|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|
|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|
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.
|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
|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).|