Skip to main content
Top
Published in: International Journal for Equity in Health 1/2013

Open Access 01-12-2013 | Research

The impact of economic growth on health care utilization: a longitudinal study in rural Vietnam

Authors: Nguyen Thi Minh Thoa, Nguyen Xuan Thanh, Nguyen Thi Kim Chuc, Lars Lindholm

Published in: International Journal for Equity in Health | Issue 1/2013

Login to get access

Abstract

Introduction

In many developing countries, including Vietnam, out-of-pocket payment is the principal source of health financing. The economic growth is widening the gap between rich and poor people in many aspects, including health care utilization. While inequities in health between high- and low-income groups have been well investigated, this study aims to investigate how the health care utilization changes when the economic condition is changing at a household level.

Method

We analysed a panel data of 11,260 households in a rural district of Vietnam. Of the sample, 74.4% having an income increase between 2003 and 2007 were defined as households with economic growth. We used a double-differences propensity score matching technique to compare the changes in health care expenditure as percentage of total expenditure and health care utilization from 2003 to 2005, from 2003 to 2007, and from 2005 to 2007, between households with and without economic growth.

Results

Households with economic growth spent less percentage of their expenditure for health care, but used more provincial/central hospitals (higher quality health care services) than households without economic growth. The differences were statistically significant.

