Advancing Diagnostic Equity in Viet Nam: Access Barriers, Unmet Diagnostic Needs and Systems-Based Improvement

Advancing Diagnostic Equity in Viet Nam: Access Barriers, Unmet Diagnostic Needs and Systems-Based Improvement

Two people may have the same underlying health condition but very different opportunities to receive an appropriate diagnosis. One may live near a healthcare facility with reliable diagnostic services and experienced professionals. The other may need to travel a considerable distance, take time away from work, or visit several facilities before obtaining the necessary assessment.

The difference may have little to do with the complexity of the disease itself. Geography, financial circumstances, workforce availability, and the organization of healthcare services can all influence whether people receive the diagnostic care they need.

This raises an important question for healthcare quality and patient safety: do people with comparable clinical needs have a fair opportunity to obtain appropriate and timely diagnostic care?

Diagnostic excellence is often associated with accuracy, timeliness, reliability, and the prevention of diagnostic errors. These remain essential objectives. Yet even a technically excellent diagnostic service cannot benefit someone who cannot reach it, afford the associated costs, or obtain the professional assessment needed to make use of its findings.

For healthcare organizations in Viet Nam, advancing diagnostic equity means understanding where diagnostic needs remain unmet, examining the barriers that may contribute to unequal opportunities, and identifying practical improvements without compromising clinical appropriateness or patient safety.

The objective is not to ensure that everyone receives the same investigations. It is to support fair access to clinically appropriate diagnostic care while recognizing that different people and communities may face different obstacles.

Diagnostic Equity Is More Than Equal Access to Tests

Diagnostic equity concerns whether people have a fair opportunity to receive diagnostic assessment that is appropriate, timely, reliable, and responsive to their clinical needs.

It is closely related to the broader concept of health equity but focuses specifically on the circumstances in which health problems are recognized, investigated, and diagnosed.

A person may be able to visit a healthcare facility but still have difficulty obtaining a necessary investigation. Another may undergo testing but lack access to an appropriately qualified professional to interpret the findings. Someone living far from a specialist facility may face repeated journeys and additional expenses for an assessment that is readily available elsewhere.

These situations illustrate why the presence of healthcare infrastructure does not automatically establish equitable diagnostic care.

Equal access and equitable care should also be distinguished. Providing identical services through identical arrangements may appear fair, but people do not necessarily face the same barriers.

A patient living near a hospital may be able to attend an appointment without substantial difficulty. Another may need transportation, financial assistance, or support from a family member. A person with a disability may require an accessible examination environment or appropriate communication assistance.

An equitable approach considers whether reasonable measures can reduce avoidable disadvantages while maintaining suitable standards of care.

However, not every difference in healthcare use represents inequity. Diagnostic decisions must remain based on clinical need, relevant evidence, professional judgment, and applicable requirements.

Patients with different symptoms, risk factors, or examination findings may appropriately receive different investigations. The important question is whether observed differences reflect clinically justified decisions or barriers that prevent people with comparable needs from obtaining suitable services.

Diagnostic equity therefore concerns the relationship between access, clinical appropriateness, and quality rather than simply the distribution or volume of diagnostic testing.

It is not a demand for identical care. It is a commitment to examining whether avoidable barriers prevent people from receiving care that is appropriate to their circumstances.

Why Diagnostic Access Has Become an International Priority

The importance of diagnostic access has received increasing international attention.

In 2021, The Lancet Commission on Diagnostics: Transforming Access to Diagnostics identified major gaps in diagnostic capacity worldwide. The Commission estimated that approximately 47% of the global population had little or no access to essential diagnostic services.

The findings highlighted the importance of primary health care, where limited diagnostic capacity can particularly affect people living in poorer, rural, or marginalized communities.

The Commission also emphasized that diagnostic services are fundamental to healthcare delivery but frequently receive less attention and investment than their importance warrants.

In May 2023, the World Health Assembly adopted Resolution WHA76.5 on strengthening diagnostic capacity. The resolution recognizes the essential role of diagnostics in disease detection, treatment, monitoring, prevention, and effective healthcare delivery.

Its scope extends beyond laboratory testing to include diagnostic imaging and other technologies used to assess health conditions.

The resolution calls for stronger diagnostic capacity through appropriate policies, workforce development, infrastructure, regulation, procurement, quality assurance, and access to services.

This broader perspective matters because diagnostic capability cannot be strengthened through equipment procurement alone.

A dependable diagnostic service requires qualified personnel, suitable facilities, reliable supplies, equipment maintenance, quality management, professional interpretation, and the ability to use findings appropriately in clinical care.

