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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

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Objectives: To calculate the out of pocket payment for the case of appendectomy treatment at Sonla General Provincial Hospital in 2012 - 2013. Subjects and methods: All of 322 appendicitis patients who were treated at Sonla General Provincial Hospital from Jan 2012 to Dec 2013 were interviewed by using a structured questionnaire.

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 127 Journal of military pharmaco-medicine n08-2018 The table 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 The Sonla provincial ethnic committee The report N 53/BC-BDT on the situation of ethnic minorities and the implementation of policies for small ethnic minority groups 2018 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 128 Journal of military pharmaco-medicine n08-2018 103 Military Hospital Acute appendicitis rd Internet access, available on Sept 2018 2002 - 2010 Social Science & Medicine 2012, Vu Duy Kien, Hoang Van Minh, Kim Bao Ashar Muhammad, Azam Syed Socioeconomic determinants of household out-ofpocket payments on healthcare in Pakistan Int J Equity Health 2012, pp.11-51 Natascha Wagner, Stella Quimbo, Riti Shimkhada, John Peabody Does health insurance coverage or improved quality protect better against out-of-pocket payment? Experimental evidence from the Philippines Social Science & Medicine 2018, 204, pp.51-58 Giang, Amy Dao, Le Thanh Tuan and Nawi Ng Socioeconomic inequalities in catatrophic health expenditure and impoverishment associated with non-communicable disease in urban Hanoi, Vietnam International Journal for Equity in Health 2016, 5, 169 DOI 10.1186/s12939-016-0460-3 Hoang Van Minh, Nguyen Thi Kim Phuong, Privanka Saksena Chris D.James, Ke Xu Financial burden of household out-of pocket health expenditure in Viet Nam: Findings from the National living standard survey pp.1-6 WHO Out-of-pocket payments, user fees and catastrophic expenditure www.who.int/health_financing/topics/financialprotection/out pocket-payments 129 ... 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. .. Hoang Van Minh, Nguyen Thi Kim Phuong, Privanka Saksena Chris D.James, Ke Xu Financial burden of household out- of pocket health expenditure in Viet Nam: Findings from the National living standard... 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

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