Encouraging Health Insurance for the Informal Sector : A Cluster Randomized Trial

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dc.creatorNguyen, Ha Thi Hong
dc.creatorWagstaff, Adam
dc.creatorDao, Huyen
dc.creatorBales, Sarah
dc.date2014-06-25T21:41:26Z
dc.date2014-06-25T21:41:26Z
dc.date2014-06
dc.date.accessioned2026-07-01T00:52:08Z
dc.descriptionSubsidized voluntary enrollment in government-run health insurance schemes is often proposed as a way of increasing coverage among informal sector workers and their families. This paper reports the results of a cluster randomized control trial in which 3,000 households in 20 communes in Vietnam were randomly assigned at baseline to a control group or one of three treatments: an information leaflet about Vietnam s government-run scheme and the benefits of health insurance; a voucher entitling eligible household members to 25 percent off their annual premium; and both. The four groups were balanced at baseline. In the control group, 6.3 percent (82/1296) of individuals were enrolled in the endline, compared with 6.3 percent (79/1257), 7.2 percent (96/1327), and 7.0 percent (87/1245) in the information, subsidy, and combined intervention groups; the adjusted odds ratios were 0.94, 1.12, and 1.15, respectively. Only among those reporting poor health were any significant intervention effects found, and only for the combined intervention: an enrollment rate of 16.3 percent (33/202) compared with 8.3 percent (18/218) in the control group, and an adjusted odds ratio of 2.50. The results suggest limited opportunities to raise voluntary health insurance enrollment through information campaigns and subsidies, and that these interventions exacerbate adverse selection.
dc.formatapplication/pdf
dc.formattext/plain
dc.identifierhttp://documents.worldbank.org/curated/en/2014/06/19641542/encouraging-health-insurance-informal-sector-cluster-randomized-trial-encouraging-health-insurance-informal-sector-cluster-randomized-trial
dc.identifierhttps://hdl.handle.net/10986/18768
dc.identifierhttps://doi.org/10.1596/1813-9450-6910
dc.identifier.urihttp://hdl.handle.net/123456789/412199
dc.languageEnglish
dc.languageen_US
dc.publisherWorld Bank, Washington, DC
dc.relationPolicy Research Working Paper;No. 6910
dc.rightsCC BY 3.0 IGO
dc.rightshttp://creativecommons.org/licenses/by/3.0/igo/
dc.subjectADVERSE SELECTION
dc.subjectCHEMOTHERAPY
dc.subjectCOMMUNES
dc.subjectCOMMUNITIES
dc.subjectCOMMUNITY HEALTH
dc.subjectDEMAND FOR HEALTH
dc.subjectDEMAND FOR INSURANCE
dc.subjectDIALYSIS
dc.subjectDISTRICTS
dc.subjectENROLLEES
dc.subjectEXPECTED LOSS
dc.subjectFAMILIES
dc.subjectFINANCIAL INCENTIVES
dc.subjectFINANCIAL PROTECTION
dc.subjectHEALTH CARE
dc.subjectHEALTH COVERAGE
dc.subjectHEALTH ECONOMICS
dc.subjectHEALTH FACILITIES
dc.subjectHEALTH FINANCING
dc.subjectHEALTH INSURANCE
dc.subjectHEALTH INSURANCE ENROLLMENT DECISION
dc.subjectHEALTH INSURANCE PROGRAM
dc.subjectHEALTH INSURANCE SCHEME
dc.subjectHEALTH INSURANCE SCHEMES
dc.subjectHEALTH ORGANIZATION
dc.subjectHEALTH PLANNING
dc.subjectHEALTH POLICY
dc.subjectHEALTH STRATEGY
dc.subjectHEALTH SYSTEM
dc.subjectHEALTH SYSTEM PERFORMANCE
dc.subjectHEALTH SYSTEMS
dc.subjectHEALTH-CARE
dc.subjectHOUSEHOLD INCOME
dc.subjectHOUSEHOLDS
dc.subjectHUMAN DEVELOPMENT
dc.subjectINCOME COUNTRIES
dc.subjectINFORMAL SECTOR
dc.subjectINFORMAL SECTOR WORKERS
dc.subjectINFORMATION CAMPAIGNS
dc.subjectINFORMATION PACK
dc.subjectINSURANCE COVERAGE
dc.subjectINSURANCE PREMIUM
dc.subjectINTERVENTION
dc.subjectINTERVENTIONS
dc.subjectLIVING STANDARDS
dc.subjectLOCALITIES
dc.subjectMEDICAL PERSONNEL
dc.subjectPHYSICIAN
dc.subjectPOLICY DISCUSSIONS
dc.subjectPOLICY RESEARCH
dc.subjectPRIMARY CARE
dc.subjectPROBABILITY
dc.subjectPUBLIC HOSPITAL
dc.subjectSOCIAL HEALTH INSURANCE
dc.subjectSOCIAL SCIENCE
dc.subjectSOCIAL SECURITY
dc.subjectSOCIAL SECURITY HEALTH INSURANCE
dc.subjectTREATMENTS
dc.subjectUNIVERSAL HEALTH INSURANCE COVERAGE
dc.subjectWORKERS
dc.titleEncouraging Health Insurance for the Informal Sector : A Cluster Randomized Trial

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