Abstract
Objectives
The Vietnamese government is committed to universal health care largely through social health insurance. The near-poor population is entitled to subsidized but not free insurance under this scheme, but remains under-represented compared to other groups. The aims of this research were to estimate the health insurance coverage of the near-poor in rural Vietnam and identify the individual and household factors associated with health insurance status.
Methods
Rates of health insurance coverage were estimated from district-level administrative data. A cross-sectional survey was conducted in a representative sample of 2000 near-poor in Cao Lanh district, Dong Thap province, Vietnam. Face-to-face interviews were conducted with a standardized questionnaire. Multiple logistic regression was applied to identify the factors associated with insurance status.
Results
The insurance coverage of the near-poor in the selected communities was 20.3%. Enrollment in the health insurance scheme was significantly associated with poor health status (OR = 4.8, 95% CI = 2.4–9.8), good knowledge of health insurance (OR = 4.6, 95% CI = 3.4–6.2), interest in health insurance (OR = 30.1, 95% CI = 11.6–78.0), and the perceived cost of the insurance premium (OR = 2.4, 95% CI = 1.7–3.6).
Conclusions
The cost of insurance premiums is a barrier to enrollment. Information, education and communication campaigns together with modified insurance scheme for the near-poor are necessary to enhance insurance coverage in Vietnam.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
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This article is part of the supplement: “Health and social determinants of health in Vietnam: local evidence and international implications”.
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Nguyen, T.D., Wilson, A. Coverage of health insurance among the near-poor in rural Vietnam and associated factors. Int J Public Health 62 (Suppl 1), 63–73 (2017). https://doi.org/10.1007/s00038-016-0911-z
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DOI: https://doi.org/10.1007/s00038-016-0911-z