The heterogeneity of public preferences for the first healthcare visit: A discrete choice experiment in the context of Vietnam.

Primary healthcare is critical in addressing the main health problems of communities. In Vietnam, the increasing healthcare demands cause major challenges, especially overcrowding. This study identified public preferences regarding the selection of healthcare facilities for first visit. A discrete choice online survey was generated from five attributes including visit duration, travel time, personal connection with medical staff, doctors' experience, and health insurance. A Dz -efficient design constructed 36 choice sets, divided into three blocks of 12 choice sets. Each block formed one version of the questionnaire, which was randomly distributed to the participants. Heterogeneity in participant preferences was analysed by a latent class model with socio demographic characteristics and experiences of the last visit. 822 participants valued doctors' experience for both minor and severe symptoms. Preference heterogeneity for minor symptoms was quick service provision, highly experienced doctors, and payment through health insurance for the first (44.18%), second (32.17%), and third classes (23.66%), respectively. Regarding severe symptoms, they favoured all five attributes, quick health service, and reduced travel time for the first, second, and third classes, respectively (heterogeneities of 58.16%, 27.79%, and 14.05%, respectively). Predictions of choice from the worst to optimal healthcare facility scenario were 8.91%-61.91% and 10.16%-69.83% for minor and severe symptoms, respectively. Knowledge regarding public preference heterogeneity supports policymakers increase public acceptance in choosing primary healthcare facilities. Visit duration and doctors' experience should be considered a priority in decision making.

Economic burden and productivity loss related to eczema: A prevalence-based follow-up study in Vietnam.

OBJECTIVE: Eczema, a chronic dermatologic disease, has been recognized as an economic burden in publications all over the word but only minimally as such in Vietnam. The aim of this prospective study was to quantify the financial hardships and impairments suffered by eczema patients. METHODS: This cross-sectional prevalence-based study involved 136 patients, whose conditions were classified into three severity levels on the basis of the medications that they were prescribed. Prescription therapy was administered for a month, after which there was patient-oriented assessment of effectiveness. The work productivity and activity impairment (WPAI) questionnaire was used to evaluate productivity loss, which was expressed in percentage form. Bootstrapping was conducted to determine continuous variables and demographybased differences in cost values among the patient groups. RESULTS: For the month-long treatment, each eczema patient needed an average of US$68.1 (range: US$56.2- US$81.5) with the highest proportion being spent on cosmetic treatments. There is noticeable difference between groups among which patients' symptoms demonstrated in distinct levels. The estimates indicated that eczema resulted in 27.8% and 23.1% impairments in work and daily activities, respectively. CONCLUSIONS: The aggravation of disease symptoms can increase the direct costs borne by eczema patients. A decrease in productivity, which is one of the most serious consequences of the condition, should be paid adequate attention to minimize burdens to society.

Economic outcomes among chronic obstructive pulmonary disease Vietnamese patients: Approach considerations from a social perspective.

OBJECTIVE: Chronic obstructive pulmonary disease (COPD) is associated with major burden on economic effects. The objective of this study was to explore cost categories caused by COPD in Vietnam and the relationships between those costs and some demographic factors. METHODS: A cross-sectional study was carried out among 359 COPD patients who visited Dong Nai General Hospital in Vietnam in 2018. Patients were classified according to codes from the International Classification of Diseases, 10th revision (ICD-10) (J44: Chronic obstructive pulmonary disease). Demographic information and clinical status of the data were illustrated by descriptive statistics. With the bootstrapping method, cost data are represented as an arithmetic mean cost (Bootstrap 95% CI). RESULTS: The sample of this study consisted of 359 patients, of which 280 (78.0%) were outpatient department (OPD) patients compared to the 79 (22%) inpatient department (IPD) patients. Total costs per visit were estimated at $87.10 (95% CI $76.20-$99.50) and $372.10 (95% CI $320.10-$430.00) for OPD and IPD, respectively. The costs had an increasing trend with the number of comorbidities, the severity, and the duration of COPD. The annual costs were higher in men than in women, but there was a "low burden" group of OPD stage IV patients. Costs per visit of the "low burden" group were more correlated with demographic categories than those of the "high burden" group. CONCLUSIONS: The results of this perspective study illustrate that Vietnamese COPD is associated with a significant economic burden. The cost of this disease per case is shown to be proportional to the severity and comorbidities of COPD; additionally, "high burden" groups have double the total costs of COPD.

