ArticleGlobal health action2020
Factors associated with patient payments exceeding National Health Insurance fees and out-of-pocket payments in Lao PDR.
Article in Global health action, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 of them syntheses that pooled it.
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Who cites it
11 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Implementation of health and health-related sustainable development goals: progress, challenges and opportunities-a systematic literature review update.BMJ global health · 2026Pooled it
- Pooled it
- Equity in health insurance coverage among women with children under two years of age in Laos: a cross-sectional study of sociodemographic disparities and implications for universal health coverage.Journal of health, population, and nutrition · 2026Article
- Medicines governance and systemic constraints: A qualitative study among healthcare professionals in South Africa.African journal of primary health care & family medicine · 2026Article
- Research gaps on universal health coverage in the South African context and other low and middle-income countries; putting things into perspective: a scoping review.BMC health services research · 2026Article
- Financial burden of severe childhood illness on households in Lao People's Democratic Republic: A prospective cohort study.PLOS global public health · 2026Article
- Hypertension management and health belief in middle-aged laotian population: a cross-sectional survey.BMC public health · 2025Article
- Assessing maternal and newborn health readiness: Insights from a service availability assessment in five provinces in Laos.PloS one · 2025Article
- Health system utilization and perceived quality among adults in Lao PDR: evidence from a nationally representative phone survey.BMC public health · 2024Article
- Factors Associated with Willingness to Pay for Cost-Sharing under Universal Health Coverage Scheme in Yogyakarta, Indonesia: A Cross-Sectional Survey.International journal of environmental research and public health · 2022Article
- Research provides evidence for health policy in Lao PDR.Global health action · 2020Article
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAttaining universal health coverage is a target in the Sustainable Development Goals. In Lao PDR, to achieve universal health coverage, the government is implementing a national insurance scheme, initially targeting the informal sector.
objectiveThe purpose was to assess: i) the percentage of NHI patients who paid above the scheduled amount, based on individual billing payment; and ii) the factors related to overpayment.
methodsDescriptive cross-sectional study based on a structured questionnaire administered at health facilities in face-to-face interviews with 1,850 patients in six provinces.
resultsAll 1,850 participants worked in the informal sector. Of these, 78.8% of respondents (77.9% of in-patients; 79.5% of out-patients) made co-payments or were exempted from. Factors associated with in-patients paying above the scheduled fee were living in the province and district (OR = 2.8; 95%CI 1.2 to 6.3); not having documents with them (OR = 21.2; 95%CI 5.6 to 80.3); or not having documents (OR: 7.8; 95% CI 2.1 to 28.6). Significant factors associated with additional costs for out-patients were level of facility used at the provincial hospital (OR:1.4; 95% CI 1.1 to 1.9); older age (OR = 2.2; 95%CI 1.5 to 3.1); living in the province and district (OR = 2.3; 95%CI 1.5 to 3.7); living more than 5 km from the facility (OR = 1.4; 95%CI 1.1 to 1.9); buying medicine or supplies outside of the health facility (OR: 5.6; 95% CI 3.1 to 10.2); not bringing documents (OR:9.1; 95% CI 6.1 to 13.5), not having the right documents (OR: 8.9; 95% CI 5.4 to 14.8).
conclusionsA number of patients paid above scheduled fee rates, which may deter people from utilising services when needing them. There is a need for increased understanding of the benefits of the national insurance scheme among patients and healthcare staff.
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