Consultancy services for analysis of social health insurance claim data: disease patterns, health services utilization and health care expenditure in Vietnam from 2018 to 2022

Local Health System Sustainability (LHSS) Vietnam

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Analysis of social health insurance claim data: disease patterns, health services utilization
and health care expenditure in Vietnam from 2018 to 2022

I. Background:

The health system of Vietnam has undergone a significant transformation in recent years. Vietnam has experienced rapid economic growth, urbanization, and demographic shifts, which have contributed to changes in disease patterns and healthcare needs. Vietnam has also made significant strides in expanding access to healthcare for its citizens in recent years, in 2022, almost 92% of the Vietnamese population had health insurance cards. As a developing country, Vietnam faces numerous challenges in ensuring all its citizens have access to affordable and quality healthcare services. The government has implemented a social health insurance system to address this issue, which has had some success in improving healthcare access and affordability.

The health insurance claims system has been developed and managed by VSS since 2017 and fully operated since 2018. This rich source of data can provide valuable insights into disease patterns, health service utilization, and healthcare expenditure among people with health insurance in Vietnam. This big data source contains a wealth of information on patient's demographic characteristics, disease profiles, healthcare service utilization, and associated healthcare expenditure. Conducting the actuarial data analysis can help to identify the disease patterns and trends of the insured population in Vietnam, health service utilization and related SHI cost, associated factors of healthcare utilization, and the healthcare system's capacity to respond to the changing healthcare needs. For these reasons, LHSS will support VSS in recruiting consultants or the research team to conduct this study with these specific objectives.

II. Objectives:

To identify the prevalence and incidence of leading diseases (including co-infection diseases) among the insured population during 2018-2022 to understand the disease patterns and trends in Vietnam.
To analyze the health services utilization and related SHI cost among the populations that used SHI services during 2018 -2022.

III. Methodology

1. Data collection

This assignment will use the SHI claim data obtained from the VSS e-claim system during the period from 2018 through 2022.
Aggregate totals of key statistics for national and each province & member group.
Specify the data required (members, services, financial and other).
Quality control: Technical oversight of the local data collection team as they collect the data.

2. Statistical analysis

Perform actuarial analysis on cost and utilization trends by different factors (e.g. age, gender, membership group)
Data will be analyzed using SQL, STATA 17.0 and visualized using ArcGIS 10.8. The primary outcome will be presented in tables with percentages and classified by provinces, gender, age groups, and residence area. Results will also be visualized on the Vietnam map with details at the province level. The data will be displayed in trend lines to see the changes in results during the study period from 2018 to 2022.

IV. Tasks:

The consultant/consulting firm will work closely with VSS and the LHSS project to oversee and coordinate the study, manage data collection efforts, provide data quality assurance, conduct data analysis, prepare reports, and provide overall logistical support. The details are as follows:

Preparation of the study

Develop a study protocol to meet the objectives and methodology of the assignment.
Develop a data collection tool to collect data from VSS according to study objectives.

Data collection:

Closely working with VSS to extract data from the e-claim system to adapt to study objectives.
Ensure quality data is collected as planned and stored in accordance throughout the process; oversee data entry to ensure quality and accuracy.

Data Analysis and Report-Writing

Conduct data analysis,
Produce preliminary results on disease patterns health services utilization and health care expenditure in Vietnam from 2018 to 2022.
Produce a study report and PowerPoint presentation.

V. Deliverables:

#	DELIVERABLE
1	Study protocol. Data collection tools.
2	Raw dataset extracted from VSS e-claim system from 2018 – 2022. Clean dataset ready to analyze. Analysis syntax (codes) in Stata and/or SPSS and clean code book.
3	Draft report on disease patterns, health services utilization, and health care expenditure in Vietnam from 2018 to 2022.
4	Final report and policy brief of disease patterns, health services utilization, and health care expenditure in Vietnam from 2018 to 2022 Final PowerPoint presentation (English and Vietnamese) on the key result of the study.

VI. Timing

The assignment is planned for the period from November 2023 to 30 May 2024.

VII. Requirements:

Qualifications in Public Health, Health Economics, or similar disciplines.
Strong understanding of SHI reimbursement and the International Code of Diseases (ICD 10).
Experience in designing quantitative research studies, ensuring data quality and data security, and writing study reports.
Experience in using Stata or SPSS to analyze data.

VIII. Submission timeline and contact point:

The LHSS Vietnam project, funded by USAID and implemented by Abt Associates, will assist VSS in conducting the analysis of social health insurance claim data: disease patterns, health services utilization, and health care expenditure in Vietnam from 2018 to 2022. Thus, we are looking for a consultant/consulting firm to do this job. Detailed Terms of Reference (TORs) [1] are attached.

Deadline for submitting technical and financial proposals: 15 Oct 2023 at email [email protected]

Job Details

Organisation Name:

Abt Associates

Application Deadline:

Sun, 2023-10-15