Thi Thuy Nga Nguyen, FitzGerald Gerard, Dunne Michael
Hanoi University of Public Health, Hanoi, Vietnam.
Queensland University of Technology, Kelvin Grove, Queensland, Australia.
Asia Pac J Public Health. 2018 Nov;30(8):699-707. doi: 10.1177/1010539518807601. Epub 2018 Oct 20.
Providing financial protection to the whole population is a top health policy priority of many countries. However, expanding social health insurance coverage to the "informal sector worker" is a challenge in many developing countries. This study analyzed the reasons for the limited coverage of health insurance for informal sector workers. Direct interviews were carried out with 391 uninsured households in Vietnam, followed by in-depth interviews with 11 key stakeholders. The study offers several possible explanations for the low enrollment in family-based health insurance scheme at both the demand and supply sides, such as inability to pay the premium, lack of information, perceived poor quality of primary health care services, and complicated enrollment procedures. The study suggests that a partial government subsidy and improvement in the quality of primary health care are crucial strategies for health insurance expansion for the informal sector workers and their families.
为全体民众提供经济保护是许多国家卫生政策的首要优先事项。然而，在许多发展中国家，将社会医疗保险覆盖范围扩大到“非正规部门工人”是一项挑战。本研究分析了非正规部门工人医疗保险覆盖范围有限的原因。对越南391户未参保家庭进行了直接访谈，随后对11名主要利益相关者进行了深入访谈。该研究从需求和供给两方面为家庭医疗保险计划参保率低提供了几种可能的解释，如无力支付保费、信息缺乏、认为初级卫生保健服务质量差以及参保手续复杂。该研究表明，政府部分补贴和初级卫生保健质量的改善是扩大非正规部门工人及其家庭医疗保险的关键策略。
