Publication: What Drives Utilization of Primary Care Facilities? Evidence from a National Facility Survey
Loading...
Files in English
180 downloads
Published
2021
ISSN
2047-9700
Date
2022-01-14
Author(s)
Editor(s)
Abstract
This analysis aims to assess the association between commune health station (CHS) service availability/readiness and health service utilization. Data from the 2015 Vietnam District and Commune Health Facility Survey was used to build a series of multivariate negative binomial regressions to measure the association between domains of service availability/readiness and CHS's average number of visits per capita. Three domains of service availability/readiness are significantly associated with higher utilization rates: health infrastructure, basic equipment availability, and capacity to deliver services for non-communicable diseases. If all three modifiable CHS characteristics were to be improved from their current level, the predicted utilization rate of the CHS would be 3.3–3.7 times as high as current levels. Investments in improving facility infrastructure, making available essential equipment items, and enabling the CHS to provide hypertension and diabetes services would all likely increase health service utilization at CHS level.
Link to Data Set
Digital Object Identifier
Associated URLs
Associated content
Other publications in this report series
Journal
Journal Volume
Journal Issue
Collections
Related items
Showing items related by metadata.
Publication What Drives Utilization of Primary Care Facilities in Vietnam?(World Bank, Washington, DC, 2019-06)This analysis aims to assess the association between commune health station (CHS) service readiness and health service utilization to inform the design of a World Bank project and policies to strengthen primary health care in Vietnam. Using data drawn from the 2015 Vietnam district and commune health facility survey (DCHFS), a series of multivariate negative binomial regressions was estimated to measure the association between domains of service readiness and CHS utilization rates (average number of visits per capita). To conclude, investments in improving facility infrastructure (especially ensuring that facilities have the mandated number of rooms and building area), making available essential equipment items, and enabling the CHS to provide hypertension and diabetes services, whether made independently or together, would all likely increase CHS utilization. Investment in CHSs in zone 3 and zone 2 should be prioritized over investments in zone 1, since investments in the former would result in the highest utilization rates.Publication The Impoverishing Effect of Adverse Health Events : Evidence from the Western Balkans(World Bank, Washington, DC, 2007-12)This paper investigates the extent to which the health systems of the Western Balkans (Albania, Bosnia and Herzegovina, Montenegro, Serbia, and Kosovo) have succeeded in providing financial protection against adverse health events. The authors examine disparities in health status, healthcare utilization, and out-of-pocket payments for healthcare (including informal payments), and explore the impact of healthcare expenditures on household economic status and poverty. Methodologies include (i) generating a descriptive assessment of health and healthcare disparities across socioeconomic groups, (ii) measuring the incidence and intensity of catastrophic healthcare payments, (iii) examining the effect of out-of-pocket payments on poverty headcount and poverty gap measures, and (iv) running sets of country-specific probit regressions to model the relationship between health status, healthcare utilization, and poverty. On balance, the findings show that the impact of health expenditures on household economic wellbeing and poverty is most severe in Albania and Kosovo, while Montenegro is striking for the financial protection that the health system seems to provide. Data are drawn from Living Standards and Measurement Surveys.Publication Transition to Diagnosis-Related Group Payments for Health(Washington, DC: World Bank, 2020)This book examines how nine different health systems--U.S. Medicare, Australia, Thailand, Kyrgyz Republic, Germany, Estonia, Croatia, China (Beijing) and the Russian Federation--have transitioned to using case-based payments, and especially diagnosis-related groups (DRGs), as part of their provider payment mix for hospital care. It sheds light on why particular technical design choices were made, what enabling investments were pertinent, and what broader political and institutional issues needed to be considered. The strategies used to phase in DRG payment receive special attention. These nine systems have been selected because they represent a variety of different approaches and experiences in DRG transition. They include the innovators who pioneered DRG payment systems (namely the United States and Australia), mature systems (such as Thailand, Germany, and Estonia), and countries where DRG payments were only introduced within the past decade (such as the Russian Federation and China). Each system is examined in detail as a separate case study, with a synthesis distilling the cross-cutting lessons learned. This book should be helpful to those working on health systems that are considering introducing, or are in the early stages of introducing, DRG-based payments into their provider payment mix. It will enhance the reader's understanding of how other countries (or systems) have made that transition, give a sense of the decisions that lie ahead, and offer options that can be considered. It will also be useful to those working in health systems that already include DRG payments in the payment mix but have not yet achieved the anticipated results.Publication Vietnam : Learning from Smart Reforms on the Road to Universal Health Coverage(World Bank Group, Washington, DC, 2014-08)Universal Health Coverage is a powerful framework for a nation aiming to protect their population against health risks. However, countries face multiple challenges in implementing, achieving and sustaining UHC strategies. Sharing and learning from diverse country experiences may enable to foster global and country progress toward that goal. The study seeks to contribute to the global effort of sharing potentially useful lessons to address policy concerns on the design and implementation of UHC strategies in LMICs. Vietnam is one of the LMICs that have taken relatively quick and effective actions to expand health coverage and improve financial protection in the last two decades. The country study, first, takes stock of UHC progress in Vietnam, examining both the breadth and the depth of health coverage and assessing financial protection and equity outputs (chapter one). Chapter two includes an in-depth analysis of some of the major success strategies and policy actions that the country took to expand health coverage and financial protection for all, including for the poor. Chapter three focuses on some of the UHC-related challenges that the country faces in pursuing expansion and sustaining UHC. Vietnam s experience suggests that, moving toward greater UHC outputs, the system must be constantly adjusted, and that UHC strategies must be adaptive, those used in the past to cover the formal sector and the poor may turn out inadequate to reach the uninsured in the informal sector.Publication The Future of Health Financing in Vietnam(World Bank, Washington, DC, 2019-06)Vietnam is changing rapidly economically, with parallel shifts in epidemiology and demographics. There have also been significant policy shifts in recent years, including in the health sector. The combined effects of these transitions pose some risks to the sustainability of essential public health services, and will continue to put upward pressure on health spending. This report analyzes how Vietnam can maintain a sufficient level of public spending on health to sustain and further good health outcomes and respond to new health challenges.
