INTERPRETATION Increased health insurance coverage generally appears to increase access to health care facilities , improve financial protection and improve health status , although findings are not totally consistent .
BACKGROUND Exp and ing public health insurance seeks to attain several desirable objectives , including increasing access to healthcare services , reducing the risk of catastrophic healthcare expenditures , and improving health outcomes .
The extent to which these objectives are met in a real-world policy context remains an empirical question of increasing research and policy interest in recent years .
Does the financial protection of health insurance vary across providers? Vietnam's experience.
Using household panel data from Vietnam , this paper compares out-of-pocket health expenditures on outpatient care at a health facility between insured and uninsured patients as well as across various providers . In the r and om effects model , the estimated coefficient of the insurance status variable suggests that insurance reduces out-of-pocket spending by 24 % for those with the compulsory and voluntary coverage and by about 15 % for those with the health insurance for the poor coverage . However , the modest financial protection of the compulsory and voluntary schemes disappears once we control for time-invariant unobserved individual effects using the fixed effects model . Additional analysis of the interaction terms involving the type of insurance and health facility suggests that the overall insignificant reduction in out-of-pocket expenditures as a result of the insurance schemes masks wide variations in the reduction in out-of-pocket sending across various providers . Insurance reduces out-of-pocket expenditures more for those enrollees using district and higher level public health facilities than those using commune health centers . Compared to the uninsured patients using district hospitals , compulsory and voluntary insurance schemes reduce out-of-pocket expenditures by 40 and 32 % , respectively . However , for contacts at the commune health centers , both the compulsory health scheme and the voluntary health insurance scheme schemes have little influence on out-of-pocket spending while the health insurance scheme for the poor reduces out-of-pocket spending by about 15 %
INTERPRETATION Increased health insurance coverage generally appears to increase access to health care facilities , improve financial protection and improve health status , although findings are not totally consistent .
BACKGROUND Exp and ing public health insurance seeks to attain several desirable objectives , including increasing access to healthcare services , reducing the risk of catastrophic healthcare expenditures , and improving health outcomes .
The extent to which these objectives are met in a real-world policy context remains an empirical question of increasing research and policy interest in recent years .