000			04275cam a22007814a 4500
001			27800
003			The World Bank
005			20181114100049.0
006			m o d
007			cr cn|||||||||
008			020129s2011 dcu o i00 0 eng
024	8		_a10.1596/27800
035			_a(The World Bank)27800
110	2		_aVietnam Ministry of Health.
245	1	0	_aLessons for Hospital Autonomy _h[electronic resource] : _bImplementation in Vietnam from International Experience.
260			_aWashington, D.C. : _bThe World Bank, _c2011.
490	1		_aPolicy Notes
520	3		_aThe Government of Vietnam sees hospital autonomy policy as important and consistent with current development trends in Vietnam. It is based on government policies as laid out in government Decree on financial autonomy of revenue-generating public service entities; and to 2006, it is replaced by decree on professional, organizational, human resource management and financial autonomy of revenue-generating and state budget-financed public service entities. These policies apply to public service entities in all sectors, including the health sector and hospitals. This policy is an important element of public administration reform in Vietnam, helping service entities survive and develop under the socialist-oriented market mechanism. It aims to help hospitals in fulfilling assigned professional tasks by allowing them to restructure their organization and staffing. The government has also allowed public service entities to mobilize private capital and joint ventures to organize activities and services responding to social and people's needs. This study will show that since the implementation of decrees, a number of improvements have been demonstrated within hospitals with respect to physical facilities, service provision, medical techniques, service quality and staff incomes, thus creating stability and satisfaction among hospital workers. But it also describes the international evidence that implementation of hospital autonomy comes with a risk of unintended outcomes driven by powerful financial incentives from the market place to increase revenue. These include supply induced demand, cost escalation, inappropriate care. There are some indications that such risks may be emerging in Vietnam as well, although these would need further research. Fortunately, there is also international evidence about policies that can mitigate such risks, and these are also described in this report. This report will inspire further studies and encourage policymakers to think about continuous improvement of policies.
650		4	_aAccess to Health Services
650		4	_aCapacity Building
650		4	_aCities
650		4	_aDecision Making
650		4	_aDeveloping Countries
650		4	_aDoctors
650		4	_aEconomic Development
650		4	_aEmployment
650		4	_aExpenditures
650		4	_aFee-For-Service Payments
650		4	_aFinancial Management
650		4	_aGood Governance
650		4	_aHealth Information
650		4	_aHealth Insurance
650		4	_aHealth Law
650		4	_aHealth Monitoring & Evaluation
650		4	_aHealth Systems Development & Reform
650		4	_aHealth, Nutrition and Population
650		4	_aHospitals
650		4	_aHousing & Human Habitats
650		4	_aHuman Resources
650		4	_aIncome Inequality
650		4	_aLaw and Development
650		4	_aMedical Records
650		4	_aMental Health
650		4	_aMobility
650		4	_aMortality
650		4	_aPharmacies
650		4	_aPopulation Policies
650		4	_aPregnancy
650		4	_aPublic Health
650		4	_aPublic Hospitals
650		4	_aPublic Policy
650		4	_aRespect
650		4	_aSocial Health Insurance
650		4	_aSurgery
650		4	_aUnions
650		4	_aUrban Areas
650		4	_aUrban Population
650		4	_aUser Fees
650		4	_aWaste
650		4	_aWorkers
650		4	_aWorld Health Organization
700	1		_aHealth Strategy and Policy Institute.
700	1		_aVietnam Ministry of Health.
700	1		_aWorld Bank.
700	1		_aWorld Health Organization.
830	1		_aPolicy Notes
830		0	_aWorld Bank e-Library.
856	4	0	_uhttp://elibrary.worldbank.org/doi/book/10.1596/27800
999			_c31183 _d31183