In June 2025, The Lancet published Moving the Dial on Diagnostics: An Update From the Lancet Commission on Diagnostics. The report examined progress since the earlier Commission and identified continuing priorities involving diagnostic access in primary care, workforce capacity, national financing, affordability, regulatory frameworks, and appropriate technology.

The report also recognized that progress has been uneven. Areas requiring substantial financial and workforce investment remain particularly challenging.

International attention continued on October 22, 2026, when the World Health Organization reported on the Global Diagnostics Coalition's efforts to address persistent gaps in diagnostic access.

WHO reiterated the estimate that approximately 47% of the world's population lacks access to a timely, reliable diagnosis.

This estimate originates from earlier international research, particularly the 2021 Lancet Commission. Its inclusion in WHO's October 2026 communication should not be interpreted as the result of a new worldwide population survey conducted that month.

Nor should the figure be treated as an estimate of diagnostic access in Viet Nam.

Nevertheless, these developments illustrate why equitable access to reliable diagnostic services remains important to universal health coverage and healthcare quality.

For healthcare organizations in Viet Nam, the international evidence provides a useful foundation for examining local capabilities and understanding where diagnostic access may be insufficient. It does not replace the need to assess local circumstances or establish identical operational requirements for every healthcare facility.

What Recent Research Reveals About Unmet Diagnostic Needs in Viet Nam

A particularly relevant contribution to understanding diagnostic equity in Viet Nam was published on August 7, 2026, in PLOS Global Public Health.

The study, Persistent Socioeconomic and Ethnic Inequalities in Unmet Need for NCD Diagnosis and Treatment in Viet Nam, 2015–2021, was conducted by Lan Thi Hoang Vu and colleagues.

The researchers analyzed data from the 2015 and 2021 WHO STEPwise Approach to Noncommunicable Disease Risk Factor Surveillance surveys.

Their analysis focused on hypertension, diabetes, and dyslipidemia, examining unmet needs for diagnosis and treatment and how these needs differed according to socioeconomic status, education, and ethnicity.

The final analytical samples included 1,300 adults in 2015 and 2,276 adults in 2021 who met the study's inclusion criteria for at least one of the three conditions.

Using the researchers' combined definition, unmet need for diagnosis was estimated at 82.2% in 2015 and 84.5% in 2021.

These figures are substantial, but their meaning requires careful explanation.

They describe unmet diagnostic needs within the study's selected analytical populations. They do not mean that more than 80% of all Vietnamese adults lacked a medical diagnosis.

The researchers identified eligible participants using specified clinical measurements, biochemical findings, and information about medication use. Unmet diagnostic need was then assessed through participants' reports of whether a healthcare professional had previously informed them of the relevant condition.

For hypertension, the eligibility criteria included measured systolic blood pressure of at least 140 mmHg, diastolic blood pressure of at least 90 mmHg, or current antihypertensive medication use.

Diabetes was identified through fasting blood glucose of at least 7.0 mmol/L or current glucose-lowering medication, with the relevant fasting requirement applied to the biochemical measurements.

Dyslipidemia was defined using total cholesterol of at least 5.2 mmol/L or current lipid-lowering medication.

These definitions supported the study's population analysis. However, meeting a survey threshold should not automatically be treated as equivalent to receiving a confirmed individual diagnosis following a comprehensive clinical assessment.

This distinction is particularly important for dyslipidemia, which accounted for the largest diagnostic gaps in the study.

Unmet diagnostic need for dyslipidemia was estimated at 87.0% in 2015 and 88.5% in 2021.

Because the study used a specified total cholesterol threshold, these figures should not be interpreted as proof that every affected participant required medication or had experienced a previous diagnostic error.

The combined findings were influenced by all three conditions, particularly the substantial contribution of dyslipidemia.

The numerical increase from 82.2% to 84.5% between the two survey years also requires caution. It does not, by itself, establish a statistically confirmed deterioration in national diagnostic performance.

The results are more appropriately understood as evidence of substantial unmet needs within the populations and conditions examined.

Persistent Socioeconomic and Ethnic Differences

Beyond the overall estimates, the study identified differences in unmet diagnostic needs associated with socioeconomic status and ethnicity.

People in lower socioeconomic groups generally experienced a greater burden of unmet diagnosis. Ethnic minority participants also had higher unmet needs than the Kinh/Hoa comparison group under the study's definitions.

For the combined indicator, the estimated unmet diagnostic need among ethnic minority participants was 90.0% in 2015, compared with 80.7% among Kinh/Hoa participants.

