Access and Utilization: Health Care Utilization Challenges

Delay in Seeking Medical Attention

The general Vietnamese population seeks medical attention less often than the Caucasian group (Kuo & Porter 1997) because Vietnamese, especially older Vietnamese hold health beliefs that impede recognition of symptoms and delay their seeking treatment crucial to their health. For example, they hold misconceptions that tuberculosis is an infectious disease without a latent phase (Carey et al, 1997). Long and colleagues (1999) found that Vietnamese believed that there are four types of tuberculosis:

  1. Inherited tuberculosis (lao truyền) that is passed down from one generation to the next through genetics,
  2. Physical tuberculosis (lao lực) that results from hard physical work,
  3. Mental tuberculosis (lao tâm) that is caused by excessive worrying and
  4. Lung tuberculosis (lao phổi) that is caused by the spread of tuberculosis germs through the respiratory system.

Traditional health beliefs such as these delay help seeking, increase social stigma and cause misconceptions about transmission routes.

Little or no knowledge about correct health care and illness also contribute to the delay in help seeking. For example, a large number of Vietnamese did not know or knew very little about chronic disease such as AIDS, cervical cancer and preventive behaviors and tests. Jenkins and colleagues (1990) emphasize that more education, awareness and preventive practices need to be aimed at the Vietnamese population in order to improve the current health status of Vietnamese especially the growing number of older Vietnamese.

Other common reasons for delay in or lack of health care access are:

  • lack of linguistically and culturally competent health services,
  • lack of insurance,
  • unaffordable health care costs,
  • not being able to access specialty care with language or cultural understanding.

Among Vietnamese who saw a physician in the last year, 47% did not receive preventive care services such as pap smears, cholesterol checks or blood pressure tests. (The Commonwealth Fund, 1995).

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Ignorance of Preventive Care

Poor knowledge of preventive care and health information put Vietnamese people at risk for developing more diseases as they age. To improve the health of Vietnamese as they age and thus help the older adults Vietnamese population, more education, awareness and health care access are pertinent. For example, Lesjack and colleagues (1999) found that female practitioners, free screening, and more health information improved recruitment of Vietnamese women for cervical cancer screening. Education and awareness help break the barriers that many Vietnamese women have regarding cancer screening tests. Such barriers to screening include the embarrassment felt during the examination, discomfort of being touched by a stranger or a male physician, the belief that cancer is incurable, and the fear of medical facilities and equipment (Kelley, et al., 1996; Mahlock, et al., 1999; Tu, et al., 2000; Yi, & Prows, 1996).

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