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Choice of healthcare provider following reform in Vietnam

BACKGROUND: In Vietnam, the health-sector reforms since 1989 have lead to a rapid increase in out-of-pocket expenses. This paper examines the choice of medical provider and household healthcare expenditure for different providers in a rural district of Vietnam following healthcare reform. METHODS: T...

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Autores principales: Thuan, Nguyen Thi Bich, Lofgren, Curt, Lindholm, Lars, Chuc, Nguyen Thi Kim
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2008
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2529291/
https://www.ncbi.nlm.nih.gov/pubmed/18664300
http://dx.doi.org/10.1186/1472-6963-8-162
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author Thuan, Nguyen Thi Bich
Lofgren, Curt
Lindholm, Lars
Chuc, Nguyen Thi Kim
author_facet Thuan, Nguyen Thi Bich
Lofgren, Curt
Lindholm, Lars
Chuc, Nguyen Thi Kim
author_sort Thuan, Nguyen Thi Bich
collection PubMed
description BACKGROUND: In Vietnam, the health-sector reforms since 1989 have lead to a rapid increase in out-of-pocket expenses. This paper examines the choice of medical provider and household healthcare expenditure for different providers in a rural district of Vietnam following healthcare reform. METHODS: The study consisted of twelve monthly follow-up interviews of 621 randomly selected households. The households are part of the FilaBavi project sample – Health System Research Project. The heads of household were interviewed at monthly intervals from July 2001 to June 2002. RESULTS: The use of private health providers and self-treatment are quite common for both episodes (60% and 23% of all illness episodes) and expenditure (60% and 12.8% of healthcare expenditure) The poor tend to use self-treatment more frequently than wealthier members of the community (31% vs. 14.5% of illness episodes respectively). All patients in this study often use private services before public ones. The poor use less public care and less care at higher levels than the rich do (8% vs.13% of total illness episodes, which decomposes into 3% vs. 7% at district level, and 1% vs. 3% at the provincial or central level, respectively). The education of the patients significantly affects healthcare decisions. Those with higher education tend to choose healthcare providers rather than self-treatment. Women tend to use drugs or healthcare services more often than men do. Patients in two highest quintiles use health services more than in the lowest quintile. Moreover, seriously ill patients frequently use more drugs, healthcare services, public care than those with less severe illness. CONCLUSION: The results are useful for policy makers and healthcare professionals to (i) formulate healthcare policies-of foremost importance are methods used to reduce self-treatment and no treatment; (ii) the management of private practices and maintaining public healthcare providers at all levels, particularly at the basic levels (district, commune) where the poor more easily can access healthcare services, is also important, as is the management of private practices and (iii) provide a background for further studies on both short and long-term health service strategies.
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spelling pubmed-25292912008-09-05 Choice of healthcare provider following reform in Vietnam Thuan, Nguyen Thi Bich Lofgren, Curt Lindholm, Lars Chuc, Nguyen Thi Kim BMC Health Serv Res Research Article BACKGROUND: In Vietnam, the health-sector reforms since 1989 have lead to a rapid increase in out-of-pocket expenses. This paper examines the choice of medical provider and household healthcare expenditure for different providers in a rural district of Vietnam following healthcare reform. METHODS: The study consisted of twelve monthly follow-up interviews of 621 randomly selected households. The households are part of the FilaBavi project sample – Health System Research Project. The heads of household were interviewed at monthly intervals from July 2001 to June 2002. RESULTS: The use of private health providers and self-treatment are quite common for both episodes (60% and 23% of all illness episodes) and expenditure (60% and 12.8% of healthcare expenditure) The poor tend to use self-treatment more frequently than wealthier members of the community (31% vs. 14.5% of illness episodes respectively). All patients in this study often use private services before public ones. The poor use less public care and less care at higher levels than the rich do (8% vs.13% of total illness episodes, which decomposes into 3% vs. 7% at district level, and 1% vs. 3% at the provincial or central level, respectively). The education of the patients significantly affects healthcare decisions. Those with higher education tend to choose healthcare providers rather than self-treatment. Women tend to use drugs or healthcare services more often than men do. Patients in two highest quintiles use health services more than in the lowest quintile. Moreover, seriously ill patients frequently use more drugs, healthcare services, public care than those with less severe illness. CONCLUSION: The results are useful for policy makers and healthcare professionals to (i) formulate healthcare policies-of foremost importance are methods used to reduce self-treatment and no treatment; (ii) the management of private practices and maintaining public healthcare providers at all levels, particularly at the basic levels (district, commune) where the poor more easily can access healthcare services, is also important, as is the management of private practices and (iii) provide a background for further studies on both short and long-term health service strategies. BioMed Central 2008-07-30 /pmc/articles/PMC2529291/ /pubmed/18664300 http://dx.doi.org/10.1186/1472-6963-8-162 Text en Copyright © 2008 Thuan et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( (http://creativecommons.org/licenses/by/2.0) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Thuan, Nguyen Thi Bich
Lofgren, Curt
Lindholm, Lars
Chuc, Nguyen Thi Kim
Choice of healthcare provider following reform in Vietnam
title Choice of healthcare provider following reform in Vietnam
title_full Choice of healthcare provider following reform in Vietnam
title_fullStr Choice of healthcare provider following reform in Vietnam
title_full_unstemmed Choice of healthcare provider following reform in Vietnam
title_short Choice of healthcare provider following reform in Vietnam
title_sort choice of healthcare provider following reform in vietnam
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2529291/
https://www.ncbi.nlm.nih.gov/pubmed/18664300
http://dx.doi.org/10.1186/1472-6963-8-162
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