RESUMEN
Antibiotic resistance (AR) rates in Vietnam are among the highest in Asia, and recent infections due to multi-drug resistance in the country have caused thousands of deaths each year. This study investigated a Vietnamese community's preferences for antibiotic treatment and its knowledge and attitudes regarding antibiotics. A discrete choice experiment-based survey was developed and administered to the population of interest. The respondents were given sociodemographic-, knowledge- and attitude-related items and 17 pairs of choice tasks. Two hypothetical options were included in each choice task. Latent class analysis was conducted to determine the differences among the respondents' preferences. Among 1,014 respondents, 805 (79.4%) gave valid questionnaires. A three-latent-class model with four covariates (age, healthcare-related education or career, occupation, and attitude classifications) was used in the analysis. All five attributes significantly influenced the respondents' decisions. The majority, including young employed respondents with non-healthcare-related work or education, found treatment failure more important. Older respondents who had healthcare-related education/careers and/or appropriate antibiotic use- and antibiotics resistance-related attitudes, regarded contribution to antibiotic resistance as an important attribute in selecting antibiotic treatments. Unemployed individuals with correct knowledge identified the cost of antibiotic treatment as the most essential decision-making factor. Findings suggest minimal antibiotic impact on resistance; only 7.83% view it as amajor concern. The respondents exhibited substantial preference heterogeneity, and the general Vietnamese public had poor knowledge of and attitudes toward antibiotic use and antibiotic resistance. This study emphasizes the need for individual responsibility for antibiotic resistance and appropriate antibiotic use.
RESUMEN
BACKGROUND: According to the International Diabetes Federation, total global health care expenditures for diabetes tripled between 2003 and 2013 because of increases in the number of people with diabetes as well as in the average expenditures per patient. This study aims to provide accurate and timely information about the economic impacts of type 2 diabetes mellitus (T2DM) in Vietnam. METHOD: The cost-of-illness estimates followed a prospective, prevalence-based approach from the societal perspective of T2DM with 392 selected diabetic patients who received treatment from a public hospital in Ho Chi Minh City, Vietnam, during the 2016 fiscal year. RESULTS: In this study, the annual cost per patient estimate was US $246.10 (95% CI 228.3, 267.2) for 392 patients, which accounted for about 12% (95% CI 11, 13) of the gross domestic product per capita in 2017. That includes US $127.30, US $34.40 and US $84.40 for direct medical costs, direct nonmedical expenditures, and indirect costs, respectively. The cost of pharmaceuticals accounted for the bulk of total expenditures in our study (27.5% of total costs and 53.2% of direct medical costs). A bootstrap analysis showed that female patients had a higher cost of treatment than men at US $48.90 (95% CI 3.1, 95.0); those who received insulin and oral antidiabetics (OAD) also had a statistically significant higher cost of treatment compared to those receiving OAD, US $445.90 (95% CI 181.2, 690.6). The Gradient Boosting Regression (Ensemble method) and Lasso Regression (Generalized Linear Models) were determined to be the best models to predict the cost of T2DM (R2=65.3, mean square error [MSE]=0.94; and R2=64.75, MSE=0.96, respectively). CONCLUSION: The findings of this study serve as a reference for policy decision making in diabetes management as well as adjustment of costs for patients in order to reduce the economic impact of the disease.
RESUMEN
Influenza is a malady related to the human respiratory system, and its influenza-like illness (ILI) can cause an economic and social burden, especially among children and the elderly. This study was conducted to estimate the cost of illness based on a social perspective of ILI cases. A prospective study was conducted between February and March of 2016 in pharmacies, private clinics at Khanh Hoa, Lam Dong, Tay Ninh, Dong Nai Province, and Ho Chi Minh City, and Hospital of Tropical Diseases. Demographic and clinical information were collected by face-to-face interview. Direct costs (e.g., diagnosis and therapeutics) and indirect costs (e.g., cost of day loss) are included as treatment costs. The average cost of treatment associated with ILI was US$ 88.09 per case for all age groups; direct non-medical cost was higher compared to direct medical cost: 39.5% in pharmacies, 71.1% in clinics, and 64.2% in hospital. The indirect cost was US$27.49 per episode. The average total cost for children below 14 years old was much higher than that for the other age groups. The cost of illness of ILI was, therefore, the reason for the economic burden of influenza patients and their families. This study provides a database for future research and programs, and policies that can be adopted for influenza or ILI in Vietnam.