Near-Suicide Phenomenon: An Investigation into the Psychology of Patients with Serious Illnesses Withdrawing from Treatment.

Patients with serious illnesses or injuries may decide to quit their medical treatment if they think paying the fees will put their families into destitution. Without treatment, it is likely that fatal outcomes will soon follow. We call this phenomenon "near-suicide". This study attempted to explore this phenomenon by examining how the seriousness of the patient's illness or injury and the subjective evaluation of the patient's and family's financial situation after paying treatment fees affect the final decision on the treatment process. Bayesian Mindsponge Framework (BMF) analytics were employed to analyze a dataset of 1042 Vietnamese patients. We found that the more serious the illnesses or injuries of patients were, the more likely they were to choose to quit treatment if they perceived that paying the treatment fees heavily affected their families' financial status. Particularly, only one in four patients with the most serious health issues who thought that continuing the treatment would push themselves and their families into destitution would decide to continue the treatment. Considering the information-filtering mechanism using subjective cost-benefit judgments, these patients likely chose the financial well-being and future of their family members over their individual suffering and inevitable death. Our study also demonstrates that mindsponge-based reasoning and BMF analytics can be effective in designing and processing health data for studying extreme psychosocial phenomena. Moreover, we suggest that policymakers implement and adjust their policies (e.g., health insurance) following scientific evidence to mitigate patients' likelihood of making "near-suicide" decisions and improve social equality in the healthcare system.

Telephone-Based Smoking Cessation Counseling Service: Satisfaction and Outcomes in Vietnamese Smokers.

BACKGROUND: As a method to acknowledge the devastating health and economic impacts of tobacco usage worldwide, telephone-based tobacco cessation counseling services have emerged as a potential tool to aid people in their quitting process. This study explores the satisfaction of smokers who use the QUITLINE service and factors associated with their quit attempts and cessation. METHODS: A cross-sectional survey of 110 participants was conducted from June to July 2016 at the Respiratory Center at Bach Mai Hospital, Hanoi, Vietnam. Multivariate logistic regression was used, and it was found that the percentage of people quitting smoking increased after using the service. RESULTS: In total, 65.5% of participants were completely satisfied with the counseling service. The mean score of staff/s capacity/responsiveness, motivation, and service convenience were 4.37 ± 0.78, 4.30 ± 0.81, and 4.27 ± 0.66, respectively. The smoking relapse rate was relatively high at 58.3%, which mainly resulted from cravings and busy work (26.2% and 14.3%, respectively). A higher satisfaction score in "Staffs' capacity and responsiveness" was negatively associated with "ever tried to quit smoking in consecutive 24 h" and actually quit smoking after receiving counseling. Meanwhile, a higher score in the "Motivation" domain was positively associated with both quit attempt indicators as well as actually quitting smoking after receiving counseling (OR = 9.48; 95%CI = 2.27; 39.57). CONCLUSIONS: These results suggest that it is crucial for decision makers to place more focus on countermeasures for smoking relapse and to strengthen the capacity of staff, especially in motivating clients. Interventions should also be maintained throughout a long period of time to prevent relapse.

Adopting open access in the social sciences and humanities: evidence from a developing nation.

Open Access (OA) publishing, with ambitious movements such as Plan S, is engendering radical changes among academic publishers. Emerging countries need to keep publishing as well as adopt open access to catch up with the changes. Using exclusive data from the Social Sciences & Humanities Peer Awards (SSHPA) database, the study employed both descriptive statistics and a Bayesian linear regression model to examine the journals and publishers in which Vietnamese social scientists published during the period 2008-2019, and the potential of pursuing the OA movement in Vietnam. We found an increasing diversification in the publishing sources of Vietnamese social science researchers with growth rates of 9.8% and 14.1% per annum in the number of publishers and journals, respectively. Given that the proportion of Gold OA articles had a fourfold increase over the examined period, it seems that the Vietnamese academic community is adopting OA. Furthermore, Bayesian analysis results hint at positive associations of internal and external collaborative power (number of domestic and foreign authors, respectively) with the decision to publish in OA (ß b_TotalVN_OpenAccess = 0.22; ß b_TotalForeign_OpenAccess = 0.15). The results and its implications suggest that Vietnamese policymakers and university director boards should facilitate as well as control the quality of the scientific publishing and the OA movement.

