SCK D U N G DICH Vy Y TE VA MOT S6 Y^U T 6 LliN QUAN Cf NGU'ai CAO TU6l HUYEN BA V], HA NOI NAM 2011 - 2012
Pham Thj Ngoc Bich, Tran Khanh Toan, Nguyen Hoang Long Trwdng D^i hoc YHa N&
Gii hoi dan sd da va dang dat ra nhidu thieh thu'c cho he thing ehSm sdc sue khoe & nw&e ta. Nghidn e&u nhim md ti mo hinh su' dung djch vu y td va cac yeu t6 lidn quan o ngw&i cao tuoi huydn Ba Vi ndm 2011 ~ 2012. Khoang 5200 ngwdi cao tudi tai co so thwc dia FilaBavi dwgc phdng vin dinh ky hdng quf ti/
2011 - 2012 vd dm dau va vide sw dung dich vu y ti khi 6m. Kit qua cho thiy khi 6m dau ngwdi eao lu6i thwdng den phdng kham tw (38,2%), mua thude a quiy thuoc (29,2%) hodc tw diiu trj (28,7%); ehi 15.6%
din bdnh vidn va 5,2% din tram y te. Cac eu bi, ngw&i cao tudi dan tdc thiiu so va nhOng ngwdi ed dieu kien kinh te xa hgi thip hon thw&ng cd xu hwdng tu dieu tri hoac mua thude han Id din eic ca sd y ti cdng.
Tir khoa: Ngum cao tuoi, su* dung djch vu y te, FilaBavi
I. DAT
V A N D ^Nhd ty sudt sinh vd c h i t thdp eiing vdi s u gia tang t u l i thp, ddn s l eao tuoi d Viet Nam dang tdng nhanh trong n h i l u ndm qua. Chi sd gia hoa ddn s l da tang manh tir 18,2% nam 1989 len 47,2% nam 2012 [1], K i t qua d i l u tra b i l n dpng dan s l nam 2012 cho thdy ngudi eao t u l l da c h i l m tren 10% tong ddn sd, d u a nude ta ehinh thire bude vao giai doan gia hod ddn s l [2].
Gia hda ddn so nhanh tae ddng manh d i n m l i quan he gia dinh, l l i sdng vd ddt ra n h i l u thach thire eho tang trudng kinh t l vd bao ddm ede djch vy an sinh xa hdi, dge biet Id he thong bao h i i m xd hpi va chdm sdc y t l [3], Do s u suy gidm ehire ndng va m i l n dieh, ngudi eao tuoi thudng co ty le mac benh cao, vdi n h i l u benh phoi hgp, dac biet la cdc benh man tinh, ddi hdi nhu e i u cao trong sir dung dieh vu cham sdc y t l [3; 4].
Dia chi lien he- Pham Thi Ngoc Bich. bo mon Y hoc gia dinh. Trif&ng Oai hoc Y Ha Noi
Email- ptnoocbich&vahoo.com Ngay nhan-20/7/2014 Ngay duoc chap thuan-16/9/2014
Trong s u i t nhirng ndm qua, Dang va Nha nude ta da ed n h i l u ehinh sdeh quan tam tdi ddi s i n g vd chdm sdc sire khoe eua ngudi eao tuoi [5; 6]. Tuy nhien, v l n cdn nhieu yeu t l v l kinh t l xa hdi cd t h i tde dpng den vISc t i l p can vd s u dung djch vu y t l eua ngudi ddn ndi ehung va ngudi cao tuoi ndi neng [5].
Ngudi eao tuoi a khu v y e ndng thdn, mien niii, vimg d i n g bdo ddn tpe t h i l u s l , ngudi cao t u l i trong cde ho ngheo vd cgn ngheo vln cdn gap khd khdn trong t i l p can vdi ede djch vy y t i [6], Nghien eiru v l sir dung djch vu yte ciia ngudi eao tuoi d khu v y c ndng thdn se eung d p them cae thdng tin cd gia trj nhdm gidm t h i l u n h i j n g bat binh ddng trong chdm sdc sire khoe cua ngudi eao tuoi [6].
Nghien eiru nay d u g e thue hign vdi muc tieu "md ta md hinh tim k i l m djch vy y te va m l i lien quan vdi mdt so y l u to kinh t l xa hpi d ngud'i cao tuoi tgi huyen Ba Vi nam 2011 - 2 0 1 2 " .
