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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Main Authors:	Nguyen, Ha Thi Hong, Bales, Sarah, Wagstaff, Adam, Dao, Huyen
Format:	Policy Research Working Paper
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

id	okr-10986-16904
recordtype	oai_dc
spelling	okr-10986-169042021-04-23T14:03:33Z Getting Incentives Right : An Impact Evaluation of District Hospital Capitation Payment in Vietnam Nguyen, Ha Thi Hong Bales, Sarah Wagstaff, Adam Dao, Huyen 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 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. 2014-02-04T22:31:51Z 2014-02-04T22:31:51Z 2013-11 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 English en_US Policy Research Working Paper;No. 6709 CC BY 3.0 IGO http://creativecommons.org/licenses/by/3.0/igo/ World Bank World Bank, Washington, DC Publications & Research :: Policy Research Working Paper Publications & Research East Asia and Pacific Vietnam
repository_type	Digital Repository
institution_category	Foreign Institution
institution	Digital Repositories
building	World Bank Open Knowledge Repository
collection	World Bank
language	English en_US
topic	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
spellingShingle	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 Nguyen, Ha Thi Hong Bales, Sarah Wagstaff, Adam Dao, Huyen Getting Incentives Right : An Impact Evaluation of District Hospital Capitation Payment in Vietnam
geographic_facet	East Asia and Pacific Vietnam
relation	Policy Research Working Paper;No. 6709
description	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.
format	Publications & Research :: Policy Research Working Paper
author	Nguyen, Ha Thi Hong Bales, Sarah Wagstaff, Adam Dao, Huyen
author_facet	Nguyen, Ha Thi Hong Bales, Sarah Wagstaff, Adam Dao, Huyen
author_sort	Nguyen, Ha Thi Hong
title	Getting Incentives Right : An Impact Evaluation of District Hospital Capitation Payment in Vietnam
title_short	Getting Incentives Right : An Impact Evaluation of District Hospital Capitation Payment in Vietnam
title_full	Getting Incentives Right : An Impact Evaluation of District Hospital Capitation Payment in Vietnam
title_fullStr	Getting Incentives Right : An Impact Evaluation of District Hospital Capitation Payment in Vietnam
title_full_unstemmed	Getting Incentives Right : An Impact Evaluation of District Hospital Capitation Payment in Vietnam
title_sort	getting incentives right : an impact evaluation of district hospital capitation payment in vietnam
publisher	World Bank, Washington, DC
publishDate	2014
url	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
_version_	1764434951337410560

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

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