Health policy and facility factors influencing the effectiveness of medical assessments for people with disabilities in Hanoi, Vietnam: A qualitative study.

Disability assessment determines access to social and healthcare support, yet the operation of assessment pathways may be shaped by policy implementation and facility capacity. We conducted a qualitative descriptive study at the Hanoi Medical Assessment Center, Vietnam, using purposive sampling and semi-structured, in-depth interviews with 13 stakeholders, including people with disabilities, guardians, administrative and reception staff, district social-protection officials, medical examiners, and center leaders. Interviews were audio-recorded, transcribed verbatim, and analyzed using thematic analysis. Four interconnected themes were identified: administrative fragmentation and procedural burden, communication gaps and reliance on informal information channels, infrastructure constraints and system-level inefficiencies, and financial ambiguity and trust-related concerns. Participants described multilevel administrative handoffs and episodic dossier submission as sources of delay; official information was often difficult to interpret, leading users to rely on healthcare professionals; limited on-site diagnostic capacity required external referrals; and uncertainty about fees, insurance coverage, and the distinction between paying for assessment and qualifying for benefits undermined trust. These findings reflected experiences at 1 urban center and were not intended to estimate prevalence or represent disability assessment nationally. They identify context-specific service priorities for Hanoi, including clearer inter-level responsibilities, accessible and standardized guidance, better coordination of diagnostic services, and transparent communication of costs. Multicenter research, including rural and under-resourced settings, is needed before broader policy implications can be drawn.