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People’s preferences for health care financing options: a choice experiment in rural Vietnam
Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin.
Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och global hälsa.
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(Engelska)Manuskript (preprint) (Övrigt vetenskapligt)
Nationell ämneskategori
Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi
Identifikatorer
URN: urn:nbn:se:umu:diva-4802OAI: oai:DiVA.org:umu-4802DiVA, id: diva2:144044
Tillgänglig från: 2005-11-16 Skapad: 2005-11-16 Senast uppdaterad: 2018-06-09Bibliografiskt granskad
Ingår i avhandling
1. The injury poverty trap in rural Vietnam: causes, consequences and possible solutions
Öppna denna publikation i ny flik eller fönster >>The injury poverty trap in rural Vietnam: causes, consequences and possible solutions
2005 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
Abstract [en]

The focus of this study is the vicious circle of poverty and ill-health. The case is injuries but it could have been any lasting and severe disease. Poverty and health have very close links to economic development and to how health care is financed. Out-of-pocket payment seems to increase the risk of poverty while prepaid health care reduces it. The overall objective is to investigate the “injury poverty trap” and suggest possible solutions for it. A cohort of 23,807 people living in 5,801 households in Bavi district of Vietnam was followed from 1999 to 2003 to investigate income losses caused by non-fatal unintentional injuries in 2000 as well as the relationships between social position in 1999 and those injuries. For the possible solutions, a survey in 2064 household was performed to elicit people’s preferences and willingness to pay for different health care financing options. The results showed that unintentional injuries imposed a large economic burden on society, especially on the victims. By two pathways – treatment costs and income losses – unintentional injury increased the risk of being poor. The losses for non-poor and poor injured households were about 15 and 11 months of income of an average person in the non-poor and poor group, respectively. Furthermore, poverty was shown to be a probable cause of non-fatal unintentional injuries. Specifically, poverty led to home injuries among children and the elderly, and adults 15 – 49 years of age were particularly at risk in the workplace. The middle-income group was at greatest risk for traffic injuries, probably due to the unsafe use of bicycles or motorbikes. About half of the population preferred to keep an out-of-pocket system and the other half preferred health insurance. People’s willingness to pay suggested that a community-based health insurance scheme would be feasible. However, improvements in the existing health insurance systems are imperative to attract people to participate in these or any alternative health insurance schemes, since the limitations of the existing systems were generalized to health insurance as a whole. A successful solution should follow two tracks: prepayment of health care and some insurance based compensation of income losses during the illness period. If the risk of catastrophic illness is more evenly spread across the society, it would increase the general welfare even if no more resources are provided.

Ort, förlag, år, upplaga, sidor
Umeå: Folkhälsa och klinisk medicin, 2005. s. 182
Serie
Umeå University medical dissertations, ISSN 0346-6612 ; 990
Nyckelord
unintentional injury, poverty, out-of-pocket payment, health insurance, Vietnam
Nationell ämneskategori
Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi
Identifikatorer
urn:nbn:se:umu:diva-627 (URN)91-7305-958-7 (ISBN)
Disputation
2005-12-09, 09:00 (Engelska)
Handledare
Tillgänglig från: 2005-11-16 Skapad: 2005-11-16 Senast uppdaterad: 2010-01-29Bibliografiskt granskad

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Löfgren, CurtLindholm, Lars

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Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi

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