What have Vietnamese scholars learned from researching entrepreneurship? A Systematic review.

This study reviews the research landscape of entrepreneurship studies done by Vietnamese researchers from 2008 to 2018. A sample size of 111 articles from 108 academic outlets (journals, conferences proceedings, and book chapters) indexed in Web-of-Science and Scopus were extracted on the SSHPA database, then read and systematically classified into 15 topics. A systematic review reveals (i) a high frequency of research on various aspects of management, (ii) a lackluster focus on innovation and creativity in entrepreneurial activities, (iii) and worrisome cultural influences on the level of creativity. Overall, there was evidence of a detachment between the academic community and the entrepreneurial community. The research landscape shows there have not been enough studies done on the following aspects of entrepreneurship: technology application, poverty reduction, network development, internationalization, inter-generational transfer, and sex/gender.

Changes in Substance Abuse and HIV Risk Behaviors over 12-Month Methadone Maintenance Treatment among Vietnamese Patients in Mountainous Provinces.

Methadone maintenance treatment (MMT) programs have been used worldwide to reduce the number of drug users and for HIV prevention; however, evidence of their effectiveness in mountainous areas is limited. This study aimed to identify changes in substance abuse and sexual practices among MMT patients after treatment in three Vietnamese mountainous provinces. A survey on risk behaviors was conducted among 300 drug users in six MMT clinics prior to and following one year of MMT. Cramér's effect size of changes was extrapolated to justify the magnitude of the intervention's effectiveness. A generalized estimation equation was used to find the factors associated with respondents' substance use and sexual risk behavior. While drug-related risk behaviors were significantly reduced, alcohol and sex-related behaviors remained risk factors for HIV in this group. Additionally, condom use was common among participants at both time points, but not among those having sex with sex workers. Socio-economic characteristics of ethnic, education, occupation, as well as drug use history influenced the possibility of engaging in drug use and/or sexual risk behavior following treatment. Further emphasis on managing these among MMT patients is required, potentially by providing integrated services including smoking and drinking counseling and condom use promotion in accordance with MMT.

Depressive Symptoms among Industrial Workers in Vietnam and Correlated Factors: A Multi-Site Survey.

Depressive disorders have been found to be a significant health issue among industrial workers, resulting from work-related factors and causing serious burdens for the workers as well as their employers. Literature on mental health problems of Vietnamese industrial workers has been limited, despite the rapid foreign investment-fueled industrialization process of the country. This study aimed to fill the gap in literature by examining the prevalence of depressive disorders and their potential associated factors among a cohort of Vietnamese industrial workers. A cross-sectional study was conducted in 3 industrial areas in Hanoi and Bac Ninh. A total of 289 workers agreed to participate in the study. Generalized linear mixed models were applied to identify associated factors with depression status of respondents. 38.6% of participants reported suffering depression. Factors found to be positively associated with the possibility of having depression and higher PHQ9 score were long working hours, suffering more health problems, and health hazards exposure at work. Meanwhile, being females, having more children, living with parents, engaging in smoking, and being local workers were found to correlate with lower likelihood of being depressed. The findings suggested the importance of regular health screening, work safety assurance, and social support outside of workplace on the mental health of the workers.

Health Inequality between Migrant and Non-Migrant Workers in an Industrial Zone of Vietnam.

