MINISTRY OF EDUCATION AND TRAINING UNIVERSITY OF ECONOMICS HO CHI MINH CITY VIETNAM Examining the Treatment Choice When Getting a Cold By DANG HOANG HAI TRUONG MASTER OF ARTS IN DEVELOPMENT ECONOMICS (SPECIALIZATION IN HEALTH ECONOMICS AND MANAGEMENT) HO CHI MINH CITY, MAY 2015 LUAN VAN CHAT LUONG download : add luanvanchat@agmail.com MINISTRY OF EDUCATION AND TRAINING UNIVERSITY OF ECONOMICS HO CHI MINH CITY VIETNAM Examining the Treatment Choice When Getting a Cold A thesis submitted in partial fulfillment of the requirements for the degree of MASTER OF ART IN DEVELOPMENT ECONOMICS (SPECIALIZATION IN HEALTH ECONOMICS AND MANAGEMENT) Major: Economics Code: 60310105 By DANG HOANG HAI TRUONG Academic Supervisor: Dr. NAM KHANH PHAM HO CHI MINH CITY, MAY 2015 LUAN VAN CHAT LUONG download : add luanvanchat@agmail.com CERTIFICATION STATEMENT I guarantee data used in this thesis were truly collected through survey progress, along with using legal documents. The implications are withdrawn by the author from the experience of working, and learning. HoChiMinh city, 2nd May 2015 Dang, Truong Hoang Hai LUAN VAN CHAT LUONG download : add luanvanchat@agmail.com Abstract Wrong decision leads to wrong destination.
We make choice at every action in our life. There are a lot of decisions that are over our knowledge or experience. Sometimes we need a convincer who knows better. However it is difficult for us to judge whether his decision will lead to our expected outcome.
He also does not know what factors we are considering. That is the reason why sometimes we make an irrational decision which is from other’s point of view. For a convincer, it is important to understand decision factors of person who is convinced. In health aspects, doctor-patient communication is significantly vital.
For a health authority, if he wants people to make a decision that benefit to the whole society, he also should understand their elements of consideration. This thesis studies treatment decision making of patients when they get a cold. Our survey shows that people have three kinds of decision when they get a cold i. either “go to the doctor”, or “self-medication” or “non-drug treatment”.
This thesis examines the impacts of psychological factors and socio-economic factors on each of the decisions. The social pressure and patient’s perceived control factors do not have influence on the decision. Females who have higher education are more likely to go to the doctor, and who have high income are less likely to choose self-medication. We employed the multivariate probit model to analyze the treatment choice and a factor analysis to construct psychological variables which were developed from the Theory of Planned Behavior.
LUAN VAN CHAT LUONG download : add luanvanchat@agmail.com ACKNOWLEDGEMENTS This thesis would not be completed without the backing and the encouragement of important individuals. First, I would like to say thanks to my instructor, Dr. Pham Khanh Nam, in spite of his busy schedule, he guided me to finish this dissertation. Second, I would like to say my gratitude to my parents who encouraged me in hard moments and their unconditional love.
Third, it would be a mistake if I did not make mention to my friends and my brother who helped me to sharpen the questionnaire. Finally, I express my gratitude to participants who play an important role in this thesis through their collaboration to complete the questionnaire. LUAN VAN CHAT LUONG download : add luanvanchat@agmail.com ABBREVIATIONS Freq. RUM Random Utility Maximization TPB Theory of Planned Behavior.
VND Vietnam dong. WHO World Health Organization. LUAN VAN CHAT LUONG download : add luanvanchat@agmail.com Table of Contents CHAPTER 1: INTRODUCTION………….3 Scope of study………………………………………………………….4 The structure of the thesis…………………………………………….3 CHAPTER 2: LITERATURE REVIEW………………………….1 Common health problems and common cold…….2 Patient choice and its special elements……….4 Self-medication and economics of self-medication………….5 Non-drug treatment…….2 Studies of socio-economic factors in health aspect……….3 Theory of Planned Behavior in Health Choice……………………….4 Review of empirical studies.5 Literature review conclusion………………………………………….12 CHAPTER 3: RESEARCH METHODOLOGY……….2 Measurement of variables.1 Indirect measure of the Theory of Planned Behavior…….2 Direct measure of the Theory of Planned behavior.29 LUAN VAN CHAT LUONG download : add luanvanchat@agmail.2 Sampling technique and sample size…………………………30 3.3 Data collection process……………………………………….31 CHAPTER 4: RESEARCH RESULTS……….1 Overview of Vietnamese health environment………………….1 Psychological factors statistic…………………….3 Perceived behavioral control……………….2 Socio-economic statistic…………………………………….2 Descriptive social capital variables…………………40 4.3 Descriptive risk variables………………………….1 Theory of Planned Behavior…………….2 Socio-economic factors………………….51 CHAPTER 5: CONCLUSIONS AND POLICY IMPLICATIONS…….……71 LUAN VAN CHAT LUONG download : add luanvanchat@agmail.com LIST OF FIGURES Figure 1. Model of the study…………….
The income and the choice………………………………………. The gender and the choice……………………………………. The social group adherence and the choice………………………….…42 LIST OF TABLES Table 1. Theories of socio-economic in health aspect…………….
Salient belief items………………………………………………………. The statistical results of the choice………………………. The attitude and the choice……………. The subjective norm and the choice…………………….
The perceived behavioral control and the choice…………………………38 Table 8. Descriptive demographic variables………………………………………. Joint social group………………………. Description of trust…………….
Risk attitude description………………. Factor analyses and Cronbach’s alpha of the indirect measure……. Multivariate probit regression of indirect measure…………………. Factor analyses and Cronbach’s alpha of the direct measure………….
