Does Socio-Economic Inequality Act as A Barrier to Medical Treatment? the Case of Vietnam

Abstract

In Vietnam, the pursuit of equitable healthcare underscores a fundamental public health imperative. Nevertheless, the realization of this goal is marked by conspicuous challenges pertaining to the accessibility of medical treatment. Given the imperative to gauge horizontal inequality in crafting healthcare policies that foster equity, this study endeavours to examine the role of socio-economic disparities as a barrier to medical treatment within the Vietnamese context. Data has been sourced from the Vietnam Household Living Standards Survey (VHLSS) spanning eight years (2008-2018). Initially, a concentration curve is delineated, serving as a foundation for the estimation of concentration indices. These indices facilitate the assessment of trends in inequality. Moreover, health disparity is quantified alongside the decomposition of inequality, aiding in the identification of factors contributing to disparate health outcomes. Concentration indices pertaining to medical treatment unveil a concentration among individuals of higher socioeconomic standing. Interestingly, the findings were deemed statistically insignificant in the year 2008. However, a pro-poor trend in healthcare inequality emerged in 2010, 2012, 2016, and 2018, while instances of horizontal inequity were evident in 2008 and 2014. Through a comprehensive analysis, we have discerned pivotal determinants influencing the utilization of medical treatment, encompassing variables such as health insurance coverage, marital status, employment conditions, and income levels. Decomposition analysis underscores the significant role of various factors including health status, age, marital status, educational attainment, employment status, ethnic background, income levels, urbanization status, and geographical location in shaping disparities within the realm of medical treatment. The findings underscore the noteworthy influence of demographic variables including age, marital status, educational attainment, ethnicity, health status, employment status, and income level on the socio-economic disparity observed in access to medical treatment.