Health-related quality of life (HRQoL) and health state utilities with chronic hepatitis-B (CHB): A population-based survey in Vietnam.

OBJECTIVE: Hepatitis-B infection is a worldwide consideration despite of vaccination availability. Chronic Hepatitis-B (CHB) results in various complications and the impairment of health-related quality of life (HRQoL). Health state utilities and HRQoL are the fundamental input to decision models as well as economic evaluation analysis. Although the effect of CHB on the HRQoL and health state utilities is well-known, the results remain uncertain. The objective is to measure health state utilities and HRQoL among CHB patients at two provincial hospitals in southern Vietnam using both preference-based and non-preference-based tools. METHODS: A cross-sectional survey was conducted from August 2017 to July 2018 in Dongnai and Kiengiang General Hospitals (DNGH and KGGH). Patients with the ICD-10 code of B18 was enrolled using convenience sampling method. Each respondent was experienced a face-to-face interview with four health measurement instruments. SPSS 20.0 software was used for data analsysis. RESULTS: The total research population included 546 patients at DNGH and 338 patients at KGGH, each of them was classified in to one of four stages of the disease. The majority were male, well-educated and alcohol-consumers. The average physical component score was highest in patients with compensated cirrhosis at KGGH (58.7}0.9). The average mental component score was highest in patients with noncirrhotic CHB at DNGH (60.3}0.2). In both hospitals, patients with noncirrhotic chronic Hepatitis B had the highest mean score of EuroQoL 5 dimensions questions; patients with decompensated cirrhosis had the lowest mean score of visual analogue scale. CONCLUSIONS: This is the first study in Vietnam which used both preference-based and non-preference-based insstrument to measure the HRQoL in HBV-infected patients. The results from different instruments were similar. These findings were promised to be a fundamental input for future cost-effectiveness analysis in the same field.

Post-stroke rehabilitation cost with traditional therapy: Evidence from a public hospital.

OBJECTIVE: After surviving from an acute phase of stroke, it is essential for stroke survivors to continue therapies to improve their function and quality of life. The aim of this study was to assess the influence of rehabilitation treatment on the society in economic aspect with evidence from a traditional hospital. METHODS: A prospective cohort study was carried out with patients who were being treated at Traditional Medicine Hospital in Ho Chi Minh City after experiencing a stroke. Patients' relevant medical information was extracted from the hospital's database and placed on a structured questionnaire. RESULTS: Among 103 eligible patients aged 60.3 } 11.4 years, 93.2% had experienced a stroke for the first time. Eighty-four patients were diagnosed with ischaemic stroke, while the number of haemorrhagic stroke patients was approximately 4.5 times lower (n = 19). The mean total cost was $3,310.40 USD, which included $1,653.60 USD, $539.90 USD and $1,117.00 USD for direct medical, direct non-medical and indirect cost, respectively. Hospital bed costs accounted for a considerable percentage of direct medical costs (41.0%). CONCLUSIONS: Stroke was determined to be a significant social burden, although patients in this study had already suffered from the acute phase. This study gives decision makers a comparative view about the economic view on the economic burden of the stroke rehabilitation treatment between using traditional national Western and Eastern therapy.

Revisiting dengue-related knowledge, attitudes and practices: A cross-sectional study in Ho Chi Minh City, Vietnam, 2018.

OBJECTIVE: In recent years, Vietnam has been recorded as one of the most endemic areas of dengue fever (DF). Thus, controlling DF has become a matter of concern to healthcare professionals and the government. Nevertheless, there has been little research exploring inhabitants' awareness about DF in Ho Chi Minh City, Vietnam. The aims of the study was to assess the knowledge, attitudes, and practices (KAP) regarding DF by the population in Ho Chi Minh City, Vietnam. METHODS: In July 2018, a cross-sectional study was conducted among 1,175 people in Ho Chi Minh City, Vietnam, using an administered questionnaire. RESULTS: Only 38% of participants had good knowledge, and 55% of the population reached the satisfactory practices score, while 74% showed positive attitudes relating to DF. Unlike many other studies, education level was not associated with KAP score. However, marital status and monthly income seemed to be related to participants' knowledge levels. In addition, the main sources of information in this research were television and the Internet. CONCLUSIONS: This study showed that participants lacked knowledge regarding DF and practices to prevent it. These results recommend improving the population's knowledge andpractices through campaigns aimed at preventing breeding of mosquitoes.

