Tran Bach Xuan, Nguyen Long Hoang, Nong Vuong Minh, Nguyen Cuong Tat
Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam.
Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Health Qual Life Outcomes. 2016 Jun 7;14:85. doi: 10.1186/s12955-016-0485-8.
Self-rated health status and healthcare services utilization are important indicators to evaluate the performance of health system. In disadvantaged areas, however, little is known about the access and outcomes of health care services. This study aimed to assess health-related quality of life (HRQOL), health status and healthcare access and utilization of residents in mountainous and remote areas in Vietnam.
A cross-sectional study was conducted in a convenient sample of residents in two provinces of Vietnam. Information about socio-economic, health status, HRQOL, healthcare seeking and services utilization were interviewed. EuroQol - 5 Dimensions - 5 Levels (EQ-5D-5 L) was used to measure HRQOL.
Of 200 respondents, mean age was 44.9 (SD = 13.9), 38.0 % were male. One third reported having any problem in Mobility, Usual activities, Pain or Discomfort, Anxiety or Depression. Women tended to suffer more problems in Pain/Discomfort and Anxiety/Depression and lower overall HRQOL than men. Over 90 % of respondents reported at least one health problem. Flu, cold and headache were the most commonly reported symptoms (41.5 %). Most of people preferred community health center when they had illness (96.0 %). Only 18.5 % people used traditional healers with the average of 5.8 times per year. Ethnicity, households' expenditure, illness and morbidity status, difficulty in accessing health care services were related to HRQOL.; Meanwhile, socioeconomic status, health problems, quality of services, and distances were associated with access to healthcare and traditional medicine services.
Residents in difficult-to-reach areas had high prevalence of health problems and experienced social and structural barriers of healthcare services access. It is necessary to improve the availability and quality of healthcare and traditional medicine services to improve the health status of disadvantaged people.
自评健康状况和医疗服务利用是评估卫生系统绩效的重要指标。然而，在贫困地区，人们对医疗服务的可及性和结果知之甚少。本研究旨在评估越南山区和偏远地区居民的健康相关生活质量（HRQOL）、健康状况以及医疗服务的可及性和利用情况。
在越南两个省份的居民中进行了一项横断面研究，选取了方便样本。对社会经济、健康状况、HRQOL、就医情况和服务利用等信息进行了访谈。采用欧洲五维健康量表（EuroQol - 5 Dimensions - 5 Levels，EQ - 5D - 5L）来测量HRQOL。
在200名受访者中，平均年龄为44.9岁（标准差 = 13.9），38.0%为男性。三分之一的受访者表示在行动、日常活动、疼痛或不适、焦虑或抑郁方面存在任何问题。女性在疼痛/不适和焦虑/抑郁方面往往比男性遭受更多问题，总体HRQOL也更低。超过90%的受访者报告至少有一种健康问题。流感、感冒和头痛是最常报告的症状（41.5%）。大多数人患病时更喜欢社区卫生中心（96.0%）。只有18.5%的人使用传统治疗师，平均每年使用5.8次。种族、家庭支出、疾病和发病状况、获得医疗服务的困难程度与HRQOL相关；同时，社会经济地位、健康问题、服务质量和距离与获得医疗服务和传统医学服务有关。
难以到达地区的居民健康问题患病率较高，且在获得医疗服务方面面临社会和结构障碍。有必要提高医疗服务和传统医学服务的可及性和质量，以改善弱势群体的健康状况。