In 2021, the corresponding estimates were 91.6% and 83.5%.

These differences are important signals for further investigation. They suggest that opportunities for disease recognition were not distributed equally across the populations examined.

However, the patterns were not identical for every condition.

Socioeconomic and ethnic inequalities were more pronounced for hypertension and dyslipidemia, while measured gradients for diabetes were less evident. Educational inequalities observed in 2015 were also less apparent in the 2021 analysis.

The study used several complementary statistical methods, including the Erreygers Concentration Index, Slope Index of Inequality, and Relative Index of Inequality. The researchers also conducted sensitivity analyses to assess whether the findings changed after accounting for selected sociodemographic characteristics.

These analyses generally reduced the magnitude of some observed differences but did not eliminate the overall finding of persistent ethnic inequalities.

The results provide evidence that differences in unmet diagnostic needs deserve attention. They do not establish that every ethnic minority community faces the same barriers or that socioeconomic circumstances explain every instance of unmet need.

Understanding the Study's Limitations

The research used repeated cross-sectional surveys rather than following the same individuals over time.

Information about previous diagnoses and treatment was self-reported, while clinical eligibility was determined using the study's measurement-based definitions.

The analysis also covered a limited set of social determinants, and the characteristics of the analytical populations differed between the two survey rounds.

Although survey weighting and sensitivity analyses strengthened the research, they cannot remove every source of uncertainty.

The study was designed to estimate unmet needs and examine patterns of inequality. It was not designed to determine whether individual healthcare professionals had made diagnostic errors, whether particular patients experienced avoidable delays, or which specific organizational barriers caused the observed differences.

Furthermore, the underlying surveys were conducted in 2015 and 2021, not in 2026.

Publication in 2026 does not make the reported estimates measurements of current diagnostic access.

The study therefore provides valuable evidence of historical unmet needs and persistent inequality patterns for the conditions and populations examined. It does not establish the current prevalence of undiagnosed disease across every healthcare setting in Viet Nam.

Its most important contribution to diagnostic excellence is demonstrating why differences in opportunities for disease recognition deserve systematic attention.

Unmet Diagnostic Need Is Not the Same as Diagnostic Error

The concepts of unmet diagnostic need, delayed diagnosis, and diagnostic error are related, but they should not be used interchangeably.

Unmet diagnostic need concerns a gap between a person's health condition or relevant need for assessment and the diagnostic information or services they have received. Its precise meaning depends on how it is defined in a particular study or improvement program.

In population surveys, unmet need may be estimated by comparing measured health indicators with participants' reports of previous diagnoses.

This approach can reveal important gaps in disease recognition, particularly for conditions that may remain asymptomatic for long periods.

However, population survey data do not necessarily establish whether someone previously sought medical care, which symptoms were present, whether particular investigations were clinically indicated, or what information was available to a healthcare professional.

Delayed diagnosis concerns the timing of establishing a diagnosis. Determining whether a delay was avoidable requires consideration of the clinical circumstances and opportunities available during the relevant period.

Diagnostic error involves a separate assessment of diagnostic accuracy, timeliness, communication, or the diagnostic process under an applicable conceptual or measurement framework.

A person may have an unmet diagnostic need because they have never received an appropriate opportunity for assessment. That does not automatically establish that a healthcare professional made an error.

Conversely, a patient may have attended several healthcare facilities and experienced a missed opportunity for diagnosis even when diagnostic services were available.

These distinctions matter because different problems require different responses.

A population-level gap may indicate a need to improve access, early detection, or essential diagnostic capabilities. A possible diagnostic error within an individual clinical encounter may require a different type of professional review.

For Diagnostic Excellence Vietnam, the significance of unmet need lies in identifying where systems may not be providing sufficient opportunities for appropriate diagnosis, rather than assigning responsibility for individual clinical decisions without evidence.

How Access Barriers Develop Across the Healthcare System

People may encounter barriers before reaching a healthcare facility, during clinical assessment, or when attempting to obtain an indicated investigation.

Geographical distance is one important factor.

Specialized services may be concentrated in major urban centers, while some communities are located far from facilities offering particular investigations or specialist interpretation.

Travel may involve transportation costs, time away from work, accommodation, or assistance from relatives. These burdens can become more significant when several appointments are required.

Financial circumstances create additional barriers.

The price of a diagnostic investigation is only one component of the total cost of obtaining care. Travel expenses, lost income, and related household costs may influence whether people can complete an assessment.

Health insurance can reduce financial barriers, but coverage does not necessarily eliminate every out-of-pocket expense or practical difficulty.

