COUNTRY REPORT OF VIET NAM AT THE 12 TH ASEAN & JAPAN HIGH LEVEL OFFICIALS MEETING ON CARING SOCIETIES

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1 COUNTRY REPORT OF VIET NAM AT THE 12 TH ASEAN & JAPAN HIGH LEVEL OFFICIALS MEETING ON CARING SOCIETIES OCTOBER 2014 I. AGEING POPULATION IN VIETNAM 1. Vietnam is one of 10 countries with the world fastest speed of aging population. Vietnam laws provide for the full 60 years and older are considered seniors. Along with the general trend of the world, Elderly of Vietnam is growing both in number and percentage ( Table 1 ) Table 1: Elderly Vietnam : The number and percentage of Year Population Number of elderly The proportion of (million person) (million person) elderly (%) ,74 3,71 6, ,41 4,64 7, ,32 6,19 8, ,85 7,45 8, ,53 9,03 10, ,59 21,16 19,3 A country is considered to have started aging population while the elderly rate reaches 10 % of the total population. When this ratio reaches almost 20%, the country is said to have an aging population. 1

2 Not only our population is aging, the aging population itself is also growing older. According to the 1979 census, the proportion of people 80 and older in the general population is 0.54 %, this rate increased to 1.47 % (in 2009) and is expected to rise to 4.16 % (in 2049) (Table 2). This age group is often dependent and has poor health, many illnesses, so the health care needs of this age group are very large. Table 2: Percentage of people over 80 years old increases Percentage of people over 80 (%) Price of population profound impact on all aspects of personal, national and international community and related to all aspects of human life such as social, economic, political, cultural, psychological and spiritual ones. The health sector will also have to cope with new challenges. In 2012, Vietnam entered the aging stage and will become the elderly population in It is worth noting that the aging process takes place in our country for 23 years ( ), the population has reached the threshold of "aging population". Meanwhile, France took 115 years, Sweden 85 years, 73 years in Australia, America and Japan 69 years 26 years. According to the UN, from now to 2050, Vietnam is among the top 10 countries with the speed of the fastest aging population in the world. From now to 2050, the last of the developing countries which are the most rapidly aging rate. Here is a list of 10 countries with the fastest aging rate. Vietnam ranks in the top 10 this correctly and ranks 7th worldwide on aging rate in the period Characteristics of elderly patients 2

3 2.1. The aging of the body When you get older, the body's organs are aging leads to functional impairment at different levels, reduces resistance to disease, stress, resilience of poor health Increase chronic diseases and degenerative diseases With the population aging, disease pattern has changed: on the one hand, we still have to deal with infectious diseases, on the other hand we are confronted with the rapid rise of chronic diseases and degeneration such as cardiovascular diseases, hypertension, stroke, diabetes, cancer types, COPD, joint degeneration, osteoporosis, dementia... Most of these diseases are more or less related to lifestyle and generally have lifelong treatment. Characteristics of the most important diseases in the elderly are most pathological nature that is getting many diseases at once. According to research of the Central Hospital of Gerontology, the average person living in the community aged 3 chronic problems. For patients hospitalized at the Central Hospital of Gerontology, 5-6 disease patients often suffer. The patients have many different diseases at the same time so often with atypical symptoms, diagnosis complexity, to use more drugs increase the risk of complications due to treatment thus approach in the diagnosis and treatment of many other points with the younger age groups. - This double burden of disease would threaten already tight- budget sources of countries in economical transition. - The transfer of the dominant models of infectious diseases to the dominant model of non-communicable diseases occurs most rapidly in the developing countries, in the coming decades. - Although the average expectancy of Vietnam is higher (73 years old), but the burden of disease is substantial (15.3 years WHO, 2009). - Elderly patients suffering from dual disabilities (about 95% of elderly patients, mostly chronic and non-communicable diseases) % of elderly people have poor or very poor health, only 5 % is good, the percentage of sick people ( male and female) in urban is higher than rural areas. 3

4 The percentage of elderly people in rural areas having poor health or illness being treated by medical staff in the 12 months was low (13.1 %) and only half of the city (23, 4 %) (According VNAS 2011: Report of the VN Madrid 10, 2012) Reduce function, increase risk of disability: Advanced age and chronic diseases are the main causes leading to reduce daily functioning in older people, such as reduce ability to walk, personal hygiene, eating, communication skills, money management assets of the elderly... the loss of independence in daily functioning that causes disability and require appropriate support measures. The risk increases each time the handicapped elderly hospitalized, so after the acute phase of treatment, the elderly should continue to strengthen health treatment and rehabilitation to ensure that they do not discharge side attached. Preventing the risk of disability in older people is of paramount importance Rising health care costs: Due to the increasing number of elderly people, often suffering multiple diseases, mostly chronic and degenerative disease to older people 's groups use health services the most. Generally, medical expenses for elderly 7-10 times higher than young people, and although only 10 % of the population but more older people using drugs 50% of the total of the whole society. Trends in mortality in health facilities increase and make medical costs. Chronic diseases are the main cause of disability and reduce quality of life in the elderly, especially elderly age group % of elderly people have poor or very poor health, only 5 % is good, the% of people who are sick men and women higher in urban than rural areas. The percentage of elderly people in rural areas having poor health or illness being treated by medical staff in the 12 months was low (13.1 %) and only half of the city (23, 4 %) (According VNAS 2011: Report of the VN Madrid 10, 2012). Medical expenses for elderly is 7-10 times higher than young people. 4

