Utilization of private and public health-care providers for tuberculosis symptoms in Ho Chi Minh City, Vietnam.
In Vietnam, as in many other countries, tuberculosis (TB) control has long been organized exclusively within the public health-care system. However, recently the private health-care sector has become more important and private health-care providers currently have a role in TB care delivery in Vietnam. Through a retrospective survey of patients at District Tuberculosis Units (DTUs) of the National Tuberculosis Programme in Ho Chi Minh City, we investigated utilization of private and public health-care providers among people with symptoms of TB. Eight hundred and one patients in eight DTUs were interviewed. For the current illness episode, about half of the patients had initially opted for a private health-care provider. Twenty-seven percent had been to a private physician and 31% to a private pharmacy at some time during their current illness. We found no significant association between socioeconomic status and use of private health-care providers. Utilization of private health-care providers among people with TB or symptoms of TB in Ho Chi Minh City seems to be similar to the general utilization of private providers in Vietnam, at least before TB is diagnosed. Since a large proportion of people with TB in Ho Chi Minh City across all economic and social strata consult private providers at some time during their illness, planners of TB control strategies need to consider both the health-care seeking behaviour of people with TB and the clinical behaviour of private providers, in order to secure early detection of TB, early initiation of appropriate treatment, and maintenance of appropriate treatment.
Department of Social Medicine, Göteborg University, Vasa Hospital, S-411 33 Göteborg, Sweden. knut.lonnroth@socmed.gu.se
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Lönnroth
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Thuong
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Linh
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Diwan
D000293:Adolescent; D000328:Adult; D000368:Aged; D003695:Delivery of Health Care / Q000458:organization & administration*; D003906:Developing Countries; D005260:Female; D006779:Hospitals, Public / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011331:Private Practice / Q000706:statistics & numerical data*; D017150:Public Sector / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy* / Q000453:epidemiology; D014505:Urban Population / Q000706:statistics & numerical data; D014600:Utilization Review; D014744:Vietnam / Q000453:epidemiology