Factors Associated with Regional Disparity in Utilization of Healthcare Services among the Vietnamese Older People

Abstract

This study examined regional differences in the utilization of healthcare services among older patients in Vietnam, using a national survey on older people. We applied logistic regression models with various predisposing factors (such as age, gender, and educational level), enabling factors (such as living arrangements and social participation) and health-needs factors (such as self-rated health and chronic conditions) associated with older people’s utilization of healthcare services. We found that about 90% of older persons visited a health facility for health treatment, with older persons living in the Central region being more likely than their Northern counterparts in using healthcare services. Also, our studies showed that the predisposing factors and enabling factors widened the regional disparities, however the health-needs factors helped narrow the differences. In addition, chronic conditions were the most important predictors for older people in utilizing healthcare services, and receiving monetary support from children was the main driver for rural older people. By contrast, health insurance was not a predictor of health service access, and this could be elucidated apart by the fact that services paid by health insurance were limited. We discussed some policies to improve the utilization of healthcare services for older people, particularly we argued that social insurance mechanisms must be improved, and familial support to older people in rural areas should be further enabled.