II. o 6 l TUONG VA PHUONG PHAP
1. Dja diem nghien CLFU
Nghien ciru d u g e thye hien tai C a s d thuc dja djch t l hpc Ba Vi (FilaBavi :^,en Ba Vi,
TCNCYH 9L
thdnh pho Ha Npi. FilaBavi d u g e thdnh lap tCr nam 1999 bao g i m 69 trong tong s6 352 eum thude 29 xa trang toan huygn d u g e chpn theo p h u a n g phap chpn mau n g l u nhien phan tang n h i l u giai doan. FilaBavi gom khoang 11.000 hO gia dinh vdi han 51.000 ddn vao nam 1999 [7] va gan 13.000 hd gia dinh vdi khoang 53.000 ddn vdo cuoi nam 2011.
2. D 6 i tug^ng
Todn bd tren 5.200 ngudi t u 60 t u l i t r d len, da e u tru trgn d|a bdn FilaBavi it nhat ba thang vao cae t h d i d i l m d i l u tra dinh ky hang quy trong hai nam 2011 va 2012.
3. P h u a n g phap
Nghien cii'u theo ddi dpe tren quan t h i thuan tap m d la cdc doi t u g n g tir 60 t u l i t r d Idn trong thdi gian 2011-2012, Cac d i l u tra vidn da d u g e ddo tao d i n tham cac hd gia dinh h i n g quy va sir dung bp cau hdi cau triie d u g e t h i l t k l san d l phdng van v l tinh hinh 6m dau va sir dung djch vu y t l eiia tat ea cae thanh vien, bao g i m ca ngudi cao tuoi trong vdng mOt thdng t r u d e ngay d i l u tra. Thdng tin v l nhan khau vd kinh t l xa hdi eua ngud'i cao t u l l d u g e trich xuat tir c a s d dtr lieu eua FilaBavi.
Bgnh khac I B$nh tim mach khac Lo Idng, mdt ngu Bgnh ly mdt Kho thd Tang huyit ap S6t Tai mui hong Ho tren 3 t u i n Dau xuang khdp Dau d i u chdng mat
| 3 , 8
| 4 , 3
• 5 , 7
^ • 7 , 7
So lieu d u g e phan tich b l n g phan m i m Stata 12.0 vdi m u e y nghTa thong kd a = 0,05 vdi cae test thong ke md ta thong thudng.
Md hinh hoi quy logistic dan va da bien vdi ty s u i t chenh OR d u g e sir dung d l xac djnh moi lien quan.
FilaBavi da d u g e Bp Y te phe duyet va da thong qua Hpi d i n g khoa hge va dao dii'C ciia Trudng Dai hpe Y Hd Ndi. Cac hd gia dinh d u g e giai thich v l mue dieh va ndi dung nghien cii'u vd t y nguyen tham gia. Thdng tin thu thdp d u g e ma hod vd giO' bi mdt, ehi phue vu mue dieh nghien cii'u.
III. KET QUA
1 . T h d n g t i n v l 6m dau t h e o khai bdo Trong hai nam 2011 - 2012 ed 10.043 lugt ngudi eao tuoi khai bao om vdi tong edng 24.598 lugt om. Trung binh m l i ngudi eao tuoi cd khoang 6,0 lugt om/nam. NU e h i l m d i n 68,4% t i n g so lugt om, dp tuoi d u d i 75 chiem 5 5 , 1 % va co 2,7% la ngudi dan tde thieu so. Da so ed trinh do hpc van tir tieu hpe t r d x u l n g (64,7%); 2 7 , 1 % v l n dang lam nong nghiep; khoang 2/3 ed the bdo hiem y te va han mdt nira dang s i n g chung vdi v g / c h i n g (52,3%).
120,5
| 4 6 , 3 50 B i l u d d 1. Cdc bgnh/tridu chu>ng d m t h e o khai bao d' ngud'i cao t u d i 'CYH90(5)-2014
Bilu do 1 cho thay ba trieu chiing 6m hay gap nhat a ngu'ai cao tuoi theo M\a\ bao la dau dau, chong mit (46,3%); dau xu'ang khap (40,5%) v4 ho (27,0%). Cac b6nh ly Tai l«ui Hong, trieu Chung sot, kho tha va benh tang huyet ap cung kh4 thuang gap & ngu'ai cao tu6i.
