effect of health expenses on household capabilities and resource allocation in a rural commune in vietnam医疗费用对家庭功能的影响和资源分配在农村公社在越南.pdfVIP

Effect of Health Expenses on Household Capabilities and Resource Allocation in a Rural Commune in Vietnam 1 2 1,3 2 2 Kim Thuy Nguyen , Oanh Thi Hai Khuat , Shuangge Ma , Duc Cuong Pham , Giang Thi Hong Khuat , Jennifer Prah Ruger1* 1 Yale University School of Medicine, New Haven, Connecticut, United States of America, 2 Institute for Social Development Studies, Hanoi, Vietnam, 3 Biostatistics, Yale University School of Public Health, New Haven, Connecticut, United States of America Abstract Background: Significant health expenses can force households to reduce consumption of items required for daily living and long-term well-being, depriving them of the capability to lead economically stable and healthy lives. Previous studies of out- of-pocket (OOP) and other health expenses have typically characterized them as ‘‘catastrophic’’ in terms of a threshold level or percentage of household income. We aim to re-conceptualize the impact of health expenses on household ‘‘flourishing’’ in terms of ‘‘basic capabilities.’’ Methods and Findings: We conducted a 2008 survey covering 697 households, on consumption patterns and health treatments for the previous 12 months. We compare consumption patterns between households with and without inpatient treatment, and between households with different levels of outpatient treatment, for the entire study sample as well as among different income quartiles. We find that compared to households without inpatient treatment and with lower levels of outpatient treatment, households with inpatient treatment and higher levels of outpatient treatment reduced investments in basic capabilities, as evidenced b