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Can rural health insurance improve equity in health care utilization? a comparison between China and Vietnam
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 acc...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2012
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3334712/ https://www.ncbi.nlm.nih.gov/pubmed/22376290 http://dx.doi.org/10.1186/1475-9276-11-10 |
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author | Liu, Xiaoyun Tang, Shenglan Yu, Baorong Phuong, Nguyen Khanh Yan, Fei Thien, Duong Duc Tolhurst, Rachel |
author_facet | Liu, Xiaoyun Tang, Shenglan Yu, Baorong Phuong, Nguyen Khanh Yan, Fei Thien, Duong Duc Tolhurst, Rachel |
author_sort | Liu, Xiaoyun |
collection | PubMed |
description | 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 non-members, 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. |
format | Online Article Text |
id | pubmed-3334712 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2012 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-33347122012-04-25 Can rural health insurance improve equity in health care utilization? a comparison between China and Vietnam Liu, Xiaoyun Tang, Shenglan Yu, Baorong Phuong, Nguyen Khanh Yan, Fei Thien, Duong Duc Tolhurst, Rachel Int J Equity Health Research 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 non-members, 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. BioMed Central 2012-02-29 /pmc/articles/PMC3334712/ /pubmed/22376290 http://dx.doi.org/10.1186/1475-9276-11-10 Text en Copyright ©2012 Liu 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 Liu, Xiaoyun Tang, Shenglan Yu, Baorong Phuong, Nguyen Khanh Yan, Fei Thien, Duong Duc Tolhurst, Rachel Can rural health insurance improve equity in health care utilization? a comparison between China and Vietnam |
title | Can rural health insurance improve equity in health care utilization? a comparison between China and Vietnam |
title_full | Can rural health insurance improve equity in health care utilization? a comparison between China and Vietnam |
title_fullStr | Can rural health insurance improve equity in health care utilization? a comparison between China and Vietnam |
title_full_unstemmed | Can rural health insurance improve equity in health care utilization? a comparison between China and Vietnam |
title_short | Can rural health insurance improve equity in health care utilization? a comparison between China and Vietnam |
title_sort | can rural health insurance improve equity in health care utilization? a comparison between china and vietnam |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3334712/ https://www.ncbi.nlm.nih.gov/pubmed/22376290 http://dx.doi.org/10.1186/1475-9276-11-10 |
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