Analysis on demand- and supply-side responses during the expansion of health insurance coverage in Vietnam: Challenges and policy implications toward universal health coverage

This study examines how the demand and supply of healthcare services have responded to the expansion of health insurance coverage in Vietnam by using biyearly provincial panel data from 2006 to 2014. The results of our analysis indicate significant progress towards universal health coverage (UHC) in Vietnam, with the expansion of health insurance coverage being accompanied by increases in admissions and inpatient days. However, some concerns remain. Our findings show a positive response of supply capacity only in terms of doctors and nurses at higher-level hospitals (provincial hospitals), and none in other relevant aspects. Moreover, we find no positive response of the number of outpatient visits. Another concern is the issue of financial protection. The decline in out-of-pocket payments is not significant throughout our observation period, suggesting that lowering the cost of healthcare is not straightforward and that the expansion of health insurance coverage alone cannot achieve this. We believe that the Vietnamese experience has valuable implications for other emerging and developing countries, considering that the expansion of health insurance coverage is likely to increase utilization of healthcare services significantly and that the supply side needs to be prepared for the increase.