Healthcare Services Utilisation and Financial Burden among Vietnamese Older People and Their Households.

BACKGROUND: This research examined differences in the utilisation of healthcare services and financial burden between and within insured and uninsured older persons and their households under the social health insurance scheme in Vietnam. METHODS: We used nationally representative data from the Vietnam Household Living Standard Survey (VHLSS) conducted in 2014. We applied the World Health Organization (WHO)'s financial indicators in healthcare to provide cross-tabulations and comparisons for insured and uninsured older persons along with their individual and household characteristics (such as age groups, gender, ethnicity, per-capita household expenditure quintiles, and place of residence). RESULTS: We found that social health insurance was beneficial to the insured in comparison with the uninsured in terms of utilization of healthcare services and financial burden. However, between and within these two groups, more vulnerable groups (i.e., ethnic minorities and rural persons) had lower utilization rates and higher rates of catastrophic spending than the better groups (i.e., Kinh and urban persons). CONCLUSION: Given the rapidly ageing population under low middle-income status and the "double burden of diseases", this paper suggested that Vietnam reform the healthcare system and social health insurance so as to provide more equitable utilisation and financial protection to all older persons, including improving the quality of healthcare at the grassroots level and reducing the burden on the provincial/central health level; improving human resources for the grassroots healthcare facilities; encroaching public-private partnerships (PPPs) in the healthcare service provision; and developing a nationwide family doctor network.

Productive activities of the older people in Vietnam.

Productive activities are crucial factors leading to an "active aging" population. With the case of Vietnam, this paper aimed to explore the productive activities among Vietnamese older people by using data from the Vietnam Aging Survey (VNAS), which was conducted in 2011 as the first-ever nationally representative survey on persons aged 50 and over in Vietnam and contained 2789 older people (those aged 60 and over) representing all older people living in 6 ecological regions and urban and rural areas in Vietnam. Productive activities included working and/or taking care of any (great)grandchild(ren) in the past 12 months prior to the survey. Using paired t-tests and probit models, we compared the differences in these productive activities among older people in terms of sex and living area. The results from various t-tests showed that educational attainment, health status and poverty status were key factors differentiating older men and women and rural and urban older people in these productive activities. For the probit estimations in terms of both gender and living location, the results indicated that age, education, health status and supportive children were determinants of working decision, while age, marital status and size of household were consistently important factors of taking care of (great)grandchildren. The paper also discussed policy implications for socio-economic and health protection in promoting older people's productive activities as well as protecting them from a variety of risks and vulnerabilities.