Page 463 - ISC PROCEEDINGS 21.4

FACTORS INFLUENCING THE INTENTION TO USE DIGITAL FAMILY DOCTOR
SERVICES IN NORTHERN VIETNAM

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Pham Van Tuan* , Pham Thi Nhat Linh , Nguyen Thi Thu Thuy , Nguyen Thi Thu Hien ,
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Nguyen Khac Thai 5
1, 2, 3, 4, 5 National Economics University, Hanoi, Vietnam.
(*E-mail: phamvantuan@neu.edu.vn)

ABSTRACT
The family doctor model is considered an effective approach to strengthening
primary healthcare by improving continuity of care and reducing hospital burden. In
Vietnam, despite policy efforts to promote family doctor services, utilization of family
doctor services remains limited, particularly in Northern regions. This study examines
factors influencing residents’ intention to use family doctor services in Northern Vietnam
by integrating the Health Belief Model (HBM) with the attitudinal component of the
Theory of Planned Behavior (TPB). A cross-sectional survey was conducted with 823
residents, and data were analyzed using Structural Equation Modeling (SEM). The results
show that perceived severity (β = 0.258, p < 0.001) and perceived benefits (β = 0.235, p <
0.001) positively influence attitude toward health behavior, while perceived barriers (β = -
0.231, p < 0.001) have a negative effect. Perceived susceptibility (β = 0.034, p = 0.292 >
0.05) is not significantly associated with attitude. Attitude toward health behavior
strongly predicts intention to use family doctor services (β = 0.488, p < 0.001). Intention
does not differ by gender, age, or occupation, but varies by education and income.
Overall, the findings support the applicability of the integrated HBM-TPB framework and
suggest that promoting family doctor services should focus on strengthening positive
attitudes by emphasizing service benefits and reducing perceived barriers.
Keywords: Family doctor services; primary healthcare; health belief model; attitude;
behavioral intention.

1. Introduction
Vietnam has experienced rapid economic growth, with GDP reaching approximately
USD 476.4 billion, alongside rising healthcare expenditure that now accounts for about
5% of GDP (World Bank, 2024). However, the healthcare system continues to face long-
standing challenges, particularly the overcrowding of tertiary hospitals and the limited
use of primary care services. Many patients bypass primary healthcare facilities and seek
care directly at higher-level hospitals, even for minor or preventable conditions,
suggesting that primary care has yet to function effectively as the first point of contact
(Nguyen et al., 2018). International evidence indicates that the family doctor model can
effectively address these challenges by improving continuity of care, guiding patient flows,
and reducing unnecessary hospital utilization. Countries such as the United Kingdom,
Canada, and the Netherlands have shown that strong family doctor systems are
associated with lower healthcare costs, improved care quality, and higher patient
satisfaction (Starfield et al., 2005; Kringos et al., 2015; Glazier et al., 2009). In Vietnam,
although the family doctor model was introduced in 2013 and expanded nationwide
between 2016 and 2020, its development remains uneven, and utilization remains limited.
Around 320 licensed family doctor clinics are currently in operation, mostly concentrated

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