Key Development
An older patient moving through five or six specialist clinics and receiving five or six separate prescriptions is not necessarily receiving better care. In many cases, it signals a system treating individual diseases without managing the patient as a whole.
At a September 27, 2026 conference on dementia and multimorbidity, Vietnam’s Deputy Minister of Health Nguyen Thi Lien Huong called for comprehensive management of older patients through coordination across geriatrics, neurology, cardiology, endocrinology, musculoskeletal care, rehabilitation and other disciplines. She also emphasized medication review, drug interactions and adjusting treatment to patients’ cognitive status. Vietnam now has more than 14 million people aged 60 and above and is ageing rapidly.
The direction is consistent with new national policy. Decision 1116/QD-TTg, issued in June 2026, provides for older people to receive at least one free health examination or screening annually from 2026 and to have longitudinal health records. By 2030, Vietnam aims for at least 90% of older people to have major noncommunicable diseases — including dementia — detected, treated and managed.
Why It Matters
- Multimorbidity exposes the limits of disease-by-disease care. Older adults often simultaneously live with hypertension, diabetes, cardiovascular disease, musculoskeletal problems and cognitive decline.
- Polypharmacy is a direct clinical risk. WHO commonly describes polypharmacy as using five or more medicines and notes that older patients seeing multiple healthcare professionals face higher risks of adverse reactions, medication errors and hospitalization.
- Dementia amplifies medication risk. Patients may forget doses, repeat medicines or fail to recognize hypoglycemia and other adverse effects, making an individually appropriate prescription unsafe when placed inside a complex regimen.
- The global direction is toward integrated care. WHO’s ICOPE framework emphasizes comprehensive assessment, personalized care plans and coordination across community, primary care and hospitals.
Healthcare Insight Analysis
Healthcare Insight believes the underlying problem is clinical fragmentation.
A cardiologist may be correct in optimizing blood pressure. An endocrinologist may be correct in targeting glucose. An orthopedist may be correct in controlling pain.
But when all individually guideline-concordant decisions are added together, an 80-year-old patient with cognitive impairment can end up with an overly complex regimen that increases hypotension, hypoglycemia, dizziness, falls and poor adherence.
That is why geriatric medicine increasingly focuses on treatment priorities, not simply disease targets.
Vietnam does not necessarily need every older patient to attend one giant multidisciplinary clinic. What it needs is a clinical coordinator — potentially a geriatrician, family physician or primary-care team — accountable for seeing the entire patient record, reconciling medicines, setting priorities and determining when specialist intervention is necessary.
This changes care in four ways.
First, multiple prescriptions become one reconciled medication list.
Second, standardized disease targets become individualized targets reflecting cognition, frailty, function and life expectancy.
Third, uncontrolled referrals become coordinated referrals, where specialists contribute expertise but patients return to a central care plan.
Fourth, episodic treatment becomes longitudinal care, supported by persistent health records and community follow-up.
This is also where digital health can create genuine value.
A shared medication record, interaction alerts and longitudinal patient profile are far more useful for an older multimorbid patient than simply digitizing several disconnected prescriptions.
WHO’s updated ICOPE model follows the same logic: basic assessment, in-depth assessment, a personalized plan and ongoing implementation and monitoring, with stronger integration into community-level care.
Market Implications
Hospitals: integrated geriatric clinics and multidisciplinary care pathways can become increasingly important service lines as Vietnam ages.
Pharmacies and pharmacists: medication reconciliation, adherence management and structured deprescribing reviews create a larger role within chronic-care delivery.
Healthtech: opportunity shifts toward shared medication lists, interaction engines and care coordination rather than appointment booking alone.
Payers: integrated care could reduce duplicate testing, avoidable adverse drug events and hospitalization, but value should be demonstrated through utilization and outcome data.
ANALYTICAL MATRIX
| Dimension | Fragmented Model | Integrated Model | KPI to Track |
|---|---|---|---|
| Care access | Multiple separate clinics | Coordinated clinical lead | Duplicate visits |
| Medication | Independent prescriptions | Medication reconciliation | Drug count, interactions, ADEs |
| Treatment target | Disease-specific guideline | Frailty/cognition-adjusted goals | Falls, function, hospitalization |
| Data | Disconnected records | Longitudinal patient record | Continuity and data completeness |
The most important measures are therefore not how many specialists a patient sees, but how many medicines remain truly necessary after reconciliation and how many avoidable falls, adverse drug events and hospitalizations are prevented.
If Vietnam can build around those metrics, older-person care can move beyond the model of “one doctor for every disease” toward something far more valuable: one coherent treatment plan for every patient.