ObjectivesThe aims of this paper were to confirm the validity and reliability of a brief CES-D measure for depression and identify the associated factors with the depression among adolescents and youth in Chi Linh, Hai Duong province, Vietnam.MethodsWe used data from a prospective-longitudinal study of adolescents and youth (aged 13–17 at baseline) and their parent (N = 1402 mother/father-child dyads). Adolescents' depression was assessed in 2009 and 2013. Parents' connectedness was measured in 2013. Confirmatory factor Analysis (CFA) was used to certify the elementary factors produced by PCA using Comparative Fit Index (CFI), Tucker Lewis Index (TLI) and RMSEA. Multivariate linear regression was used to predict the factors associated with depression.ResultsThe results demonstrate that the depression items correspond as CFI (0.89), TLI (0.87) and RMSEA (0.084) are acceptable fit indices. The mean score of depression among adolescents and youth was 30.9 (Min = 16 and Max = 70; SD = 8.3). Age (β = −0.01; CI 95% = −0.1; −0.03), parent and youth can talk freely (β = −0.042; CI 95% = −0.08; −0.001) and good health status (β = −0.07; CI 95% = −0.1; −0.03) were found to be significantly associated with depression.ConclusionsDepression scale should be widely applied for screening the depression symptoms of adolescents and youth population. The necessary strategies should be implemented to improve the adolescent and young population's depression status.

ObjectiveThe aim of this paper was to develop a leadership and managerial competency framework for public hospital managers in Vietnam.MethodsThis 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.ResultsThe 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.ConclusionsThese 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.

Out-of-pocket expenditure/payment (OOP) is one of the indicators measuring the achievement of Universal Health Coverage. This article aimed to compare OOP among the insured and uninsured for their outpatient and inpatient health care services. The data of 6710 individuals using outpatient care and 924 individuals using inpatient care at 78 district hospitals and 246 commune health centers in 6 provinces from the World Bank survey, "The 2015 Vietnam District and Commune Health Facility," were used for analysis. In the ordinary least square model, the estimated coefficient of the insurance status variable suggested that insurance reduced OOP by 31.1% for outpatient care and 31.5% for inpatient care of the insured as compared with the uninsured (P <0.001). For outpatient care, insurance reduced OOP more for those enrollees using commune health centers than those using district health facilities, 42.3% and 20.2%, respectively. For inpatient care at district health facilities, insurance reduced OOP by 34.9% as compared with the uninsured (P <0.001). The study suggested that more active solutions should be created to promote the universal health insurance 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.

The Policy Research Working Paper Series disseminates the findings of work in progress to encourage the exchange of ideas about development issues. An objective of the series is to get the findings out quickly, even if the presentations are less than fully polished. The papers carry the names of the authors and should be cited accordingly. The findings, interpretations, and conclusions expressed in this paper are entirely those of the authors. They do not necessarily represent the views of the International Bank for Reconstruction and Development/World Bank and its affiliated organizations, or those of the Executive Directors of the World Bank or the governments they represent.