2. IVI6 hinh tim kiSm djch vu y t l cua ngu'ai cao tu6i
Bai da so ngu'ai cao tuoi (99,6%) du'ac dilu tri l(hi 6m. M c hinh thuc dilu trj ph6 biln nhat la phong kham tu (32,3% cho kham iSn dau va 38,2% cho ca dat 6m), quIy thulc (23,1% cho l8n dau va 29,2% ca dot 6m) va tu dieu tri (25,6% lan dau va 28,7% cho ca doi). Chi 15,6% din benh vien va 5,2% din tram y t l kha thSp cho oi doi dieu tri (bilu do 2).
Khac Trgm y te Benh yen Ty d i l u tn Quay thulc Phdng kham tu'
|gj|4,4
T.—-_j4,1
JH^5,2
.^..|11,9
•
•
^ ^ ^ 2 5 . 6
Lan dau tien Cd dgt om
^ ^ ^ ^ i ^ ^ ^ B i ^ ^ a ^ ^ ^ ^ ^ ^ ^ ^ ^ 1
^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ 1 ^ 1 1 ^ 2 9 , 2
^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ • • R ' ' ^ ^ ! ! 7 ! ? ? n 3 2 3
^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ ^ H E B J ^ H ^ ^ ^ ^ H H
10
20 30
Bigu dd 2. No>i ngud'i cao tudi di§u trj khi dm dau (%)
Bilu do 3 eho thay trang ea dot om, dieu tri tai phdng khdm tu, din cac quay thuoc va ty dilu tri la 3 hinh thire dieu tri phi biln d tat ea cac nhdm. Tu dieu tri gap nhilu han d nu' gidi, ngudi tren 75 tuoi, ngudi dan too Kinh, ngudi cd trinh d l hpc van thap, ngud'i thuoc ede hO gia dinh ngh^o nhat, ngudi lam nghi nong, ngudi cd bao hiim y t l , ngud'i khdng co vg/chlng. Din quay thulc gap nhilu han d eae eu ba, ngudi dudi 75 tuli vd ngudi khdng cd vg/chlng. Dilu tri phong kham tu hay ggp han d cac cu Ing, ngudi tir 75 tuli trd len, ngudi dan tpe thilu s6, ngudi co hpc vln tieu hpe trd xuong, ngudi khdng ed bao hiim y t l va ngudi khdng ed vg/chlng. Dilu tri d benh vien hay gap han d cdc ey dng, ngud'i dud'i 75 tuli, ngud'i dan tpe Kinh, ngudi cd hgc van tnjng hpc pho thong trd' len, ngudi cd bao hiim y t l vd ngudi ed vg/chong.
3. Cac y6u to lien quan dgn su dung djch vu y t l cua ngud'i cao tudi
Ket qua phan tich da bien trong bang 1 cho thay ngudi tir 75 tuoi trd len hay di kham d phdng kham tu, it di benh vien va tu mua thulc han so vai ngudi dud'i 75 tuoi. Nu gidi thudng tu dilu tri hoae mua thuoc d quay thuoe va it di khdm d- cdc ca sd y t l khde han
nam gidi. Ngud'i ddn tpe thieu so it tu dilu trj, din tram y t l vd bdnh vien han ngud-i Kinh.
Ngudi cd hgc vln cang eao cang hay di benh vien va it dilu trj d cae nai khde. Ngudi cd dieu kign kmh t l khd han hay di mua thulc d quay thulc va it dilu trj tai cde nai khac.
Ngudi lam nghi phi nong nghiep hay di mua thulc d quay thuoc vd din tram y t l nhung it
TCNCYH 90 (
tu dieu tri han ngudi lam nghi ndng. Ngud'i va hay dilu tn d- benh vidn han ngudi khflng ed bao hiim y te thudng tu dilu tri hay den cd vg/chong. Nhu'ng khac biet ndy ed y nghTa benh vien nhung it din phdng kham tu. Ngudi thing ke, p < 0,05.
