Health Insurance Impacts on Health and Nonmedical Consumption in a Developing Country
The authors examine the effects of the introduction of Vietnam's health insurance (VHI) program on health outcomes, health care utilization, and non-medical household consumption. The use of panel data collected before and after the insurance program's introduction allows them to eliminate...
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| Format: | Policy Research Working Paper |
| Language: | English |
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World Bank, Washington, DC
2012
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| Online Access: | http://documents.worldbank.org/curated/en/2005/04/5745333/health-insurance-impacts-health-nonmedical-consumption-developing-country-health-insurance-impacts-health-non-medical-consumption-developing-country http://hdl.handle.net/10986/8988 |
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okr-10986-89882021-04-23T14:02:42Z Health Insurance Impacts on Health and Nonmedical Consumption in a Developing Country Wagstaff, Adam Pradhan, Menno AGED APPLICATIONS CHILD NUTRITION CLINICS COMMODITIES ECONOMICS EMPIRICAL ANALYSIS EMPLOYMENT EXPENDITURES HEALTH CARE HEALTH CARE UTILIZATION HEALTH CENTERS HEALTH ECONOMICS HEALTH IMPACTS HEALTH INSURANCE HEALTH INSURANCE COVERAGE HEALTH OUTCOMES HEALTH SECTOR HEALTH SERVICES HEALTH STATUS HOSPITAL CARE HOSPITAL COST HOSPITALS HOUSING HUMAN DEVELOPMENT HYGIENE INCOME INFANT MORTALITY INFANTS INFORMAL INSURANCE INFORMATION ASYMMETRIES INPATIENT CARE INTERVENTION LABOR FORCE LABOR SUPPLY LEGISLATION LIBERALIZATION LIVING STANDARDS MEDICAID MEDICAL CARE MEDICAL EXPENSES MEDICINES MIGRATION MORAL HAZARD MORTALITY MOTHERS NUTRITION NUTRITIONAL STATUS ORAL REHYDRATION THERAPY OUTPATIENT CARE PARENTS PATIENTS PHARMACISTS PHARMACY POLICY RESEARCH PRIMARY CARE PRIVATE SECTOR PROBABILITY PROGRAMS PUPILS SAVINGS SCHOOLS URBAN AREAS USE VALUE VACCINATIONS WORKERS WORKPLACE The authors examine the effects of the introduction of Vietnam's health insurance (VHI) program on health outcomes, health care utilization, and non-medical household consumption. The use of panel data collected before and after the insurance program's introduction allows them to eliminate any confounding effects due to selection on time-invariant un-observables, and their coupling of propensity score matching with a double-difference estimator allows them to reduce the risk of biases due to inappropriate specification of the outcome regression model. The authors' results suggest that Vietnam's health insurance program impacted favorably on height-for-age and weight-for-age of young school children, and on body mass index among adults. Their results suggest that among young children, VHI increases use of primary care facilities and leads to a substitution away from the use of pharmacists as a source of advice and non-prescribed medicines toward the use of them as a supplier of medicines prescribed by a health professional. Among older children and adults, VHI results in a marked increase in the use of hospital inpatient and outpatient departments. The results also suggest that VHI causes a reduction in annual out-of-pocket expenditures on health and an increase in non-medical household consumption, including food consumption, but mostly nonfood consumption. The authors' estimate of the VHI-induced reduction in out-of-pocket health spending is considerably smaller than their estimate of the VHI-induced increase in non-medical consumption, which is consistent with the idea that households hold back their consumption considerably if, through lack of health insurance, they are exposed to the risk of large out-of-pocket expenditures. This is especially plausible in a country where at the time (1993), a single visit to a public hospital cost on average the equivalent of 20 percent of a person's annual nonfood consumption. 2012-06-25T22:17:52Z 2012-06-25T22:17:52Z 2005-04 http://documents.worldbank.org/curated/en/2005/04/5745333/health-insurance-impacts-health-nonmedical-consumption-developing-country-health-insurance-impacts-health-non-medical-consumption-developing-country http://hdl.handle.net/10986/8988 English Policy Research Working Paper; No. 3563 CC BY 3.0 IGO http://creativecommons.org/licenses/by/3.0/igo/ World Bank 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 |
| topic |
