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Hospital fee and poor people in Vietnam
Hospital fee and poor people in Vietnam
Pham Huy Dung, Nguyen Kim Chuc,
Nguyen Khanh Phuong, Tran Thi Mai Oanh
Place of publication: Health strategy and policy institute
Year of publication: 1999
Objectives: Analyze the effects of the hospital fee policy implementation and evaluate its influence on poor people.
Methods: This is a cross-sectional descriptive study conducted in four provinces: BacKan, Thai Nguyen, Ninh Binh and Hai Phong.
Findings: The quality of health care for the poor is lower than that for paying patients. Data analysis of the medical records of doctors showed that the number of days at the hospital is bigger for patients with fee exemption than for paying patients. In opposite, health care expenses of these patients are the lowest in all the localities exept for BacKan province. Expenses for medicine are the main part of the health care expenses. Therefore, these patients might have been treated with less and cheaper medicine than the paying patients. However, this is not yet a persuasive proof for conclusions. To identify who are poor people is still difficult for realizing fee exemption policy. The rich and moderate provinces suggest to increase hospital fee to compensate for hospital expenses and assist poor people in accessing health care services.
Conclusion: Hospital fee policy should be continued. However, the increase of hospital fee should be considered carefully. Fee exemption and reduction policy should be be more emphasized. There needs to be a balance of subsidy and fee collection among provinces with different levels of income. The issuing of health insurance cards for poor people in Hanoi should be encouraged because it has the advantages of equity and effectiveness.
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