{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T17:59:44Z","timestamp":1785347984066,"version":"3.55.0"},"reference-count":30,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T00:00:00Z","timestamp":1785024000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100004426","name":"The Atlantic Philanthropies","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100004426","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Health Serv Res Policy"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Vietnam has expanded primary health care (PHC) services and the health insurance (HI) scheme to increase access to NCD services at PHC facilities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To examine patterns of regular hypertension care across health facility levels, identify factors associated with PHC use, and explore barriers to regular PHC engagement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a sequential explanatory mixed-methods study. The quantitative phase analysed a household survey conducted in six provinces, including 1,706 adults with self-reported hypertension. Regular care was categorised as no regular facility-based care, PHC care, or non-PHC care. Multinomial logistic regression analyses identified factors associated with care-seeking. The qualitative phase involved in-depth interviews with 13 patients in two rural communes within Hanoi city. Interviews were audio-recorded, transcribed verbatim, and analysed using reflexive thematic analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, 44.2% of patients did not seek regular care. Among those seeking regular care, less than half used PHC-level services: 23.7% attended district hospitals and 23.5% visited commune health stations. Older age, rural residence, lower socioeconomic status, good hypertension knowledge, health insurance ownership, and NCD comorbidity were associated regular care for hypertension at the PHC level. Qualitative findings revealed barriers at both individual and system levels. At the individual level, misconceptions, limited awareness, and financial constraints, despite high HI coverages, led to irregular care, prompting patients to resort to self-medication or traditional remedies. At the system level, structural challenges, including out-of-pocket costs, medicine stockouts, long waiting times and poor provider communication, weakened patients\u2019 trust and continuity of care at PHC facilities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>HI and PHC reforms have improved access, particularly for disadvantaged groups, but implementation gaps still limit regular hypertension care. Improving patient education, medicine availability, service organisation and provider communication is essential for stronger PHC-based chronic disease management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/13558196261471353","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T02:41:01Z","timestamp":1785120061000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["What drives patients to utilise regular hypertension care at primary health care facilities in Vietnam? A sequential mixed-methods study"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4944-2825","authenticated-orcid":false,"given":"Giang Hoang","family":"Nguyen","sequence":"first","affiliation":[{"name":"Department of Public Health, Health Strategy and Policy Institute"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"My Tra","family":"Do","sequence":"additional","affiliation":[{"name":"Department of Science, Training and Professional Guidance, Hospital of University of Medicine and Pharmacy - Linh Dam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oanh Thi Mai","family":"Tran","sequence":"additional","affiliation":[{"name":"Health Strategy and Policy Institute, Hanoi, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1181-7580","authenticated-orcid":false,"given":"Hien Thi","family":"Ho","sequence":"additional","affiliation":[{"name":"Adelaide University"},{"name":"Faculty of Medicine, Health and Life Sciences, Queen\u2019s University Belfast, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rohan","family":"Jayasuriya","sequence":"additional","affiliation":[{"name":"UNSW Sydney"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,26]]},"reference":[{"key":"e_1_3_8_2_2","unstructured":"Institute for Health Metrics and Evaluation. High systolic blood pressure\u2014Level 2 risk. (2022 accessed 23\/08\/2024 2024).https:\/\/www.healthdata.org\/research-analysis\/diseases-injuries-risks\/factsheets\/2021-high-systolic-blood-pressure-level-2-risk"},{"key":"e_1_3_8_3_2","volume-title":"The burden of disease, mortality, and healthy life expectancy: concepts, methods, and Vietnam\u2019s results from 2008 to 2017 (in Vietnamese)","author":"Hanoi University of Public Health","year":"2020","unstructured":"Hanoi University of Public Health. The burden of disease, mortality, and healthy life expectancy: concepts, methods, and Vietnam\u2019s results from 2008 to 2017 (in Vietnamese). Medical Publishing House, 2020."},{"key":"e_1_3_8_4_2","unstructured":"World Health Organization. National survey on the risk factors of noncommunicable diseases in Viet Nam 2021. 2024. 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World Health Organization, 2024."},{"key":"e_1_3_8_7_2","volume-title":"Top 10 outstanding achievements made by Vietnam social security in 2023","author":"Vietnam Social Security","unstructured":"Vietnam Social Security. Top 10 outstanding achievements made by Vietnam social security in 2023. (2024, accessed 12\/11\/2024 2024).https:\/\/vss.gov.vn\/english\/news\/Pages\/vietnam-social-security.aspx?CateID=0&ItemID=11581#:\u223c:text=In_2023%2C_health_insurance_covered,reaching_the_universal_coverage_target"},{"key":"e_1_3_8_8_2","unstructured":"Vietnam Ministry of Health and Health Partnership Group. The joint annual health review 2015: strengthening primary health care at the grassroots towards universal health coverage 2016. 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