Vietnam has achieved impressiveimprovements in its health outcomes over the last fewdecades. Life expectancy has increased significantly overthe years, and mortality rates have declined substantially.The prevalence of chronic, noncommunicable diseases (NCDs)in Vietnam has also risen sharply. These trends imply ashift in the health needs of Vietnam’s population away fromacute episodic care, towards disease management for NCDs.Ensuring that care is appropriate for the changing needs ofthe population, including older persons, will require aparadigm shift in the way services are delivered. Today,Vietnam’s health service delivery system ishospital-centric, which is both expensive and notwell-suited to the management of chronic conditions andNCDs. An important contributor to the persistence of thehospital-centric model of service delivery and hospitalovercrowding is a weak primary health care (PHC) system,especially for NCD management. In theory, most patients withNCDs and chronic conditions can be managed in the community,where care is closer to home, more appropriate, and cheaper.Putting this into practice in Vietnam will entail a neworientation in health service delivery - one which focuseson shifting the delivery of low complexity care out ofhospitals to PHC and other intermediate units. Globally,there has been a push towards service delivery models whichare more responsive to individual health needs and candeliver the right care in appropriate settings. Such servicemodels typically promote a person-centered approach andinvolve integration of care.
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