title: Willingness to use and pay for options of care for community-dwelling older people in rural Vietnam.
abstract: BACKGROUND
  The proportion of people in Vietnam who are 60 years and over has increased rapidly. The emigration of young people and impact of other socioeconomic changes leave more elderly on their own and with less family support. This study assesses the willingness to use and pay for different models of care for community-dwelling elderly in rural Vietnam.
  
  
  METHODS
  In 2007, people aged 60 and older and their family representatives, living in 2,240 households, were randomly selected from the FilaBavi Demographic Surveillance Site. They were interviewed using structured questionnaires to assess dependence in activities of daily living (ADLs), willingness to use and to pay for day care centres, mobile care teams, and nursing centres. Respondent socioeconomic characteristics were extracted from the FilaBavi repeated census. Percentages of those willing to use models and the average amount (with 95% confidence intervals) they are willing to pay were estimated. Multivariate analyses were performed to measure the relationship of willingness to use services with ADL index and socioeconomic factors. Four focus group discussions were conducted to explore people's perspectives on the use of services. The first discussion group was with the elderly. The second discussion group was with their household members. Two other discussion groups included community association representatives, one at the communal level and another at the village level.
  
  
  RESULTS
  Use of mobile team care is the most requested service. The fewest respondents intend to use a nursing centre. Households expect to use services for their elderly to a greater extent than do the elderly themselves. Willingness to use services decreases when potential fees increase. The proportion of respondents who require that services be free-of-charge is two to three times higher than the proportion willing to pay full cost. Households are willing to pay more than the elderly for day care and nursing centres. The elderly are more willing to pay for mobile teams than are their households. Age group, sex, literacy, marital status, living arrangement, living area, working status, poverty, household wealth and dependence in ADLs are factors related to willingness to use services.
  
  
  CONCLUSIONS
  Community-centric elderly care will be used and partly paid for by individuals if it is provided by the government or associations. Capacity building for health professional networks and informal caregivers is essential for developing formal care models. Additional support is needed for the most vulnerable elderly to access services.
authors.affiliation: Umeå Centre for Global Health Research, Department of Public Health and Clinical Medicine, Umeå University, Sweden. hoilv@yahoo.com
authors.forename: Le
authors.initials: L
authors.lastname: Van Hoi
authors.forename: Nguyen
authors.initials: N
authors.lastname: Thi Kim Tien
authors.forename: Nguyen
authors.initials: N
authors.lastname: Van Tien
authors.forename: Dao
authors.initials: D
authors.lastname: Van Dung
authors.forename: Nguyen
authors.initials: N
authors.lastname: Thi Kim Chuc
authors.forename: Klas
authors.initials: K
authors.lastname: Goran Sahlen
authors.forename: Lars
authors.initials: L
authors.lastname: Lindholm
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D003153:Community Health Services / Q000191:economics*; D005190:Family; D005382:Financing, Personal / Q000592:standards*; D017144:Focus Groups; D006301:Health Services Needs and Demand / Q000191:economics*; D006299:Health Services for the Aged / Q000191:economics*; D006801:Humans; D008875:Middle Aged; D008952:Mobile Health Units / Q000191:economics; D011157:Population Dynamics; D019035:Rural Health Services / Q000191:economics; D011795:Surveys and Questionnaires; D014744:Vietnam