Quality of Private Health Services in Vietnam

Abstract

Objective: To analyze the quality of private health services in Bac Giang City, Vietnam. Method: All private health care providers were assessed for quality of care through site visits and interviews. Structure including equipment and staffing was assessed through interview with the facility manager and competence of private health providers was investigated through interviews of staff using vignettes on cases with tracer conditions for acute and chronic disease. Patient exit interviews were performed to assess patient satisfaction with services. In addition, staff in public Commune Health Centers was interviewed with vignettes to allow for comparison of skills with private providers. Results: 50 private medicine facilities were included in the study. The facilities were small in scope, mainly out-patient clinics. They were mostly operated by a single physician (66%), or small group of physicians. Services were mainly regular examination and treatment (76%) with common health problems. Only 20% offered more advanced services like ECG and X-Ray. Most private allopathic medicine providers had basic equipment for examining patients but little equipment for basic surgery and testing. Around half (55%) had sterilizing instrument. In patient interviews stated reasons for seeking private care were good attitude of staff (72%), proximity to home (69%), perceived competence of physician (63%) and time-saving (58%). Mean score of overall client satisfaction was 3.9 on a scale of 1-5. Knowledge on recognizing symptoms and handling cases of was low both in private and public facilities. Conclusion: Most private providers at urban district level are limited in size, staffing, service provision and patient load. Their services are usually appreciated by clients. However, their skills appear to be less than optimal, though not significantly lower than those of public sector staff.