Health status and health service utilization in remote and mountainous areas in Vietnam.
Health status and health service utilization in remote and mountainous areas in Vietnam.
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DOI：
10.1186/s12955-016-0485-8
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发表时间：
2016-06-07
影响因子：
3.6
通讯作者：
Nguyen CT
中科院分区：
文献类型：
--
作者：
Tran BX;Nguyen LH;Nong VM;Nguyen CT
自评健康状况和卫生服务利用是评价卫生系统绩效的重要指标。然而，在处境不利的地区，人们对卫生保健服务的获取和结果知之甚少。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）、健康状况和医疗保健的获取和利用。在越南两个省方便的居民样本中进行了横断面研究。采访了有关社会经济、健康状况、HRQOL、寻求医疗保健和服务利用的信息。采用EuroQol -5 Dimensions -5 Levels （eq - 5d - 5l）测量HRQOL。200名受访者平均年龄44.9岁（SD = 13.9），男性占38.0%。三分之一的人报告在行动能力、日常活动、疼痛或不适、焦虑或抑郁方面有任何问题。女性在疼痛/不适、焦虑/抑郁方面的问题往往比男性多，总体HRQOL也比男性低。超过90%的答复者报告了至少一个健康问题。流感、感冒和头痛是最常见的症状（41.5%）。大多数人在生病时选择社区卫生中心（96.0%）。只有18.5%的人使用传统疗法，平均每年5.8次。族裔、家庭支出、疾病和发病率状况、获得保健服务的困难程度与HRQOL有关；同时，社会经济地位、健康问题、服务质量和距离与获得保健和传统医学服务的机会有关。生活在交通不便地区的居民普遍存在健康问题，在获得保健服务方面存在社会和结构性障碍。有必要提高保健和传统医学服务的可得性和质量，以改善弱势群体的健康状况。
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.