Seminars & Events

APL (Ajiken Power Lunch) is a lunchtime workshop open to public, including IDE staffs, visiting research fellows, IDEAS students, outside researchers and graduate students. This workshop provides a platform for presentation of any work in progress where we can discuss in either English or Japanese.

Please have a contact with APL organizers by email in advance (contact information is shown in the bottom of this page), if you would like to present your work or attend a seminar.

August 31, 2012, (Friday) 13:00-14:30

Institute of Developing Economies, Japan External Trade Organization C22 Meeting Room　

Determinants and Impacts of Health Insurance Nonutilization


Abstract:　Many developing countries have tried to expand the coverage of health insurance to the poor and disadvantaged group in recent years by subsidizing the insurance premium for these group or by inducing private companies to provide “micro health insurance.” Some countries even set their goal as the universal coverage of health insurance. However, insurance will be of no use if it is not utilized, though the literature has paid little attention on the insurance utilization behavior. In this paper, we use the original data collected in Thai Nguyen Province in Vietnam, and show that the insurance utilization rate is generally high, but significantly and substantially lower at the central hospital, with taking into account the sample selection problem and the endogeneity of the healthcare facility choice. The result also suggests that the time cost, proxied by the household income per capita, affects the insurance utilization choice. Given the fact that the central hospital is the most crowded healthcare facility in the surveyed area, the discriminate treatments against the insurees such as longer waiting time considerably discourages the utilization of the health insurance. The results also suggest that the low prospect of using insurance at the central hospital discourage people from visiting the central hospital. The average effect of noninsurance utilization on the healthcare expenses per visit is around 1.5 times more larger than the average healthcare expenses per visit of our sample. It is suggested that streamlining the administrative procedures of insurance utilization to reduce the central hospital's incentive for discriminate treatment for the insurees and the regulation for ensuring the quality of health care for the insurees are required, especially at the crowded public healthcare facilities.

KONO Hisaki (Development Studies Center)

English