Analyzing the variation in treatment costs for colorectal cancer (CRC): A retrospective study to assess an underlying threat among the Vietnamese.

OBJECTIVE: Colorectal cancer (CRC) is the third most common, and the second deadliest, cancer documented in recent years, and numerous studies have addressed this issue. Nevertheless, little attention has been given to the CRC burden in Vietnam. Our study aims to analyze variations in cost for CRC treatments using the cost of illness (COI) method. METHODS: Utilizing medical records spanning from 2014 to 2017 supplied by a primary healthcare facility in Ho Chi Minh City, a population of 9,126 patients, diagnosed with and treated for CRC, was analyzed in terms of demographic detail and individual treatment cost. RESULTS: Among the 9,126 patients hospitalized with CRC, 3,699 patients were between the ages of 50 and 65. Colon cancer accounted for 56.4% and 60.4% of the total patients in Inpatient Department (IPD) and Outpatient Department (OPD). The total direct medical cost was calculated to be over ten million USD for IPD patients and over three million USD for OPD patients over a four year span of data. The per-patient cost was $2,741.00 (IPD) and $588.80 (OPD), with chemotherapy drugs being 53% (IPD) and 73% (OPD) of the overall treatment cost. Patients going through both treatment regimens incurred a mean cost of $4,271.20 (IPD) and $1,779.80 (OPD). CONCLUSIONS: There is a similarity in the costs of CRC treatment in developing countries in Asia. Despite many limitations, we are certain this study will be useful for future studies regarding the CRC burden in Asia in general, as well as in developing countries like Vietnam.

Quality of life measurement alteration among Vietnamese: Impact and treatment benefit related to eczema.

OBJECTIVE: Health-related quality of life is an important factor when assessing the impairment of a disease and the benefit of treatment, especially eczema-a chronic dermatologic condition. The objective of this study is to express the distinction between quality of life and clinical characteristics of Vietnamese eczema patients pre- and posttreatment by using repeated measurement. METHODS: A before-and-after, prevalence-based study was conducted with a minimum sample size of 132 patients in a dermatology hospital in southern Vietnam. Two domains of SCORAD were applied to demonstrate clinical characteristics while DLQI and EQ-5D-5L were used to identify the impact on patients' quality of life. The difference and correlation between variables were used to express the benefit of treatment through the bootstrapping method, the Spearman test, and multivariable regression. RESULTS: A total of 136 respondents were eligible for this study design, with an average age of 36.9}15.9. The effect of eczema on participants' quality of life was demonstrated through a DLQI mean score of 7.0 (6.2-7.8). There was a correlation between clinical factors, DLQI, and EQ-5D results (p-value < 0.01). After the post-treatment evaluation, the DLQI score decreased by 3.7 points, and a multivariable model reflected the effect levels of symptoms on patient improvement. CONCLUSIONS: Eczema led to a negative effect on patients in many aspects of their lives. Reducing subjective symptoms significantly enhances the quality of life of eczema patients.

The economic burden attributable to asthmatic inpatients and outpatients in a military hospital, Vietnam: A retrospective 5-year analysis.

OBJECTIVES: Asthma is a disease that causes significant health and economic burdens worldwide. The prevalence and incidence of asthma have been rising around the world over recent decades. The current study is to capture the direct medical costs of inpatient and outpatient asthma treatment for the period from 2013 to 2017. METHODS: This study was conducted at Military Hospital 175 in Vietnam. The study was performed from the patient and social insurance perspective, which means all types of costs were identified and measured based on patients' healthcare insurance. Cost analysis was measured using the medical records for estimating the economic burden of asthma. The study adopted descriptive statistics and bootstrap techniques to calculate asthma-related costs as well as analyze the background characteristics of asthma patients. RESULTS: The average outpatient and inpatient costs were US$64.90 and US$141.20, respectively, over the period from 2013 to 2017, for which out-of-pocket payments accounted for 10-12%. Medications, specifically asthma controller drugs, were the key driver leading to the substantial burden of direct medical costs for treating asthma. The cost burden was also significantly higher for adult patients compared to children. CONCLUSIONS: Asthma continues to be a concerning problem in Vietnam. The economic impact of either preventive or promotive health interventions that can reduce the prevalence of asthma can be predicted from the statistics found in this research. Moreover, this data will help policymakers plan and allocate national expenditures for asthma treatment in a more rational way.

