Tat Sonny, Barr Donald
School of Medicine, University of Washington, Box 356340, A-300, Health Sciences, Seattle, WA 98195-6340, USA.
Soc Sci Med. 2006 Mar;62(5):1229-36. doi: 10.1016/j.socscimed.2005.07.015. Epub 2005 Sep 12.
As Vietnam opens its economy to privatization, its system of healthcare will face a series of crucial tests. Vietnam's system of private healthcare--once comprised only of individual physicians holding clinic hours in their homes--has come to also include larger customer-oriented clinics based on an American business model. As the two models compete in the expanding private market, it becomes increasingly important to understand patients' perceptions of the alternative models of care. This study reports on interviews with 194 patients in two different types of private-sector clinics in Vietnam: a western-style clinic and a traditional style, after-hours clinic. In bivariate and multivariate analyses, we found that patients at the western style clinic reported both higher expectations of the facility and higher satisfaction with many aspects of care than patients at the after-hours clinic. These different perceptions appear to be based on the interpersonal manner of the physician seen and the clinic's delivery methods rather than perceptions of the physician's technical skill and method of treatment. These findings were unaffected by the ethnicity of physician seen. These findings suggest that patients in Vietnam recognize and prefer more customer-oriented care and amenities, regardless of physician ethnicity and perceive no significant differences in technical skill between the private delivery models.
随着越南经济向私有化开放,其医疗体系将面临一系列关键考验。越南的私立医疗体系——曾经仅由在家中坐诊的个体医生组成——如今也包括了基于美国商业模式的、面向更多客户的大型诊所。由于这两种模式在不断扩大的私立市场中相互竞争,了解患者对不同医疗模式的看法变得越来越重要。本研究报告了对越南两种不同类型私立诊所的194名患者的访谈情况:一家西式诊所和一家传统的非工作时间营业的诊所。在双变量和多变量分析中,我们发现,与非工作时间营业诊所的患者相比,西式诊所的患者对该机构的期望更高,并且对护理的许多方面满意度也更高。这些不同的看法似乎基于所见到的医生的人际沟通方式以及诊所的服务方式,而非对医生技术水平和治疗方法的看法。这些发现不受所见到的医生种族的影响。这些发现表明,越南的患者认可并更喜欢更以客户为导向的护理和便利设施,无论医生的种族如何,并且认为私立医疗模式之间在技术水平上没有显著差异。