Service availability presents another challenge.

A healthcare facility may provide basic clinical assessment but lack a particular test, specialist expertise, or sufficient capacity to deliver a service when needed.

Workforce shortages, equipment maintenance problems, interruptions in supplies, or limited operating hours may also affect access.

Information can be equally important.

Some conditions develop without obvious symptoms, and people may not recognize when professional assessment is appropriate. Others may have difficulty understanding which services are available or how to reach a suitable healthcare provider.

Language and communication needs can create further barriers when healthcare services are not adequately adapted to the population being served.

These challenges often interact.

Someone living far from a diagnostic facility may also face financial constraints and difficulty obtaining reliable information about available care.

Healthcare organizations should therefore avoid assuming that purchasing equipment, increasing appointment capacity, or providing more written information will independently resolve every access problem.

Understanding the barriers experienced by the intended population is essential before choosing an improvement strategy.

Different Communities May Need Different Forms of Support

Diagnostic equity requires attention to the circumstances of the populations served without assuming that everyone within a particular group has the same needs.

Ethnic minority communities in Viet Nam, for example, differ in language, geography, socioeconomic circumstances, cultural practices, and access to healthcare.

The 2026 study of unmet noncommunicable disease needs identified inequalities involving an aggregated ethnic minority category.

These findings justify closer investigation, but they do not establish that every ethnic minority community experiences the same disadvantage or that cultural practices explain the observed differences.

The same caution applies to geographical comparisons.

People living in rural areas should not automatically be assumed to have poor access to all diagnostic services. Availability and quality can vary considerably between localities.

Older people may encounter challenges involving mobility, transportation, multiple health conditions, or the need for assistance. People with disabilities may face barriers related to physical accessibility, communication, or the suitability of diagnostic equipment.

Financially disadvantaged individuals may experience difficulties attending investigations even when the service itself is available.

Others may have limited opportunities to seek care because of employment, caregiving responsibilities, or the operating hours of healthcare facilities.

The significance of these circumstances depends on the individual and the local healthcare environment.

Organizations should therefore combine population-level evidence with an understanding of the communities they serve.

The purpose is not to classify particular groups as inherently vulnerable or less capable of participating in care. It is to identify avoidable disadvantages and consider whether services can be organized more appropriately.

Patient and community perspectives can be particularly useful in identifying practical barriers that may not be visible in routine service data.

However, obtaining these perspectives should be undertaken respectfully, without assuming that individual experiences represent an entire population or that participation in improvement activities can replace professional assessment of clinical needs.

Strengthening Diagnostic Opportunities Through Primary Health Care

Primary health care has an important role in diagnostic equity because it can bring selected essential services closer to communities.

Some conditions can be identified or initially assessed using clinical examinations and relatively accessible investigations, provided that qualified personnel, suitable equipment, and reliable quality arrangements are available.

Hypertension offers one example.

Blood pressure can be measured in many healthcare settings, but appropriate diagnosis requires suitable measurement techniques, interpretation, and confirmation according to relevant professional guidance.

Diabetes and dyslipidemia may require biochemical testing and additional clinical evaluation.

Access to these services at appropriate levels of care can influence whether people receive timely recognition of relevant health conditions.

In Viet Nam, WHO and the Ministry of Health have worked to strengthen noncommunicable disease services through primary health care.

WHO's September 2025 reporting described an initiative that began in late 2022 to bring hypertension and diabetes services closer to communities in Ho Chi Minh City.

The initiative initially supported 43 commune health stations and 10 district health centers, using the organizational arrangements in place during the project period.

The model was subsequently expanded to additional facilities.

WHO reported increased use of participating community-based services, together with improvements in selected measures of blood pressure and glucose control.

These results illustrate how strengthening services closer to communities may improve access and reduce some practical burdens associated with care.

However, increased service use and improved disease control should not automatically be interpreted as proof that diagnostic inequalities have been eliminated.

The initiative involved a particular population, service model, and implementation context. Its findings do not establish that equivalent outcomes would occur in every locality without adaptation.

The effectiveness of community-based services depends on workforce capacity, reliable supplies, diagnostic quality, service organization, and the needs of the population.

In December 2025, WHO also published Primary Health Care in Viet Nam: A Review of the Commune Health System, developed in collaboration with the Ministry of Health.

The report examined the strengths, challenges, and opportunities of Viet Nam's grassroots healthcare system, with particular attention to service delivery, financing, and governance.

For diagnostic excellence, these developments raise a practical question: which investigations and clinical assessments can be provided reliably at the local level, and how can people obtain specialist services when their needs exceed local capabilities?

