title: Implementation of GINA guidelines in Ho Chi Minh City: a model for Viet Nam.
abstract: METHODS
  The Global Initiative for Asthma (GINA) guidelines have not been implemented effectively in primary care settings in Viet Nam.
  
  
  OBJECTIVE
  To estimate the proportion of patients with controlled asthma and the direct health care costs of managing asthma according to GINA guidelines at four out-patient clinics in Ho Chi Minh City (HCMC), Viet Nam.
  
  
  METHODS
  One hundred and six patients with asthma were treated and followed up according to GINA guidelines for 12 months. Clinical and pulmonary function responses and direct health care costs were evaluated every 3 months during the study.
  
  
  RESULTS
  The proportion of patients with controlled asthma rose from 1.0% at the start of the study to 36.8% by the end of the study (P < 0.0001). The proportion of patients who had at least one hospitalisation per year decreased significantly, from 32.1% to 5.7% (P < 0.0001). The annual per patient median direct health care cost was US$169. Using asthma controllers continuously gave better asthma control than using them intermittently (OR 12.9, 95%CI 4.7-35.7).
  
  
  CONCLUSIONS
  The implementation of GINA guidelines at out-patient clinics in HCMC, Viet Nam, improved asthma control with modest direct health care costs.
authors.affiliation: Department of Tuberculosis and Lung Diseases, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Viet Nam ; Respiratory Care Centre, University Medical Centre at Ho Chi Minh City, Ho Chi Minh City, Viet Nam.
authors.forename: N V
authors.initials: NV
authors.lastname: Tho
authors.affiliation: Health Care Centre of Phu Nhuan District, Ho Chi Minh City, Viet Nam.
authors.forename: H T H
authors.initials: HT
authors.lastname: Loan
authors.affiliation: Health Care Centre of Hoc Mon District, Ho Chi Minh City, Viet Nam.
authors.forename: N T P
authors.initials: NT
authors.lastname: Thao
authors.affiliation: Regional General Hospital of Thu Duc District, Ho Chi Minh City, Viet Nam.
authors.forename: N T T
authors.initials: NT
authors.lastname: Dung
authors.affiliation: Respiratory Care Centre, University Medical Centre at Ho Chi Minh City, Ho Chi Minh City, Viet Nam ; Department of Physiology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Viet Nam.
authors.forename: L T T
authors.initials: LT
authors.lastname: Lan
keywords: asthma; cost-effectiveness; management; out-patient