Unmet Healthcare Needs and Associated Factors in Rural and Suburban Vietnam: A Cross-Sectional Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Participant Recruitment
2.2. Survey Instrument and Measurements
2.3. Unmet Healthcare Needs Group
2.4. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Characteristic, n (%) or Median (IQR) | Unmet Needs Group | Control Group | p-Value |
---|---|---|---|
N = 43 | N = 190 | ||
Age in years | 0.555 | ||
19–34 | 11 (26) | 64 (34) | |
35–49 | 16 (37) | 59 (31) | |
50–64 | 9 (21) | 46 (24) | |
≥65 | 7 (16) | 21 (11) | |
Sex | 0.049 | ||
Male | 25 (58) | 79 (42) | |
Female | 18 (42) | 111 (58) | |
Marital status | 0.192 | ||
Married | 34 (79) | 165 (87) | |
Education levels completed | 0.618 | ||
Illiterate or primary school | 30 (70) | 125 (66) | |
Secondary or more | 13 (30) | 65 (34) | |
Ethnicity | 0.045 | ||
Vietnamese | 26 (60) | 131 (69) | |
Mnong/Stieng | 14 (33) | 32 (17) | |
Others | 3 (7) | 27 (14) | |
Occupation | 0.538 | ||
Farmer | 32 (74) | 127 (67) | |
Homemaker | 7 (16) | 31 (16) | |
Service or sale workers | 3 (7) | 16 (8) | |
Others | 1 (2) | 16 (8) | |
Area | 0.040 | ||
Binh Phuoc | 35 (81) | 124 (65) | |
Da Lat | 8 (19) | 66 (35) | |
Having insurance | 0.132 | ||
Yes | 34 (79) | 128 (67) | |
No | 9 (21) | 62 (33) | |
Number of family members (median, IQR) | 5 (4, 6) | 4 (3, 5) | 0.029 |
Monthly income, VND 1000 (median, IQR) | 3333 (1666, 6000) | 3500 (1500, 5000) | 0.930 |
BMI, kg/m2 | 0.442 | ||
<18.5 | 20 (47) | 112 (60) | |
18.5–22 | 9 (21) | 27 (14) | |
23–24 | 9 (21) | 29 (15) | |
≥25 | 5 (12) | 20 (11) | |
Blood pressure, mmHg | 0.054 | ||
SBP < 130 and DBP < 85 | 16 (37) | 108 (57) | |
130 ≤ SBP < 140 or 85 ≤ DBP < 90 | 9 (21) | 36 (19) | |
140 ≤ SBP < 160 or 90 ≤ DBP < 100 | 10 (23) | 31 (16) | |
SBP ≥ 160 or DBP ≥ 100 | 8 (19) | 15 (8) | |
Chronic disease | |||
Hypertension | 7 (16) | 33 (17) | |
Diabetes mellitus | 1 (2) | 7 (4) | |
Dyslipidemia | 0 (0) | 10 (5) | |
Heart disease | 1 (2) | 27 (14) | |
Stroke | 0 (0) | 4 (2) | |
Chronic lung disease | 5 (12) | 7 (4) | |
Chronic viral hepatitis | 1 (2) | 1 (1) | |
Depression | 4 (9) | 37 (19) | |
Currently smoking | 0.015 | ||
Yes | 18 (42) | 45 (24) | |
Hazardous drinking | 0.056 | ||
Yes | 15 (35) | 38 (20) | |
Physical activity | 0.127 | ||
High | 12 (28) | 55 (29) | |
Moderate | 6 (14) | 52 (27) | |
Low | 25 (58) | 80 (42) |
Characteristic, n (%) or Median (IQR) | Unmet Group | Control Group | p-Value |
---|---|---|---|
N = 43 | N = 190 | ||
Number of admissions to the hospital during the past 12 months | 0 | 1 | |
Average cost per night at the hospital (VND 1000) | Not applicable | 300 | |
Distance from home to the hospital (km) | Not applicable | 33 | |
Number of visits to emergency room | 5 | 26 | 0.720 |
Average costs per emergency service at the hospital (VND 1000) | 1300 (1000, 1700) | 1000 (500, 1300) | 0.515 |
Distance to the emergency department (km) | 34 (30, 37) | 25 (4, 38) | 0.434 |
Total cost for health services during the past 12 months (VND 1000) | 15 (0, 750) | 1500 (300, 3000) | <0.001 |
Having a place to go for advice about health | 30 (70) | 180 (95) | <0.001 |
Type of transportation | 0.348 | ||
Private car or motorcycle | 28 (70) | 141 (74) | |
Public car | 1 (3) | 5 (3) | |
Ambulance | 1 (3) | 2 (1) | |
Other | 6 (15) | 36 (19) | |
Transportation time in minutes | 20 (10, 90) | 30 (15, 90) | 0.557 |
General health status | 0.932 | ||
Excellent/Very good | 1 (2) | 5 (3) | |
Good | 9 (21) | 43 (23) | |
Fair | 21 (49) | 98 (52) | |
Poor | 12 (28) | 44 (23) | |
Health status compared to the previous 12 months | 0.142 | ||
Better | 7 (16) | 20 (11) | |
Worse | 19 (44) | 115 (61) | |
About the same | 17 (40) | 55 (29) | |
Place to go to when you are sick | 0.086 | ||
District hospital | 13 (30) | 55 (29) | |
Emergency department | 8 (19) | 24 (13) | |
Private Health Clinic | 7 (16) | 64 (34) | |
Commune health Center | 6 (14) | 58 (31) | |
University/teaching hospital | 3 (7) | 17 (9) | |
