Encouraging Health Insurance for the Informal Sector : A Cluster Randomized Trial
Subsidized voluntary enrollment in government-run health insurance schemes is often proposed as a way of increasing coverage among informal sector workers and their families. This paper reports the results of a cluster randomized control trial in w...
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| Format: | Policy Research Working Paper |
| Language: | English en_US |
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World Bank, Washington, DC
2014
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| Online Access: | http://documents.worldbank.org/curated/en/2014/06/19641542/encouraging-health-insurance-informal-sector-cluster-randomized-trial-encouraging-health-insurance-informal-sector-cluster-randomized-trial http://hdl.handle.net/10986/18768 |
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okr-10986-187682021-04-23T14:03:49Z Encouraging Health Insurance for the Informal Sector : A Cluster Randomized Trial Wagstaff, Adam Nguyen, Ha Thi Hong Dao, Huyen Bales, Sarah ADVERSE SELECTION CHEMOTHERAPY COMMUNES COMMUNITIES COMMUNITY HEALTH DEMAND FOR HEALTH DEMAND FOR INSURANCE DIALYSIS DISTRICTS ENROLLEES EXPECTED LOSS FAMILIES FINANCIAL INCENTIVES FINANCIAL PROTECTION HEALTH CARE HEALTH COVERAGE HEALTH ECONOMICS HEALTH FACILITIES HEALTH FINANCING HEALTH INSURANCE HEALTH INSURANCE ENROLLMENT DECISION HEALTH INSURANCE PROGRAM HEALTH INSURANCE SCHEME HEALTH INSURANCE SCHEMES HEALTH ORGANIZATION HEALTH PLANNING HEALTH POLICY HEALTH STRATEGY HEALTH SYSTEM HEALTH SYSTEM PERFORMANCE HEALTH SYSTEMS HEALTH-CARE HOUSEHOLD INCOME HOUSEHOLDS HUMAN DEVELOPMENT INCOME COUNTRIES INFORMAL SECTOR INFORMAL SECTOR WORKERS INFORMATION CAMPAIGNS INFORMATION PACK INSURANCE COVERAGE INSURANCE PREMIUM INTERVENTION INTERVENTIONS LIVING STANDARDS LOCALITIES MEDICAL PERSONNEL PHYSICIAN POLICY DISCUSSIONS POLICY RESEARCH PRIMARY CARE PROBABILITY PUBLIC HOSPITAL SOCIAL HEALTH INSURANCE SOCIAL SCIENCE SOCIAL SECURITY SOCIAL SECURITY HEALTH INSURANCE TREATMENTS UNIVERSAL HEALTH INSURANCE COVERAGE WORKERS Subsidized voluntary enrollment in government-run health insurance schemes is often proposed as a way of increasing coverage among informal sector workers and their families. This paper reports the results of a cluster randomized control trial in which 3,000 households in 20 communes in Vietnam were randomly assigned at baseline to a control group or one of three treatments: an information leaflet about Vietnam s government-run scheme and the benefits of health insurance; a voucher entitling eligible household members to 25 percent off their annual premium; and both. The four groups were balanced at baseline. In the control group, 6.3 percent (82/1296) of individuals were enrolled in the endline, compared with 6.3 percent (79/1257), 7.2 percent (96/1327), and 7.0 percent (87/1245) in the information, subsidy, and combined intervention groups; the adjusted odds ratios were 0.94, 1.12, and 1.15, respectively. Only among those reporting poor health were any significant intervention effects found, and only for the combined intervention: an enrollment rate of 16.3 percent (33/202) compared with 8.3 percent (18/218) in the control group, and an adjusted odds ratio of 2.50. The results suggest limited opportunities to raise voluntary health insurance enrollment through information campaigns and subsidies, and that these interventions exacerbate adverse selection. 2014-06-25T21:41:26Z 2014-06-25T21:41:26Z 2014-06 http://documents.worldbank.org/curated/en/2014/06/19641542/encouraging-health-insurance-informal-sector-cluster-randomized-trial-encouraging-health-insurance-informal-sector-cluster-randomized-trial http://hdl.handle.net/10986/18768 English en_US Policy Research Working Paper;No. 6910 CC BY 3.0 IGO http://creativecommons.org/licenses/by/3.0/igo/ World Bank, Washington, DC Publications & Research :: Policy Research Working Paper Publications & Research East Asia and Pacific Vietnam |
| repository_type |
Digital Repository |
| institution_category |
Foreign Institution |
| institution |
Digital Repositories |
| building |
World Bank Open Knowledge Repository |
| collection |
World Bank |
| language |
English en_US |
| topic |
