Background Health insurance is an important social protection mechanism to insure vulnerable populations against health shocks caused by injury. This study aims to examine the association between health insurance and long-term injury-related disability in Vietnam.
Methods We are conducting a prospective cohort study of 1200 moderate to severe injury patients recruited from a public hospital in Ninh Binh, Vietnam. We administer a baseline and four follow-up surveys (at 1, 2, 4, 12 months after discharge) to participants about health insurance, socio-demographic and injury characteristics, and self-assessed disability (using WHO disability assessment schedule 2.0 (WHODAS). The outcome measure is WHODAS score.
Results We have recruited 1094 injury patients at baseline; 611 (44%) had health insurance and 483 (56%) did not. Insured subjects were on average 48 years in age, 64% male, and 40% farmers; while uninsured patients were on average 37 years in age, 77% male, and >50% were farmers. Road traffic and falls were the top two causes of injury for the insured (59% and 27% respectively) and uninsured (71% and 14%, respectively). Insured patients had significantly higher WHODAS global average score, 1.86 (SD: 4.8), on a scale of 0–48 (0 for no functional limitation and 48 for extreme limitation) than the uninsured patients (0.49, SD: 2.1) (p < 0.001). We will use propensity score matching methods with mixed-effects models to examine the association between insurance status and average WHODAS score over time.
Conclusions Health insurance may be associated with health care access prior to injury, and may influence the medical care and rehabilitation services throughout the functional recovery. This study will provide empirical evidence on how health insurance status is associated with disability related to injury over time in Vietnam.
- Health insurance
- Propensity score