP spending for children in general. Health insurance was associated with modest improvements in self-reported health outcomes. Our research suggests that expanded access to insurance among Vietnamese children improved access to care and health outcomes, though it did not necessarily reduce OOP spending.
我们的研究调查了 2005 年越南面向 6 岁以下儿童的全民医疗保险计划对医疗保健利用、家庭自付（OOP）支出和自我报告的健康结果的影响，使用了 2002-2004-2006-2008 年越南家庭生活水平调查的数据。我们使用双重差分法将符合该计划的儿童与不符合该计划的大龄儿童进行比较。结果表明，该计划使 0-5 岁儿童的保险覆盖率相对于政策前时期增加了 250%。我们发现门诊和住院就诊人数都大幅增加。医疗保险的普及也增加了公共和私人医疗机构的门诊就诊次数，这表明公共和私人医疗服务是互补的。尽管医疗保险与 3-5 岁儿童住院 OOP 支出的减少有关，但它并没有减少儿童一般的门诊 OOP 支出。医疗保险与自我报告的健康结果的适度改善有关。我们的研究表明，越南儿童获得保险的机会增加改善了他们获得医疗保健和健康结果的机会，尽管它不一定减少 OOP 支出。
