<p>Catastrophic health expenditure of Vietnamese patients with gallstone diseases &ndash; a case for health insurance policy revaluation</p>

Abstract

PurposeDespite gallstone diseases (GSDs) being a major public health concern with both acute and chronic episodes, none of the studies in Vietnam has been conducted to investigate the household expenditure for the GSD treatment. The objective of this study was to estimate the costs of managing GSD and to explore the prevalence and determinants of catastrophic health expenditure (CHE) among Vietnamese patients.Materials and methodsA cross-sectional study was conducted from June 2016 to March 2017 in the Department of Hepatobiliary and Pancreatic Surgery, Viet Duc Hospital in Hanoi, Vietnam. A total of 206 patients were enrolled. Demographic and socioeconomic data, household income, and direct and indirect medical costs of patients seeking treatment for GSD were collected through face-to-face interview. Multivariate logistic regression was used to explore factors associated with CHE.ResultsThe prevalence of CHE in patients suffering from GSD was 35%. The percentage of patients who were covered by health insurance and at risk for CHE was 41.2%, significantly higher than that of those noninsured (15.8%). Proportions of patients with and without health insurance who sought outpatient treatment were 30.6% and 81.6%, respectively. Patients who were divorced or widowed and had intrahepatic gallstones were significantly more likely to experience CHE. Those who were outpatients, were women, had history of pharmacological treatment to parasitic infection, and belong to middle and highest monthly household income quantile were significantly less likely to experience CHE.ConclusionThe findings suggested that efforts to re-evaluate health insurance reimbursement capacity, especially for acute diseases and taking into account the varying preferences of people with different disease severity, should be conducted by health authority. Further studies concerning CHE of GSD in the context of ongoing health policy reform should consider utilizing WHO-recommended measures like the fairness in financial contribution index, as well as taking into consideration the behavioral aspects of health care spending.

Determinants of catastrophic health expenditure in Vietnam

“…This study shows that severe illness or injury is also a determinant of risk of CHE. This result is consistent with other studies 2,28,45,49,50 . Because of a severe illness, people need more healthcare, leading to an increased probability of incurring CHE.…”

“…This result is consistent with other studies. 2,28,45,49,50 Because of a severe illness, people need more healthcare, leading to an increased probability of incurring CHE.…”

Complex impacts of gallstone disease on metabolic syndrome and nonalcoholic fatty liver disease

“…Its incidence is also high in the worldwide population with a prevalence of 5-25% in Westerners ( 5 ) and 3-15% in Asians ( 6 ). In spite of lower mortality, much payment should be listed from medical insurance for hospitalization and treatment for GSD patients ( 7 ). Cholecystectomy is the most common surgical procedure for the treatment of cholelithiasis and its complications in the world, where laparoscopic surgery was used in about 90% of cases ( 5 ).…”

Good budget or good care: The dilemma of social health insurance in Vietnam

“…When many governments worldwide are trying to achieve universal healthcare coverage, the factors affecting patients’ financial status and their satisfaction with the health insurance should be of great concern. Research into health insurance in Vietnam has assessed the catastrophic health expenditure or OOP payment, 7 , 8 the impact of insurance to reduce financial burden, 9 and household vulnerability to healthcare cost. 10 , 11 Research also assessed the financial protection of health insurance regarding the level of healthcare providers 12 and the financial burden associated with residence.…”