Vietnam has experienced massive internal migration waves from rural to industrialized zones. However, little efforts have been made to understand differences in health conditions and health-related quality of life (HRQOL) between local and migrant industrial workers. This study aimed to examine the inequality in health status and HRQOL between these workers. We conducted a cross-sectional study of 289 Vietnamese workers at three industrial areas in Hanoi and Bac Ninh. Self-reported health status and HRQOL were measured using the EuroQOL-5 dimensions-5 levels (EQ-5D-5L) instrument. Sociodemographic, working, and environmental factors were also investigated. Overall, the mean EQ-5D index was 0.74 (SD = 0.21) and the average number of health problems in the last 12 months in our sample was 1.91 (SD = 1.63) problems. Migrant people had a lower EQ-5D index (ß = -0.08, p < 0.01) and more health problems (ß = 0.20, p < 0.05) compared to local workers. Those being male, working in the same posture more than 60 min, and exposed to more hazards at work were correlated with a lower EQ-5D index and higher number of health problems. The results highlighted inequalities in health status and HRQOL between migrant and local workers. Reinforcing regular health check-ups, ensuring sufficient protective equipment and working conditions may help improve the health outcomes of the workers.

Global Evolution of Research in Artificial Intelligence in Health and Medicine: A Bibliometric Study.

The increasing application of Artificial Intelligence (AI) in health and medicine has attracted a great deal of research interest in recent decades. This study aims to provide a global and historical picture of research concerning AI in health and medicine. A total of 27,451 papers that were published between 1977 and 2018 (84.6% were dated 2008⁻2018) were retrieved from the Web of Science platform. The descriptive analysis examined the publication volume, and authors and countries collaboration. A global network of authors' keywords and content analysis of related scientific literature highlighted major techniques, including Robotic, Machine learning, Artificial neural network, Artificial intelligence, Natural language process, and their most frequent applications in Clinical Prediction and Treatment. The number of cancer-related publications was the highest, followed by Heart Diseases and Stroke, Vision impairment, Alzheimer's, and Depression. Moreover, the shortage in the research of AI application to some high burden diseases suggests future directions in AI research. This study offers a first and comprehensive picture of the global efforts directed towards this increasingly important and prolific field of research and suggests the development of global and national protocols and regulations on the justification and adaptation of medical AI products.

HIV- and AIDS-related knowledge and attitude of residents in border regions of Vietnam.

BACKGROUND: Residents in border areas are vulnerable to HIV/AIDS due to high rates of risk behaviors such as unprotected sexual practices or illicit drug use. Improving knowledge and attitude toward HIV/AIDS prevention and treatment are vital to diminish the burden of the HIV epidemic in this setting. However, evidence about this issue in Vietnam has been limited. This study aims to explore the knowledge and attitude toward HIV/AIDS among people in Vietnam border zones. METHODS: We conducted a cross-sectional study in three border communes in Thanh Hoa province with 600 HIV(-) residents. Data about socio-demographic characteristics, general HIV knowledge, knowledge about prevention of mother-to-child transmission, treatment and care, HIV testing services, and attitude toward HIV/AIDS were collected. Multivariate Tobit regression was used to determine related factors with the knowledge and attitude. RESULTS: The highest percentage of people having correct statements was for "HIV could be transmitted from mother to child" (98.2%), while the lowest percentage was for item "Know health facilities where HIV-positive people could register for care and check-up" (28.2%). People had the highest score in "Knowledge about HIV transmission routes" and the lowest score in "Knowledge about HIV/AIDS prevention measures". Most of the people were not afraid of being exposed to HIV-positive individuals (66.0%), willing to buy goods from HIV-positive sellers (78.9%), and willing to take care of people living with HIV in their family (90.1%). Education, ethnic, marital status, occupations, and HIV/AIDS information sources were found to be associated with knowledge and attitude toward HIV/AIDS. CONCLUSIONS: The general knowledge and attitude on HIV/AIDS of residents were relatively good. Educational campaigns to improve knowledge and attitude toward PLWH, involving peer educators and local associations, are potential strategies for sustaining HIV intervention in this remote setting.

Artificial Intelligence vs. Natural Stupidity: Evaluating AI readiness for the Vietnamese Medical Information System.