cd va/ching it ty dilu trj va it din quIy thulc
• Ty dilu trj
• QuIy thulc
^ Phdng khdm tu
• Tram y te 1^ Benh vien .. Khde
20 40 60 80 100 120 140
Bilu d i 3. Phan b l no'i dilu trj theo cac nhdm dli tuang khac nhau (%)* PT7H. phS thdng trung hoc; BHYT: bdo hiim y ti
TCf : YH 90 (5) - 2014
Bang 1 . Ty s u i t chenh trong h l i quy logistics da b i l n cdc y l u td lien quan d i n su" dyng djch vu y t l d> ngud'i cao t u l i (OR; 95%CI)
T u d i l u trj Q u I y t h u l c P K t u TYT B#nh vign
1,1(1.0-1,1) 0.8{07-0,9)- 1,4(1,3-1,5)* 1,0(0,9-1,1) 0,6(0,5-0,7)*
Nam NO
1 1,3(1,2-1,4)*
1 1,2(1,1-1,3)*
1 0,8 (0,8 - 0,9)*
1 0,8(0,7- 0,9)*
1 0,7 (0,6 - 0,8)*
DSn toe
Kinh 1 1 1 1 1
T h i l u so 0,7 (0,6 - 0,9)* 1,1 (0,9-1,3) 1,0(0,9-1,3) 0,2(0,1 - 0,4)* 0.7(0,5- 0,9)*
Hpc van
Tieu hpc t r a 1 1 1 1 1
xuong Toing hoc c o so"
THPT tra ien
0,8(0,7-0,9)*
0,8 (0,7 - 0,9)*
1,0(0,9-1,1) 0 8 (0,7 - 0,9)*
0,9(0,8-0,9)*
0,9(0,8-0,9)*
0,9(0,8.
0,8 (0,7 -1,1) -1,2)
1,2(1,1- 1,4(1,3-
1.3)* 1,6)* Kinh t l gia dinh
Ngheo 1 1 1 1 1
Tmng binh Kha
0,8(0,8-0,9)*
0,7 (0,6 - 0,8)*
1,1 (1,1-1,2)*
1,3(1,2-1,5)*
1,0(0,9-1,1) 1,0(0,9-1,1)
0,7 (0,6 - 0,6 (0,5 -
. 0,8)*
- 0,8)*
1,1 (1,0- 1,0(0,9-
-1,2)
•1,1) N g h i nghiep
Nong nghiep 1 1 1 1 1
Nghe khac 0,8(0,7-0,9)* 1,1 (1,0-1,2)* 1,0(0,9-1,0) 1,2(1,1 . -1,4)* 1,1 (1,0 -1.2) Bao hiltti y t l
Khong 1 1 1 1 1
Co 1,3(1,2-1,4)* 1,0(09-1,1) 0,7(0,6-0,7)* 1,0(0,9 -1.1) 2.2 (2,0 . •2,4)*
Co v a chdng
Khong 1 1 1 1 1
Co 0,9(0,8-1,0)* 0,9(0,8-0,9)* 1,0(0.9-1,1) 0,9(0.8 Gtti ch(t: s6 li$u ISy trdn 1 ct)i> s6 th$p phSn; *c6y ngliia th6ng fte v6f PK: phdng k/i^m; TYT:- traw y K; THPT: trung hoc phd thdng.
-1,0) 1,3(1,2
mCKy nghia 95%
-1,4)*
TCNCYH 90(5) 7014
IV. BAN LUAN
K i t qua d i l u tra eho t h i y cd d i n 99,6%
ngudi cao tuoi d u g e d i l u trj khi om dau, cao han nhieu so vdi nghien ciru cua chiing tdi vdo nam 2002 (70,7%) [8]. D i l u ndy cd t h i do cac hO gia dinh dd quan tdm han d i n eham sdc sire khoe ngudi eao tuoi, eung cd t h i do cdc ehinh sdeh h i tra da giup tang khd ndng tilp cgn vdi djch vg y te ciia ngudi cao t u l i .
Ba hinh thirc dieu trj d u g e ngudi eao tuoi lya chgn n h i l u nhat la phdng khdm t u , mua thuoc tgi quay thuoc vd t u d i l u tri. Cd 32,3%
ngudi cao tuoi chpn phdng khdm t u cho ldn dieu tri dau tien va 38,2% chpn eho ca dgt 6m.
Ty 1^ ndy da nhieu giam so vdi nghien eiru nam 2002 Id 48,1%[8] nhung vdn cao han nhilu so vdl nghidn ciru d Binh Lue, Ha Nam (11,0%)[9]. S y san ed va d l t i l p cdn v l dja ly, thdl glan Idm viee linh hoat vd hinh thirc thanh toan da dgng (hign vgt, n g , trd n h i l u lan) ed t h i la nhu'ng Igi t h i giup phdng khdm t u duge nhieu n g u d I ddn lya chgn han.
