Moving to Social Health Insurance Financing and Payment for HIV/AIDS Treatment in Vietnam

• Published in: Health services insights 2021-01, Vol.14, p.1178632920988843-1178632920988843
• Main Authors: Vu, Lan Thi Hoang, Johns, Benjamin, Bui, Quyen Thi Tu, Duong Thuy, Anh, Nguyen Thi, Diu, Nguyen Thi, Hien, Nguyen Cam, Anh
• Format: Article
• Language: English
• Subjects: Acquired immune deficiency syndrome; AIDS; Antiretroviral drugs; Critical Issues in Health Services in Vietnam; Expenditures; Health insurance; HIV; Human immunodeficiency virus
• ISSN: 1178-6329; 1178-6329
• DOI: 10.1177/1178632920988843

This study estimates the amount antiretroviral therapy (ART) clients paid out of pocket for preventive and treatment services and the percentage of ART clients incurring catastrophic payments during the period when ART services were transitioning from donor funding to domestic social health insurance (SHI) in Vietnam. Using a cross-sectional facility-based survey in 9 provinces, a sample of 582 clients across 18 ART facilities representatives of all facilities where SHI-financed ART was being implemented were interviewed in 2019. Results indicated 13.4% (95% CI: 5.7%, 28.2%) of clients incurred a payment for outpatient ART care. The average out of pocket expenditures for outpatient visits and HIV related outpatient visits was USD $71.2 and $8 per year, respectively. The average out of pocket expenditure for inpatient admission and HIV related inpatient admission was $7.1 and $1.6, respectively. Only 0.1% clients currently experienced HIV-related catastrophic payment at the 25% of total expenditures threshold. The study confirms the transition from donor-financed ART to SHI-financed ART is not causing financial hardship for ART clients. However, more commitment from the Government of Vietnam to strengthen HIV-related services under SHI may be needed in the future, and there is still need to ensure universal SHI coverage among people with HIV/AIDs in Vietnam.