Improving access should not mean requiring every healthcare facility to perform every diagnostic investigation.

A dependable healthcare system needs accessible essential services together with appropriate arrangements for obtaining more specialized expertise.

Diagnostic Equity Must Include Quality and Clinical Appropriateness

Increasing access to diagnostic investigations does not automatically improve diagnostic equity.

A service may become easier to reach while still experiencing problems involving specimen quality, staff competence, equipment reliability, interpretation, or appropriate use of findings.

These concerns matter because unreliable investigations can create new risks rather than resolve an existing diagnostic need.

For example, introducing point-of-care testing without adequate training, quality assurance, maintenance, or professional interpretation may increase testing availability without providing the intended clinical benefit.

Similarly, expanding imaging services requires attention to technical quality, qualified interpretation, patient safety, and appropriate clinical indications.

There is also an important distinction between receiving a test and receiving appropriate diagnostic care.

An investigation may produce information that requires additional clinical evaluation before its meaning can be established. A technically accurate result may not fully resolve the original clinical question.

An equitable system should therefore consider whether available investigations provide clinically useful information and whether patients can obtain the level of assessment appropriate to their needs.

Expanding services can also create unintended consequences when clinical appropriateness receives insufficient attention.

Increasing screening or testing may appear beneficial, but not every investigation is suitable for every population or clinical situation.

Inappropriate testing can lead to false-positive findings, incidental abnormalities, unnecessary procedures, anxiety, and avoidable expenditure.

Some forms of screening can also contribute to overdiagnosis by identifying conditions that would not have caused symptoms or harm during a person's lifetime.

Conversely, overly restrictive testing policies may make necessary investigations harder to obtain.

An equity initiative should therefore avoid treating the highest possible testing volume as its objective.

The appropriate goal is to improve access to investigations and clinical assessments supported by relevant evidence and professional guidance.

Service expansion also needs to consider whether people can obtain appropriate clinical evaluation after an important abnormal finding is identified.

A program that detects possible health problems without adequate arrangements for further assessment may leave people facing additional uncertainty, travel, or financial burdens.

For Diagnostic Excellence Vietnam, the central principle is that equitable diagnostic care must be both accessible and clinically reliable.

Improved availability is valuable, but access without sufficient quality does not necessarily result in better or safer diagnosis.

Measuring Diagnostic Equity Responsibly

Healthcare organizations need reliable information to understand whether diagnostic opportunities differ between populations, services, or geographical areas.

However, measuring equity requires more than comparing the number of investigations performed.

A higher testing rate does not automatically indicate better access. Different populations may have different clinical needs, and some investigations may be unnecessary.

Likewise, a lower testing rate does not automatically establish undertesting.

The measures selected should reflect the clinical question and the population being studied.

For selected conditions, organizations may examine the proportion of clinically eligible individuals who receive an indicated assessment or investigation.

Where reliable data are available, they may also examine access to confirmatory testing, the availability of necessary services, or the time between an indicated assessment and its completion.

A fundamental requirement is the use of an appropriate denominator.

The number of people receiving a test needs to be interpreted in relation to the population for whom the investigation was clinically indicated, rather than the total population without regard to clinical need.

Data completeness is also important.

A healthcare organization may not know whether a patient received an investigation at another facility. An apparent gap in local records may therefore partly reflect missing information.

Differences in age, disease prevalence, clinical complexity, healthcare use, and service availability may influence comparisons.

For example, a higher proportion of abnormal test findings in one population does not necessarily indicate poorer diagnostic quality. It may reflect differences in underlying disease risk or how patients were selected for testing.

The 2026 Vietnamese study used several statistical methods to examine inequality, including the Erreygers Concentration Index, Slope Index of Inequality, and Relative Index of Inequality.

These measures can help describe how unmet needs are distributed across socioeconomic or other population groups when the study population, variables, and analytical assumptions are appropriately defined.

However, sophisticated statistical methods are not always necessary for an initial organizational improvement activity.

A carefully designed local assessment using clear definitions, reliable information, and clinically meaningful comparisons may provide a more practical starting point.

The important questions are what is being measured, which population is included, whether differences in clinical need have been considered, and what conclusions the available data can support.

An observed difference in diagnostic access may be associated with geography, service capacity, financial circumstances, health needs, workforce distribution, healthcare-seeking behavior, or several interacting factors.

Some differences may reflect avoidable structural barriers. Others may arise partly from clinically justified decisions or limitations in the available information.

A statistical association does not establish causation.

For example, a study showing greater unmet diagnostic needs among one population group does not identify which healthcare organization, professional decision, or policy produced that difference.

