Volume 1. No.1

   Willingness to use and pay for options of care for community-dwelling older people in rural Vietnam

   Hoi Le Van, Tien Nguyen Thi Kim, Tien Nguyen Van, Dung Dao Van, Chuc Nguyen Thi Kim, Klas Goran Sahlen, Lars Lindholm

ABSTRACT

 

The proportion of people in Vietnam who are 60 years and over has increased rapidly. The emigration of young people and impact of other socioeconomic changes leave more elderly on their own and with less family support. This study assesses the willingness  to use and pay for different models of care for community-dwelling elderly in rural Vietnam.

 

Methods

 

In 2007, people aged 60 and older and their family  representatives, living in 2,240 households,  were randomly selected from the FilaBavi Demographic Surveillance Site. They were interviewed using struc­ tured questionnaires to assess dependence  in activities of daily living (ADLs), willingness to use and to pay for day care centres, mobile care teams, and nursing centres. Respondent  socioeconomic charac­ teristics were extracted from the FilaBavi repeated census. Percentages  of those willing to use models and the average amount they are willing to pay were  estimated. Multivariate  analyses  were performed to measure the relationship  of willingness  to use services  with ADL index and socioeconomic factors. Four focus group discussions  were conducted to explore people's perspectives on the use of services.

 

Results

 

Use of mobile team care is the most requested service. The fewest respondents  intend to use a nursing centre. Households  expect to use services for their elderly to a greater extent than do the elderly them­ selves. Willingness to use services decreases when potential fees increase. The proportion of respond­ ents who require that services be free-of-charge is two to three times higher than the proportion willing to pay full cost. Households are willing to pay more than the elderly for day care and nursing centres. The elderly are more willing to pay for mobile teams than are their households. Age group, sex, literacy, marital status, living arrangement, living area, working  status, poverty, household  wealth and depend­ ence in ADLs are factors related to willingness to use services.

 

Conclusion

 

Community-centric elderly care will be used and partly paid for by individuals if it is provided by the gov­ ernment or associations. Capacity building  for health professional networks  and informal caregivers  is essential for developing formal care models. Additional support is needed for the most vulnerable elderly to access services.

 

Keywords

 

Elderly, willingness to use, willingness to pay, activities of daily living (ADL), socioeconomic, rural


 

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