Nguyen, Ha Thi HongBales, SarahWagstaff, AdamDao, Huyen2014-02-042014-02-042013-11https://hdl.handle.net/10986/16904With 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.en-USCC BY 3.0 IGOACCESS TO HEALTH CAREADVERSE EVENTSC-SECTIONC-SECTIONSCANCERCAPITATIONCAPITATION BASISCITIESCLINICAL PROTOCOLSCOMMUNITY HEALTHCOMPLICATIONSDEATHSDEVELOPING COUNTRIESDEVELOPMENT POLICYDIAGNOSISDIALYSISDISCHARGE PATIENTSDOCTORSDRUGSECONOMIC STATUSENROLLEESEPIDEMICSEPILEPSYEXPENDITURESFAMILIESFAMILY MEDICINEFEE-FOR-SERVICEFEE-FOR-SERVICE BASISFINANCIAL RISKGLOBAL HEALTHHAZARDHEALTH CAREHEALTH CARE COVERAGEHEALTH CARE FINANCEHEALTH CARE FINANCINGHEALTH CARE PROVIDERHEALTH CARE PROVIDERSHEALTH CENTERSHEALTH CENTREHEALTH COVERAGEHEALTH ECONOMICSHEALTH FACILITIESHEALTH FINANCINGHEALTH INDICATORSHEALTH INSURANCEHEALTH ORGANIZATIONHEALTH OUTCOMESHEALTH POLICYHEALTH PROMOTIONHEALTH REFORMHEALTH RESEARCHHEALTH RISKSHEALTH SECTORHEALTH SERVICEHEALTH SERVICE PROVIDERSHEALTH SERVICE UTILIZATIONHEALTH SERVICESHEALTH STATUSHEALTH STRATEGYHEALTH SYSTEMHEALTH WORKFORCEHOSPITALHOSPITAL ADMISSIONSHOSPITAL AUTONOMYHOSPITAL BEDSHOSPITAL CAREHOSPITAL MANAGERSHOSPITALIZATIONSHOSPITALSHUMAN DEVELOPMENTILLNESSINCOMEINDUCED DEMANDINPATIENT ADMISSIONINPATIENT ADMISSIONSINSURANCE COVERAGEINSURANCE SCHEMESINTERVENTIONKIDNEY DIALYSISLAB TESTSLACK OF INFORMATIONLIVING STANDARDSMEDICAL CAREMEDICAL EQUIPMENTMEDICAL PRACTICEMEDICAL SERVICESMEDICINEMICRO HEALTHMINISTRY OF HEALTHMORTALITYMORTALITY RATENEGATIVE EFFECTSNUTRITIONPATIENTPATIENT SATISFACTIONPATIENTSPHYSICIANSPOLICY DISCUSSIONSPOLICY MAKERSPOLICY RESEARCHPOLICY RESEARCH WORKING PAPERPRESCRIPTIONSPREVALENCEPRIMARY CAREPROBABILITYPROGRESSPROVIDER INCENTIVESPROVIDER PAYMENTPUBLIC HEALTHPUBLIC HOSPITALSPUBLIC SERVICESPURCHASING POWERQUALITATIVE INFORMATIONQUALITY OF CAREQUALITY OF LIFEREFERRALSRESEARCH COMMUNITYRESOURCE USERISK GROUPSSCREENINGSERVICE PROVISIONSEXSOCIAL HEALTH INSURANCESOCIAL MOBILIZATIONSOCIAL SCIENCESOCIAL SECURITYSTDSURGERYTREATMENTUSER FEESVISITSWARWORKERSWORLD HEALTH ORGANIZATIONWorld Bank10.1596/1813-9450-6709