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People's willingness to pay for health insurance in rural Vietnam

BACKGROUND: The inequity caused by health financing in Vietnam, which mainly relies on out-of-pocket payments, has put pre-payment reform high on the political agenda. This paper reports on a study of the willingness to pay for health insurance among a rural population in northern Vietnam, exploring...

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Autores principales: Lofgren, Curt, Thanh, Nguyen X, Chuc, Nguyen TK, Emmelin, Anders, Lindholm, Lars
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2008
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2527552/
https://www.ncbi.nlm.nih.gov/pubmed/18691440
http://dx.doi.org/10.1186/1478-7547-6-16
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author Lofgren, Curt
Thanh, Nguyen X
Chuc, Nguyen TK
Emmelin, Anders
Lindholm, Lars
author_facet Lofgren, Curt
Thanh, Nguyen X
Chuc, Nguyen TK
Emmelin, Anders
Lindholm, Lars
author_sort Lofgren, Curt
collection PubMed
description BACKGROUND: The inequity caused by health financing in Vietnam, which mainly relies on out-of-pocket payments, has put pre-payment reform high on the political agenda. This paper reports on a study of the willingness to pay for health insurance among a rural population in northern Vietnam, exploring whether the Vietnamese are willing to pay enough to sufficiently finance a health insurance system. METHODS: Using the Epidemiological Field Laboratory for Health Systems Research in the Bavi district (FilaBavi), 2070 households were randomly selected for the study. Existing FilaBavi interviewers were trained especially for this study. The interview questionnaire was developed through a pilot study followed by focus group discussions among interviewers. Determinants of households' willingness to pay were studied through interval regression by which problems such as zero answers, skewness, outliers and the heaping effect may be solved. RESULTS: Households' average willingness to pay (WTP) is higher than their costs for public health care and self-treatment. For 70–80% of the respondents, average WTP is also sufficient to pay the lower range of premiums in existing health insurance programmes. However, the average WTP would only be sufficient to finance about half of total household public, as well as private, health care costs. Variables that reflect income, health care need, age and educational level were significant determinants of households' willingness to pay. Contrary to expectations, age was negatively related to willingness to pay. CONCLUSION: Since WTP is sufficient to cover household costs for public health care, it depends to what extent households would substitute private for public care and increase utilization as to whether WTP would also be sufficient enough to finance health insurance. This study highlights potential for public information schemes that may change the negative attitude towards health insurance, which this study has uncovered. A key task for policy makers is to win the trust of the population in relation to a health insurance system, particularly among the old and those with relatively low education.
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spelling pubmed-25275522008-09-02 People's willingness to pay for health insurance in rural Vietnam Lofgren, Curt Thanh, Nguyen X Chuc, Nguyen TK Emmelin, Anders Lindholm, Lars Cost Eff Resour Alloc Research BACKGROUND: The inequity caused by health financing in Vietnam, which mainly relies on out-of-pocket payments, has put pre-payment reform high on the political agenda. This paper reports on a study of the willingness to pay for health insurance among a rural population in northern Vietnam, exploring whether the Vietnamese are willing to pay enough to sufficiently finance a health insurance system. METHODS: Using the Epidemiological Field Laboratory for Health Systems Research in the Bavi district (FilaBavi), 2070 households were randomly selected for the study. Existing FilaBavi interviewers were trained especially for this study. The interview questionnaire was developed through a pilot study followed by focus group discussions among interviewers. Determinants of households' willingness to pay were studied through interval regression by which problems such as zero answers, skewness, outliers and the heaping effect may be solved. RESULTS: Households' average willingness to pay (WTP) is higher than their costs for public health care and self-treatment. For 70–80% of the respondents, average WTP is also sufficient to pay the lower range of premiums in existing health insurance programmes. However, the average WTP would only be sufficient to finance about half of total household public, as well as private, health care costs. Variables that reflect income, health care need, age and educational level were significant determinants of households' willingness to pay. Contrary to expectations, age was negatively related to willingness to pay. CONCLUSION: Since WTP is sufficient to cover household costs for public health care, it depends to what extent households would substitute private for public care and increase utilization as to whether WTP would also be sufficient enough to finance health insurance. This study highlights potential for public information schemes that may change the negative attitude towards health insurance, which this study has uncovered. A key task for policy makers is to win the trust of the population in relation to a health insurance system, particularly among the old and those with relatively low education. BioMed Central 2008-08-11 /pmc/articles/PMC2527552/ /pubmed/18691440 http://dx.doi.org/10.1186/1478-7547-6-16 Text en Copyright © 2008 Lofgren et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( (http://creativecommons.org/licenses/by/2.0) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research
Lofgren, Curt
Thanh, Nguyen X
Chuc, Nguyen TK
Emmelin, Anders
Lindholm, Lars
People's willingness to pay for health insurance in rural Vietnam
title People's willingness to pay for health insurance in rural Vietnam
title_full People's willingness to pay for health insurance in rural Vietnam
title_fullStr People's willingness to pay for health insurance in rural Vietnam
title_full_unstemmed People's willingness to pay for health insurance in rural Vietnam
title_short People's willingness to pay for health insurance in rural Vietnam
title_sort people's willingness to pay for health insurance in rural vietnam
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2527552/
https://www.ncbi.nlm.nih.gov/pubmed/18691440
http://dx.doi.org/10.1186/1478-7547-6-16
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