The effects of free government health insurance among small children-evidence from the free care for children under six policy in Vietnam
The effects of free government health insurance among small children-evidence from the free care for children under six policy in Vietnam
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DOI：
10.1002/hpm.2114
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发表时间：
2013-01-01
影响因子：
2.7
通讯作者：
Wang, Wenjuan
中科院分区：
文献类型：
--
作者：
Ha Nguyen;Wang, Wenjuan
在过去几年中，对发展中国家的医疗保险和其他需求方融资计划的影响评估越来越多。然而，关于保险对幼儿影响的文献有限。本文评估了越南政府2005年的一项政策的效果，该政策允许所有6岁以下的儿童免费获得公共设施的卫生服务。特别是，我们关注那些没有资格参加在全国同时实施的穷人方案的家庭中的儿童。使用政策开始之前和之后进行的两波越南家庭生活水平调查和差异中的差异方法，我们发现二级公立医院的住院和门诊治疗都有大幅增加。与此同时，有证据表明三级医院的使用有所减少。与政策的非受益人相比，45岁年龄组的受益人也经历了更少的病假，在医疗保健方面的自付支出更少，遇到灾难性支出的可能性也更小。因此，有证据表明，保险单提供的保险起到了安全网的作用，通过减少使用昂贵的三级保健，帮助提高了保健系统的效率。版权所有（c）2012约翰威利父子有限公司
Over the last few years, there have been an increasing number of impact evaluations of health insurance and other demand-side financing programs in developing countries. Yet the literature on insurance impact among small children is limited. This paper evaluates the effects of a Vietnamese government's policy in 2005, which granted free access to health services in public facilities to all children younger than 6years. In particular, we focus on children among households who are not eligible for a program for the poor, which has been administered concurrently in the country. Using two waves of the Vietnam Household Living Standard Surveys conducted right before and after the policy started and a difference-in-differences method, we found a major increase in both inpatient and outpatient care in the secondary public hospitals. At the same time, there is evidence indicating a reduction in the use of tertiary hospitals. Compared with the policy's non-beneficiaries, beneficiaries in the age group 45years also experienced fewer sick days, incurred less out-of-pocket spending on healthcare, and were less likely to encounter catastrophic expenditure. Evidence thus suggests that insurance provided by the policy has served the function as a safety net and helped improving efficiency of the health system by reducing the use of costly tertiary care. Copyright (c) 2012 John Wiley & Sons, Ltd.