This review paper presents a framework to evaluate the artificial intelligence (AI) readiness for the healthcare sector in developing countries: a combination of adequate technical or technological expertise, financial sustainability, and socio-political commitment embedded in a healthy psycho-cultural context could bring about the smooth transitioning toward an AI-powered healthcare sector. Taking the Vietnamese healthcare sector as a case study, this paper attempts to clarify the negative and positive influencers. With only about 1500 publications about AI from 1998 to 2017 according to the latest Elsevier AI report, Vietnamese physicians are still capable of applying the state-of-the-art AI techniques in their research. However, a deeper look at the funding sources suggests a lack of socio-political commitment, hence the financial sustainability, to advance the field. The AI readiness in Vietnam's healthcare also suffers from the unprepared information infrastructure-using text mining for the official annual reports from 2012 to 2016 of the Ministry of Health, the paper found that the frequency of the word "database" actually decreases from 2012 to 2016, and the word has a high probability to accompany words such as "lacking", "standardizing", "inefficient", and "inaccurate." Finally, manifestations of psycho-cultural elements such as the public's mistaken views on AI or the non-transparent, inflexible and redundant of Vietnamese organizational structures can impede the transition to an AI-powered healthcare sector.

HIV knowledge and risk behaviors among drug users in three Vietnamese mountainous provinces.

BACKGROUND: Globally, people who inject drugs are highly vulnerable to HIV transmission. Methadone maintenance treatment (MMT) programs are one of the most cost-effective mechanisms to substitute opioid use and improve the quality of life of patients. Since the coverage of MMT is still limited and even for those patients who are treated, improving their knowledge on HIV and maintaining healthy behaviors are key to maximizing the outcomes of HIV harm reduction programs. This study examined the knowledge on HIV, perceived risk and HIV testing among drug users accessing methadone maintenance services in three Vietnamese mountainous areas. METHODS: A cross-sectional study of 300 people enrolling for MMT services in three provinces in Vietnam was conducted. The factors associated with the knowledge, attitudes, and practices of respondents about HIV/AIDS were exploited using multivariable logistic model. RESULTS: Of the 300-people surveyed, 99% knew of HIV and 60.6% were identified as having good knowledge. While 75.2% identified that injecting drugs was a risk factor for HIV, 52.2% thought they were not at risk of HIV mainly as they did not share needles. 92.6% had undergone HIV testing with 17.4% being positive, a number which was significantly lower than Vietnam's national average for people who inject drugs. Age, ethnicity and education were associated with knowledge of HIV while ART treatment was linked to self-assessed HIV status. CONCLUSIONS: This study sheds new light on the knowledge attitudes and practices of people who inject drugs, particularly males in mountainous areas of Vietnam regarding HIV prevention. Overall, knowledge was good with most conducting safe practices towards transmission. Enhanced education and targeting of minority groups could help in increasing the numbers receiving MMT and HIV services.

Righting the Misperceptions of Men Having Sex with Men: A Pre-Requisite for Protecting and Understanding Gender Incongruence in Vietnam.

Protecting the rights of the lesbians, gays, bisexuals, transgender, intersex, and queers (LGBTIQ) population requires, first and foremost, a proper understanding of their sexual orientation and gender identity. This study highlights a severe misunderstanding and lack of knowledge among health professionals in Vietnam with regard to the men who have sex with men (MSM) and transgenders. This study uses (i) a survey based on the convenience sampling method among 150 health workers that covered 61 questions and (ii) 12 in-depth interviews in two metropolitan centres in Vietnam, Hanoi and Ho Chi Minh city. Three main topics are explored: (i) the general knowledge of healthcare workers about MSM and transgenders; (ii) their knowledge about the sexual reproductive health and human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) risks of MSM and transgenders; and (iii) their attitudes and behaviors towards MSM and transgenders. One of the notable findings is how prevalent the misperceptions are across the board, namely, in staff of both sexes, in both cities, at various kinds of medical facilities, at different work positions and educational levels. Half of the respondents consider transgenders to have a curable mental problem while 45% say MSM only have sex with males. Most remarkably, 12.7% state if they have any choice, they want nothing to do with MSM and transgenders. The study finds there is a considerable percentage of health professionals who lack knowledge about the diversity of sexual orientation, gender identity, and health issues related to the sexual minorities and gender non-conforming population. To improve the clinical process for serving these at-risk groups, the study suggests the continual education for the health workers needs to be added to their formal as well as in-job training.

