Factors influencing enrolment in Vietnamese National Health Insurance: Evidence from six provinces in 2018.

ABSTRACT

OBJECTIVE: This study examines the reasons why Vietnamese do not avail or subscribe to Social Health Insurance (SHI). METHODS: This study collected data from the Project of Development and Strengthening the Management of Provider Payment Methods and Basic Health Service Package Reimbursed by Health Insurance Fund in Vietnam implemented by Japan International Cooperation Agency. In-depth interviews of nonsubscribers and logistic regression analysis were conducted to identify factors that influence enrolment in Vietnam's SHI. RESULTS: The results showed that financial burden, sound health condition, preference for prescriptions from pharmacies, and complicated enrolment procedures were factors that influenced subscription to SHI. Regression analysis displayed that respondents with high education and those who were aware of their rights and benefits and copayment responsibilities were more likely to subscribe to SHI. A negative correlation between household affluence and enrolment implies that the affluent was likely to subscribe to private health insurance over SHI. CONCLUSIONS: In-depth interviews revealed the need to address demand and supply factors and institutional procedures to improve programme enrolment. Disseminating information about SHI could also boost enrolment.