Faculty of Economics, TNU - University of Economics and Business Administration, Tan Thinh Ward, Thai Nguyen 24000, Vietnam.
Department of Economics, Queens College CUNY, Queens, NY, 11367, USA.
Soc Sci Med. 2024 Nov;361:117357. doi: 10.1016/j.socscimed.2024.117357. Epub 2024 Sep 25.
Over the past few decades, Vietnam has experienced a substantial improvement in health outcomes, providing an example of a low-income country that has achieved a major success in public health despite the lack of resources. However, inequalities in access to healthcare services persist among the poor, ethnic minorities, and other vulnerable groups. To address this issue, the Vietnamese government implemented a healthcare support program in ethnic minority areas in 2013. We examine the effects of this program on healthcare utilization among older individuals aged 55-74. Employing a difference-in-differences approach and data from the Vietnam Household Living Standards Survey from 2008 to 2018, we find that the program has a positive effect on inpatient visits at public health facilities. However, the program has no impact on outpatient visits. Additional analysis reveals that the program increases outpatient visits at commune health stations and inpatient visits at district hospitals. There is also suggestive evidence of a switch from private to public facilities. Our results suggest that providing healthcare resources to disadvantaged areas can increase healthcare utilization of older people, which can, in turn, improve their health outcomes.
在过去的几十年里，越南的健康状况得到了显著改善，为资源匮乏的低收入国家在公共卫生领域取得重大成功树立了典范。然而，在贫困人群、少数民族和其他弱势群体中，获得医疗服务的机会仍存在不平等。为了解决这个问题，越南政府于 2013 年在少数民族地区实施了一项医疗支持计划。我们考察了该计划对 55-74 岁老年人医疗利用的影响。利用 2008 年至 2018 年越南家庭生活水平调查的数据，采用双重差分法，我们发现该计划对公立医疗机构的住院治疗有积极影响。然而，该计划对门诊治疗没有影响。进一步的分析表明，该计划增加了社区卫生站的门诊就诊次数和区医院的住院治疗次数。也有迹象表明，人们会从私人医疗机构转向公立医院。我们的研究结果表明，向弱势地区提供医疗资源可以增加老年人的医疗利用，进而改善他们的健康状况。