Acceptability of and willingness to pay for using a smartphone-based vaccination application in a Vietnamese cohort.

BACKGROUND: The increasing accessibility of smartphone in Vietnam shows potential in using smartphone applications for vaccination management to improve compliance. However, the acceptability and financial feasibility of using this application in Vietnam have not yet been understood. This study measured the general perception of and willingness to pay (WTP) for using smartphone-based vaccination management applications and their associated factors in Vietnam. SUBJECTS AND METHODS: A cross-sectional study was conducted between March and April 2016 in an urban vaccination clinic at the Hanoi Medical University in Vietnam. Convenience sampling was used to recruit 429 adult participants who had received vaccinations or whose children were vaccinated. Sociodemographic characteristics and the acceptability of and WTP for using smartphone-based vaccination management applications were evaluated. RESULTS: Among participants who used smartphone applications, 5% were aware of existing vaccination management applications, of whom 57.9% had previously used the applications. About 69.6% of participants believed that the applications were necessary, 93.7% of them were also willing to use the applications, and 79.1% were willing to pay 92.7 thousand Vietnamese dong (VND) for the applications on average. Participants who were older, unemployed, earned more household income, and having knowledge about functions and benefits of vaccination were less likely to use the vaccination applications. Participants who brought their children to get vaccinated at younger age and with higher level of education were willing to pay more for vaccination applications. CONCLUSION: High levels of acceptability of, willingness to use, and WTP for smartphone-based vaccination management applications among Vietnamese participants are reported. Increased education and awareness about the benefits of vaccination and vaccination management applications through community health workers might increase the feasibility of implementing such applications and perception toward their usage among young adult smartphone users. In addition, building a stronger relationship with health care providers at hospitals might improve the application's visibility and adoption.

Methadone Maintenance Treatment Reduces the Vulnerability of Drug Users on HIV/AIDS in Vietnamese Remote Settings: Assessing the Changes in HIV Knowledge, Perceived Risk, and Testing Uptake after a 12-Month Follow-Up.

Methadone Maintenance Treatment (MMT) program has been considered a medium through which human immunodeficiency virus (HIV) risks assessment and prevention on drug use/HIV-infected population can be effectively conducted. Studies concerning the implementation of such idea on patients in remote, under-developed areas, however, have been limited. Having the clinics established in three mountainous provinces of Vietnam, this study aimed to evaluate the changes in knowledge of HIV, perceived risk, and HIV testing uptake of the patients. A longitudinal study was conducted at six MMT clinics in three provinces with a pre- and post-assessments among 300 patients. Outcomes of interest were compared between baseline and after 12 months. The magnitude of changes was extrapolated. The proportion of participants reporting that their HIV knowledge was not good fell by 4.4% (61.3% at the baseline vs. 56.8% at 12 months). The significant improvement seen was in the knowledge that needle sharing was a mode of transmission (82.7% vs. 89.6%). Nevertheless, the majority of participants reportedly considered mosquitoes/insect and eating with the HIV-infected patient were the route of transmission at both time points (84.7% vs. 89.1%, 92.2% vs. 93.3%, respectively). This study found a limited improvement in HIV knowledge and testing uptake among MMT patients following a 12-month period. It also highlighted some shortcomings in the knowledge, attitudes and practices (KAP) of these patients, in particular, incorrect identification of HIV transmission routes, among patients both at program initiation and follow-up. The findings lent support to the argument for enhancing education and counseling efforts at MMT clinics regarding HIV, as well as for improving access to preventive and health care services through the integration of MMT/HIV services.

