The policy of free healthcare for children under the age of 6 years in Vietnam: assessment of the uptake for children hospitalised with acute diarrhoea in Ho Chi Minh City. Shieh, M., Thompson, C., Phan, V. T. M., Van, T. T. L., Tediosi, F., Merson, L., Farrar, J. J., Ha, M. T., Ho, L. V., Pham, T. N. T., & Baker, S. Tropical medicine & international health : TM & IH, 18(12):1444–1451, December, 2013.
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OBJECTIVE: To assess the proportion of, and reasons for, households not utilising the policy of free healthcare for children under 6 years of age (FCCU6) for hospitalisation with diarrhoea, and assess the risk of catastrophic expenditure for households that forgo FCCU6 and pay out of pocket. METHODS: Invoices detailing insurance information and charges incurred from 472 hospitalised diarrhoeal cases in one paediatric hospital in Ho Chi Minh City were retrieved. Hospital charges and the utilisation of elective services were analysed for patients utilising and not utilising FCCU6. Associations between socio-economic factors with non-utilisation of FCCU6 were evaluated. RESULTS: Overall, 29% of patients were FCCU6 non-users. The FCCU6 non-users paid a median hospital charge of $29.13 (interquartile range, IQR: $18.57-46.24), consuming no more than 1.4% of a medium-income household's annual income. Seventy per cent of low-income FCCU6 non-users utilised less-expensive elective services, whereas only 43% of medium income patients and 21% of high-income patients did (P = 0.036). Patients from larger households and those with a parent working in government were more likely to use FCCU6. CONCLUSIONS: The rate of FCCU6 non-usage in this study population was 29%. A significant proportion of those that did not use FCCU6 was from lower income households and may perceive a justifiable cost-benefit ratio when forgoing FCCU6. Although a single diarrhoeal hospitalisation is unlikely to induce a catastrophic expenditure, FCCU6 non-usage may disproportionately increase the risk of catastrophic expenditure for lower income households over multiple illnesses.
@article{shieh_policy_2013,
	title = {The policy of free healthcare for children under the age of 6 years in {Vietnam}: assessment of the uptake for children hospitalised with acute diarrhoea in {Ho} {Chi} {Minh} {City}.},
	volume = {18},
	copyright = {(c) 2013 John Wiley \& Sons Ltd.},
	issn = {1365-3156 1360-2276},
	doi = {10.1111/tmi.12208},
	abstract = {OBJECTIVE: To assess the proportion of, and reasons for, households not utilising the policy of free healthcare for children under 6 years of age (FCCU6) for hospitalisation with diarrhoea, and assess the risk of catastrophic expenditure for households that forgo FCCU6 and pay out of pocket. METHODS: Invoices detailing insurance information and charges incurred from 472 hospitalised diarrhoeal cases in one paediatric hospital in Ho Chi Minh City were retrieved. Hospital charges and the utilisation of elective services were analysed for patients utilising and not utilising FCCU6. Associations between socio-economic factors with non-utilisation of FCCU6 were evaluated. RESULTS: Overall, 29\% of patients were FCCU6 non-users. The FCCU6 non-users paid a median hospital charge  of \$29.13 (interquartile range, IQR: \$18.57-46.24), consuming no more than 1.4\% of a medium-income household's annual income. Seventy per cent of low-income FCCU6 non-users utilised less-expensive elective services, whereas only 43\% of medium income patients and 21\% of high-income patients did (P = 0.036). Patients  from larger households and those with a parent working in government were more likely to use FCCU6. CONCLUSIONS: The rate of FCCU6 non-usage in this study population was 29\%. A significant proportion of those that did not use FCCU6 was  from lower income households and may perceive a justifiable cost-benefit ratio when forgoing FCCU6. Although a single diarrhoeal hospitalisation is unlikely to  induce a catastrophic expenditure, FCCU6 non-usage may disproportionately increase the risk of catastrophic expenditure for lower income households over multiple illnesses.},
	language = {eng},
	number = {12},
	journal = {Tropical medicine \& international health : TM \& IH},
	author = {Shieh, Mae and Thompson, Corinne and Phan, Vu Tra My and Van, Thi Thuy Linh and Tediosi, Fabrizio and Merson, Laura and Farrar, Jeremy J. and Ha, Manh Tuan and Ho, Lu Viet and Pham, Thi Ngoc Tuyet and Baker, Stephen},
	month = dec,
	year = {2013},
	pmid = {24134427},
	pmcid = {PMC3992841},
	keywords = {Age Factors, Child, Preschool, Diarrhea/economics/*epidemiology/therapy, Female, Financing, Personal/statistics \& numerical data, Health Care Costs/statistics \& numerical data, Health Policy, Hospitalization/*statistics \& numerical data, Hospitals, Pediatric/statistics \& numerical data, Humans, Income/statistics \& numerical data, Infant, Male, Tertiary Care Centers/economics/utilization, Universal Coverage/organization \& administration/statistics \& numerical data/*utilization, Vietnam, Vietnam/epidemiology, acute diarrhoea, child health, health insurance utilisation, hospital charges, out-of-pocket expenditures, social health insurance},
	pages = {1444--1451},
}
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