ADVERSE SELECTION CHEMOTHERAPY COMMUNES COMMUNITIES COMMUNITY HEALTH DEMAND FOR HEALTH DEMAND FOR INSURANCE DIALYSIS DISTRICTS ENROLLEES EXPECTED LOSS FAMILIES FINANCIAL INCENTIVES FINANCIAL PROTECTION HEALTH CARE HEALTH COVERAGE HEALTH ECONOMICS HEALTH FACILITIES HEALTH FINANCING HEALTH INSURANCE HEALTH INSURANCE ENROLLMENT DECISION HEALTH INSURANCE PROGRAM HEALTH INSURANCE SCHEME HEALTH INSURANCE SCHEMES HEALTH ORGANIZATION HEALTH PLANNING HEALTH POLICY HEALTH STRATEGY HEALTH SYSTEM HEALTH SYSTEM PERFORMANCE HEALTH SYSTEMS HEALTH-CARE HOUSEHOLD INCOME HOUSEHOLDS HUMAN DEVELOPMENT INCOME COUNTRIES INFORMAL SECTOR INFORMAL SECTOR WORKERS INFORMATION CAMPAIGNS INFORMATION PACK INSURANCE COVERAGE INSURANCE PREMIUM INTERVENTION INTERVENTIONS LIVING STANDARDS LOCALITIES MEDICAL PERSONNEL PHYSICIAN POLICY DISCUSSIONS POLICY RESEARCH PRIMARY CARE PROBABILITY PUBLIC HOSPITAL SOCIAL HEALTH INSURANCE SOCIAL SCIENCE SOCIAL SECURITY SOCIAL SECURITY HEALTH INSURANCE TREATMENTS UNIVERSAL HEALTH INSURANCE COVERAGE WORKERS |
| spellingShingle |
ADVERSE SELECTION CHEMOTHERAPY COMMUNES COMMUNITIES COMMUNITY HEALTH DEMAND FOR HEALTH DEMAND FOR INSURANCE DIALYSIS DISTRICTS ENROLLEES EXPECTED LOSS FAMILIES FINANCIAL INCENTIVES FINANCIAL PROTECTION HEALTH CARE HEALTH COVERAGE HEALTH ECONOMICS HEALTH FACILITIES HEALTH FINANCING HEALTH INSURANCE HEALTH INSURANCE ENROLLMENT DECISION HEALTH INSURANCE PROGRAM HEALTH INSURANCE SCHEME HEALTH INSURANCE SCHEMES HEALTH ORGANIZATION HEALTH PLANNING HEALTH POLICY HEALTH STRATEGY HEALTH SYSTEM HEALTH SYSTEM PERFORMANCE HEALTH SYSTEMS HEALTH-CARE HOUSEHOLD INCOME HOUSEHOLDS HUMAN DEVELOPMENT INCOME COUNTRIES INFORMAL SECTOR INFORMAL SECTOR WORKERS INFORMATION CAMPAIGNS INFORMATION PACK INSURANCE COVERAGE INSURANCE PREMIUM INTERVENTION INTERVENTIONS LIVING STANDARDS LOCALITIES MEDICAL PERSONNEL PHYSICIAN POLICY DISCUSSIONS POLICY RESEARCH PRIMARY CARE PROBABILITY PUBLIC HOSPITAL SOCIAL HEALTH INSURANCE SOCIAL SCIENCE SOCIAL SECURITY SOCIAL SECURITY HEALTH INSURANCE TREATMENTS UNIVERSAL HEALTH INSURANCE COVERAGE WORKERS Wagstaff, Adam Nguyen, Ha Thi Hong Dao, Huyen Bales, Sarah Encouraging Health Insurance for the Informal Sector : A Cluster Randomized Trial |
| geographic_facet |
East Asia and Pacific Vietnam |
| relation |
Policy Research Working Paper;No. 6910 |
| description |
Subsidized voluntary enrollment in
government-run health insurance schemes is often proposed as
a way of increasing coverage among informal sector workers
and their families. This paper reports the results of a
cluster randomized control trial in which 3,000 households
in 20 communes in Vietnam were randomly assigned at baseline
to a control group or one of three treatments: an
information leaflet about Vietnam s government-run scheme
and the benefits of health insurance; a voucher entitling
eligible household members to 25 percent off their annual
premium; and both. The four groups were balanced at
baseline. In the control group, 6.3 percent (82/1296) of
individuals were enrolled in the endline, compared with 6.3
percent (79/1257), 7.2 percent (96/1327), and 7.0 percent
(87/1245) in the information, subsidy, and combined
intervention groups; the adjusted odds ratios were 0.94,
1.12, and 1.15, respectively. Only among those reporting
poor health were any significant intervention effects found,
and only for the combined intervention: an enrollment rate
of 16.3 percent (33/202) compared with 8.3 percent (18/218)
in the control group, and an adjusted odds ratio of 2.50.
The results suggest limited opportunities to raise voluntary
health insurance enrollment through information campaigns
and subsidies, and that these interventions exacerbate
adverse selection. |
| format |
Publications & Research :: Policy Research Working Paper |
| author |
Wagstaff, Adam Nguyen, Ha Thi Hong Dao, Huyen Bales, Sarah |
| author_facet |
Wagstaff, Adam Nguyen, Ha Thi Hong Dao, Huyen Bales, Sarah |
| author_sort |
Wagstaff, Adam |
| title |
Encouraging Health Insurance for the Informal Sector : A Cluster Randomized Trial |
| title_short |
Encouraging Health Insurance for the Informal Sector : A Cluster Randomized Trial |
| title_full |
Encouraging Health Insurance for the Informal Sector : A Cluster Randomized Trial |
| title_fullStr |
Encouraging Health Insurance for the Informal Sector : A Cluster Randomized Trial |
| title_full_unstemmed |
Encouraging Health Insurance for the Informal Sector : A Cluster Randomized Trial |
| title_sort |
encouraging health insurance for the informal sector : a cluster randomized trial |
| publisher |
World Bank, Washington, DC |
| publishDate |
2014 |
| url |
http://documents.worldbank.org/curated/en/2014/06/19641542/encouraging-health-insurance-informal-sector-cluster-randomized-trial-encouraging-health-insurance-informal-sector-cluster-randomized-trial http://hdl.handle.net/10986/18768 |
| _version_ |
1764442645909733376 |