Description: Getting Incentives Right : An Impact Evaluation of District Hospital Capitation Payment in Vietnam

Getting Incentives Right : An Impact Evaluation of District Hospital Capitation Payment in Vietnam

With the movement toward universal health coverage gaining momentum, the global health research community has made significant efforts to advance knowledge about the impact of various schemes to expand population coverage. The impacts on efficiency...

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Bibliographic Details
Main Authors:	Nguyen, Ha Thi Hong, Bales, Sarah, Wagstaff, Adam, Dao, Huyen
Language:	English en_US
Published:	World Bank, Washington, DC 2014
Subjects:	ACCESS TO HEALTH CARE ADVERSE EVENTS C-SECTION C-SECTIONS CANCER CAPITATION CAPITATION BASIS CITIES CLINICAL PROTOCOLS COMMUNITY HEALTH COMPLICATIONS DEATHS DEVELOPING COUNTRIES DEVELOPMENT POLICY DIAGNOSIS DIALYSIS DISCHARGE PATIENTS DOCTORS DRUGS ECONOMIC STATUS ENROLLEES EPIDEMICS EPILEPSY EXPENDITURES FAMILIES FAMILY MEDICINE FEE-FOR-SERVICE FEE-FOR-SERVICE BASIS FINANCIAL RISK GLOBAL HEALTH HAZARD HEALTH CARE HEALTH CARE COVERAGE HEALTH CARE FINANCE HEALTH CARE FINANCING HEALTH CARE PROVIDER HEALTH CARE PROVIDERS HEALTH CENTERS HEALTH CENTRE HEALTH COVERAGE HEALTH ECONOMICS HEALTH FACILITIES HEALTH FINANCING HEALTH INDICATORS HEALTH INSURANCE HEALTH ORGANIZATION HEALTH OUTCOMES HEALTH POLICY HEALTH PROMOTION HEALTH REFORM HEALTH RESEARCH HEALTH RISKS HEALTH SECTOR HEALTH SERVICE HEALTH SERVICE PROVIDERS HEALTH SERVICE UTILIZATION HEALTH SERVICES HEALTH STATUS HEALTH STRATEGY HEALTH SYSTEM HEALTH WORKFORCE HOSPITAL HOSPITAL ADMISSIONS HOSPITAL AUTONOMY HOSPITAL BEDS HOSPITAL CARE HOSPITAL MANAGERS HOSPITALIZATIONS HOSPITALS HUMAN DEVELOPMENT ILLNESS INCOME INDUCED DEMAND INPATIENT ADMISSION INPATIENT ADMISSIONS INSURANCE COVERAGE INSURANCE SCHEMES INTERVENTION KIDNEY DIALYSIS LAB TESTS LACK OF INFORMATION LIVING STANDARDS MEDICAL CARE MEDICAL EQUIPMENT MEDICAL PRACTICE MEDICAL SERVICES MEDICINE MICRO HEALTH MINISTRY OF HEALTH MORTALITY MORTALITY RATE NEGATIVE EFFECTS NUTRITION PATIENT PATIENT SATISFACTION PATIENTS PHYSICIANS POLICY DISCUSSIONS POLICY MAKERS POLICY RESEARCH POLICY RESEARCH WORKING PAPER PRESCRIPTIONS PREVALENCE PRIMARY CARE PROBABILITY PROGRESS PROVIDER INCENTIVES PROVIDER PAYMENT PUBLIC HEALTH PUBLIC HOSPITALS PUBLIC SERVICES PURCHASING POWER QUALITATIVE INFORMATION QUALITY OF CARE QUALITY OF LIFE REFERRALS RESEARCH COMMUNITY RESOURCE USE RISK GROUPS SCREENING SERVICE PROVISION SEX SOCIAL HEALTH INSURANCE SOCIAL MOBILIZATION SOCIAL SCIENCE SOCIAL SECURITY STD SURGERY TREATMENT USER FEES VISITS WAR WORKERS WORLD HEALTH ORGANIZATION
Online Access:	http://documents.worldbank.org/curated/en/2013/11/18533462/getting-incentives-right-impact-evaluation-district-hospital-capitation-payment-vietnam http://hdl.handle.net/10986/16904

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Summary:	With the movement toward universal health coverage gaining momentum, the global health research community has made significant efforts to advance knowledge about the impact of various schemes to expand population coverage. The impacts on efficiency, quality, and gaps in service utilization of reforms to provider payment methods are less well studied and understood. The current paper contributes to this limited knowledge by evaluating the impact of a shift by Vietnam's social health insurance agency from reimbursing hospitals on a fee-for-service basis to making a capitation payment to the district hospital where the enrollee lives. The analysis uses panel data on hospitals over the period 2005-2011 and multiple cross-section data sets from the Vietnam Household Living Standards Surveys to estimate impacts on efficiency, quality, and equity. The paper finds that capitation increases hospitals' efficiency, as measured by recurrent expenditure and drug expenditure per case, but has no effect on surgery complication rates or in-hospital deaths. In response to the shift to capitation, hospitals scaled down service provision to the insured and increased provision to the uninsured (who continue to pay out-of-pocket on a fee-for-service basis). The study points to the need to anticipate the intended and unintended effects of any payment reform and the trade-offs among policy objectives.

Getting Incentives Right : An Impact Evaluation of District Hospital Capitation Payment in Vietnam

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