Expanding co-payment for methadone maintenance services in Vietnam: the importance of addressing health and socioeconomic inequalities
Identifieur interne : 000244 ( Main/Exploration ); précédent : 000243; suivant : 000245Expanding co-payment for methadone maintenance services in Vietnam: the importance of addressing health and socioeconomic inequalities
Auteurs : Bach Xuan Tran [Viêt Nam, États-Unis] ; Quyen Le Nguyen [Viêt Nam] ; Long Hoang Nguyen [Viêt Nam] ; Huong Thu Thi Phan [Viêt Nam] ; Huong Thi Le [Viêt Nam] ; Tho Dinh Tran [Viêt Nam] ; Thuc Thi Minh Vu [Viêt Nam] ; Carl A. Latkin [États-Unis]Source :
- BMC Health Services Research [ 1472-6963 ] ; 2017.
Abstract
Ensuring high enrollment while mobilizing resources through co-payment services is critical to the success of the methadone maintenance treatment (MMT) program in Vietnam. This study assessed the willingness of patients to pay (WTP) for different MMT services delivery models and determined its associated factors.
A facility based survey was conducted among 1016 MMT patients (98.7% male, 42% aged 35 or less, and 67% living with spouse) in five MMT clinics in Hanoi and Nam Dinh province in 2013. Socioeconomic, HIV and health status, history of drug use and rehabilitation, and MMT experience were interviewed. WTP was assessed using contingent valuation method, including a set of double-bounded binary questions and a follow-up open-ended question. Point and interval data models were used to estimate maximum willingness to pay.
95.5% patients were willing to pay for MMT at the monthly mean price of US$ 32 (95%CI = 28–35). Higher WTP was associated with higher level of educational attainment, higher income, male sex, and had high expenses on opiates prior to MMT. Patients who reported having any problem in Pain/ Discomfort, and who did not have outpatient care last year were willing to pay less for MMT than others.
High level of WTP supports the co-payment policies as a strategy to mobilize resources for the MMT program in Vietnam. However, it is necessary to ensure equalities across patient groups by acknowledging socioeconomic status of different settings and providing financial supports for disadvantaged patients with severe health status.
Url:
DOI: 10.1186/s12913-017-2405-y
PubMed: 28701208
PubMed Central: 5508786
Affiliations:
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<front><div type="abstract" xml:lang="en"><sec><title>Background</title>
<p id="Par1">Ensuring high enrollment while mobilizing resources through co-payment services is critical to the success of the methadone maintenance treatment (MMT) program in Vietnam. This study assessed the willingness of patients to pay (WTP) for different MMT services delivery models and determined its associated factors.</p>
</sec>
<sec><title>Methods</title>
<p id="Par2">A facility based survey was conducted among 1016 MMT patients (98.7% male, 42% aged 35 or less, and 67% living with spouse) in five MMT clinics in Hanoi and Nam Dinh province in 2013. Socioeconomic, HIV and health status, history of drug use and rehabilitation, and MMT experience were interviewed. WTP was assessed using contingent valuation method, including a set of double-bounded binary questions and a follow-up open-ended question. Point and interval data models were used to estimate maximum willingness to pay.</p>
</sec>
<sec><title>Results</title>
<p id="Par3">95.5% patients were willing to pay for MMT at the monthly mean price of US$ 32 (95%CI = 28–35). Higher WTP was associated with higher level of educational attainment, higher income, male sex, and had high expenses on opiates prior to MMT. Patients who reported having any problem in Pain/ Discomfort, and who did not have outpatient care last year were willing to pay less for MMT than others.</p>
</sec>
<sec><title>Conclusion</title>
<p id="Par4">High level of WTP supports the co-payment policies as a strategy to mobilize resources for the MMT program in Vietnam. However, it is necessary to ensure equalities across patient groups by acknowledging socioeconomic status of different settings and providing financial supports for disadvantaged patients with severe health status.</p>
</sec>
</div>
</front>
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