The economic impact of asthma treatment on patients, 2014-2017: The Vietnamese experience from a public hospital.

OBJECTIVES: To estimate the economic burden of asthma treatment by quantifying direct medical expenditures at one of Southern Vietnam's public hospitals base on the hospital perspective. METHODS: A retrospective, prevalence-based, cost-of-illness analysis was developed using the hospital's electronic medical record data to calculate the economic burden of asthma (ICD-10 code J45, J46) through direct medical costs from January 2014 to December 2017. All costs were converted to US dollars and to the year 2018. Data were analyzed using descriptive statistics. The potential correlations between variables were evaluated using the chisquare test and bootstrap difference. RESULTS: The average direct medical cost of asthma was estimated to range from $34.7 to $55.3 per - outpatient and $45.1 to $107.2 per - inpatient annually. The total economic burdens for 4 years from 2014 to 2017 were $110,387.4 from outpatients and $13,413.8 from inpatients. The most influential component was medication cost. CONCLUSIONS: Asthma places a high economic burden on individuals and the healthcare system in Vietnam. The findings of this study provide health administrators with important evidence to enhance surveillance of the disease and to allow suitable drafting of national health policy.

Non-surgical chronic rhinosinusitis and quality of life: A Vietnamese perspective.

OBJECTIVE: Evidences which illustrate symptoms of chronic rhinosinusitis (CRS) had negative effects on society and individuals are growing these days. The aims of this study are to assess the quality of life (QoL) of individuals with CRS and to analyze the relationship between socio-demographic as well as clinical factors and the quality of life of patients. METHODS: A cross-sectional and prevalence-based study was conducted from May to July, 2018. We used The Sinonasal Outcome Test-22 (SNOT-22) questionnaire to evaluate the quality of life of patients with chronic rhinosinusitis. In addition, the univariate logistic regression analysis and logistic regression models were used to calculate the Crude odds ratio (OR), adjusted odds ratio (aOR), and 95% confidence intervals (CIs) for factors. Statistical significance was considered as P-value <0.05. RESULTS: Among 315 participants, about two fifths of them were diagnosed with CRS. The statistical test illustrated that all factors illustrated significant differences. The main exposure variable, CRS, was significantly associated with poor quality of life, with a 78.02-fold increase in the odds of having a good quality of life score. CONCLUSIONS: Our findings have shown that patients with CRS experience a poorer quality of life than healthy controls. The influencing factors included gender, economic status, exercise and nasal discharge.

Assessment of cost of illness and quality of life in chronic rhinosinusitis patients with surgical treatment.

OBJECTIVE: Chronic rhinosinusitis (CRS) is a popular and tiring disease with significant impacts on the economy and on the Health-related Quality of Life (HRQOL) of patients. This study aims to estimate the cost of illness (COI) and to assess the Health-related Quality of Life (HRQOL) in patients with CRS who underwent surgery in Vietnam and to analyse the relationship between socio-demographic characteristics and the COI as well as the HRQOL. METHODS: A cross-sectional study was conducted in Ear, Nose, Throat Hospital in Ho Chi Minh City (ENT Hospital HCMC), Vietnam between August and October 2018. The direct medical and non-medical costs, the indirect costs (productivity loss), and the HRQOL of patients with CRS were measured. A subjective assessment of quality of life (QOL) using EuroQol 5 Dimensions 5 Levels (EQ-5D-5L) was used to evaluate the health status of these patients after surgery. Characteristics related with the COI and the HRQOL were identified by multiple regression. RESULTS: A total of 264 inpatients with CRS participated in the study. The mean COI for inpatients with CRS was $812.83 and direct costs accounted for a major proportion (89.32%) of the total cost. In addition, the surgery represented the most significant direct medical cost with 58.57% of the total cost. Most of the patients reported no problems with mobility (89.1%), self-care (93.9%), usual activities (77.2%), and anxiety/depression (64.0%). The mean EQ-5D-5L utility score was 0.76 (SD = 0.17), and the mean Visual Analogue Scale (EQ-VAS) score was 76.57 (SD = 13.34). The results of multiple regression showed that gender, occupations, monthly income, prior surgery and family history of CRS affected the total cost while the HRQOL of patients were related to education, smoking behaviour, exercise behaviour and family history of CRS. CONCLUSIONS: This study showed that although endoscopic sinus surgery (ESS) accounted for the largest expense in the COI, this surgical treatment helped to improve the HRQOL in patients with CRS. The findings provided a reference for policy makers in CRS management as well as for adjustment of costs for patients so as to reduce disease burden and to enhance their QOL.

