Household utilization and expenditure on private and public health services in Vietnam (PDF)
Nguyen Thi Hong Ha; Berman,Peter; Larsen,Ulla
Health Policy and Planning 17(1): 61-70
Publication date: 2002
The private provision of health services in Vietnam was legalizedin 1989 as one of the country's means to mobilize resourcesand improve efficiency in the health system. Ten years afterits legalization, the private sector has widely expanded itsactivities and become an important provider of health servicesfor the Vietnamese people. However, little is known about itscontribution to the overall objectives of the health systemin Vietnam.This paper assesses the role of the private health care providerby examining utilization patterns and financial burden for householdsof private, as compared with public, services. We found thatthe private sector provided 60% of all outpatient contacts inVietnam. There was no difference by education, sex or placeof residence in the use of private ambulatory health care. Althoughthere was evidence suggesting that rich people use private caremore than the poor, this finding was not consistent across allincome groups. The private sector served young children in particular.Also, people in households with several sick members at thesame time relied more on private than public care, while thosewith severe illnesses tended to use less private care than public.The financial burden for households from private health careservices was roughly a half of that imposed by the public providers.Expenditure on drugs accounted for a substantial percentageof household expenditure in general and health care expenditurein particular. These findings call for a prompt recognitionof the private sector as a key player in Vietnam's healthsystem. Health system policies should mobilize positive privatesector contributions to health system goals where possible andreduce the negative effects of private provision development.
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