Nor does it automatically demonstrate that an individual experienced unlawful discrimination or a diagnostic error.

Such conclusions require additional evidence and, where relevant, assessment under the applicable legal framework.

This does not reduce the importance of investigating disparities.

A persistent difference may indicate that a service or organizational arrangement deserves closer attention, even when its causes are not yet understood.

Responsible equity measurement should make potential problems visible while preserving scientific uncertainty and fairness.

Matching Improvement Strategies to the Actual Barrier

Once a credible access concern has been identified, the next challenge is determining which intervention may address it.

Different barriers require different responses.

Where geographical distance is a major obstacle, providing selected essential services closer to communities may be appropriate.

Where diagnostic capacity is limited, improvement may require workforce development, suitable equipment, dependable supplies, or better access to specialist expertise.

Where financial circumstances affect attendance, organizations may need to examine whether eligible patients can access existing insurance coverage or assistance arrangements.

Where communication barriers are important, clearer information or appropriately adapted support may help people obtain the assessment they need.

No single intervention will resolve every type of access problem.

Healthcare organizations also need to distinguish between problems within their authority and those requiring broader health system coordination.

A clinic may be able to improve appointment arrangements, service information, or local workflows. It may not independently control transportation infrastructure, national reimbursement policies, or regional workforce distribution.

Effective improvement therefore requires realistic objectives and appropriate cooperation.

Consider a healthcare facility that identifies low participation in an indicated diagnostic service.

Before introducing changes, the team needs to understand why eligible patients are not completing the assessment.

If travel is the main barrier, additional reminders may have little effect. If the service is frequently unavailable, improving operational reliability may be more important than increasing public awareness.

If patients do not understand the purpose of the investigation, clearer explanations may help, but they will not resolve a shortage of qualified personnel.

The intervention should follow from the problem identified rather than from a general assumption about what patients need.

Proposed changes should also be feasible, clinically appropriate, and supported by the necessary quality safeguards.

Small-scale implementation may help identify difficulties before wider expansion.

Success should not be judged solely by an increase in service use. Where possible, it should reflect better access among clinically eligible patients, improved reliability, and a reduction in avoidable barriers.

The effect of an intervention should also be examined across the populations it is intended to benefit.

An overall improvement may conceal a situation in which people who already had relatively good access experienced most of the benefit, while those facing greater barriers saw little change.

This is one reason equity-oriented improvement may require examining results by relevant population characteristics, provided that the information is sufficiently reliable and its use complies with applicable law.

Digital Solutions Can Improve Access but Also Create New Barriers

Digital technologies may help improve access to diagnostic expertise through remote consultation, information exchange, service coordination, and electronic clinical records.

Appropriately organized teleconsultation or teleradiology services, for example, may help healthcare professionals obtain specialist input when particular expertise is not readily available locally.

However, these benefits depend on connectivity, technical performance, professional competence, clinical suitability, and appropriate oversight.

Digital services may also create barriers.

Some patients lack suitable devices, reliable internet access, or the skills needed to use digital platforms. Healthcare facilities may face difficulties involving incompatible information systems or limited technical support.

A service delivered exclusively through digital channels could unintentionally disadvantage some of the people it aims to help.

Remote diagnostic activities must also comply with applicable professional, technical, licensing, confidentiality, and other legal requirements.

Technology should not be presented as a substitute for a necessary physical examination or qualified clinical interpretation.

The important question for diagnostic equity is whether a particular technology improves access to reliable and clinically appropriate services for the intended population.

Introducing a platform or device does not, by itself, establish that an access gap has been reduced.

Organizations should consider who benefits, whether service quality is maintained, and whether new barriers have emerged.

Making Diagnostic Equity Part of Healthcare Improvement in Viet Nam

Healthcare organizations in Viet Nam serve different populations and operate with varying resources, workforce capabilities, and diagnostic services.

A large hospital may offer extensive investigations but receive patients who face substantial travel or financial barriers.

A smaller facility may be closer to the community yet have limited access to certain tests or specialist expertise.

Improvement should reflect these differences.

A practical starting point is to identify a clinically important diagnostic service or patient population for which an access concern has been observed.

The organization can then examine whether the principal barrier involves availability, affordability, service organization, communication, or another factor.

Relevant healthcare professionals should help assess the clinical importance of the gap.

Patient and community perspectives may provide additional insight into difficulties not visible in routine organizational records.

The initial intervention should address a clearly defined concern and remain feasible within the organization's responsibilities.

Its effects should be evaluated using measures appropriate to the improvement objective.

