OBJECTIVES : 27% of children under age 6 were using private health services with full or partial fee for services although they have been granted health insurance coverage by the Vietnamese government if they go to public providers. Therefore, it is important to understand what makes these children go to private over public providers. This study aims to examine predisposing, enabling (income per capita by quintiles, education level of the household other than health insurance) and medical need factors associated with the choice of private over public healthcare services in Vietnamese children under age 6.

METHODS : Using Andersen Model of Health Services Utilization as a thematic framework, this study applied binary logistic regression models of private and public health service utilization, using nationally representative data from the Vietnam Household Living Standards Survey 2016.

RESULTS : 2898 children under age 6 (50.2% male, 68% living in rural areas and 80.2% ethnic majority) were included in the study. Private healthcare services are more likely to be used by children who are living in urban areas while public healthcare services are preferred by children living in the Midland and Mountainous area. Income per capita does not correlate with the use of private over public health care services. However, children living in a household with education of university degree or higher are more likely to use public healthcare services. In terms of medical needs, the odds of using private over public services are 44 times higher for non-severe illness (95% CI: 25.9 - 74.6, p<0.001) than for vaccinations, followed by health check-ups with 22 times higher (95% CI: 12.3 - 39.7, p<0.001).

CONCLUSIONS : The private health services are more likely to be used by children who live in urban area and who need non-severe treatment or health check-ups.