What Drives Utilization of Primary Care Facilities? - Evidence from a National Facility Survey

Jul 19, 2026

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This analysis assesses the relationship between commune health station (CHS) service availability/readiness and health service utilization in Vietnam. Using data from the 2015 Vietnam District and Commune Health Facility Survey, multivariate negative binomial regressions estimate associations between readiness domains and CHS average visits per capita. Three domains show significant positive links: health infrastructure, availability of basic equipment, and capacity to deliver services for noncommunicable diseases. Improving all three modifiable CHS characteristics could raise predicted utilization 3.3–3.7 times, suggesting that targeted investments at facility level increase use of CHS services.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages23

Reading Time58 min

Abstract

Introduction

Service readiness

Public Disc losure Authorized AUTHOR ACCEPTED MANUSCRIPT FINAL PUBLICATION INFORMATION What Drives Utilization of Primary Care Facilities? Evidence from a National Facility Survey The definitive version of the text was subsequently published in International Journal of Healthcare Management, 14(4), 2021 Published by Taylor and Francis and found at [http://dx.doi.org/10.1080/20479700.2020.1752984](http://dx.doi.org/10.1080/20479700.2020.1752984) Pub lic Disc losure Authorized THE FINAL PUBLISHED VERSION OF THIS MANUSCRIPT IS AVAILABLE ON THE PUBLISHER’S PLATFORM This Author Accepted Manuscript is copyrighted by World Bank and published by Taylor and Francis. It is posted here by agreement between them. Changes resulting from the publishing process—such as editing, corrections, structural formatting, and other quality control mechanisms—may not be reflected in this version of the text. You may download, copy, and distribute this Author Accepted Manuscript for noncommercial purposes. Your license is limited by the following restrictions: (1) You may use this Author Accepted Manuscript for noncommercial purposes only under a CC BY-NC-ND 3.0 IGO license [http://creativecommons.org/licenses/by-nc-nd/3.0/igo](http://creativecommons.org/licenses/by-nc-nd/3.0/igo). (2) The integrity of the work and identification of the author, copyright owner, and publisher must be preserved in any copy. (3) You must attribute this Author Accepted Manuscript in the following format: This is an Author Accepted Manuscript by Vu, Lan T.H.; Bales, Sarah; Bredenkamp, Caryn What Drives Utilization of Primary Care Facilities? Evidence from a National Facility Survey © World Bank, published in the International Journal of Healthcare Management14(4) 2021 CC BY-NC-ND 3.0 IGO [http://creativecommons.org/licenses/by-nc](http://creativecommons.org/licenses/by-nc)nd/3.0/igo [http://dx.doi.org/10.1080/20479700.2020.1752984](http://dx.doi.org/10.1080/20479700.2020.1752984) © 2022 World Bank What drives utilization of primary care facilities?: evidence from a national facility survey Lan TH Vu 1, Sarah Bales 1, Caryn Bredenkamp2, 1 Hanoi University of Public Health 2 World Bank Vietnam Correspondence details: Lan TH Vu, Hanoi University of Public Health, 1st Duc Thang, Bac Tu Liem, Hanoi, Vietnam, Phone: (84)-918358886, [email: ](email: Vhl@huph.edu.vn)[Vhl@huph.edu.vn](email: Vhl@huph.edu.vn) Author's information • Lan TH Vu, MD, PhD, Hanoi University of Public Health • Sarah Bales, PhD, Hanoi University of Public Health • Caryn Bredenkamp, PhD, World Bank Vietnam What drives utilization of primary care facilities?: evidence from a national facility survey Abstract This analysis aims to assess the association between commune health station (CHS) service availability/readiness and health service utilization. Data from the 2015 Vietnam District and Commune Health Facility Survey was used to build a series of multivariate negative binomial regressions to measure the association between domains of service availability/readiness and CHS's average number of visits per capita. Three domains of service availability/readiness are significantly associated with higher utilization rates: health infrastructure, basic equipment availability, and capacity to deliver services for noncommunicable diseases. If all three modifiable CHS characteristics were to be improved from their current level, the predicted utilization rate of the CHS would be 3.3 to 3.7 times as high as current levels. Investments in improving facility infrastructure, making available essential equipment items, and enabling the CHS to provide hypertension and diabetes services would all likely increase health service utilization at CHS level. Key words: commune health stations, health service utilization, non-communicable diseases, service readiness, service availability Introduction Rapid socioeconomic and demographic change, including rapidly risin

FAQs

What does the study aim to measure about commune health stations?

The study evaluates the association between CHS service availability/readiness and health service utilization, focusing on how readiness relates to the number of visits per capita.

Which readiness domains are found to significantly increase CHS utilization?

Health infrastructure, basic equipment availability, and the CHS capacity to provide services for noncommunicable diseases are significantly associated with higher utilization.

How much could utilization increase if modifiable CHS characteristics improve?

If all three modifiable characteristics improve from their current levels, the predicted utilization rate could rise to about 3.3 to 3.7 times current levels.

Jul 19, 2026

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