Some issues concerning hospital activities
in Vietnam

Pham Huy Dung, Nghiem Tran Dung,

Pham Huy Tuan Kiet, Nguyen Ngoc Ham

"Hospital in the context of health system reforms", Stockholm, 2002

Objective: To give a general picture of the hospital sector in order to find an answer to the question: How can the hospital sector be adapted to the system of state and private health integration in the stage of transition from a socialist health system to a period of reforms?

Method: Secondary data analysis

Results:

- Hospital finance: There has not yet been a clear policy frame for the regulations concerning health care services provisionand finance for the system of state and private health integration. The accessibility of hospital health services is closely related to the issue of hospital fee and hospital levels. There are great differences in the hospital finance in the period of reforms compared to the previous period, especially the implementation of health insurance and hospital fee policy. Health insurance and hospital fee are the two important sources of income for the hospital, constituting more than 31% of the total hospital budget at all levels. The main source of funding for the hospital is from the state budget.

- Hospital human resources: There exist two big issues: unreasonable proportion between the number of doctors and nurses and the lack of specialized doctors at the province and district hospitals. The salary of the health workers is still low.

- Examination and treatment at the hospital: Ministry of Health hasmore than 100 treatment norms, but their application is not homogeneous. There exists unreasonable use of medicine, especially increasing use of antibiotics.

Recommendations: It is necessary to set up a policy frame for the diversified health system in Vietnam. Accessibility of health care services for poor people should be increased. The state funding for hospitals should be redistributed to rural and poor areas. It is also necessary to find out the reasons causing unhomogeneous realisation of treatment norms of the Ministry of Health.