Factors affecting healthcare pathways for chronic lung disease management in Vietnam: a qualitative study on patients’ perspectives

BMC Public Health

Guy B. Marks¹  Giap Van Vu²  Greg J. Fox³  Toan Thanh Do⁴  Shannon McKinn⁵  Joel Negin⁵  Sarah Bernays⁶  Nhung Phuong Doan⁷  Thao Huong Nguyen⁷  Yen Ngoc Pham⁷  Thu-Anh Nguyen⁸ 

[1] Australia South Western Sydney Clinical School, University of New South Wales, Sydney, Australia;Bach Mai Hospital, Hanoi, Vietnam;Faculty of Medicine and Health, University of Sydney, Sydney, Australia;School of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam;School of Public Health, University of Sydney, Sydney, Australia;School of Public Health, University of Sydney, Sydney, Australia;London School of Hygiene and Tropical Medicine, London, UK;Woolcock Institute of Medical Research, 298 Kim Ma, Ba Dinh, Hanoi, Vietnam;Woolcock Institute of Medical Research, 298 Kim Ma, Ba Dinh, Hanoi, Vietnam;Faculty of Medicine and Health, University of Sydney, Sydney, Australia;

关键词: COPD;    Asthma;    Healthcare pathway;   

DOI  :  10.1186/s12889-021-11219-4

来源: Springer

【 摘 要 】

BackgroundChronic obstructive pulmonary disease (COPD) and asthma rank among the leading causes of respiratory morbidity, particularly in low- and middle-income countries. This qualitative study aimed to explore the healthcare pathways of patients with chronic respiratory disease, and factors influencing their ability to access healthcare in Vietnam, where COPD and asthma are prevalent.MethodsWe conducted 41 in-depth interviews among patients, including 31 people with COPD, eight with asthma and two with asthma-COPD overlap syndrome. Participants were recruited at provincial- or national-level health facilities in two urban and two rural provinces in Vietnam. The interviews were audio-recorded, transcribed, and analysed using thematic analysis.ResultsPatients’ healthcare pathways were complex and involved visits to multiple health facilities before finally obtaining a definitive diagnosis at a provincial- or national-level hospital. Access to healthcare was affected considerably by participants’ limited knowledge of their respiratory conditions, the availability of social support, especially from family members, the costs of healthcare as well as health system factors (including the coverage of public health insurance, the distance to health facilities, and attitude of healthcare providers).ConclusionThe study demonstrated the need for improved access to timely diagnosis and treatment of chronic lung disease within the lower level of the health system. This can be achieved by enhancing the communication skills and diagnostic capacity of local healthcare workers. Health education programmes for patients and caregivers will contribute to improved control of lung disease.

【 授权许可】

CC BY