title: Financial burden of health care for HIV/AIDS patients in Vietnam.
abstract: OBJECTIVE
  To assess the out-of-pocket (OOP) payments for health-care services of HIV/AIDS patients, and identify associated factors in Vietnam.
  
  
  METHODS
  Cross-sectional multisite survey of 1016 HIV/AIDS patients attending 7 hospitals and health centres in Ha Noi, Hai Phong and Ho Chi Minh City in 2012.
  
  
  RESULTS
  HIV/AIDS patients used inpatient and outpatient care on average 5.1 times (95% CI = 4.7-5.4) besides ART services. Inpatient care cost US$ 461 on average and outpatient care US$ 50. Mean annual health-care expenditure for HIV/AIDS patients was US$ 188 (95% CI = 148-229). 35.1% of households (95% CI = 32.2-38.1) experienced catastrophic health expenditure; 73.3% (95% CI = 70.6-76.1) of households would be affected if ART were not subsidised. Being a patient at a provincial clinic, male sex, unstable employment, being in the poorest income quintile, a CD4 count of <200 cells/mL and not yet receiving ART increased the likelihood of catastrophic medical expense.
  
  
  CONCLUSIONS
  HIV/AIDS patients in Vietnam frequently use medical services and incur OOP payments for health care. Scaling up free-of-charge ART services, earlier access to and initiation of ART, and decentralisation and integration of HIV/AIDS-related services could reduce their financial burden.
authors.affiliation: School of Public Health, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Bach X
authors.initials: BX
authors.lastname: Tran
authors.forename: Anh T
authors.initials: AT
authors.lastname: Duong
authors.forename: Long T
authors.initials: LT
authors.lastname: Nguyen
authors.forename: Jongnam
authors.initials: J
authors.lastname: Hwang
authors.forename: Binh T
authors.initials: BT
authors.lastname: Nguyen
authors.forename: Quynh T
authors.initials: QT
authors.lastname: Nguyen
authors.forename: Vuong M
authors.initials: VM
authors.lastname: Nong
authors.forename: Phu X
authors.initials: PX
authors.lastname: Vu
authors.forename: Arto
authors.initials: A
authors.lastname: Ohinmaa
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy / Q000191:economics*; D000328:Adult; D044966:Anti-Retroviral Agents / Q000191:economics* / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active / Q000191:economics* / Q000379:methods; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000191:economics*; D017048:Health Care Costs; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D010342:Patient Acceptance of Health Care / Q000523:psychology; D012959:Socioeconomic Factors; D014744:Vietnam / Q000453:epidemiology
chemical_list: D044966:Anti-Retroviral Agents