Primary care experiences in Central Vietnam : a comparison between different health care settings

Background: Primary care has been shown to result in better health outcomes for populations. The structure of health care systems and their associated facilities can have a substantial impact on the effectiveness and quality of primary care. The aim of this study was therefore to compare the primary care experiences of the population related to different health facilities in Vietnam. Methods: A cross-sectional study. 1662 people utilised health care services at least once over the past two years in Central Vietnam were surveyed by the primary care assessment tool VN PCAT- AE from Johns Hopkins University which was validated in Vietnamese. Results: Commune health centers (CHC) were the primary choice for primary care of respondents (39.6%) and had the highest ranking of primary care overall (PCAT expanded score: 21.46), especially in first contact utilization (3.11), ongoing care (2.68). Private clinics and pharmacy stores were significantly the worst (18.04 and 16.47). District hospitals (DHC) and other government hospitals (GVH) achieved 20.19 and 19.77 of PCAT expanded scores respectively, comprehensive-services available is the strongest attribute of DHC and GVH. Polyclinic achieved 19.17 of PCAT expanded scores, performed well in comprehensiveness-services available (3.11), first contact-access (2.73) but worse in other domains, particularly in cultural competency (1.89). Conclusions: This study reaffirms that CHC is the most appropriate primary care provider compared with other health care settings in Vietnam. Thus, the population might benefit from strengthening the CHC’s network by investigating more substantial efforts as well as encourage patients using CHC as the first contact point for primary care.