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Can rural health insurance improve equity in health care utilization? a comparison between China and Vietnam
Liu, Xiaoyun1,2; Tang, Shenglan3; Yu, Baorong4; Nguyen Khanh Phuong5; Yan, Fei6; Duong Duc Thien7; Tolhurst, Rachel2
关键词Health Insurance Rural Area Equity Health Services Utilization China Vietnam
刊名INTERNATIONAL JOURNAL FOR EQUITY IN HEALTH
2012-02-29
DOI10.1186/1475-9276-11-10
11
收录类别SSCI
文章类型Article
WOS标题词Science & Technology
类目[WOS]Public, Environmental & Occupational Health
研究领域[WOS]Public, Environmental & Occupational Health
关键词[WOS]SYSTEM REFORM ; CHALLENGES ; ACCESS
英文摘要

Introduction: Health care financing reforms in both China and Vietnam have resulted in greater financial difficulties in accessing health care, especially for the rural poor. Both countries have been developing rural health insurance for decades. This study aims to evaluate and compare equity in access to health care in rural health insurance system in the two countries.

Methods: Household survey and qualitative study were conducted in 6 counties in China and 4 districts in Vietnam. Health insurance policy and its impact on utilization of outpatient and inpatient service were analyzed and compared to measure equity in access to health care.

Results: In China, Health insurance membership had no significant impact on outpatient service utilization, while was associated with higher utilization of inpatient services, especially for the higher income group. Health insurance members in Vietnam had higher utilization rates of both outpatient and inpatient services than the nonmembers, with higher use among the lower than higher income groups. Qualitative results show that bureaucratic obstacles, low reimbursement rates, and poor service quality were the main barriers for members to use health insurance.

Conclusions: China has achieved high population coverage rate over a short time period, starting with a limited benefit package. However, poor people have less benefit from NCMS in terms of health service utilization. Compared to China, Vietnam health insurance system is doing better in equity in health service utilization within the health insurance members. However with low population coverage, a large proportion of population cannot enjoy the health insurance benefit. Mutual learning would help China and Vietnam address these challenges, and improve their policy design to promote equitable and sustainable health insurance.

语种英语
WOS记录号WOS:000303152000001
引用统计
被引频次:29[WOS]   [WOS记录]     [WOS相关记录]
文献类型期刊论文
条目标识符http://ir.bjmu.edu.cn/handle/400002259/56145
专题北京大学中国卫生发展研究中心
作者单位1.Shandong Univ, Jinan 250012, Shandong, Peoples R China
2.Hlth Strategy & Policy Inst, Hanoi, Vietnam
3.Minist Hlth, Hlth Policy Unit, Hanoi, Vietnam
4.Peking Univ, China Ctr Hlth Dev Studies, Beijing 100191, Peoples R China
5.Univ Liverpool, Liverpool Sch Trop Med, Liverpool L3 5QA, Merseyside, England
6.World Hlth Org, Special Programme Res & Training Trop Dis TDR, CH-1211 Geneva 27, Switzerland
7.Fudan Univ, Sch Publ Hlth, Shanghai 200433, Peoples R China
推荐引用方式
GB/T 7714
Liu, Xiaoyun,Tang, Shenglan,Yu, Baorong,et al. Can rural health insurance improve equity in health care utilization? a comparison between China and Vietnam[J]. INTERNATIONAL JOURNAL FOR EQUITY IN HEALTH,2012,11.
APA Liu, Xiaoyun.,Tang, Shenglan.,Yu, Baorong.,Nguyen Khanh Phuong.,Yan, Fei.,...&Tolhurst, Rachel.(2012).Can rural health insurance improve equity in health care utilization? a comparison between China and Vietnam.INTERNATIONAL JOURNAL FOR EQUITY IN HEALTH,11.
MLA Liu, Xiaoyun,et al."Can rural health insurance improve equity in health care utilization? a comparison between China and Vietnam".INTERNATIONAL JOURNAL FOR EQUITY IN HEALTH 11(2012).
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