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药物依赖人群对美沙酮维持治疗服务的满意度:公立和私立诊所的比较——对越南私营部门参与美沙酮维持治疗方案提供的启示。

Satisfaction Amongst Drug-dependent Population with Methadone Maintenance Treatment Services, A Comparison between Public and Private Clinics: Implications for Private Sector Engagement in the Delivery of Methadone Maintenance Programs Across Vietnam.

机构信息

National Institute of Hygiene and Epidemiology, Hanoi, 100000, Vietnam.

Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, 100000, Vietnam.

出版信息

AIDS Behav. 2024 Dec;28(12):4127-4135. doi: 10.1007/s10461-024-04521-w. Epub 2024 Oct 8.

Abstract

In Vietnam, the public sector has largely been responsible for delivering methadone maintenance treatment (MMT) services. However, with foreign aid anticipated to decline in the coming years, the involvement of the private sector in delivering MMT services is critical to ensure the continued sustainability of MMT programs across Vietnam. This study aims to evaluate patient satisfaction and identify correlated factors among Vietnamese drug users undergoing MMT in both public and private methadone clinics. A cross-sectional study was conducted in one private and two public methadone facilities in Nam Dinh, a province in the North of Vietnam. A convenience sampling technique was applied to recruit 395 participants. Data was collected through 20-minute face-to-face interviews using a structured questionnaire. Multivariate Tobit regression was utilized to measure associated factors with patient satisfaction. Results showed that patients were highly satisfied with MMT services in both public and private; however, they expected a higher degree of comprehensive care services. Compared with public facilities, the satisfaction level of patients in private facilities was significantly lower in the following aspects: health administration and professional capacity of health workers. However, there were insignificant differences in regard to infrastructure, equipment, and availability of medical services resources, supporting a promising role of the private sector in supporting the expansion of the MMT programs in Vietnam. Integrating MMT with other physical and mental healthcare services, along with strategies for improving administrative procedures and health workers' capacity in private clinics, are critical implications of this study.

摘要

在越南,公共部门在提供美沙酮维持治疗(MMT)服务方面发挥了重要作用。然而,随着未来几年外国援助的减少,私营部门参与提供 MMT 服务对于确保越南各地 MMT 项目的持续可持续性至关重要。本研究旨在评估越南吸毒者在公共和私人美沙酮诊所接受 MMT 治疗的患者满意度,并确定相关因素。本研究在越南北部南定省的一家私人和两家公共美沙酮诊所进行了一项横断面研究。采用便利抽样技术招募了 395 名参与者。通过 20 分钟的面对面访谈使用结构化问卷收集数据。采用多元 Tobit 回归来衡量与患者满意度相关的因素。结果表明,患者对公共和私人美沙酮维持治疗服务非常满意;然而,他们希望获得更高程度的综合护理服务。与公共设施相比,私人设施的患者在以下方面的满意度水平明显较低:卫生行政管理和卫生工作者的专业能力。然而,在基础设施、设备和医疗服务资源的可及性方面,两者没有显著差异,这为私营部门在支持越南扩大 MMT 项目方面发挥积极作用提供了希望。本研究的重要启示是将 MMT 与其他身心保健服务相结合,并制定改善私营诊所行政程序和卫生工作者能力的战略。

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