[Show abstract][Hide abstract] ABSTRACT: Background: Projected increases in weather variability due to climate change will have severe consequences on human health, increasing mortality, and disease rates. Among these, cardiovascular diseases (CVD), highly prevalent among the elderly, have been shown to be sensitive to extreme temperatures and heat waves. Objectives: This study aimed to find out the relationship between daily temperature (and other weather parameters) and daily CVD hospital admissions among the elderly population in Thai Nguyen province, a northern province of Vietnam. Methods: Retrospective data of CVD cases were obtained from a data base of four hospitals in Thai Nguyen province for a period of 5 years from 2008 to 2012. CVD hospital admissions were aggregated by day and merged with daily weather data from this period. Distributed lag non-linear model (DLNM) was used to derive specific estimates of the effect of weather parameters on CVD hospital admissions of up to 30 days, adjusted for time trends using b-splines, day of the week, and public holidays. Results: This study shows that the average point of minimum CVD admissions was at 26°C. Above and below this threshold, the cumulative CVD admission risk over 30 lag days tended to increase with both lower and higher temperatures. The cold effect was found to occur 4-15 days following exposure, peaking at a week's delay. The cumulative effect of cold exposure on CVD admissions was statistically significant with a relative risk of 1.12 (95% confidence interval: 1.01-1.25) for 1°C decrease below the threshold. The cumulative effect of hot temperature on CVD admissions was found to be non-significant and was estimated to be at a relative risk of 1.17 (95% confidence interval: 0.90-1.52) for 1°C increase in the temperature. No significant association was found between CVD admissions and the other weather variables. Conclusion: Exposure to cold temperature is associated with increasing CVD admission risk among the elderly population.
Full-text · Article · Dec 2014 · Global Health Action
[Show abstract][Hide abstract] ABSTRACT: Objectives: This study aimed to estimate and analyse the “actual” unit cost of providing key clinical services in selected rural district hospitals in the North of Vietnam. It also examined the relationship between actual costs and the levels of cost covered by the corresponding user fees paid by patients.
Methods: This was a facility-based costing study which estimates the costs of health care services from the perspective of the service providers. Three rural district hospitals from three provinces in the North of Vietnam were purposively selected for this study. The “step-down” approach was applied.
Results: There was little difference in the costs of an outpatient visit across the hospitals, but the costs of an operation and an inpatient day varied considerably. In terms of cost structure, personnel costs accounted for the highest share of total cost of the clinical services. The shares of operating cost were considerable while depreciation of buildings/equipments made up a small “proportion”. The study results revealed that the user fee levels were much lower than the actual costs of providing the corresponding services. The present study highlights the importance of costing data for hospital planning and management. Copyright
No preview · Article · Jan 2009 · International Journal of Health Planning and Management