PHÂN TÍCH CHI PHÍ TRỰC TIẾP Y TẾ VÀ MỨC SẴN LÒNG CHI TRẢ Ở NGƯỜI BỆNH ĐÁI THÁO ĐƯỜNG TÍP 2 ĐIỀU TRỊ NGOẠI TRÚ CÓ BẢO HIỂM Y TẾ

Abstract

Background: Type 2 diabetes imposes a substantial economic burden, while real-world evidence on outpatient direct medical costs and patients’ willingness to pay (WTP) under health insurance in Vietnam remains limited. Objectives: To describe direct medical costs per outpatient visit, estimate the maximum annual WTP for a hypothetical treatment not covered by health insurance, and identify associated factors. Materials and methods: A cross-sectional study was conducted among 240 outpatients with type 2 diabetes at HCMC Hospital for Rehabilitation - Professional Diseases, from July 2025 to January 2026. Cost data were obtained from electronic medical records and billing statements; WTP was elicited through face-to-face interviews using a hypothetical valuation scenario. Results: The mean age was 61.5 ± 12.0 years, and 54.2% were women. The mean direct medical cost per outpatient visit was VND 667,329 ± 200,502, with medication accounting for the largest component. Mean WTP was VND 6.7 ± 2.2 million per year. Higher WTP was associated with age 60–74 years (β = 0.74; p = 0.012), having two comorbidities (β = 0.42; p = 0.010), and higher income (β = 0.35; p < 0.001). Conclusion: Medication costs constituted the largest component of direct medical costs per outpatient visit. WTP was associated with age, comorbidity burden, and income. The reported WTP reflects patients’ stated ability and preference to pay under a hypothetical scenario and should not be interpreted as a societal cost-effectiveness threshold.