Mua thuoc tai cdc q u I y t h u l c dirae 2 3 , 1 % ngudi cao tuoi lua chgn cho lan d i l u tri ddu tidn vd 29,2%. chpn' eho ea dot 6m. Ty le tuang irng eho t y d i l u trj Id 25,6% va 28,7%.
Ty Ig t y d i l u trj vd mua thuoe tgi quay t h u l c cao dan den nguy c a lam dung, sir dung thuoe khdng h g p ly, n h i t id vdi cde t h u l c khdng sinh ed t h i d i n d i n hgu qua tang nguy ca khdng khang sinh.
Ty le d i l u tq tai trgm y te xd chi e h i l m 5,2%; thap han n h i l u so vdi k i t qua cac nghien cu'u t r u d c dd (20,5%), (58.7%) [8; 9].
Tinh ehung ea trgm y t l vd benh vien, ehi cd khoang 2 0 % ngudi eao tuoi lya chgn cac c a s d y t l "dng de d i l u tri khi om dau. D l dam bao tinh cong bdng vd gidm gdnh ndng chi trd eho khdm chu'a bgnh cua ngudi cao tuoi, can ed cac gi • phdp lam tang ty le si> dyng cac diehv ! c d n g .
Cd s u khac biet trong md hinh sir dung djch vu y t l theo gid'i, dan tde, nghe nghidp, hpe van, hdn nhan, tinh trang bao hiem y te d ngudi eao tuoi vd d i l u kign kinh t l hp gia dinh. Cde eu bd cd ty le mdc bgnh cao han, ed nhu c l u tim k i l m eac djch vu y t l eao han cac eu dng [10]. Vdi ty le t y d i l u tri vd mua t h u l c tgi q u I y t h u l c cao han vd ty Id d i l u trj tgi cdc ea s d y t l khde thdp han dudng nhu eae cy ba t h u d n g uu tien sir dung ede djch vu y t l ed mirc chi phi t h i p .
Ty le dieu tri t h i p cua ngudi cao tuoi dan too t h i l u s l d hdu h i t cde loai hinh djch vu, nhdt Id trgm y t l vd benh vien. D i l u nay ddi hoi phai ed nhung ehinh sach hu'u hieu han d l tdng khd ndng t i l p can cua nhdm d l l tuang nay vdi cae ca s d y t l cdng [10; 11].
Ngudi cao tuoi ed trinh dp hpe van eao ed ty le d i l u tn tai benh vien cao han vd ty le d i l u tri tai cac nai khae t h i p han so vdi ngudi cd hoc v l n t h i p . Trong khi do, ngudi eo d i l u kign kinh t l tot han cd xu hudng mua thuoc tai quay thude n h i l u han, it t y d i l u trj va it d i l u trj tai trgm y t l han so vdi ngudi thupe nhdm ngheo han. Dieu nay phii hgp vdi k i t qua ede nghien ciru trude dd eho t h i y y l u t l kinh t l ddng vai trd quan trong trong viec lua chgn dich vu y t l cua ngudi eao tuoivd nhO'ng ngudi cd d i l u kien kinh t l tot han thudng lya ehpn cdc djch vu y t l t u y i n eao han [6]. Y l u td kinh t l eung ed t h i ddng vai trd trong viee ngudi lam n g h i ndng nghiep thudng t y dieu tri n h i l u han va it di mua t h u l c han so vdi ngudi tam n g h i khde [6; 10].
T u a n g t y cac nghien ciru trude dd, ngud'i cd bao h i i m y t l cd xu hudng d i l u trj tgi benh vign n h i l u han vd it d i l u trj phdng khdm t u han ngudi cao tuoi khdng cd bao h i l m y t e [9;
12]. Tuy nhien trong nghien ciru eua chiing tdi, ngudi cd bao hiem y t l cd xu h u d n g t y dieu tn cao han, cd the do ngudi ed bao h i l m y te
90 (5) - 2014 137
s u dung lai cdc thuoc d u p e edp tir nhirng lan khdm benh trude dd.
Nhirng ngudi cd vp/ehdng thudng hay d i l u trj d eae bgnh vien va it t u d i l u tri cung nhu mua thule d q u I y thude. D i l u nay ggi y rang nhung ngudi khdng song vdi v g / c h l n g ed t h i gap khd khdn trong viec t i l p cdn vdi cdc ca s d y t l cdng vd c i n duge quan tdm han trong hoach djnh ehinh sdeh y t e .