The Dark Side of Female HIV Patient Care: Sexual and Reproductive Health Risks in Pre- and Post-Clinical Treatments.

This study examines the pre- and post-clinical issues in human immunodeficiency virus (HIV) care and treatment for women and girls of high-risk population groups-namely sex workers, injecting drug users, women living with HIV, primary sexual partners of people living with HIV, adolescent girls who are children of these groups, and migrant young girls and women-in five provinces and cities in Vietnam. Through a sample of 241 surveyed participants and 48 respondents for in-depth interviews and 32 respondents in the focus group discussions, the study identifies multiple barriers that keep these groups from receiving the proper health care that is well within their human rights. Most respondents rated HIV testing as easily accessible, yet only 18.9% of the surveyed women living with HIV disclosed their infection status, while 37.8% gave no information at the most recent prenatal care visit. The level of knowledge and proper practices of sexual and reproductive health (SRH) care also remains limited. Meanwhile, modern birth control methods have yet to be widely adopted among these populations: only 30.7% of respondents reported using condoms when having sex with their husband. This increases the risks of unwanted pregnancy and abortion, as well as vulnerability to sexually transmitted infections (STIs) and HIV transmission. On the other hand, HIV-related stigma and discrimination at health care settings are still pervasive, which create significant barriers for patients to access proper care services. Based on these results, six recommendations to improve SRH status of women and girls of populations at high risk are put forward.

An open database of productivity in Vietnam's social sciences and humanities for public use.

This study presents a description of an open database on scientific output of Vietnamese researchers in social sciences and humanities, one that corrects for the shortcomings in current research publication databases such as data duplication, slow update, and a substantial cost of doing science. Here, using scientists' self-reports, open online sources and cross-checking with Scopus database, we introduce a manual system and its semi-automated version of the database on the profiles of 657 Vietnamese researchers in social sciences and humanities who have published in Scopus-indexed journals from 2008 to 2018. The final system also records 973 foreign co-authors, 1,289 papers, and 789 affiliations. The data collection method, highly applicable for other sources, could be replicated in other developing countries while its content be used in cross-section, multivariate, and network data analyses. The open database is expected to help Vietnam revamp its research capacity and meet the public demand for greater transparency in science management.

Factors Associated with Substance Use and Sexual Behavior among Drug Users in Three Mountainous Provinces of Vietnam.

Due to their geographical characteristics, the mountainous areas of Vietnam are particularly vulnerable to illicit drug use. Drug users in remote areas are also more likely to engage in risky sexual behaviors. This study aimed to describe the prevalence and characteristics of substance use and sexual behaviors and explored their related factors among newly admitted drug users in three mountainous provinces of Vietnam. A cross-sectional study was conducted on 300 newly-admitted drug users registering for Methadone Maintenance Treatment (MMT) at 6 clinics in three provinces: Dien Bien, Lai Chau and Yen Bai from October 2014 to December 2015. Information about the socio-demographic characteristics, history of substance use, and sexual behaviors were collected. The multivariate logistic regression model was used to identify potential predictors of four outcomes, which included: drug injection, re-use of needles, using condoms during the last time of having sex, and having sexual intercourse with female sex workers. The proportion of injecting drug users was 68.3%; of those 9% never re-used needles. Of note, 69% of those who reported having sex with female sex workers in the last month did not use condoms. Regression models showed that those who injected drugs and had health problems in last 30 days had greater odds of having sex with female sex workers. Drug users in mountainous settings acknowledged the high prevalence of human immunodeficiency virus (HIV)-related risk behaviors and a demand for physical and psychological care. Scaling up MMT services is key to approaching this high-risk group; however, at the same time, comprehensive harm-reduction interventions, counseling, and health care services should also be made accessible and effective in this setting.

