Catastrophic health expenditure of Vietnamese patients with gallstone diseases - a case for health insurance policy revaluation

Bach Xuan Tran, Tho Dinh Tran, Nila Nathan, Chau Quy Ngo, Loi Thi Nguyen, Long Hoang Nguyen, Huong Lan Thi Nguyen, Cuong Tat Nguyen, Huyen Phuc Do, Trang Huyen Thi Nguyen, Tung Thanh Tran, Thao Phuong Thi Thai, Anh Kim Dang, Nam Ba Nguyen, Carl A Latkin, Cyrus S.H. Ho, Roger C.M. Ho

Research output: Contribution to journalArticle

Abstract

Purpose: Despite gallstone diseases (GSDs) being a major public health concern with both acute and chronic episodes, none of the studies in Vietnam has been conducted to investigate the household expenditure for the GSD treatment. The objective of this study was to estimate the costs of managing GSD and to explore the prevalence and determinants of catastrophic health expenditure (CHE) among Vietnamese patients. Materials and methods: A cross-sectional study was conducted from June 2016 to March 2017 in the Department of Hepatobiliary and Pancreatic Surgery, Viet Duc Hospital in Hanoi, Vietnam. A total of 206 patients were enrolled. Demographic and socioeconomic data, household income, and direct and indirect medical costs of patients seeking treatment for GSD were collected through face-to-face interview. Multivariate logistic regression was used to explore factors associated with CHE. Results: The prevalence of CHE in patients suffering from GSD was 35%. The percentage of patients who were covered by health insurance and at risk for CHE was 41.2%, significantly higher than that of those noninsured (15.8%). Proportions of patients with and without health insurance who sought outpatient treatment were 30.6% and 81.6%, respectively. Patients who were divorced or widowed and had intrahepatic gallstones were significantly more likely to experience CHE. Those who were outpatients, were women, had history of pharmacological treatment to parasitic infection, and belong to middle and highest monthly household income quantile were significantly less likely to experience CHE. Conclusion: The findings suggested that efforts to re-evaluate health insurance reimbursement capacity, especially for acute diseases and taking into account the varying preferences of people with different disease severity, should be conducted by health authority. Further studies concerning CHE of GSD in the context of ongoing health policy reform should consider utilizing WHO-recommended measures like the fairness in financial contribution index, as well as taking into consideration the behavioral aspects of health care spending.

Original languageEnglish (US)
Pages (from-to)151-158
Number of pages8
JournalClinicoEconomics and Outcomes Research
Volume11
DOIs
StatePublished - Jan 1 2019

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Gallstones
Health Insurance
Health Expenditures
Health Policy
Vietnam
Outpatients
Health Insurance Reimbursement
Costs and Cost Analysis
Widowhood
Gift Giving
Parasitic Diseases
Divorce
Health expenditures
Health insurance
Acute Disease
Therapeutics
Public Health
Cross-Sectional Studies
Logistic Models
Demography

Keywords

  • Catastrophic health expenditure
  • Gallstone
  • Health insurance
  • Out-of-pocket payments
  • Vietnam

ASJC Scopus subject areas

  • Economics, Econometrics and Finance (miscellaneous)
  • Health Policy

Cite this

Catastrophic health expenditure of Vietnamese patients with gallstone diseases - a case for health insurance policy revaluation. / Tran, Bach Xuan; Tran, Tho Dinh; Nathan, Nila; Ngo, Chau Quy; Nguyen, Loi Thi; Nguyen, Long Hoang; Nguyen, Huong Lan Thi; Nguyen, Cuong Tat; Do, Huyen Phuc; Nguyen, Trang Huyen Thi; Tran, Tung Thanh; Thai, Thao Phuong Thi; Dang, Anh Kim; Nguyen, Nam Ba; Latkin, Carl A; Ho, Cyrus S.H.; Ho, Roger C.M.

