Coverage of health insurance among the near-poor in rural Vietnam and associated factors

• DOI: 10.1007/s00038-016-0911-z
• Publication Date: 2016-10-28T01:26:39Z
• Authors: Thanh Duc Nguyen; Andrew Wilson
• Keywords: Adult; Male; Rural Population; Health Knowledge, Attitudes, Practice; Insurance, Health; Health Status; 1. No poverty; Middle Aged; Insurance Coverage; 3. Good health; 03 medical and health sciences; Cross-Sectional Studies; Logistic Models; 0302 clinical medicine; Social Class; Vietnam; Surveys and Questionnaires; Humans; Female; Aged

The Vietnamese government is committed to universal health care largely through social health insurance. The near-poor population is entitled to subsidized but not free insurance under this scheme, but remains under-represented compared to other groups. The aims of this research were to estimate the health insurance coverage of the near-poor in rural Vietnam and identify the individual and household factors associated with health insurance status.Rates of health insurance coverage were estimated from district-level administrative data. A cross-sectional survey was conducted in a representative sample of 2000 near-poor in Cao Lanh district, Dong Thap province, Vietnam. Face-to-face interviews were conducted with a standardized questionnaire. Multiple logistic regression was applied to identify the factors associated with insurance status.The insurance coverage of the near-poor in the selected communities was 20.3%. Enrollment in the health insurance scheme was significantly associated with poor health status (OR = 4.8, 95% CI = 2.4-9.8), good knowledge of health insurance (OR = 4.6, 95% CI = 3.4-6.2), interest in health insurance (OR = 30.1, 95% CI = 11.6-78.0), and the perceived cost of the insurance premium (OR = 2.4, 95% CI = 1.7-3.6).The cost of insurance premiums is a barrier to enrollment. Information, education and communication campaigns together with modified insurance scheme for the near-poor are necessary to enhance insurance coverage in Vietnam.