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. 2021 Jun 15;21(1):1145.
doi: 10.1186/s12889-021-11219-4.

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

Thu-Anh Nguyen  1   2 , Yen Ngoc Pham  3 , Nhung Phuong Doan  3 , Thao Huong Nguyen  3 , Toan Thanh Do  4 , Giap Van Vu  5 , Guy B Marks  6 , Shannon McKinn  7 , Joel Negin  7 , Sarah Bernays  7   8 , Greg J Fox  9
Affiliations

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

Thu-Anh Nguyen et al. BMC Public Health. .

Abstract

Background: Chronic 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.

Methods: We 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.

Results: Patients' 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).

Conclusion: The 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.

Keywords: Asthma; COPD; Healthcare pathway.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Conceptual framework of access to care (Levesque et al. (2013))
Fig. 2
Fig. 2
The pathway to get health care service of participant A
Fig. 3
Fig. 3
The pathway to get health care service of participant B
See this image and copyright information in PMC

References

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