Unmet needs for informal care among people with type 2 diabetes in rural communities in Vietnam.

Objectives: The objective of this study was to identify determinants associated with unmet needs for informal support among people with type-2 diabetes in rural communities of Vietnam in order to inform development of effective interventions aimed at bridging the gap between community members and resource constrained health systems. Study design: A cross-sectional survey was conducted from December 2018 to February 2019 in a rural area of northern Vietnam. Methods: From 2 districts in northern Vietnam, 806 people with type-2 diabetes participated in a survey to assess who were their most important informal caregivers (ICGs) and to measure the association between demographic and socio-economic predictors and unmet needs of informal support of relevance for diabetes self-care using bivariate and multivariate analyses. Results: The spouse was reported as the most important ICG (62.9%) followed by a daughter or son (28.4%). 32.0% reported at least one type of unmet need for informal support. The most commonly reported unmet needs of informal care were: transport to health facilities and company when seeking formal care (20.5%), financial support related to costs of diabetes self-management (18.5%), and reminders to engage in physical exercise (14.5%). People living alone reported the highest odds ratio (OR) for unmet need of informal care (OR = 4.41; CI95%: 2.19-8.88), followed by those being poor (OR = 3.79; CI95%: 1.25-11.52) and those being unemployed (OR = 2.85; CI95%: 1.61-5.05). Conclusions: Almost one-third of people with type-2 diabetes reported at least one type of unmet need for informal care. These findings provide a basis for development of new modalities for strengthening support provided by ICGs in rural communities in Vietnam and in other low- and middle-income countries.

Cross-Cultural Adaption and Validation of SERVPERF Tool for Measuring Healthcare Quality in an Oncology Public Hospital, Vietnam.

SERVPERF (Service Performance) tool needs to be adapted to the context and the usage purpose. Our study aimed to validate the context adapted SERVPERF tool in an Oncology public hospital in Vietnam. A study was conducted in 2020 with 227 in-patients as respondents the modified SERVPERF tool. Data collected were analyzed for tool assessment (reliability and validity). The new order in 5 factors in the modified tool were: (1) Responsiveness; (2) Empathy; (3) Reliability; (4) Tangible and (5) Assurance. The modified tool has a high Cronbach's alpha of .94. The tool validity was confirmed by Confirmatory Factor Analysis (CFA) where the healthcare service quality item corresponds as χ2/df = 3.79, Comparative Fit Index (CFI) = 0.85, Tucker Lewis Index (TLI) = 0.83, and Root Mean Squared Error of Approximation (RMSEA) = 0.08 are good fit indices. The modified tool SERVPERF with high reliability and validity could be applied for measuring the clients' perceptions about healthcare service quality in other Oncology public hospitals in Vietnam.

Patient Satisfaction With Healthcare Service Quality and Its Associated Factors at One Polyclinic in Hanoi, Vietnam.

Introduction: Patient satisfaction is one of the most important components of measuring healthcare quality. Objectives: The study aimed to evaluate the validity and reliability of the patient satisfaction scale with the quality of health services and its associated factors. Methods: A cross-sectional study was conducted to collect data on patient satisfaction with 301 outpatients at one polyclinic in Hanoi, Vietnam. Results: The overall outpatient satisfaction was 53.5%. There were five factors (facilities, services provision results, information transparency and administrative procedures, accessibility, and interaction and communication of staff) including one major factor with high Eigenvalues coefficient, 22.5 for satisfaction with facility, and four others with lower Eigenvalues coefficient, 3.2, 2.0, 1.5, and 1.2 for satisfaction with service provision results, information transparency and administrative procedures, accessibility, and interaction and communication of staff respectively. All satisfaction-factors show internal consistency reliability, with a Cronbach's Alpha of over 0.9. The insured are 3.5 times (95% CI: 1.9-6.2) more likely to be satisfied with health services than the uninsured. Conclusion: The patient satisfaction measurement tool should be used for intervention to improve the quality of health services at the clinic.

Impact of Public Health Insurance on Out-of-Pocket Health Expenditures of the Near-Poor in Vietnam.

Out-of-pocket payment is one of the indicators measuring the achievement of Universal Health Coverage. According to the World Health Organization, for countries from the Asia Pacific Region, out-of-pocket payments should not exceed 30%-40% of total health expenditure. This study aimed to identify factors influencing out-of-pocket payment for the near-poor for outpatient healthcare services as well as across health facilities at different levels. The data of 1143 individuals using outpatient care were used for analysis. Healthcare payments were analyzed for those who sought outpatient care in the past 6 months. The Heckman selection model was used to control any bias resulting from self-selection of the insurance scheme. The finding revealed that health insurance reduces average out-of-pocket payments by about 21% (P < .001). Using private health facilities incurred more out-of-pocket payments than public health facilities (P < .001). The study suggested that health insurance for the near-poor should be modified to promote universal health coverage in Vietnam.

Origin of Novel Coronavirus (COVID-19): A Computational Biology Study using Artificial Intelligence

Origin of the COVID-19 virus (SARS-CoV-2) has been intensely debated in the scientific community since the first infected cases were detected in December 2019. The disease has caused a global pandemic, leading to deaths of thousands of people across the world and thus finding origin of this novel coronavirus is important in responding and controlling the pandemic. Recent research results suggest that bats or pangolins might be the hosts for SARS-CoV-2 based on comparative studies using its genomic sequences. This paper investigates the SARS-CoV-2 origin by using artificial intelligence (AI) and raw genomic sequences of the virus. More than 300 genome sequences of COVID-19 infected cases collected from different countries are explored and analysed using unsupervised clustering methods. The results obtained from various AI-enabled experiments using clustering algorithms demonstrate that all examined SARS-CoV-2 genomes belong to a cluster that also contains bat and pangolin coronavirus genomes. This provides evidence strongly supporting scientific hypotheses that bats and pangolins are probable hosts for SARS-CoV-2. At the whole genome analysis level, our findings also indicate that bats are more likely the hosts for the COVID-19 virus than pangolins.

A Leadership and Managerial Competency Framework for Public Hospital Managers in Vietnam.

OBJECTIVE: The aim of this paper was to develop a leadership and managerial competency framework for public hospital managers in Vietnam. METHODS: This mixed-method study used a four-step approach. The first step was a position description content analysis to identify the tasks hospital managers are required to carry out. The resulting data were used to identify the leadership and managerial competency factors and items in the second step. In the third step, a workshop was organized to reach consensus about the validity of these competency factors and items. Finally, a quantitative survey was conducted across a sample of 891 hospital managers who are working in the selected hospitals in seven geographical regions in Vietnam to validate the competency scales using exploratory factor analysis (EFA) and Cronbach's alpha. RESULTS: The study identified a number of tasks required for public hospital managers and confirmed the competencies for implementing these tasks effectively. Four dimensions with 14 components and 81 items of leadership and managerial competencies were identified. These components exhibited 83.8% of variance and Cronbach's alpha were at good level of 0.9. CONCLUSIONS: These competencies are required for public hospital managers which provide guidance to the further development of the competency-based training for the current management taskforce and preparing future hospital managers.