COPING WITH HEALTH CARE EXPENSES IN VIETNAM
With the 1980s “Doi Moi” economic reforms, Vietnam transitioned from state-funded health care to a privatized user fee system. Out-of-pocket payments became a major source of funding for treatments received at both public and private health facilities. We studied coping strategies used by residents of Dai Dong, a rural commune of Hanoi, for paying health care costs, assessing the effects of such costs on economic and health stability.
We found that coping strategies used by households decrease the health and economic stability of households already suffering from poverty and poor health. Our study demonstrates that high aggregate outpatient costs necessitate reform of primary care facilities, where insurance is inadequate in decreasing out-of-pocket payments. Decreased funding and increased costs in health care rendered the population vulnerable to the consequences of detrimental coping strategies, such as debt and food reduction. Findings from this study highlight the need for risk prevention and mitigation strategies and institutional strengthening. Future policy reforms should focus on addressing these funding issues among at-risk populations.