Users also downloaded
Showing related downloaded files
Publication Digital Africa(Washington, DC: World Bank, 2023-03-13)All African countries need better and more jobs for their growing populations. "Digital Africa: Technological Transformation for Jobs" shows that broader use of productivity-enhancing, digital technologies by enterprises and households is imperative to generate such jobs, including for lower-skilled people. At the same time, it can support not only countries’ short-term objective of postpandemic economic recovery but also their vision of economic transformation with more inclusive growth. These outcomes are not automatic, however. Mobile internet availability has increased throughout the continent in recent years, but Africa’s uptake gap is the highest in the world. Areas with at least 3G mobile internet service now cover 84 percent of Africa’s population, but only 22 percent uses such services. And the average African business lags in the use of smartphones and computers as well as more sophisticated digital technologies that catalyze further productivity gains. Two issues explain the usage gap: affordability of these new technologies and willingness to use them. For the 40 percent of Africans below the extreme poverty line, mobile data plans alone would cost one-third of their incomes—in addition to the price of access devices, apps, and electricity. Data plans for small- and medium-size businesses are also more expensive than in other regions. Moreover, shortcomings in the quality of internet services—and in the supply of attractive, skills-appropriate apps that promote entrepreneurship and raise earnings—dampen people’s willingness to use them. For those countries already using these technologies, the development payoffs are significant. New empirical studies for this report add to the rapidly growing evidence that mobile internet availability directly raises enterprise productivity, increases jobs, and reduces poverty throughout Africa. To realize these and other benefits more widely, Africa’s countries must implement complementary and mutually reinforcing policies to strengthen both consumers’ ability to pay and willingness to use digital technologies. These interventions must prioritize productive use to generate large numbers of inclusive jobs in a region poised to benefit from a massive, youthful workforce—one projected to become the world’s largest by the end of this century.Publication Regional Poverty and Inequality Update: Latin America and the Caribbean, October 2025(Washington, DC: World Bank, 2025-10-23)This brief summarizes recent facts related to poverty and inequality in Latin America and the Caribbean (LAC) using the latest wave of harmonized household surveys from the Socio-Economic Database for LAC (SEDLAC). This brief was produced by the Poverty Global Practice in the LAC Region of the World Bank.Publication Falling Long-Term Growth Prospects(World Bank : Washington, DC, 2024-02-01)A structural growth slowdown is underway across the world: at current trends, the global potential growth rate is expected to fall to a three-decade low over the remainder of the 2020s. Nearly all the forces that have powered growth and prosperity since the early 1990s have weakened, not only because of a series of shocks to the global economy over the past three years. A persistent and broad-based decline in long-term growth prospects imperils the ability of emerging market and developing economies to combat poverty, tackle climate change, and meet other key development objectives. These challenges call for an ambitious policy response at the national and global levels. This book presents the first detailed analysis of the growth slowdown and a rich menu of policy options to deliver better growth outcomes.Publication Integrating Noncommunicable Disease Management into Primary Health Care(Washington, DC: World Bank, 2024-04-05)Non-communicable diseases (NCDs) are increasingly placing significant health and economic burdens on low- and middle-income countries (LMICs). Primary care serves as the initial point of contact for individuals seeking medical assistance and plays a pivotal role in promoting health, preventing diseases, and managing chronic conditions like cardiovascular diseases, diabetes, cancer, and respiratory illnesses. By embedding NCD services within primary health care (PHC) settings, individuals receive timely screening, diagnosis, treatment, and ongoing support, leading to improved health outcomes and reduced healthcare costs. The World Bank has significantly increased its investments in NCD management, particularly over the past decade. The aim of this report is to collate real-world examples showcasing the integration of best practices for managing NCDs within PHC systems. This anthology accompanies the NCD system assessment tool, which aims to support World Bank country teams to a rapidly (~3 months) assess gaps implementation of a set of best practices for NCD prevention and management. Specifically, the tool evaluates health systems against 43 best practices - practical policies, plans, programs or structures - recommended by global consensus panels or proven to be effective in meta-analyses, systematic reviews and Cochrane reviews. These best practices that make up the assessment tool are the foundation of the case studies in this anthology. Drawing on desk-based review of available data, peer-reviewed and grey literature, and a small set of key informant interviews, the cases in this anthology detail the successes, challenges, and lessons learned from the adoption of these best practices in diverse country contexts.Publication Thailand Monthly Economic Monitor, October 2025(Washington, DC: World Bank, 2025-10-22)Fiscal conditions remained stable, with a modest widening of the deficit to 3.1 percent of GDP. New stimulus measures are expected to support short-term demand without breaching the public debt ceiling. Inflation stayed negative, reflecting lower energy and food prices amid subdued domestic demand. The central bank kept the policy rate unchanged, citing limited policy space. Thailand’s growth momentum has slowed further as manufacturing activity and services weakened as projected. Tourism remained subdued, largely due to fewer Chinese visitors. Goods exports also slowed as earlier front-loaded orders faded, particularly in agriculture and industrial goods. The Thai baht depreciated in early October as the US dollar appreciated and the current account turned negative.