Health status and health service utilization in remote and mountainous areas in Vietnam.
BACKGROUND
Self-rated health status and healthcare services utilization are important indicators to evaluate the performance of health system. In disadvantaged areas, however, little is known about the access and outcomes of health care services. This study aimed to assess health-related quality of life (HRQOL), health status and healthcare access and utilization of residents in mountainous and remote areas in Vietnam.


METHODS
A cross-sectional study was conducted in a convenient sample of residents in two provinces of Vietnam. Information about socio-economic, health status, HRQOL, healthcare seeking and services utilization were interviewed. EuroQol - 5 Dimensions - 5 Levels (EQ-5D-5 L) was used to measure HRQOL.


RESULTS
Of 200 respondents, mean age was 44.9 (SD = 13.9), 38.0 % were male. One third reported having any problem in Mobility, Usual activities, Pain or Discomfort, Anxiety or Depression. Women tended to suffer more problems in Pain/Discomfort and Anxiety/Depression and lower overall HRQOL than men. Over 90 % of respondents reported at least one health problem. Flu, cold and headache were the most commonly reported symptoms (41.5 %). Most of people preferred community health center when they had illness (96.0 %). Only 18.5 % people used traditional healers with the average of 5.8 times per year. Ethnicity, households' expenditure, illness and morbidity status, difficulty in accessing health care services were related to HRQOL.; Meanwhile, socioeconomic status, health problems, quality of services, and distances were associated with access to healthcare and traditional medicine services.


CONCLUSIONS
Residents in difficult-to-reach areas had high prevalence of health problems and experienced social and structural barriers of healthcare services access. It is necessary to improve the availability and quality of healthcare and traditional medicine services to improve the health status of disadvantaged people.
Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam.|Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Bach Xuan
BX
Tran
School of Medicine and Pharmacy, Vietnam National University, Hanoi, Vietnam.
Long Hoang
LH
Nguyen
Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam.
Vuong Minh
VM
Nong
Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam. tatcuong.hmu@gmail.com.
Cuong Tat
CT
Nguyen
D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011788:Quality of Life; D012424:Rural Population / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D014744:Vietnam; D055815:Young Adult
Accessibility; Health service; Mountainous; Quality of life; Remote; Self-rated health; Utilization; Vietnam