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

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.

Respiratory Health Among Older Adults in Vietnam: Does Earlier-Life Military Role and War Exposure Matter?

“…For instance, a qualitative study on health-seeking behaviors among patients with chronic lung diseases in Vietnam suggests that military veterans, especially formerly wounded soldiers, have a better access to specialist care compared to others (T.A. Nguyen et al, 2021). Another noteworthy finding is the absence of statistically significant associations between war exposure, PTSD, and low PEF-the objectively assessed measure of respiratory conditions in this study.…”

“…For instance, a qualitative study on health-seeking behaviors among patients with chronic lung diseases in Vietnam suggests that military veterans, especially formerly wounded soldiers, have a better access to specialist care compared to others (T.A. Nguyen et al, 2021).…”

“…Furthermore, in LMICs such as Vietnam, chronic lung diseases tend to be underdiagnosed due to significant economic disparity in health access and utilization (T.A. Nguyen et al, 2021). In this study, we complement self-reported measures of respiratory health with a measure of pulmonary function test (PEF).…”

Everyday disease diplomacy: an ethnographic study of diabetes self-care in Vietnam

“…In the context of Vietnam, hospital overcrowding, lack of adequate primary level health care services, and lack of essential medicines have previously been found to place constraints on health care delivery [ 29 , 30 ]. Although existing research indicates that motivations for appropriate disease management are high among people with chronic health conditions in Vietnam [ 31 – 34 ], lack of knowledge and limited health provider support often render self-care difficult. The comprehensive everyday life work that the present study documents must be seen on the background of these health systems constraints.…”

Spectrum and antimicrobial resistance in acute exacerbation of chronic obstructive pulmonary disease with pneumonia among Vietnamese patients: A cross-sectional prospective study

“…Exacerbations signi cantly contribute to this phenomenon [1]. In Vietnam, the prevalence of COPD is estimated to range from 7% to 10% [2][3][4]. Notably, more than half of COPD patients experience exacerbations, leading to hospitalization and increasing the economic burden on both individuals and the health system [3].…”