Medical expenses matter most for the poor: evidence from Vietnam

Introduction: Less developed countries, Vietnam included, face serious challenges of inefficient diagnosis, inaccessibility to healthcare facilities, and high medical expenses. Information on medical costs, technical and professional capabilities of healthcare providers and service deliveries becomes influential when it comes to patients' decision on choices of healthcare providers.Methods: The study employs a data set containing 1,459 observations collected from a survey on Vietnamese patients in late 2015. The standard categorical data analysis is performed to provide statistical results, yielding insights from the empirical data.Results: Patients' socio-economic status (SES) is found to be associated with the degree of significance of key factors (i.e. medical costs, professional capabilities and service deliveries), but medical expenses are the single most important factor that influence a decision by the poor, 2.28 times as critical as the non-poor. In contrary, the non-poor tend to value technical capabilities and services more, with odds ratios being 1.54 and 1.32, respectively.Discussion: There exists a risk for the poor in decision making based on medical expenses solely. The solution may rest with: a) improved health insurance mechanism; and, b) obtaining additional revenues from value-added services, which can help defray the poor's financial burdens.