School of Public Health, University of Alberta, Edmonton, Alberta, Canada.
Trop Med Int Health. 2013 Feb;18(2):212-8. doi: 10.1111/tmi.12032. Epub 2012 Dec 5.
To assess the out-of-pocket (OOP) payments for health-care services of HIV/AIDS patients, and identify associated factors in Vietnam.
Cross-sectional multisite survey of 1016 HIV/AIDS patients attending 7 hospitals and health centres in Ha Noi, Hai Phong and Ho Chi Minh City in 2012.
HIV/AIDS patients used inpatient and outpatient care on average 5.1 times (95% CI = 4.7-5.4) besides ART services. Inpatient care cost US$ 461 on average and outpatient care US$ 50. Mean annual health-care expenditure for HIV/AIDS patients was US$ 188 (95% CI = 148-229). 35.1% of households (95% CI = 32.2-38.1) experienced catastrophic health expenditure; 73.3% (95% CI = 70.6-76.1) of households would be affected if ART were not subsidised. Being a patient at a provincial clinic, male sex, unstable employment, being in the poorest income quintile, a CD4 count of <200 cells/mL and not yet receiving ART increased the likelihood of catastrophic medical expense.
HIV/AIDS patients in Vietnam frequently use medical services and incur OOP payments for health care. Scaling up free-of-charge ART services, earlier access to and initiation of ART, and decentralisation and integration of HIV/AIDS-related services could reduce their financial burden.
评估越南艾滋病毒/艾滋病患者的医疗服务自费支出，并确定相关因素。
2012 年在河内、海防和胡志明市的 7 家医院和保健中心对 1016 名艾滋病毒/艾滋病患者进行了跨部门多地点横断面调查。
艾滋病毒/艾滋病患者除接受抗逆转录病毒治疗服务外，平均还使用住院和门诊服务 5.1 次（95%CI=4.7-5.4）。住院治疗平均花费 461 美元，门诊治疗平均花费 50 美元。艾滋病毒/艾滋病患者的年均医疗支出为 188 美元（95%CI=148-229）。35.1%（95%CI=32.2-38.1）的家庭发生灾难性医疗支出；如果不补贴抗逆转录病毒治疗，73.3%（95%CI=70.6-76.1）的家庭将受到影响。在省级诊所就诊、男性、不稳定就业、处于最贫困收入五分位、CD4 计数<200 个细胞/毫升且尚未接受抗逆转录病毒治疗的患者更有可能发生灾难性医疗费用。
越南的艾滋病毒/艾滋病患者经常使用医疗服务并自费支付医疗费用。扩大免费抗逆转录病毒治疗服务、更早获得和开始抗逆转录病毒治疗以及将艾滋病毒/艾滋病相关服务下放和整合，可减轻他们的经济负担。
