Healthcare Services Utilisation and Financial Burden among Vietnamese Older People and Their Households

• Published in: International journal of environmental research and public health 2023-06, Vol.20 (12), p.6097
• Main Authors: Giang, Long Thanh, Pham, Tham Hong Thi, Phi, Phong Manh, Nguyen, Nam Truong
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Aging; Chronic illnesses; Delivery of Health Care - economics; Expenditures; Facilities and Services Utilization - economics; Family Characteristics; Financial Stress; Food; Health care; Health care facilities; Health care policy; Health Expenditures; Health facilities; Health insurance; Health services; Households; Humans; Insurance; Insurance coverage; Insurance, Health; Medically Uninsured; Minority & ethnic groups; Older people; Population; Poverty; Southeast Asian People; Uninsured people; Vietnam
• ISSN: 1660-4601; 1661-7827; 1660-4601
• DOI: 10.3390/ijerph20126097

This research examined differences in the utilisation of healthcare services and financial burden between and within insured and uninsured older persons and their households under the social health insurance scheme in Vietnam. We used nationally representative data from the Vietnam Household Living Standard Survey (VHLSS) conducted in 2014. We applied the World Health Organization (WHO)'s financial indicators in healthcare to provide cross-tabulations and comparisons for insured and uninsured older persons along with their individual and household characteristics (such as age groups, gender, ethnicity, per-capita household expenditure quintiles, and place of residence). We found that social health insurance was beneficial to the insured in comparison with the uninsured in terms of utilization of healthcare services and financial burden. However, between and within these two groups, more vulnerable groups (i.e., ethnic minorities and rural persons) had lower utilization rates and higher rates of catastrophic spending than the better groups (i.e., Kinh and urban persons). Given the rapidly ageing population under low middle-income status and the "double burden of diseases", this paper suggested that Vietnam reform the healthcare system and social health insurance so as to provide more equitable utilisation and financial protection to all older persons, including improving the quality of healthcare at the grassroots level and reducing the burden on the provincial/central health level; improving human resources for the grassroots healthcare facilities; encroaching public-private partnerships (PPPs) in the healthcare service provision; and developing a nationwide family doctor network.