For example, an organization may examine whether a greater proportion of clinically eligible patients can obtain an indicated investigation, whether a specific access barrier has become less significant, or whether an observed difference between groups has narrowed.

Such findings should be interpreted alongside service reliability, clinical appropriateness, and possible unintended consequences.

Leadership support is important, but diagnostic equity does not necessarily require a separate administrative program.

It can be incorporated into existing quality improvement, patient safety, and service planning activities.

At the same time, local initiatives cannot replace broader policies addressing healthcare workforce distribution, financing, infrastructure, and regional service capacity.

Meaningful progress may require cooperation among healthcare facilities, health authorities, professional organizations, communities, and other relevant stakeholders.

The long-term objective is to make appropriate diagnostic care more accessible without lowering expectations for quality, safety, or professional practice.

Legal, Ethical, and Professional Considerations in Viet Nam

Diagnostic equity initiatives must operate within the legal and professional framework governing healthcare in Viet Nam.

The Law on Medical Examination and Treatment No. 15/2023/QH15 provides an important foundation concerning patient rights, professional responsibilities, healthcare facility operations, quality management, and patient safety.

The Law should be read together with applicable amendments, including those reflected in Consolidated Document No. 26/VBHN-VPQH, issued by the Office of the National Assembly on February 26, 2026.

Article 3 establishes fundamental principles of medical examination and treatment, including respect for patients, equal treatment, and the prohibition of stigma and discrimination.

It also provides for priority in medical examination and treatment for specified groups, subject to the conditions and characteristics of healthcare facilities.

These provisions demonstrate that equal respect for patients and legally established priority arrangements can operate within the same healthcare framework.

Article 4 addresses state policies concerning healthcare development, including investment priorities for grassroots healthcare, disadvantaged geographical areas, and services for specified populations.

These provisions are relevant to the broader policy context of healthcare access and equity.

However, they do not establish a specific legal obligation for every healthcare organization to implement a program named Diagnostic Equity or adopt a particular international measurement framework.

Article 9 addresses patients' rights to receive information and explanations concerning their health conditions and medical examination and treatment.

Article 10 provides additional protections concerning dignity, privacy, and freedom from discrimination in healthcare.

Articles 57 and 58 address quality standards and quality assessment for healthcare facilities, while Article 60 establishes relevant responsibilities concerning facility operations, professional requirements, and quality.

These requirements provide a legal context for improving diagnostic services.

Healthcare organizations should distinguish their existing legal obligations from voluntary quality improvement approaches informed by international research and professional guidance.

WHO resolutions, research studies, and international diagnostic equity frameworks can inform improvement, but they do not automatically become mandatory Vietnamese clinical protocols or organizational structures.

Equity assessments must also be interpreted responsibly.

A statistical difference between population groups does not, by itself, establish unlawful discrimination, professional negligence, or an individual diagnostic error.

Such determinations require consideration of the relevant facts, applicable legal standards, and legally prescribed procedures.

Protecting Personal and Sensitive Information

The use of clinical information and population characteristics for equity assessment requires careful attention to privacy and personal data protection.

Viet Nam's Law on Personal Data Protection No. 91/2025/QH15 and Decree No. 356/2025/ND-CP, both effective January 1, 2026, form part of the applicable legal framework governing personal data processing, including health-related information.

Healthcare organizations conducting diagnostic equity assessments should evaluate the lawful basis and purposes of data processing, authorized access, security safeguards, retention requirements, and other applicable obligations.

Where an analysis involves characteristics such as ethnicity, disability, health status, or other potentially sensitive information, collection and processing require particular care.

Information should be relevant to a legitimate purpose and handled according to the legal requirements applicable to that activity.

Organizations should not assume that collecting additional personal characteristics is automatically justified because an activity aims to improve equity.

Even aggregated results may create confidentiality concerns when small population groups could be indirectly identified through combinations of information.

Appropriate aggregation and de-identification can reduce these risks, but they do not automatically eliminate every legal obligation.

Research activities, external data sharing, or public dissemination may require additional ethical or regulatory assessment depending on their design and applicable requirements.

International evidence should support lawful and responsible improvement, not justify unrestricted access to or disclosure of sensitive information.

Toward Fairer and More Reliable Diagnosis

Diagnostic excellence requires more than technically accurate investigations and appropriate clinical decisions once people reach healthcare services.

It also requires attention to whether people have a fair opportunity to obtain the diagnostic care they need.

Geographical distance, financial circumstances, workforce distribution, communication barriers, and differences in service capacity can all influence that opportunity.