In: ClinicoEconomics and Outcomes Research, Vol. 11, 01.01.2019, p. 151-158.

Research output: Contribution to journalArticle

Tran, BX, Tran, TD, Nathan, N, Ngo, CQ, Nguyen, LT, Nguyen, LH, Nguyen, HLT, Nguyen, CT, Do, HP, Nguyen, THT, Tran, TT, Thai, TPT, Dang, AK, Nguyen, NB, Latkin, CA, Ho, CSH & Ho, RCM 2019, 'Catastrophic health expenditure of Vietnamese patients with gallstone diseases - a case for health insurance policy revaluation', ClinicoEconomics and Outcomes Research, vol. 11, pp. 151-158. https://doi.org/10.2147/CEOR.S191379
Tran, Bach Xuan ; Tran, Tho Dinh ; Nathan, Nila ; Ngo, Chau Quy ; Nguyen, Loi Thi ; Nguyen, Long Hoang ; Nguyen, Huong Lan Thi ; Nguyen, Cuong Tat ; Do, Huyen Phuc ; Nguyen, Trang Huyen Thi ; Tran, Tung Thanh ; Thai, Thao Phuong Thi ; Dang, Anh Kim ; Nguyen, Nam Ba ; Latkin, Carl A ; Ho, Cyrus S.H. ; Ho, Roger C.M. / Catastrophic health expenditure of Vietnamese patients with gallstone diseases - a case for health insurance policy revaluation. In: ClinicoEconomics and Outcomes Research. 2019 ; Vol. 11. pp. 151-158.
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AU - Tran, Bach Xuan

AU - Tran, Tho Dinh

AU - Nathan, Nila

AU - Ngo, Chau Quy

AU - Nguyen, Loi Thi

AU - Nguyen, Long Hoang

AU - Nguyen, Huong Lan Thi

AU - Nguyen, Cuong Tat

AU - Do, Huyen Phuc

AU - Nguyen, Trang Huyen Thi

AU - Tran, Tung Thanh

AU - Thai, Thao Phuong Thi

AU - Dang, Anh Kim

AU - Nguyen, Nam Ba

AU - Latkin, Carl A

AU - Ho, Cyrus S.H.

AU - Ho, Roger C.M.

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N2 - Purpose: Despite gallstone diseases (GSDs) being a major public health concern with both acute and chronic episodes, none of the studies in Vietnam has been conducted to investigate the household expenditure for the GSD treatment. The objective of this study was to estimate the costs of managing GSD and to explore the prevalence and determinants of catastrophic health expenditure (CHE) among Vietnamese patients. Materials and methods: A cross-sectional study was conducted from June 2016 to March 2017 in the Department of Hepatobiliary and Pancreatic Surgery, Viet Duc Hospital in Hanoi, Vietnam. A total of 206 patients were enrolled. Demographic and socioeconomic data, household income, and direct and indirect medical costs of patients seeking treatment for GSD were collected through face-to-face interview. Multivariate logistic regression was used to explore factors associated with CHE. Results: The prevalence of CHE in patients suffering from GSD was 35%. The percentage of patients who were covered by health insurance and at risk for CHE was 41.2%, significantly higher than that of those noninsured (15.8%). Proportions of patients with and without health insurance who sought outpatient treatment were 30.6% and 81.6%, respectively. Patients who were divorced or widowed and had intrahepatic gallstones were significantly more likely to experience CHE. Those who were outpatients, were women, had history of pharmacological treatment to parasitic infection, and belong to middle and highest monthly household income quantile were significantly less likely to experience CHE. Conclusion: The findings suggested that efforts to re-evaluate health insurance reimbursement capacity, especially for acute diseases and taking into account the varying preferences of people with different disease severity, should be conducted by health authority. Further studies concerning CHE of GSD in the context of ongoing health policy reform should consider utilizing WHO-recommended measures like the fairness in financial contribution index, as well as taking into consideration the behavioral aspects of health care spending.

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