Economic burden of eczema in a middle-income country: A public hospital-based retrospective study in 2016-2017 in Vietnam.

OBJECTIVES: Eczema, which is synonymous with atopic eczema, is classified as a complex, chronic, and relapsing inflammatory skin condition, affecting both adults and children. However, there has not been any research into health-care expenditure to evaluate the medical cost of eczema from patients' perspective in Vietnam. This retrospective study aimed to fill in the gap concerning the medical cost of eczema treatment from patients' perspective. METHODS: Data from Ho Chi Minh City Hospital of Dermato Venereology's electronic medical database on demographics and drug therapy from June 2016 to May 2017 were collected. The patients who met the study's criteria were included in the study and were then categorized as mild, moderate, and severe according to received treatment level. Bootstrapping methods were used to evaluate average and emphasized the difference of cost burden adjusted by factors. RESULTS: A total of 6,212 patients (52.1% women and 85% urban residents) participated in the study; they were divided into three groups according to treatment stage: mild (n = 3,159, 50.9%), moderate (n = 599, 9.6%), and severe (n = 2,454, 39.5%). The evaluated total cost for the three groups was 5,255.82, 1,064.03, and 5,8154.60 US dollars, respectively; the average expenditure per patient per year was around $12.11 ($11.63-12.59). CONCLUSIONS: The results suggested that the estimated direct medical cost of eczema treatment was much lower than that in the Western countries, mostly because of insurance coverage. The findings provide useful insights into health economic evaluations and treatment costs of eczema in Vietnam.

Knowledge, attitudes, and practices among university students in relation to dengue fever: A multi-center study across Vietnamese regions.

OBJECTIVE: Dengue fever (DF) is a serious illness worldwide that can spread rapidly and become a dangerous epidemic. Vietnam is an endemic country affected by the health and economic burden of dengue. This study was conducted to assess the knowledge, attitudes, and practices related to DF among university students across Vietnam. METHODS: A student-based cross-sectional study was performed with a structured questionnaire in Vietnam between July and September 2018. A Chi-square test and Fisher's exact test were used to compare different issues between two student groups, including medical and non-medical student, and P-values of <0.05 were considered significant. RESULTS: A total of 1,542 students from universities in Vietnam responded to the survey, which was reflective of 315 medical students learning in public schools, 689 medical students learning in private schools, and 538 non-medical students. The majority of participants had good knowledge on the transmission of DF, good attitudes toward DF, and good practices to prevent the disease. Medical students had better knowledge of the signs and symptoms than non-medical students. However, both student groups' knowledge of signs and symptoms was low. CONCLUSIONS: Quality of education is a key determinant of the knowledge of the disease, as well as of attitudes and practices. This study supported the government's implementation of intervention projects and DF prevention campaigns and its positive participation in the community.

Dengue fever in Southern of Vietnam: A survey of reported knowledge, attitudes, and practices.

