The situation of the use of health insurance cards among informal employees and the factors affecting the likelihood of their participating in household-based health insurance

Abstract

       This mixed-method study was conducted in Long Bien, Hanoi in 2015 with the aim to identify the current situation of the use of health insurance cards among informal employees and analyze factors affecting the likelihood of their participating in household-based health insurance. Using a multi-stage sampling method, we recruited 377 employees from the informal sector to our study. Investigators conducted face-to-face interviews using a structured questionnaire. Two focus group discussions and four in-depth interviews were also conducted to collect data from main informants. Results: 10.6% of informal employees were ill within the past four weeks. Only 47% of those with health insurance cards used their cards when seeking health care in case of illnesses. Some barriers to their participation in health insurance: they lacked out-of-pocket money, perceived it was unnecessary to buy health insurance, laid little or no trust in the quality of insured health care, encountered difficulties related to the purchase of household-based health insurance, or had no knowledge of health insurance/where to buy health insurance cards. Recommendations: (1) communication and dissemination about the benefits of health insurance and household-based health insurance to employees should be strengthened; and (2) appropriate regulations and procedures should be taken into careful consideration in order to address difficulties in buying household-based health insurance.