Health service use and associated factors among old Khmer people: a cross-sectional survey in Tri Ton District, An Giang Province

Abstract

Background: The health status of ethnic minorities of all ages lags far behind that of the general population, particularly in the old. The old minor ethnic population is more likely to have chronic diseases but less likely to access health services. This study assesses the rate of health services use and associated factors in the old Khmer population. Method: A cross-sectional study was conducted on 400 Khmer people aged 60+ year-old from March to May 2020. Eligible participants were randomly recruited from households of five clusters out of nine communes of Tri Ton District, An Giang province, Vietnam. A structured questionnaire was designed to collect data on socio-demography, health status, health service use and accessibility to health services and quality of life. Quality of life was measured using EQ-5D-5L. All eligible participants were face-to-face interviewed by a bilingual researcher. Result: The rate of health services use was 63.3%. The EQ-5D-5L utility index mean score was 0.46 (SD=0.28) and EQ-VAS mean score was 49.01 (SD=16.19). The odds of using health services were higher in those reported to have problems in mobility (OR=2.56, 95%CI 1.43-4.61, p<0.01), self-care (OR=2.05, 95%CI 1.30-3.24, p<0.01), activity (OR=2.35, 95%CI 1.44-3.82, p<0.01), pain/discomfort (OR=2.63, 95%CI 1.22-5.67, p=0.01), and anxiety/depression (OR=2.07, 95%CI 1.00-4.29, p=0.05) in univariate but not in multivariable analysis. The multivariable logistic regression showed that the odds of using health services were lower in those who were currently working (aOR=0.48, 95%CI 0.30-0.79, p<0.01), accessible to health information (aOR=0.47, 95%CI 0.27-0.80, p<0.01), but higher in those using health insurance (aOR=5.09, 95%CI 3.19-8.14, p<0.01), and in health facilities used Khmer language (aOR=2.04, 95%CI 1.15-3.62, p=0.01). Conclusion: This study suggested that Khmer people should be involved in all stages of planning and implementing health programs and services for Khmer communities to improve the accessibility and health equity.