OBJECTIVE: Dengue fever (DF) is an acute infectious disease with high incidence in tropical countries, such as Vietnam, where dengue prevention is a challenge for the health sector, government, and policy makers. The aim of this study was to assess the knowledge, attitudes, and practices in southern Vietnam and explore their relationships with the characteristics of the people. METHODS: A cross-sectional study was conducted, using interviews with 1,906 urban participants and 493 rural participants in southern Vietnam in July 2018. RESULTS: The study found a lack of knowledge regarding DF symptoms, with only 37.2% having a good level of knowledge, although 57.1% had good attitudes and 56.1% had good practices. Television (85.4 %) and the internet (69.5%) were the two main sources of information, and information provided by healthcare professionals was low. Participants with good knowledge had approximately 1.7 times the probability of having a good attitude and 5.0 times the probability of having good practices of those without. Urban participants had 1.3 times the level of knowledge than those in rural areas (p = 0.025), while the quality of attitude scores of rural participants was 1.3 times (p = 0.029) that of urban participants. CONCLUSIONS: Improvements in knowledge of DF, as well as in attitudes and practices toward dengue, are required, such as might be achieved through increased publicity and knowledge dissemination.

Cost-effectiveness of treating multidrug- and extensively drug-resistant tuberculosis: A systematic review.

OBJECTIVE: Tuberculosis (TB), along with the human immunodeficiency virus, is one of the leading causes of death from infectious diseases. Its prevalence has rendered the treatment of drug-resistant TB a major public health problem that threatens the progress made in TB care and control worldwide. Our objectives were to conduct a systematic review of the cost-effectiveness of treatment for multidrug-resistant and extensively drug-resistant TB (MDR-TB/XDR-TB) and to synthesise available data from scientific research. METHODS: Using English keywords, we searched for papers over reputable databases, such as Scopus, PubMed, Cochrane and Google Scholar, from Jan. 23 to Mar. 23, 2019. RESULTS: The search and screening yielded 13 articles, whose results were extracted and reviewed to draw conclusions on the cost-effectiveness of MDR-TB/XDR-TB treatment. The data extraction table used to cull and categorise the results comprised the characteristics of a given study, as well as its objectives, the perspectives used to guide the investigation, methods and results (outcome, sensitivity analysis). The measured outcome was the incremental cost-effectiveness ratio. CONCLUSIONS: The review indicated that MDR -TB/XDR-TB treatment can be very cost-effective in countries with low to high incomes, regardless of whether minimal or considerable disease burdens exist.

Assessing quality of life for multidrug-resistant and extensively drug-resistant tuberculosis patients.

OBJECTIVE: One can hypothesize that Mycobacterium genus originated more than 150 million years ago and has evolved to become one of the leading lethal infectious diseases. Multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB) patients are directly affected by the disease and other subjective issues, such as related diseases, medical costs and social issues, which all have negative impacts on patient quality of life (QOL). Our purpose is to define the status of health-related QOL for international MDR-TB and XDR-TB patients. METHODS: Systematic review is a good method for searching and selecting related researches and articles. As such, we have searched for and cited related articles on reputable databases, such as PubMed, Cochrance, and Google Scholar. A data overview was performed to draw conclusions and results on the QOL of MDR-TB and XDR-TB patients. RESULTS: A total of 18 articles were included, using instruments from the World Health Organization, Euroqol, Short Form, AQ and the Seattle Obstructive Lung Disease Questionnaire. The QOL of MDR-TB and XDR-TB patients was found to be compromised due to the strong resistance of Mycobacterium tuberculosis, economic pressure and community alienation. CONCLUSIONS: A number of QOL and health-related QOL studies on MDR-TB and XDR-TB patients are limited, especially with XDR-TB patients. Significant numbers of MDR-TB and XDR-TB patients still have sequelae after completing treatment, reducing the health-related QOL among these patients.

Direct Medical Costs of Dengue Fever in Vietnam: A Retrospective Study in a Tertiary Hospital.

BACKGROUND: In Vietnam, dengue fever is a major health concern, yet comprehensive information on its economic costs is lacking. The present study investigated treatment costs associated with dengue fever from the perspective of health care provision. METHODS: This retrospective study was conducted between January 2013 and December 2015 in Cu Chi General Hospital. The following dengue-related treatment costs were calculated: hospitalisation, diagnosis, specialised services, drug usage and medical supplies. Average cost per case and treatment cost across different age was calculated. RESULTS: In the study period, 1672 patients with dengue fever were hospitalised. The average age was 24.98 (SD = 14.10) years, and 47.5% were males (795 patients). Across age groups, the average cost per episode was USD 48.10 (SD = 3.22). The highest costs (USD 56.61, SD = 48.84) were incurred in the adult age group (> 15 years), and the lowest costs (USD 30.10, SD = 17.27) were incurred in the paediatric age group (< 15 years). CONCLUSION: The direct medical costs of dengue-related hospitalisation place a severe economic burden on patients and their families. The probable economic value of dengue management in Vietnam is significant.