A Bibliometric Analysis of the Global Research Trend in Child Maltreatment.

Child maltreatment remains a major health threat globally that requires the understanding of socioeconomic and cultural contexts to craft effective interventions. However, little is known about research agendas globally and the development of knowledge-producing networks in this field of study. This study aims to explore the bibliometric overview on child maltreatment publications to understand their growth from 1916 to 2018. Data from the Web of Science Core Collection were collected in May 2018. Only research articles and reviews written in the English language were included, with no restrictions by publication date. We analyzed publication years, number of papers, journals, authors, keywords and countries, and presented the countries collaboration and co-occurrence keywords analysis. From 1916 to 2018, 47,090 papers (53.0% in 2010⁻2018) were published in 9442 journals. Child Abuse & Neglect (2576 papers; 5.5%); Children and Youth Services Review (1130 papers; 2.4%) and Pediatrics (793 papers, 1.7%) published the most papers. The most common research areas were Psychology (16,049 papers, 34.1%), Family Studies (8225 papers, 17.5%), and Social Work (7367 papers, 15.6%). Among 192 countries with research publications, the most prolific countries were the United States (26,367 papers), England (4676 papers), Canada (3282 papers) and Australia (2664 papers). We identified 17 authors who had more than 60 scientific items. The most cited papers (with at least 600 citations) were published in 29 journals, headed by the Journal of the American Medical Association (JAMA) (7 papers) and the Lancet (5 papers). This overview of global research in child maltreatment indicated an increasing trend in this topic, with the world’s leading centers located in the Western countries led by the United States. We called for interdisciplinary research approaches to evaluating and intervening on child maltreatment, with a focus on low-middle income countries (LMICs) settings and specific contexts.

Health Care Payments in Vietnam: Patients' Quagmire of Caring for Health versus Economic Destitution.

In the last three decades many developing and middle-income nations' health care systems have been financed via out-of-pocket payments by individuals. User fees charges, however, may not be the best approach or thenmost equitable approach to finance and/or reform health services in developing nations. This study investigates the status of Vietnam's current health system as a result of implementing user fees policies. A recent mandate by the government to increase the universal cover to 100% attempts to tackle inadequate insurance cover, one of the four major factors contributing to the high and increasing probability of destitution for Vietnamese patients (the other three being: non-residency, long stay in hospital, and high cost of treatment). Empirical results however suggest that this may be catastrophic for low-income earners: if insurance cover reimbursement decreases below 50% of actual health expenditures, the probability of Vietnamese falling into destitution will rise further. Our findings provide policy implications and directions to improve Vietnam's health care system, in particular by ensuring the utilization of health services and financial protection for the people.

Exploring Vietnamese co-authorship patterns in social sciences with basic network measures of 2008-2017 Scopus data.

Background: Collaboration is a common occurrence among Vietnamese scientists; however, insights into Vietnamese scientific collaborations have been scarce. On the other hand, the application of social network analysis in studying science collaboration has gained much attention all over the world. The technique could be employed to explore Vietnam's scientific community. Methods: This paper employs network theory to explore characteristics of a network of 412 Vietnamese social scientists whose papers can be found indexed in the Scopus database. Two basic network measures, density and clustering coefficient, were taken, and the entire network was studied in comparison with two of its largest components. Results: The networks connections are very sparse, with a density of only 0.47%, while the clustering coefficient is very high (58.64%). This suggests an inefficient dissemination of information, knowledge, and expertise in the network. Secondly, the disparity in levels of connection among individuals indicates that the network would easily fall apart if a few highly-connected nodes are removed. Finally, the two largest components of the network were found to differ from the entire networks in terms of measures and were both led by the most productive and well-connected researchers. Conclusions: High clustering and low density seems to be tied to inefficient dissemination of expertise among Vietnamese social scientists, and consequently low scientific output. Also low in robustness, the network shows the potential of an intellectual elite composed of well-connected, productive, and socially significant individuals.