Abstract
BACKGROUND: The rapidly growing aging population poses major challenges for health systems in Vietnam. This study was therefore aimed to examine factors influencing the choices of healthcare facilities among older patients in Vietnam, using a national survey on older people. METHODS: We applied multinomial logistic regression models based on Andersen's Behavioral Model with various predisposing factors, enabling factors and healthcare-needs factors associated with different types of healthcare facilities where older patients utilized services. DATA: We used data from the Vietnam Aging Survey (VNAS) in 2011. This was the first-ever nationally representative survey on older persons in Vietnam. RESULTS: Among those who used healthcare services, 15.1% visited central hospitals; 23.6% visited provincial hospitals; 28.0% visited district hospitals; 8.8% visited commune heath centres; 18.3% visited private hospitals/clinics; and 6.2% visited other facilities. The results showed that "having to pay cost" and "having sufficient income" were strong predictors for using commune health centres, district hospitals, and private facilities, while "having health insurance" was not a significant predictor for using these facilities. Also, we showed that apart from enabling factors (such as age, gender, educational levels, employment status, living regionand place of residence), predisposing factor (such as health insurance, perceived sufficient income, household wealth and having to pay medical cost) as well as need factors (such as self-rated health and chronic disease) were also associated with the choice of healthcare facilities. CONCLUSIONS: Based on the findings, we discussed the implications of the results for organizing healthcare finance and delivery to achieve efficiency and equity for older people in Vietnam.