Abstract:
The objectives of this study are (1) to study the situation of health care utilization in Hungha district, Thaibinh province, Vietnam; (2) to identify factors affecting patient's dectsion for the differenct types of health services; i.e. commune health center, private doctor, drug vendor; and (3) to determine sources of finance for health care expenditure. This study was conducted during 14-29 February in 2004 in Hungha district, Thaibinh province, Vietnam. Binary logistic regression was used to identify factors affecting patients' choice for the different types of health services. Descriptive statistics were applied to analyze the sources of finance for health care expenditure, and payment among different income groups and different types of diseases. 250 patients, who were ill 4 weeks before were interviewed. The results of this study show that commune health center and private doctor are common health services that patients use. Patients with high income tend to use commune health center more than lower income group do. Waiting time is the most important factor for commune health center and has negative sign. Distance is one of the reasons why patients choose private doctor. Mostly, patients choose drug vendor because the price of this service is cheap. According to the findings, probability of patient using commune health center increases when income increases but vice versa for private doctor. The study also shows that, the average payment for the same kind of diseases of high income groupwas nearly 2 times higher than low income group, but payment as the percentage share of income for the low income group was nearly 2 times higher than high income group. Poor people usually do not enough money to access health care services. Selling rice or livestock is the main source of finance for health care expenditue for the low income group, especially for the high-cost diseases, while monthly income is the main source for the middle and high income groups. Improving the quality of services in commune health center, managing and supervising private doctor and drug vendor, supporting finance for poor people are some suggestions that health policy makers should consider in order to achieve the government' goal, i.e. assuring health care services for all citizens.
