Publication: What Drives Utilization of Primary Care Facilities in Vietnam?: Evidence from a Facility Survey
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Date
2019-06
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2019-06
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This analysis aims to assess the association between commune health station (CHS) service readiness and health service utilization to inform the design of a World Bank project and policies to strengthen primary health care in Vietnam. Using data drawn from the 2015 Vietnam district and commune health facility survey (DCHFS), a series of multivariate negative binomial regressions was estimated to measure the association between domains of service readiness and CHS utilization rates (average number of visits per capita). To conclude, investments in improving facility infrastructure (especially ensuring that facilities have the mandated number of rooms and building area), making available essential equipment items, and enabling the CHS to provide hypertension and diabetes services, whether made independently or together, would all likely increase CHS utilization. Investment in CHSs in zone 3 and zone 2 should be prioritized over investments in zone 1, since investments in the former would result in the highest utilization rates.
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“Vu, Lan TH; Bales, Sarah; Bredenkamp, Caryn. 2019. What Drives Utilization of Primary Care Facilities in Vietnam?: Evidence from a Facility Survey. Health, Nutrition, and Population Discussion Paper;. © World Bank. http://hdl.handle.net/10986/32186 License: CC BY 3.0 IGO.”
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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.Publication Arab Republic of Egypt : Management and Service Quality in Primary Health Care Facilities in the Alexandria and Menoufia Governorates(Washington, DC, 2010-06-25)This report provides an assessment of the performance of public primary facilities in the Alexandria and Menoufia governorates. The performance is evaluated against the standards introduced with the Health Sector Reform Program; analyzes the quality perceptions, health situation, utilization and economic situation of households living in the catchment areas of the facilities; and examines the management processes of different institutions involved in primary care. Despite Egypt's health sector reform efforts, evidence suggests that issues remain in the quality of service and management in both reformed and non-reformed public primary care facilities, including availability of supplies, correct co-payment exemptions for the poor, and consequently, utilization through the population. There is also increasing evidence that the demand-side empowerment of beneficiaries could improve the governance of health care, which would lead to a quality increase and higher utilization of health care. This suggests the need to explore the potential for demand-side mechanisms to improve service delivery and help ensure improvements in individual and population health.Publication Patterns of Health Care Utilization in Vietnam : Analysis of 1997-98 Vietnam Living Standards Survey Data(World Bank, Washington, DC, 2002-02)The author provides an econometric analysis of health care utilization in Vietnam based on individual and household level data from the 1997-98 Vietnam Living Standards Survey. The author focuses on the major features of health care utilization patterns, including the determinants of largely self-prescribed use of pharmaceutical drugs, and the use of government hospitals, commune health centers, and private health facilities. The role of income and health insurance is emphasized. Econometric models are estimated for use probability and frequency of contact for all major categories of care, and for individual and household medical expenditure. Econometric results reveal differential responses to income changes at different levels of income. Commune health centers and self-medication are normal goods at lower income levels but inferior goods at higher income levels. The author discusses the policy implications of these results.
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