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Nhan đề: An institutional analysis of the fiscal autonomyof public hospitals in Vietnam
Tác giả: Hải, Võ Thị Minh
Löfgren, Karl
Từ khoá: Autonomy
Health care
Public hospitals
Năm xuất bản: 2018
Tùng thư/Số báo cáo: Wiley;pp. 1 - 18
Tóm tắt: This paper explores the fiscal autonomy of Vietnam's pub-lic hospitals through analysing the formal autonomy rulesand the actual autonomy practices among selectedhospitals. We argue that Vietnam's autonomisation ofpublic hospitals underpins the increasing switch ofhealthcare costs from the state onto society alongsidethe transition from the universal and free healthcare ser-vices to a mix of state subsidy and fees‐for‐services.Utilised as a strategic instrument, hospital autonomyis reinforced in service provision, capital mobilisation,and allocation of net revenues, leaving autonomy inother dimensions increase incrementally. Consequently,Vietnam's hospital autonomisation has occasioned vari-ous revenue‐maximising practices including the provisionof“patient‐requested”services, provider‐induced supplyof unnecessary services, excessive use of high‐tech diag-nostic equipment, inappropriate prescription of drugs,increase in patients' length of stay, and receipt of informalpayments. While discerning healthcare reform in acountry context, this paper expects to offer lessons topolicy‐makers in developing countries, which reformtheir healthcare services along the market principle.
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