Multivariate probit regression of direct measure………. Factor analyses and Cronbach’s alpha of the socio-economic…………. Multivariate probit regression of socio-economic……….52 LUAN VAN CHAT LUONG download : add luanvanchat@agmail.com 1 CHAPTER 1: INTRODUCTION 1.1 Research problems: In a big picture, there is an unbalanced diversity among hospitals. There is a very common situation that in central hospitals, such as Cho Ray hospital, hospital overload is the serious trouble that causes two patients have to share one bed.
However in the others hospital, like district hospitals or private hospitals, there are usually free beds as a result of lacking of patients. The ability of “downstream” hospitals, by doubting not only about technique ability but also service ability could damage deeply in patient’s belief. Even when they can completely cure the common diseases, people still want to stay away and move to higher level hospitals. There is information asymmetry between the patients and medical staffs.
For instance, patients do not know whether drugs they are using are good or bad for their health and also do not know which are the good sides and which are the drawbacks of the medicine services that they are consuming as well as the opportunity cost they have to pay when they could get to other hospitals or choose to not experience in medical care. Moreover, until now in medicine area, for a certain health problem, we still do not have powerful measure tools to predict which doctor, or drug, is better and completely guarentee for a positive outcome. There are chances existing, chances for getting cured, and chances for complication. The result is mostly on individual basis, which one experiences himself as a patient or who know the patient, don’t know thoroughly about the situation.
In this lack of information and uncertainty environment, individual seems to make a choice between various solutions by their feeling and belief. Health is a vital matter for each individual. Good health allows us to live and work more efficiently and positively. Bad health on other hand could negatively affect people attitude and productivity.
That is the reason why an increase in level of citizens’ health can improve the productivity, GDP, research, or education so that the social community can be enhanced in all areas. In the other side of the coin, when a health problem LUAN VAN CHAT LUONG download : add luanvanchat@agmail.com 2 appears, it is important to find a suitable method which can cure the disease with appropriate cost, not only be measured by money, but also by time, career, health, relationship, etc. This thesis stays focused on in aspect how health’s belief impacts on health decision- making. In order to explain this relationship, common cold is used as a common health problem.
Common cold’s nature is a popular health problem and patients have many choices. The author believes that investigation of this event could lead to a new insight, especially in Vietnam, a country that lacks of health behavior research. Moreover, successful explanation of this relationship provides a suggestion on communication with patient. Since talking with doctor takes a main part in making patients satisfy (Bensing 1991; Maguire & Pitceathly 2002), and health decision-making is based on belief, this thesis will become a milestone for healthcare practice.2 Research objectives: The overall aim of this research is to analyze the impacts of socio-economic factors and psychological factors on treatment choice when getting a cold.
Specially, based on the Vietnam’s health environment, the specific objectives of this research are to: 1. Measure psychological factors in three dimensions: attitude, subjective norm, and perceived behavioral control. Examine the relationship between psychological factors and treatment choice, i. go to the doctor, self-medication, and non-drug treatment.
Examine the relationship between socio-economic factors (demographic, social capital, and risk attitude) and treatment choice i.e: go to the doctor, self-medication, and non-drug treatment. LUAN VAN CHAT LUONG download : add luanvanchat@agmail.3 Scope of study: This study compares the causes of treatment decision-making: go to the doctor, self- medication, and non-drug treatment. To be specific, the subjective of research is common-cold, a common health’s problem that patients have many solutions. Data are received by survey method.
The location and time to survey is district 3, from April to May, 2015. Collected data have been analyzed by multivariate probit model. Data have been collected by cluster sampling method. District 3 citizens who are at ages from 18 to 80 are selected.4 Structure of the thesis: The thesis is divided into five chapters.
Chapter I is the introduction that presents the research problem, as well as research objectives and scope of study. Chapter II is the literature review which defines concepts, provides theoretical background, and discusses empirical related studies. Chapter III is the methodology which gives the method of study, including analytical framework, measurement variables, qualitative progress and variable definition. After data are analyzed, the result of study appears at chapter IV.
Chapter V is the conclusions and political implications. LUAN VAN CHAT LUONG download : add luanvanchat@agmail.com 4 CHAPTER 2: LITERATURE REVIEW 2.1 Common health problems and common cold: Everyone wants to live a healthy life, and want to recover from disease. However, there is usually not only one option to solve the problem. Specially, in common health problems, people have more solutions than in serious health events.
Common cold is a common health problem mostly because of virut. From patient’s point of view, Mayo Clinic’s definition is suitable. According to Mayo Clinic, healthy adults are expected to have a few cold each year, and most people recover from a common cold in about a one or two weeks. Sign and symptoms include runny or stuffy nose, cough, and mild fatigue.
Not all cases need to see a doctor and these patients only seek medical attention when getting high temperature fever. Fever is accompanied by sweating, chills, and a cough with colored phlegm, severe sinus pain.2 Patient choice and its special elements: Patient choice as Community Pharmacy Standards of Practice declared in 2015, relates to rights, which is that no one can enter into agreement with any person, who limit a patient’s choice of pharmacy, excepts as required or permitted under the bylaws. Dixon et al. (2010) gave evidence that the patient valued the ability to make choice.
They also had evidences that patient rely on their own or others’ experience to inform their choice. There are different points of patient and doctor when comparing to normal buyers and firms. Dixon et al. (2010) also argued that patients do not act as normal consumers, they cannot test the product before consuming or even after having consumed it.
It is also hard for patients to find out relevant information to their condition, and they place trust on the provider. Externalities are also an important factor in health aspect.3 Patient belief: As mentioned before, patients have to place their trust on the providers. Therefore, the concept of patient belief is necessary to join the thesis. LUAN VAN CHAT LUONG download : add luanvanchat@agmail.