Center for Population Health Sciences (Dr Van Minh and Ms Bao Ngoc) and Health Management Training Institute (Mr Minh Hoang), Hanoi University of Public Health, Hanoi, Vietnam; LEE Jong-wook Center for Global Medicine of Seoul National University College of Medicine, Seoul, Korea (Drs Oh and Lee); Departments of Health Education (Dr Giang), Health Management and Organization (Dr Van Huy), and Biostatistics and Health Informatics (Drs Son and Hoat), Hanoi Medical University, Hanoi, Vietnam; and Department of International Cooperation, Ministry of Health, Hanoi, Vietnam (Dr Giang Huong).
J Public Health Manag Pract. 2018 Mar/Apr;24 Suppl 2:S60-S66. doi: 10.1097/PHH.0000000000000696.
Chronic noncommunicable diseases (NCDs) have been shown to be major causes of morbidity and mortality in hospitals for the whole country.
This study aims to describe the situation of health service utilization among people with NCDs in a rural area and identify association between the situation of health service utilization among people with chronic diseases and their socioeconomic status.
This was a cross-sectional study.
A rural district located in the North of Vietnam.
People 15 years of age and older. Health service utilization was analyzed only among people who reported having NCD.
Data were collected through a personal household interview conducted by 12 trained field workers. The dependent variable is health care service utilization among people with chronic NCDs. The explanatory variables include both household attributes such as household economic conditions, and so forth, and individual characteristics.
Eighteen percent of the adults and 51% of the elderly respondents reported having at least 1 of the NCDs. The proportions of people with NCDs who used at least 1 outpatient service and used at least 1 inpatient health service during the last 12 months were 68.1% and 10.7%, respectively (the nonutilization rates of 31.9% and 89.3%, respectively). The statistically significant correlates of health care service utilization among people with NCDs were ethnicity (ethnic minority was significantly associated with a lower odds of health care service utilization) and health insurance (no health insurance was significantly associated with lower odds of health care service utilization).
Given the evidence from this study, actions to improve access to health care services among people with NCDs are clearly needed. The capacity of primary health care system for the prevention and control of NCDs should be ranked a top priority.
慢性非传染性疾病（NCDs）已被证明是导致全国医院发病率和死亡率的主要原因。
本研究旨在描述农村地区 NCD 患者的卫生服务利用情况，并确定慢性病患者卫生服务利用情况与社会经济地位之间的关系。
这是一项横断面研究。
越南北部的一个农村地区。
15 岁及以上的人群。仅分析报告患有 NCD 的人群的卫生服务利用情况。
数据通过由 12 名经过培训的现场工作人员进行的个人家庭访谈收集。因变量是慢性 NCD 患者的医疗保健服务利用情况。解释变量包括家庭属性（如家庭经济状况等）和个人特征。
18%的成年人和 51%的老年人报告患有至少 1 种 NCD。在过去 12 个月内，至少使用 1 次门诊服务和至少使用 1 次住院卫生服务的 NCD 患者比例分别为 68.1%和 10.7%（未利用率分别为 31.9%和 89.3%）。NCD 患者卫生服务利用的统计学显著相关因素包括民族（少数民族患者卫生服务利用的可能性显著较低）和医疗保险（无医疗保险患者卫生服务利用的可能性显著较低）。
鉴于本研究的证据，显然需要采取行动改善 NCD 患者获得卫生服务的机会。初级卫生保健系统预防和控制 NCD 的能力应被列为重中之重。
