Out of pocket payment for health care in Vietnam: An example from the case of appendectomy treatment at sonla general provincial hospital in 2012-2013

Mean (25 - 75%)

%

Median (25 - 75%)

%

Antibiotics

0.714 ± 0.977

53.9

0.363 ± 0.417

64.4

< 0.05

Painkiller

0.162 ± 0.161

12.2

0.097 ± 0.121

17.2

< 0.05

Infusion

0.318 ± 0.844

24.0

0.080 ± 0.113

14.2

< 0.05

Other medicines

0.131 ± 0.571

9.9

0.024 ± 0.097

4.2

< 0.05

Total

1.324 ± 1.979

100

0.564 ± 0.636

100

< 0.05

The biggest parts of OOP medicines were for antibiotics and painkillers. It’s
reasonable because the operated patients are suffering from the pain and have high
risk with infection.
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Journal of military pharmaco-medicine n08-2018
The table 4 showed that the higher
income patients had the less paid by HI.
The patients who paid all by themself had
daily income almost three time higher
than that of patients who were totally
covered by HI. It’s not be sure to say that
the better income group had no HI.
Appendectomy treatment can be done at
district hospitals and the HI will pay for
insured patients but for some cases the
insured want to take health service at
higher level and they are able and happy
to pay.

The study had some limitation, such as:

- Recall bias could be existed in the
case of the interviewing was conducted
long time after the hospitalization.
- It did not include the household
income and economical quintile groups,
therefore we cannot calculate the
economical burden of the household in
general and for each quintile group.
- It just look at OOP for one acute
condition (one episode) at individual level
but not for the whole family for longer time
period (usually one year).

Table 4: OOP payment in comparison with studied patients’ income.
Unit: thousand VND
Subject

OOP

Average daily Income

Ratio

Totally covered by HI (n = 10)

650,0

36.0

18.1

Partly covered by HI (n = 265)

1,959.5

94.4

20.8

Totally covered by OOP (n = 57)

4,478.0

107.7

41.6

All patients

2,270.7

94.9

23.9

Averagely, the patients had to pay 23.9 daily income for appendectomy treatment at
the province hospital. The figure for patients with totally covered by HI, partly covered
by HI and totally covered by themselves was 18.1; 20.8 and 41.6 daily income,
respectively. The more covered by HI the less daily income was.
CONCLUSION

REFERENCES

The average OOP for appendectomy
treatment at Sonla General Provincial
Hospital in 2012 and 2013 for all patients
was 2,228 million VND and accounted
for 43.8% of total direct cost. The
corresponding figure for patients with HI
was 34.4%. The better HI coverage will
reduce the OOP.

1. The Sonla provincial ethnic committee.
0
The report N 53/BC-BDT on the situation of
ethnic minorities and the implementation of
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2. The Ministry of Labour, Invalids and
Social Affairs. Decision 749/QĐ-LDTBXH
rd
dated 13 May 2013 approving the results of
the survey on poor households. 2013.

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Journal of military pharmaco-medicine n08-2018
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