Do the more educated utilize more health care services? Evidence from Vietnam using a regression discontinuity design

Int J Health Econ Manag. 2018 Sep;18(3):277-299. doi: 10.1007/s10754-018-9233-4. Epub 2018 Jan 10.

Abstract

In 1991, Vietnam implemented a compulsory primary schooling reform that provides this study a natural experiment to estimate the causal effect of education on health care utilization with a regression discontinuity design. This paper finds that education causes statistically significant impacts on health care utilization, although the signs of the impacts change with specific types of health care services examined. In particular, education increases the inpatient utilization of the public health sector, but it reduces the outpatient utilization of both the public and private health sectors. The estimates are strongly robust to various windows of the sample choice. The paper also discovers that the links between education and the probability of health insurance and income play essential roles as potential mechanisms to explain the causal impact of education on health care utilization in Vietnam.

Keywords: Education; Health care utilization; Regression discontinuity design; Vietnam.

MeSH terms

  • Adult
  • Developing Countries
  • Educational Status*
  • Female
  • Health Status
  • Humans
  • Male
  • Middle Aged
  • National Health Programs / organization & administration
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Private Sector / statistics & numerical data
  • Public Sector / statistics & numerical data
  • Regression Analysis
  • Vietnam