title: Chronic diseases among the elderly in a rural Vietnam: prevalence, associated socio-demographic factors and healthcare expenditures.
abstract: BACKGROUND
  Globally, the population of elderly persons is increasing as well as the prevalence of chronic diseases. This change is causing increased healthcare costs to health care systems threatening to push many households into poverty. Low and middle income countries are projected to experience the greatest impact from this change. This study aims to describe the prevalence of common chronic diseases (CCDs) among the elderly in Vietnam, the associated socio-demographic factors and healthcare expenditures.
  
  
  METHODS
  This is a cross-sectional study in the FilaBavi demographic surveillance site in Vietnam. 2873 persons over 60 years were randomly sampled. Prevalence of CCDs was reported from study subjects who previously were informed by physicians. Healthcare expenditures were determined from recall of expenses during the last hospital visit. Binomial logistic regression was done to determine the socio demographic predictors of having a CCD or multiple CCDs. Mean healthcare expenditures for the elderly with CCDs and those without CCDs were summarised and compared.
  
  
  RESULTS
  Forty two percent of the elderly were found to have at least one CCD. Joint problems were the most common CCD at 35 %, followed by hypertension at 15 % and chronic bronchitis at 11 %. Being female (OR = 1.51, 95 % CI = 1.03-2.21, p-value = 0.036), higher education (OR = 2.54, 95 % CI = 1.13-5.74, p-value = 0.025) and having advanced age (OR = 1.92, 95 % CI = 1.22-3.00, p-value = 0.005), were associated with common chronic diseases in the elderly. Outpatient healthcare expenditures were found to be significantly higher for the elderly with CCDs than those without CCDs.
  
  
  CONCLUSIONS
  Higher education and being female are important key predictors of having a CCD, while wealth quintile is a predictor of multimorbidity, in the elderly. Healthcare expenditures for outpatient health services are higher for elderly persons with CCDs and these costs should be targeted when planning for financial protection.
authors.affiliation: Global Health, Department of Public Health Sciences, Karolinska Institute, Widerströmska Huset, Tomtebodavägen 18A, Stockholm, Sweden. jonathanmwangi@gmail.com.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Mwangi
authors.affiliation: Global Health, Department of Public Health Sciences, Karolinska Institute, Widerströmska Huset, Tomtebodavägen 18A, Stockholm, Sweden. Asli.kulane@ki.se.
authors.forename: Asli
authors.initials: A
authors.lastname: Kulane
authors.affiliation: National Lung Hospital, EVIPNet Vietnam, 463, Hoang Hoa Tham, Ba Dinh, Hanoi, Vietnam. hoilv@yahoo.com.
authors.forename: Le
authors.initials: L
authors.lastname: Van Hoi
mesh_terms: D002908:Chronic Disease / Q000191:economics* / Q000453:epidemiology / Q000628:therapy; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care / Q000191:economics*; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D012424:Rural Population / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D014744:Vietnam / Q000453:epidemiology