Conclusions

The results suggest that households with economic growth are better off also in terms of health services utilization. Efforts for reducing inequalities in health should therefore consider the inequality in income growth over time.
Literature
1.
go back to reference Daniel DR, Pascale A: Measuring global health inequity. Int J Equity Health. 2007, 6: 16-10.1186/1475-9276-6-16.CrossRef Daniel DR, Pascale A: Measuring global health inequity. Int J Equity Health. 2007, 6: 16-10.1186/1475-9276-6-16.CrossRef
2.
go back to reference Thuan NTB, Curt L, Chuc NTK, Urban J, Lars L: Household out-of-pocket payments for illness: Evidence from Vietnam. BMC Publ Health. 2006, 6: 283-10.1186/1471-2458-6-283.CrossRef Thuan NTB, Curt L, Chuc NTK, Urban J, Lars L: Household out-of-pocket payments for illness: Evidence from Vietnam. BMC Publ Health. 2006, 6: 283-10.1186/1471-2458-6-283.CrossRef
3.
go back to reference Dao HT, Waters H, Le QV: User fees and health service utilization in Vietnam: How to protect the poor?. BMC Publ Health. 2008, 122: 1068-1078. 10.1016/j.puhe.2008.01.002.CrossRef Dao HT, Waters H, Le QV: User fees and health service utilization in Vietnam: How to protect the poor?. BMC Publ Health. 2008, 122: 1068-1078. 10.1016/j.puhe.2008.01.002.CrossRef
4.
go back to reference Mylene L, Natasha P: The impact of user fees on health service utilization in low- and middle-income countries: how strong is the evidence?. Bull World Health Organ. 2008, 86: 839-848. 10.2471/BLT.07.049197.CrossRef Mylene L, Natasha P: The impact of user fees on health service utilization in low- and middle-income countries: how strong is the evidence?. Bull World Health Organ. 2008, 86: 839-848. 10.2471/BLT.07.049197.CrossRef
6.
go back to reference Henrik A: Health financing for the poor produces promising short-term effects on utilization and out-of-pocket expenditure: evidence from Vietnam. Int J Equity Health. 2009, 8: 20-10.1186/1475-9276-8-20.CrossRef Henrik A: Health financing for the poor produces promising short-term effects on utilization and out-of-pocket expenditure: evidence from Vietnam. Int J Equity Health. 2009, 8: 20-10.1186/1475-9276-8-20.CrossRef
8.
go back to reference Wagstaff A: The economic consequences of health shocks: evidence from Vietnam. J Health Economics. 2007, 26: 82-100. 10.1016/j.jhealeco.2006.07.001.CrossRef Wagstaff A: The economic consequences of health shocks: evidence from Vietnam. J Health Economics. 2007, 26: 82-100. 10.1016/j.jhealeco.2006.07.001.CrossRef
9.
go back to reference Gwatkin DR, Rutstein S, Johnson K, Suliman EA, Wagstaff A, Amouzou A: Socio-economic differences in health, nutrition, and population within developing countries – an overview. 2007, Washington DC: World Bank Gwatkin DR, Rutstein S, Johnson K, Suliman EA, Wagstaff A, Amouzou A: Socio-economic differences in health, nutrition, and population within developing countries – an overview. 2007, Washington DC: World Bank
10.
go back to reference MOH: Health statistic yearbook 2008. 2010, Vietnam: Ministry of Health (MOH) MOH: Health statistic yearbook 2008. 2010, Vietnam: Ministry of Health (MOH)
11.
go back to reference Segall M, Tipping G, Lucas H, Dung TV, Tam NT, Vinh DX, Huong DL: Economic transition should come with a health warning: the case of Vietnam. J Epidemiology Community Health. 2002, 56: 497-505. 10.1136/jech.56.7.497.CrossRef Segall M, Tipping G, Lucas H, Dung TV, Tam NT, Vinh DX, Huong DL: Economic transition should come with a health warning: the case of Vietnam. J Epidemiology Community Health. 2002, 56: 497-505. 10.1136/jech.56.7.497.CrossRef
12.
go back to reference Hoi LV, Phuc HD, Dung TV, Chuc NTK, Lars L: Remaining life expectancy among older people in a rural area of Vietnam: trends and socioeconomic inequalities during a period of multiple transitions. BMC Publ Health. 2009, 9: 471-10.1186/1471-2458-9-471.CrossRef Hoi LV, Phuc HD, Dung TV, Chuc NTK, Lars L: Remaining life expectancy among older people in a rural area of Vietnam: trends and socioeconomic inequalities during a period of multiple transitions. BMC Publ Health. 2009, 9: 471-10.1186/1471-2458-9-471.CrossRef
13.
go back to reference Adams P, Hurd MD, McFadden D, Merrill A, Ribeiro T: Healthy, wealthy, and wise? Tests for direct causal paths between health and socioeconomic status. J Econ. 2003, 112: 3-CrossRef Adams P, Hurd MD, McFadden D, Merrill A, Ribeiro T: Healthy, wealthy, and wise? Tests for direct causal paths between health and socioeconomic status. J Econ. 2003, 112: 3-CrossRef
14.
go back to reference Ardeshir S, Saeed M, Wayne S, Sisira S: Taking account of context: how important are household characteristics in explaining adult health-seeking behavior? The case of Vietnam. Health Policy Plan. 2008, 23: 397-407. 10.1093/heapol/czn034.CrossRef Ardeshir S, Saeed M, Wayne S, Sisira S: Taking account of context: how important are household characteristics in explaining adult health-seeking behavior? The case of Vietnam. Health Policy Plan. 2008, 23: 397-407. 10.1093/heapol/czn034.CrossRef
15.
go back to reference Chuc NTK, Vinod KD: FilaBavi, a demographic surveillance site, an epidemiological field laboratory in Vietnam. Scand J Public Health. 2003, 31: Chuc NTK, Vinod KD: FilaBavi, a demographic surveillance site, an epidemiological field laboratory in Vietnam. Scand J Public Health. 2003, 31:
16.
go back to reference HBB: Hanoi Health Annual Report 2009. 2010, Hanoi: Hanoi Health Bureau (HBB) HBB: Hanoi Health Annual Report 2009. 2010, Hanoi: Hanoi Health Bureau (HBB)
17.
go back to reference Hoa NQ, Ohman A, Stalsby LC, Chuc NTK: Drug use and health-seeking behavior for childhood illness in Vietnam- A qualitative study. Health Policy. 2007, 82 (3): 320-329. 10.1016/j.healthpol.2006.10.005.CrossRefPubMed Hoa NQ, Ohman A, Stalsby LC, Chuc NTK: Drug use and health-seeking behavior for childhood illness in Vietnam- A qualitative study. Health Policy. 2007, 82 (3): 320-329. 10.1016/j.healthpol.2006.10.005.CrossRefPubMed
18.
go back to reference Thuan NTB, Curt L, Lars L, Chuc NTK: Choice of healthcare provider following reform in Vietnam. BMC Health Serv Res. 2008, 8: 162-10.1186/1472-6963-8-162.PubMedCentralCrossRefPubMed Thuan NTB, Curt L, Lars L, Chuc NTK: Choice of healthcare provider following reform in Vietnam. BMC Health Serv Res. 2008, 8: 162-10.1186/1472-6963-8-162.PubMedCentralCrossRefPubMed
19.
go back to reference Rosenbaum PR, Rubin DB: The Central Role of the Propensity Score in Observational Studies for Casual Effects. Biometrical. 1983, 70 (1): 41-55. 10.1093/biomet/70.1.41.CrossRef Rosenbaum PR, Rubin DB: The Central Role of the Propensity Score in Observational Studies for Casual Effects. Biometrical. 1983, 70 (1): 41-55. 10.1093/biomet/70.1.41.CrossRef
20.
go back to reference Becker SO, Ichino A: Estimation of average treatment effects based on propensity scores. Stata J. 2002, 2: 358-377. Becker SO, Ichino A: Estimation of average treatment effects based on propensity scores. Stata J. 2002, 2: 358-377.
21.
go back to reference Dehejia RH, Wahba S: Propensity Score Matching Methods for non-experimental causal studies. Rev Econ Stat. 2002, 84 (1): 151-161. 10.1162/003465302317331982.CrossRef Dehejia RH, Wahba S: Propensity Score Matching Methods for non-experimental causal studies. Rev Econ Stat. 2002, 84 (1): 151-161. 10.1162/003465302317331982.CrossRef
22.
go back to reference Jingji Y: Income-Related Inequalities of Health and Health Care Utilization. Econ Res J. 2009, 2: 92-105. Jingji Y: Income-Related Inequalities of Health and Health Care Utilization. Econ Res J. 2009, 2: 92-105.
23.
go back to reference Thanh NX, Curt L, Phuc HD, Chuc NTK, Lars L: An assessment of the implementation of the Health Care Funds for the Poor policy in rural Vietnam. Health Policy. 2010, 98: 58-64. 10.1016/j.healthpol.2010.05.005.CrossRefPubMed Thanh NX, Curt L, Phuc HD, Chuc NTK, Lars L: An assessment of the implementation of the Health Care Funds for the Poor policy in rural Vietnam. Health Policy. 2010, 98: 58-64. 10.1016/j.healthpol.2010.05.005.CrossRefPubMed
Metadata
Title
The impact of economic growth on health care utilization: a longitudinal study in rural Vietnam
Authors
Nguyen Thi Minh Thoa
Nguyen Xuan Thanh
Nguyen Thi Kim Chuc
Lars Lindholm
Publication date
01-12-2013
Publisher
BioMed Central
Published in
International Journal for Equity in Health / Issue 1/2013
Electronic ISSN: 1475-9276
DOI
https://doi.org/10.1186/1475-9276-12-19

Other articles of this Issue 1/2013

International Journal for Equity in Health 1/2013 Go to the issue