These barriers do not affect everyone in the same way.

Research published in 2026 using Vietnamese survey data from 2015 and 2021 provides evidence of substantial historical unmet diagnostic needs for selected noncommunicable diseases and persistent socioeconomic and ethnic inequalities.

International developments, including WHO's work on strengthening diagnostic capacity and the Global Diagnostics Coalition's activities in 2026, reinforce the importance of improving access to reliable services.

However, reducing diagnostic gaps requires more than increasing the availability of tests.

Healthcare organizations need to understand which populations experience barriers, what may be contributing to those barriers, and which improvements can be implemented safely and effectively.

They must also distinguish unmet diagnostic needs from differences in healthcare use, delayed diagnosis, and confirmed diagnostic errors.

For Viet Nam, progress may involve strengthening essential diagnostic capabilities at appropriate levels of care, improving access to specialist expertise, reducing practical barriers, and using reliable evidence to guide improvement priorities.

These efforts should be adapted to local conditions and evaluated according to their intended objectives.

Advancing diagnostic equity means improving the opportunity for every person to receive clinically appropriate, timely, and reliable diagnostic care, while recognizing that different people and communities may need different forms of support to achieve that goal.

Equity is not separate from diagnostic quality and safety. It is an important consideration in determining whether the benefits of diagnostic excellence can reach the people who need them.

Strengthening this connection can help healthcare organizations in Viet Nam develop more inclusive, dependable, and patient-centered diagnostic services.

Evidence and Policy Context

This article draws on international evidence and professional guidance, including World Health Assembly Resolution WHA76.5 on strengthening diagnostic capacity (2023); The Lancet Commission on Diagnostics: Transforming Access to Diagnostics (2021); Moving the Dial on Diagnostics: An Update From the Lancet Commission on Diagnostics (2025); and the World Health Organization's work on universal health coverage, diagnostic access, and the Global Diagnostics Coalition, including its October 2026 communication.

The discussion also considers the U.S. Centers for Disease Control and Prevention's Core Elements of Hospital Diagnostic Excellence (2026), particularly its emphasis on organizational improvement, diagnostic safety, appropriate testing, and identifying disparities that may warrant further examination.

Evidence specific to Viet Nam includes Vu and colleagues' Persistent Socioeconomic and Ethnic Inequalities in Unmet Need for NCD Diagnosis and Treatment in Viet Nam, 2015–2021, published in PLOS Global Public Health in August 2026.

The study analyzed WHO STEPS data collected in 2015 and 2021 and examined unmet diagnostic and treatment needs involving hypertension, diabetes, and dyslipidemia.

Its findings should be interpreted according to the researchers' operational definitions, analytical populations, statistical methods, and methodological limitations. They should not be presented as measurements of current diagnostic access in 2026 or as confirmed evidence of individual diagnostic errors.

The article also considers WHO's collaboration with the Ministry of Health of Viet Nam on strengthening primary healthcare, including its September 2025 reporting on community-based noncommunicable disease services in Ho Chi Minh City and Primary Health Care in Viet Nam: A Review of the Commune Health System (2025).

The Vietnamese legal context includes the Law on Medical Examination and Treatment No. 15/2023/QH15, as amended and reflected in Consolidated Document No. 26/VBHN-VPQH (2026); Decree No. 96/2023/ND-CP, as applicable; the Law on Personal Data Protection No. 91/2025/QH15; and Decree No. 356/2025/ND-CP.

International diagnostic equity principles and research findings are presented as sources of evidence-informed improvement. They should not be interpreted as mandatory Vietnamese diagnostic protocols, legal determinations of discrimination, or substitutes for applicable laws, professional standards, and institutional responsibilities.

Professional Scope and Disclaimer

This article is published by Diagnostic Excellence Vietnam (DxEx.vn) for professional education, knowledge-sharing, and general information. It examines diagnostic equity from the perspectives of healthcare quality, patient safety, access to diagnostic services, unmet diagnostic needs, risk management, and systems-based improvement.

The content does not constitute individualized medical advice, clinical diagnosis, screening or treatment recommendations for individual patients, legal advice, a determination of discriminatory conduct, or a legally binding interpretation of Vietnamese regulations. Diagnostic Excellence Vietnam (DxEx.vn) is not a healthcare provider, regulatory authority, or accreditation or certification body.

Clinical decisions, diagnostic service provision, health equity assessments, personal data processing, research activities, and organizational improvement remain subject to applicable Vietnamese laws, professional standards, institutional responsibilities, and the judgment of appropriately qualified professionals and authorized healthcare organizations.