The annual economic burden incurred by heart failure patients in Vietnam: a retrospective analysis.

Introduction: Heart failure (HF) is a chronic condition associated with substantial mortality and hospitalisation, resulting in costly inpatient visits. The healthcare systems of several countries, including Vietnam, experience considerable difficulty in dealing with the enormous fiscal burden presented by HF. This study aims to analyse the direct medical costs associated with HF inpatient treatment from the hospital perspective. Materials and methods: This study retrospectively analysed the electronic medical records of patients diagnosed with HF from 2018 to 2021 at Military Hospital 175 in Vietnam. The sample consisted of 906 hospitalised patients (mean age: 71.2 ± 14.1 years). The financial impact of HF was assessed by examining the direct medical expenses incurred by the healthcare system, and the costs of pharmaceutical categories used in treatment were explored. Results: The cumulative economic burden of HF from 2018 to 2021 was US$1,068,870, with annual costs ranging from US$201,670 to US$443,831. Health insurance covered 72.7% of these costs. Medications and infusions, and medical supplies accounted for the largest expenses, at 29.8% and 22.1%, respectively. The medication HF group accounted for 13.01% of these expenses, of which the costliest medications included nitrates (2.57%), angiotensin II receptor blockers (0.51%), ivabradine (0.39%), diuretics (0.24%), and mineralocorticoid receptor antagonists (0.23%). Comorbidities and the length of hospital stay significantly influenced annual treatment costs. Conclusion: The study reveals that HF significantly impacts Vietnam's healthcare system and citizens, requiring a comprehensive understanding of its financial implications and efficient management of medical resources for those diagnosed. This study highlights the substantial economic burden of HF on Vietnam's healthcare system, with medication costs, particularly antithrombotic drugs, representing the largest expense. Most healthcare costs were covered by health insurance, and expenses were significantly influenced by comorbidity and length of hospital stay. These findings can inform healthcare policy, resource allocation and optimise management strategies in Vietnam.

Healthcare students' knowledge, attitudes, and perspectives toward artificial intelligence in the southern Vietnam.

The application of new technologies in medical education still lags behind the extraordinary advances of AI. This study examined the understanding, attitudes, and perspectives of Vietnamese medical students toward AI and its consequences, as well as their knowledge of existing AI operations in Vietnam. A cross-sectional online survey was administered to 1142 students enrolled in undergraduate medicine and pharmacy programs. Most of the participants had no understanding of AI in healthcare (1053 or 92.2 %). The majority believed that AI would benefit their careers (890 or 77.9 %) and that such innovation will be used to oversee public health and epidemic prevention on their behalf (882 or 77.2 %). The proportion of students with satisfactory knowledge significantly differed depending on gender (P < 0.001), major (P = 0.003), experience (P < 0.001), and income (P = 0.011). The percentage of respondents with positive attitudes significantly differed by year level (P = 0.008) and income (P = 0.003), and the proportion with favorable perspectives regarding AI varied considerably by age (P = 0.046) and major (P < 0.001). Most of the participants wanted to integrate AI into radiology and digital imaging training (P = 0.283), while the fifth-year students wished to learn about AI in medical genetics and genomics (P < 0.001, 4.0 ± 0.8). The male students had 1.898 times more adequate knowledge of AI than their female counterparts, and those who had attended webinars/lectures/courses on AI in healthcare had 4.864 times more adequate knowledge than those having no such experiences. The majority believed that the barrier to implementing AI in healthcare is the lack of financial resources (83.54 %) and appropriate training (81.00 %). Participants saw AI as a "partner" rather than a "competitor", but the majority of low knowledge was recorded. Future research should take into account the way to integrate AI into medical training programs for healthcare students.