5 - The elderly uses 50 % of the total amount of drug - Trends in mortality in health facilities increase and increase medical costs. The rate of women's participation in labor. Are there differences in employment, income, social security, political power. Women live longer with higher risk of disability. Proportion of elderly widowed women (56.8 %) higher than older widowed men (16.1 %) Proportion of elderly women living alone (17.7 %) than older men to live alone (8.6 %) PART II. GOOD PRACTICE ELDERLY HEALTH CARE I. HEALTH CARE FACILITIES IN ELDERLY CARE AND TREATMENT 1. Examination of inpatient and outpatient treatment follow the provisions of the Law on Examination and Treatment and the Law on Health Insurance. 2. Examination and Treatment combines modern medicine and traditional medicine in medical examination and treatment for the elderly, combining traditional medicine with modern medicine in medical examination and treatment. 3. Rooms for elderly patients. 4. Training of health workers in geriatrics. 5. Scientific research, application of scientific and technological progress in the prevention, care and treatment, rehabilitation and health promotion elderly. 6. Mentoring: To direct, support, technical transfer of the hospitals on the lower level. 7. Cooperate and exchange experiences on disease prevention, medical treatment, rehabilitation, scientific research and staff training on specialized geriatric with international organizations, countries around the world and foreign individuals. 5

6 II. HEALTH CARE FOR ELDERLY PEOPLE IN THE COMMUNITY AND MANAGEMENT CHRONIC DISEASES 1. Implement propagation and dissemination of knowledge about physical training, health promotion and disease prevention, especially for diseases common in the elderly to self- elderly patients. Depending on the conditions of each locality to select appropriate forms of communication such as documents, books, pamphlets, posters, banners, slogans, seminars, talks and media mass. 2. Guide elderly prevention skills, self- healing and wellness. 3. Organize physical examination to document health monitoring for the elderly. Encourage physician network organizations and family health care services for the elderly at home. 4. Periodic Health Examinations for the elderly be done at least once a year. 5. The elderly be examined medical clinics in communes, wards and towns at the residence of the elderly. 6. Rehabilitation of community-based elderly people with disabilities to prevent sequela and recovery from injury, accident or illness due to cerebral vascular accident, chronic diseases, and occupational diseases other diseases. - Develop models of health care in the community: the diversification of services to support older people living at home: cleaning house, laundry, grocery shopping, meal providers, nursing home care, the rehabilitation centers, occupational therapy, elderly valet hourly, health consultant, providing assistive devices, club entertainment, entertainment... - Pilot daytime hospital established for the elderly: This is a new approach is suitable for the elderly to allow elderly evaluated in a comprehensive manner, care planning, rehabilitation, health counseling... and for reducing load at the hospital. Many countries have succeeded with this model. - Establishment of the Faculty of Aging at the hospital for treatment and care for the elderly subjects suffering from multiple diseases at once complex, with the geriatric syndrome characterized (usually those over 80 years old). Geriatrics have suitable facilities for the elderly, are divided into short -term faculty (acute 6

7 phase treatment), and medium-term (after the acute phase of treatment and rehabilitation). Encourage the establishment of mobile geriatric teams. Human, can immediate use medical doctors, psychiatric, rehabilitation training improving geriatric. Organization dedicated clinics for the elderly in clinics. - 46/63 provinces have established provincial department of Gerontology in the general hospital. - Increasing human clinical outpatient elderly. - The elderly having a periodic health examination at least once a year. - Hospital of Gerontology deployed daytime treatment center at the hospital and rehab diversified health care services for the elderly. PART III. FUTURE VISION 1. Develop partnership between private, public and community care providers to promote synergy, mutual support and learning. 2. Adopt and adapt successful innovative and programme to promote active inclusion of families and communities. 3. Improve the capacity of both public and private health care system. 4. Strengthening human clinical outpatient elderly. 5. Training and capacity building for doctors, nurses specialized in geriatrics. 6. Capacity building of the health care system, public and private. 7

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