Traditional | 1 (2) | 3 (2) | |
Others | 6 (14) | 16 (8) | |
Top three health challenges you are dealing with | |||
Joint pain or back pain | 21 (49) | 94 (49) | 0.939 |
Chronic disease | 7 (16) | 55 (29) | 0.089 |
Stroke | 6 (14) | 20 (11) | 0.519 |
Cancer | 5 (12) | 51 (27) | 0.035 |
Heart disease | 4 (9) | 50 (26) | 0.017 |
What is needed to improve the health of you, your family, and neighbors | |||
Wellness services | 19 (44) | 81 (43) | 0.853 |
Health screening program | 15 (35) | 68 (36) | 0.911 |
Healthier food | 10 (23) | 56 (29) | 0.413 |
Specialized physicians | 8 (19) | 64 (34) | 0.053 |
Types of health screenings and services needed | |||
Routine medical check-up program | 18 (42) | 93 (49) | 0.401 |
Blood pressure management | 11 (26) | 72 (38) | 0.128 |
Disease outbreak prevention | 11 (26) | 35 (19) | 0.328 |
Treatment of alcohol abuse | 10 (23) | 18 (9) | 0.012 |
Reasons | Prevalence n (%) |
---|---|
Accessibility | |
Transportation | 13 (30) |
Do not know how to find doctors | 5 (12) |
No insurance and unable to pay for the care | 4 (9) |
Unable to pay co-pays/deductibles | 4 (9) |
Fear | 3 (7) |
Language barriers | 2 (5) |
Availability | |
Healthcare provider did not prescribe any medicine at your last visit | 20 (47) |
Unable to get medicines prescribed | 20 (47) |
Did not use healthcare insurance at last visit | 10 (23) |
Lack of availability of doctors | 6 (14) |
Unable to receive refund from healthcare insurance | 4 (9) |
Acceptability | |
Clarity of communication | 7 (16) |
Waiting room | 5 (12) |
Health services in general | 5 (12) |
Information about treatment | 4 (9) |
Involvement in decision making | 4 (9) |
Room hygiene at health facilities | 4 (9) |
Do not understand the need to see a doctor | 3 (7) |
Time healthcare provider spent for you | 3 (7) |
Freedom to choose healthcare provider | 1 (2) |
Factors | Odds Ratio | 95% Confidence Interval | p-Value |
---|---|---|---|
Age (in years) | |||
19–34 | 1.00 | 1.00 | |
35–49 | 2.71 | 0.62–11.78 | 0.863 |
50–64 | 1.49 | 0.41–5.39 | 0.548 |
≥65 | 2.69 | 0.51–14.24 | 0.545 |
Sex | |||
Female | 0.47 | 0.19–1.11 | 0.085 |
Marital status | |||
Married | 0.31 | 0.10–1.08 | 0.062 |
Education levels completed | |||
Illiterate or primary school | 1.00 | 1.00 | |
Secondary or more | 2.24 | 0.82–6.10 | 0.115 |
Ethnicity | |||
Vietnamese | 1.00 | 1.00 | |
Ethnic minorities | 2.52 | 0.83–7.62 | 0.101 |
Occupation | |||
Farmer | 1.00 | 1.00 | |
Others | 0.54 | 0.19–1.56 | 0.257 |
Area | |||
Da Lat | 1.00 | 1.00 | |
Binh Phuoc | 3.61 | 1.13–11.55 | 0.031 |
Having insurance | |||
No | 1.00 | 1.00 | |
Yes | 7.11 | 1.45–34.84 | 0.016 |
Number of family members increase by one person | 1.07 | 0.76–1.50 | 0.070 |
Blood pressure, mmHg | |||
SBP < 130 and DBP < 85 | 1.00 | 1.00 | |
130 ≤ SBP < 140 or 85 ≤ DBP < 90 | 1.93 | 0.64–5.81 | 0.856 |
140 ≤ SBP < 160 or 90 ≤ DBP < 100 | 2.58 | 0.79–8.34 | 0.373 |
SBP ≥ 160 or DBP ≥ 100 | 3.82 | 1.17–12.45 | 0.037 |
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Kim, J.Y.; Kim, D.I.; Park, H.Y.; Pak, Y.; Tran, P.N.H.; Thai, T.T.; Thuy, M.T.T.; Dung, D.V. Unmet Healthcare Needs and Associated Factors in Rural and Suburban Vietnam: A Cross-Sectional Study. Int. J. Environ. Res. Public Health 2020, 17, 6320. https://doi.org/10.3390/ijerph17176320
Kim JY, Kim DI, Park HY, Pak Y, Tran PNH, Thai TT, Thuy MTT, Dung DV. Unmet Healthcare Needs and Associated Factors in Rural and Suburban Vietnam: A Cross-Sectional Study. International Journal of Environmental Research and Public Health. 2020; 17(17):6320. https://doi.org/10.3390/ijerph17176320
Chicago/Turabian StyleKim, Ju Young, Dae In Kim, Hwa Yeon Park, Yuliya Pak, Phap Ngoc Hoang Tran, Truc Thanh Thai, Mai Thi Thanh Thuy, and Do Van Dung. 2020. "Unmet Healthcare Needs and Associated Factors in Rural and Suburban Vietnam: A Cross-Sectional Study" International Journal of Environmental Research and Public Health 17, no. 17: 6320. https://doi.org/10.3390/ijerph17176320