As economic growth and a rapidly aging population drive substantial demand for healthcare services in Vietnam, it is salient that more attention be paid to assessing patient satisfaction among older adults. Specifically, the study aims to shed light on the critical aspect of patient satisfaction among older adults, which has not been extensively explored in previous research conducted within the country. By utilizing national data from the Vietnam Aging Survey, our analysis showed that approximately 83.2% of older patients were satisfied with healthcare services. Notably, there were significant differences in healthcare service satisfaction between the Northern and Southern regions. Furthermore, healthcare satisfaction varied based on educational levels and social insurance holding status. While insurance coverage and socio-demographic factors played important roles in narrowing the gap between the Northern and Southern regions, the type of facility widened the regional difference in healthcare satisfaction. In light of these results, our study underscores the importance of national policies prioritizing enhancing social insurance mechanisms and improving the quality of healthcare services at the district level in rural areas. These measures are crucial for achieving geographic equity in patient satisfaction with healthcare services in Vietnam.