AGED APPLICATIONS CHILD NUTRITION CLINICS COMMODITIES ECONOMICS EMPIRICAL ANALYSIS EMPLOYMENT EXPENDITURES HEALTH CARE HEALTH CARE UTILIZATION HEALTH CENTERS HEALTH ECONOMICS HEALTH IMPACTS HEALTH INSURANCE HEALTH INSURANCE COVERAGE HEALTH OUTCOMES HEALTH SECTOR HEALTH SERVICES HEALTH STATUS HOSPITAL CARE HOSPITAL COST HOSPITALS HOUSING HUMAN DEVELOPMENT HYGIENE INCOME INFANT MORTALITY INFANTS INFORMAL INSURANCE INFORMATION ASYMMETRIES INPATIENT CARE INTERVENTION LABOR FORCE LABOR SUPPLY LEGISLATION LIBERALIZATION LIVING STANDARDS MEDICAID MEDICAL CARE MEDICAL EXPENSES MEDICINES MIGRATION MORAL HAZARD MORTALITY MOTHERS NUTRITION NUTRITIONAL STATUS ORAL REHYDRATION THERAPY OUTPATIENT CARE PARENTS PATIENTS PHARMACISTS PHARMACY POLICY RESEARCH PRIMARY CARE PRIVATE SECTOR PROBABILITY PROGRAMS PUPILS SAVINGS SCHOOLS URBAN AREAS USE VALUE VACCINATIONS WORKERS WORKPLACE |
| spellingShingle |
AGED APPLICATIONS CHILD NUTRITION CLINICS COMMODITIES ECONOMICS EMPIRICAL ANALYSIS EMPLOYMENT EXPENDITURES HEALTH CARE HEALTH CARE UTILIZATION HEALTH CENTERS HEALTH ECONOMICS HEALTH IMPACTS HEALTH INSURANCE HEALTH INSURANCE COVERAGE HEALTH OUTCOMES HEALTH SECTOR HEALTH SERVICES HEALTH STATUS HOSPITAL CARE HOSPITAL COST HOSPITALS HOUSING HUMAN DEVELOPMENT HYGIENE INCOME INFANT MORTALITY INFANTS INFORMAL INSURANCE INFORMATION ASYMMETRIES INPATIENT CARE INTERVENTION LABOR FORCE LABOR SUPPLY LEGISLATION LIBERALIZATION LIVING STANDARDS MEDICAID MEDICAL CARE MEDICAL EXPENSES MEDICINES MIGRATION MORAL HAZARD MORTALITY MOTHERS NUTRITION NUTRITIONAL STATUS ORAL REHYDRATION THERAPY OUTPATIENT CARE PARENTS PATIENTS PHARMACISTS PHARMACY POLICY RESEARCH PRIMARY CARE PRIVATE SECTOR PROBABILITY PROGRAMS PUPILS SAVINGS SCHOOLS URBAN AREAS USE VALUE VACCINATIONS WORKERS WORKPLACE Wagstaff, Adam Pradhan, Menno Health Insurance Impacts on Health and Nonmedical Consumption in a Developing Country |
| geographic_facet |
East Asia and Pacific Vietnam |
| relation |
Policy Research Working Paper; No. 3563 |
| description |
The authors examine the effects of the introduction of Vietnam's health insurance (VHI) program on health outcomes, health care utilization, and non-medical household consumption. The use of panel data collected before and after the insurance program's introduction allows them to eliminate any confounding effects due to selection on time-invariant un-observables, and their coupling of propensity score matching with a double-difference estimator allows them to reduce the risk of biases due to inappropriate specification of the outcome regression model. The authors' results suggest that Vietnam's health insurance program impacted favorably on height-for-age and weight-for-age of young school children, and on body mass index among adults. Their results suggest that among young children, VHI increases use of primary care facilities and leads to a substitution away from the use of pharmacists as a source of advice and non-prescribed medicines toward the use of them as a supplier of medicines prescribed by a health professional. Among older children and adults, VHI results in a marked increase in the use of hospital inpatient and outpatient departments. The results also suggest that VHI causes a reduction in annual out-of-pocket expenditures on health and an increase in non-medical household consumption, including food consumption, but mostly nonfood consumption. The authors' estimate of the VHI-induced reduction in out-of-pocket health spending is considerably smaller than their estimate of the VHI-induced increase in non-medical consumption, which is consistent with the idea that households hold back their consumption considerably if, through lack of health insurance, they are exposed to the risk of large out-of-pocket expenditures. This is especially plausible in a country where at the time (1993), a single visit to a public hospital cost on average the equivalent of 20 percent of a person's annual nonfood consumption. |
| format |
Publications & Research :: Policy Research Working Paper |
| author |
Wagstaff, Adam Pradhan, Menno |
| author_facet |
Wagstaff, Adam Pradhan, Menno |
| author_sort |
Wagstaff, Adam |
| title |
Health Insurance Impacts on Health and Nonmedical Consumption in a Developing Country |
| title_short |
Health Insurance Impacts on Health and Nonmedical Consumption in a Developing Country |
| title_full |
Health Insurance Impacts on Health and Nonmedical Consumption in a Developing Country |
| title_fullStr |
Health Insurance Impacts on Health and Nonmedical Consumption in a Developing Country |
| title_full_unstemmed |
Health Insurance Impacts on Health and Nonmedical Consumption in a Developing Country |
| title_sort |
health insurance impacts on health and nonmedical consumption in a developing country |
| publisher |
World Bank, Washington, DC |
| publishDate |
2012 |
| url |
http://documents.worldbank.org/curated/en/2005/04/5745333/health-insurance-impacts-health-nonmedical-consumption-developing-country-health-insurance-impacts-health-non-medical-consumption-developing-country http://hdl.handle.net/10986/8988 |
| _version_ |
1764407229158522880 |