Preventive health care and health care services utilization of Vietnamese older persons : results from National Household Living Standards Survey 2018

Abstract

As many countries are aging rapidly, improving older persons’ health and reducing the burden of disease are important goals. However, many developing countries still lack effective policies in the areas of preventive health care and health services utilization of older persons. This study aims: (1) to determine the health status by severe injury report and health care service needs of Vietnamese older persons, (2) to investigate the factors associated with the use of health check-up services of Vietnamese older persons, and (3) to investigate the differences in health care services utilization between different medical needs of Vietnamese older persons. Using data from Vietnam Household Living Standards Survey (VHLSS) 2018, this study has a sample of 5037 older persons with 6030 responses regarding healthcare facility visits. The study employs multinomial logistic regressions to analyze the predisposing, enabling, and medical need factors associated with health care services utilization. The results show that 15.9% of elderly respondents had at least one severe injury. The percentages reporting no use of any services, use for health check-ups, and use for medical treatment were 29.7%, 17.0%, and 53.3%, respectively. The results show that age, being female, education, and having health insurance were positively associated with the likelihood of using health check-up services as compared to not using any services. In contrast, being from the minority group and co-residence with family members were negatively associated with the likelihood of using health check-up services. Besides, older persons with non-severe illness tended to use more private healthcare services while those with severe illness were more likely to use district hospitals and provincial/central hospitals. To conclude, the health status of older persons needs to be concerned. The main motivation for the elderly to seek health care services was medical treatment while the proportion of older persons who used preventive health care was quite low. The main barriers came from differences in demographic characteristics such as age, education, ethnicity and not having health insurance. Policies to increase coverage of health insurance, and to improve understanding of the importance of health check-ups are necessary. The results also have implications for targeted programs that focus on certain groups such as the youngest-old and the minority group. Besides, policies need to focus on an innovative reform toward a diversified structure of health care facilities, especially reorganizing services and improving service quality at commune health centers.