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An institutional analysis of the fiscal autonomy of public hospitals in Vietnam

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  • Minh Thị Hải Võ
  • Karl Löfgren

Abstract

This paper explores the fiscal autonomy of Vietnam's public hospitals through analysing the formal autonomy rules and the actual autonomy practices among selected hospitals. We argue that Vietnam's autonomisation of public hospitals underpins the increasing switch of healthcare costs from the state onto society alongside the transition from the universal and free healthcare services to a mix of state subsidy and fees‐for‐services. Utilised as a strategic instrument, hospital autonomy is reinforced in service provision, capital mobilisation, and allocation of net revenues, leaving autonomy in other dimensions increase incrementally. Consequently, Vietnam's hospital autonomisation has occasioned various revenue‐maximising practices including the provision of “patient‐requested” services, provider‐induced supply of unnecessary services, excessive use of high‐tech diagnostic equipment, inappropriate prescription of drugs, increase in patients' length of stay, and receipt of informal payments. While discerning healthcare reform in a country context, this paper expects to offer lessons to policy‐makers in developing countries, which reform their healthcare services along the market principle.

Suggested Citation

  • Minh Thị Hải Võ & Karl Löfgren, 2019. "An institutional analysis of the fiscal autonomy of public hospitals in Vietnam," Asia and the Pacific Policy Studies, Wiley Blackwell, vol. 6(1), pages 90-107, January.
    • Handle: RePEc:bla:asiaps:v:6:y:2019:i:1:p:90-107
    DOI: 10.1002/app5.268
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    References listed on IDEAS

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    1. James Riedel & William S. Turley, 1999. "The Politics and Economics of Transition to an Open Market Economy in Viet Nam," OECD Development Centre Working Papers 152, OECD Publishing.
    2. World Bank & Government of Vietnam, 2017. "Vietnam Public Expenditure Review," World Bank Publications - Reports 28610, The World Bank Group.
    3. Thelen,Kathleen, 2004. "How Institutions Evolve," Cambridge Books, Cambridge University Press, number 9780521546744.
    4. Sjors Overman, 2016. "Great Expectations of Public Service Delegation: A systematic review," Public Management Review, Taylor & Francis Journals, vol. 18(8), pages 1238-1262, September.
    5. Samuel S. Lieberman & Adam Wagstaff, 2009. "Health Financing and Delivery in Vietnam : Looking Forward," World Bank Publications - Books, The World Bank Group, number 2594, December.
    6. Quan-Hoang Vuong, 2014. "Vietnam’s political economy: a discussion on the 1986-2016 period," Working Papers CEB 14-010, ULB -- Universite Libre de Bruxelles.
    7. Van Tho Tran, 2013. "Vietnamese Economy at the Crossroads: New Doi Moi for Sustained Growth," Asian Economic Policy Review, Japan Center for Economic Research, vol. 8(1), pages 122-143, June.
    8. Pierson, Paul, 2000. "Increasing Returns, Path Dependence, and the Study of Politics," American Political Science Review, Cambridge University Press, vol. 94(2), pages 251-267, June.
    9. Michael Keating, 2001. "Public Management Reform and Economic and Social Development," OECD Journal on Budgeting, OECD Publishing, vol. 1(2), pages 141-212.
    10. Alexander S. Preker & April Harding, 2003. "Innovations in Health Service Delivery : The Corporatization of Public Hospitals," World Bank Publications - Books, The World Bank Group, number 15145, December.
    11. Thelen,Kathleen, 2004. "How Institutions Evolve," Cambridge Books, Cambridge University Press, number 9780521837682.
    12. De Geyndt, Willy, 2017. "Does autonomy for public hospitals in developing countries increase performance? Evidence-based case studies," Social Science & Medicine, Elsevier, vol. 179(C), pages 74-80.
    13. Hall, Peter A. & Taylor, Rosemary C. R., 1996. "Political science and the three new institutionalisms," MPIfG Discussion Paper 96/6, Max Planck Institute for the Study of Societies.
    14. Martin Painter, 2005. "The Politics of State Sector Reforms in Vietnam: Contested Agendas and Uncertain Trajectories," Journal of Development Studies, Taylor & Francis Journals, vol. 41(2), pages 261-283.
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