Household out-of-pocket payments for illness: Evidence from Vietnam

The study was performed by twelve monthly follow-up interviews of 621 randomly selected households. The households are part of the FilaBavi project sample – Health System Research Project. The heads of household were interviewed at monthly intervals from July 2001 to June 2002.For the population in the Bavi district, communicable illnesses predominate among the episodes of illness and are the reason for most household health care expenditure. This is the case for almost all groups within the study and for the study population as a whole. However, communicable illnesses are more dominant in the poor population compared to the rich population, and are more dominant in households that have very large, or catastrophic, health care expenditure, compared to those without such expenditures.The main findings indicate that catastrophic health care spending for a household is not usually the result of one single disastrous event, but rather a series of events and is related more to "every-day illnesses" in a developing country context than to more spectacular events such as injuries or heart illnesses.Ill health can have a significant economic impact on a household. Such an impact can trigger a spiral of asset depletion, indebtedness and reductions of essential consumption [1]. Health services may impose a regressive cost burden on households, especially in developing countries[2,3]. However, facing high user fees the poor may also restrict their utilisation of health services even to the extent that health expenses for the poor constitute a smaller share of income than for the rich[4]. The risk for very large (catastrophic) health expenditure has in some studies found to be larger for the rich The economic burden has two effects: first, the immediate loss of income due to absence from work; and second, large out-of-pocket expenses to cover the necessary medical care. Costly health care also deters people from using health services thereby generating prolonged or worsened hea