The impact of health insurance for children under age 6 in Vietnam: A regression discontinuity approach
The impact of health insurance for children under age 6 in Vietnam: A regression discontinuity approach
复制标题
DOI：
10.1016/j.socscimed.2014.08.012
复制
发表时间：
2015-11-01
影响因子：
5.4
通讯作者：
Groce, Nora
中科院分区：
文献类型：
--
作者：
Palmer, Michael;Mitra, Sophie;Groce, Nora
早期的健康服务对未来的健康和生活结果很重要。然而，目前人们对健康保险在促进儿童获得护理方面的作用知之甚少。本文利用通过为越南学龄前儿童提供健康保险的政策而实现的回归不连续设计，评估了健康保险对六年资格门槛儿童医疗保健利用结果的影响。通过三轮越南家庭生活水平调查，该研究发现，住院和门诊就诊率受到积极影响，而公共设施的每次就诊支出没有受到显著影响。我们发现私人门诊服务的使用率较高，没有证据表明从私人转向有保险的公共设施。研究结果表明，为6岁以下儿童采用公共医疗保险计划可能是提高低收入和中等收入国家服务利用率的一个重要手段。在提供充分的保护，使其免受成本和其他护理障碍方面，仍然存在挑战。(C)2014作者由Elsevier Ltd.发布。这是CC BY许可下的开放获取文章（http：//creativecommons.org/licenses/by/3.0/）。
Accessing health services at an early age is important to future health and life outcomes. Yet, little is currently known on the role of health insurance in facilitating access to care for children. Exploiting a regression discontinuity design made possible through a policy to provide health insurance to pre-school aged children in Vietnam, this paper evaluates the impact of health insurance on the health care utilization outcomes of children at the eligibility threshold of six years. Using three rounds of the Vietnam Household Living Standards Survey, the study finds a positive impact on inpatient and outpatient visits and no significant impact on expenditures per visit at public facilities. We find moderately high use of private outpatient services and no evidence of a switch from private to covered public facilities under insurance. Results suggest that adopting public health insurance programs for children under age 6 may be an important vehicle to improving service utilization in a low- and middle-income country context Challenges remain in providing adequate protections from the costs and other barriers to care. (C) 2014 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/3.0/).