Improving Hospital's Quality of Service in Vietnam: The Patient Satisfaction Evaluation in Multiple Health Facilities.

We developed a patient satisfaction (PS) scale to measure PS and determined associated factors with PS in several hospitals in Vietnam. In this cross-sectional survey, study on 108 patients in three hospitals in Hanoi, Vietnam was conducted. A PS instrument covering four domains: 1) Transparency of information and procedure; 2) Facilities and equipment; 3) Attitude and capacities of health professionals, and 4) Outcomes of service was used. Multivariate linear regression was performed to detect factors associated with patient satisfaction scores. The internal consistency reliability was excellent at 0.9400. The highest percentage of people having complete satisfaction was 64.8% in the item "Doctors have good attitudes and communication with patients," while the lowest percentage was in "the level of satisfaction with the price of medical services of the hospital" (13.0%). Overall, 23.2% of patients rated complete satisfaction with health services. There were 54.6%, 44.4%, 40.7%, and 26.9% patients having satisfaction/complete satisfaction with Outcomes of service, Facilities and Equipment, Attitude and capacities of health professionals and Transparency of information and procedure, respectively. Patients who were outpatients, living in other provinces, using on-demand services, and unable to pay service fees had lower levels of satisfaction compared to others. To conclude, the satisfaction with health service in our sample was moderately low, particularly transparency in information and procedure. Improving the quality of administrative procedures and the application of information technology are priority issues in improving the quality of hospitals and assure equality in health care delivery among different patient groups.

Starch behaviors and mechanical properties of starch blend films with different plasticizers.

The main objective of the study was to gain insight into structural and mechanical starch behaviors of the plasticized starch blend films. Mechanical properties and starch behaviors of cassava (CS)/and mungbean (MB) (50/50, w/w) starch blend films containing glycerol (Gly) or sorbitol (Sor) at 33% weight content were investigated. It was found that tensile strength TS and %E of the Gly-CSMB films were similar to those of MB films; but%E of all Sor-films was identical. TS of plasticized films increased when AM content and crystallinity increased. When Sor was substituted for Gly, crystallinity of starch films and their TS increased. The CSMB and MB films had somewhat a similar molecular profile and comparable mechanical properties. Therefore, it was proposed the starch molecular profile containing amylopectin with high M¯w, low M¯w of amylose, and the small size of intermediates may impart the high TS and%E of starch films.

Comparison of long-term outcome between white and Vietnamese children treated for acute lymphoblastic leukemia according to the FRALLE 2000 protocol.

AIM OF THIS STUDY: To compare the relapse-free survival (RFS) in Vietnamese (n=141) and white (n=94) children living in Vietnam and Belgium, respectively, and treated in their own country for acute lymphoblastic leukemia according to the same FRALLE 2000 protocol. RESULTS: RFS was significantly worse in Vietnamese children (hazards ratio=4.48; 95% confidence interval [CI], 2.16-9.3; P<0.01). The 5-year RFS was 83.8% (95% CI, 76.3%-92.0%) and 47.8% (95% CI, 35.6%-64.2%) for white and Vietnamese children, respectively. In the latter group, relapses occurred in bone marrow and cerebrospinal fluid at a much earlier stage. The outcome was compared at first relapse only because of different treatments afterward, according to the country. Both series were similar for sex, age at diagnosis, initial white blood cell count, cytogenetic abnormalities, and corticosensitivity at day 8. Higher frequency of L2-acute lymphoblastic leukemia (P<0.001) but lower frequency of T-acute lymphoblastic leukemia (P=0.004) were observed in Vietnamese children. CONCLUSIONS: Several factors may contribute to the poor RFS in Vietnamese children, which include the time interval before the first intrathecal therapy and differences in the management of drug-related toxicity. However, additional contribution of socioeconomic factors and/or variations in pharmacogenetic polymorphisms in Vietnamese patients cannot currently be ruled out.