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- Vu Thi Quynh, Mai, 1991-
(författare)
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A feasibility and applicability study of a health-related quality of life measurement in Vietnam
- 2023
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: An evidence-based strategy is used the national social health-insurance programme in Vietnam to assess healthcare technologies. Health technology assessments (HTA) have become increasingly important within decision-making processes. This doctoral project involved developing a health-related quality of life (HRQOL) measurement to be used in HTA in Vietnam.Methodology: The doctoral project used a mixed-methods approach, which comprised a health-preference elicitation study using a combination of time-trade-off and discrete choice experiments method for the EQ-5D-5L, as recommended by the EuroQol Group (Objective 1). The project incorporated a validity study that utilised secondary data (Objective 2), a cost-utility analysis that utilised both secondary data and normative costing data (Objective 3), and a qualitative study that utilised empirical data (Objective 4). Additionally, the doctoral project resulted in an EQ-5D-5L reference dataset for the general population of Vietnam.Results: A generic preference-based HRQOL measurement was developed for the Vietnamese population using the EQ-5D-5L instrument. This tool can be utilised not only as an outcome measurement for HTA, but in other health-science disciplines. The EQ-5D-5L comprises a descriptive system with five questions, a visual analogue scale (EQ-VAS), and a value set that facilitates the assignment of health-state values (Sub-study 1). The doctoral project proposed an EQ-5D-5L reference dataset that could serve as a basis for HRQOL comparison in Vietnam (Sub-study 2). It has added evidence on the validity of the EQ-5D-5L for the Vietnamese population through a known-groups validation conducted on individuals with hypertension (Sub-study 2). This validation has facilitated the establishment of a favourable environment for the implementation of this tool in Vietnam. Additionally, the satisfactory performance of the EQ-5D-5L has been shown in producing data that is useful for the cost utility analysis in Vietnam (Sub-study 3). Despite concerns regarding the appropriateness of the EQ-5D-5L in reflecting HRQOL for disease-specific populations, the tool has been accepted and is commonly used in Vietnam (Sub-study 4).Conclusion: The outcomes of the doctoral project are a favourable HTA environment, facilitation of evidence-based decision-making, and contribution to the goal of achieving universal health coverage in Vietnam.
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- Trang, Phan Minh, 1974-
(författare)
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Weather and extreme heat in association to mental disorders : The case of Hanoi, Vietnam
- 2017
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Vietnam suffers consequences of global warming. There is limited data of the relationship between weather, extreme heat and potential mental health problems. It is therefore crucial to study heat-related mental illnesses and to establish good solutions with relevant adaptations to global warming. The adaptation measures should give attention to people that live in areas facing annual extreme weather, and protecting health in general and more specifically mental health of citizens. The study aimed to examine relationships between weather patterns, extreme heat or heatwaves, and mental disorders, and to investigate factors contributing to increased vulnerability and susceptibility.Methods: The thesis includes a systematic review and a hospital-based study using data from the Hanoi Mental Hospital for five years (2008 – 2012), with mental disorders diagnosed by ICD10 (F00-99) to estimate the effects of weather variation, seasonality, increased temperatures, and heatwaves on hospital admissions for depression and other mental disorders. A negative binomial regression model accounting for yearly study period, time trends, and day of the week was used to analyze the relationship between seasonality, heatwaves, and monthly and daily mental disorder hospitalizations.Results: Our findings showed (i) a general tendency for more admissions between May and December, with a seasonal bi-annual high between May-June and November-December, and elevated ambient temperature was significantly related to increasing admissions for depressive disorders; (ii) the number of hospital cases for mental disorders increased in the summer seasone specially in June, and two percent of cases emerged during elevated temperature of one degree Celsius; and (iii) when compared with non-heatwave periods, heatwaves amounted to increasing risks for admission for the whole group of mental disorders (F00-79), and admissions for mental disorders among residents in rural communities and in the elderly population increased significantly during heatwaves.Conclusion: There were associations between hospital admissions for depression and other mental disorders and seasonality, weather patterns, elevated temperatures, and heatwaves. The associations grew stronger with the length of the heatwaves and particularly the elderly appeared more sensitive to seasonality, hot weather and heatwaves.
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