V. KET LUAN VA KI^N NGH!
Khi dm dau ngudi cao tuoi thudng d i n phdng kham t u (38,2%), mua t h u l c d q u I y thule (29,2%) hodc t y d i l u tri (28,7%). Chi 15,6%i d i n tram y t l vd 5,2% d i n benh vien.
Cde cy ba, ngudi cao tuoi ddn tdc t h i l u so vd nhO'ng ngudi cd d i l u kien kinh t l xa hdi t h i p han thudng cd xu hudng t y d i l u tri hodc d i l u trj tgi cde ca s d d t u y i n t h i p han, ed c h i t lugng thap han nhu t u mua t h u l e . Cdn nang eao ehdt lugng djch vu tai tram y t l xa phudng de thu hiit ngudi cao tuoi d i n kham ehira benh vd tang bao phii bao h i l m y te de tang kha nang t i l p can dich vu y t l ciia ngudi eao tuoi.
Lo'i cam on
Chung toi xin chan thanh cam a n Ban d i l u hdnh Du an Nghien ciru he t h i n g y t l da cho phep chiing tdi s u dyng s l lieu cho nghien ciru. Tran trpng cam a n PGS.TS. N g u y i n Thj Kim Chuc da cd nhirng y k i l n ddng gdp quy bau cho bai bao. Cam an ngudi dan C a s d thye dja FilaBavi da cung edp thdng tin eho nghien eiru nay. Cac tde gid eam k i t khdng ed xung dot Igi ieh.
Tai lieu tham khao
1. Nguyen Thanh Van (2013). Dan sd dang gid nhanh, Viet Nam can Idm gl? Tap chi Ddn so va Phat trien, 11 (152), 1 4 - 1 6 .
2. T i n g cue Thong ke (2012). D i l u tra b i l n ddng ddn sd va k l hoach hod gia dinii thdi d i l m 1/4/2012: Cde k i t qua chu ylu.
Cdng ty In vd Phdt hanh b i l u m i u t h i n g kS, Tong cue thong ke, Ha Ndi.
3. Hoi le v., Thang P., Lindholm L (2011). Elderiy care in daily living in rural Vietnam: need and its socioeconomic determinants. BMC geriatrics. 11, 8 1 .
4. N g u y i n Van Tap Doan Phuoic Thugc, Hoang Thj Lien va cong sy* (2004). Nhu clu cham sdc sire khoe ngudi eao tuoi d huyen Cam Ld, tinh Quang Tri. Y duge hgc quan sw, 6, 1 9 - 2 4 .
5. Huong N. T., Hai Ha le T., Quynh Chi N. T et al (2012). Exploring quality of life among the elderiy in Hai Duong province, Vietnam: a rural-urban dialogue. Global health action, 5, 1 - 1 2 .
6. Thanh N. X., Lindholm L (2012). Has Vietnam Health care funds for the poor policy favored the elderiy poor? BMC health services research, 12, 333.
7. Chuc N. T., Diwan V (2003). FilaBavi, a demographic surveillance site, an epidemiol- ogical field laboratory in Vietnam. Scandina- vian journal of public health. Supplement, 62, 3 - 7 .
8. Tran Khanh Toan (2003). Tim hieu gdnh nang ehi phi cho khdm chua bgnh cua ngudi gia khdng cd bdo h i l m y t l tai huydn Ba Vi - tinh Ha Tdy. Tuyen tap eac Ludn van Thac sT vd T i l n sT Y t l cdng cdng 1999-2003.
Nha xuat ban Y hgc, Ha Ngi, 39 - 49.
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TCNCYH 90 (5)-2014
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Summary
HEALTH CARE UTILIZATION AND RELATED FACTORS AMONG THE ELDERLY IN BAVI DISTRICT, HANOI 2011 -2012
Increasing aging population creates many challenges to the health care system in our country.
The aim of the study is to describe the pattern of health care utilization and related factors among the elderly in Ba Vi district in 2011 - 2012. Approximately 5200 adults in the FilaBavi health and demographic surveillance site were quarterly interviewed during 2011 to 2012 about their reported illness and the use of health care services. Results showed that when they were siek, the elderiy often visited private clinics (38.2%), went to pharmacies (29.2%) or self - medicate (28.7%); only 15.6% went to hospitals and 5.2% visited commune health centers. Women, ethnic minorities and those who were at lower socio - economic conditions tended to go to pharmacies or self - medicated rather than visited public health facilities.
Keywords: Elderly, health care utilization, FilaBavi
TCNCYH 90 (5)-2014
