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Health Financing and Delivery in Vietnam

Health Financing and Delivery in Vietnam. Kevin Arts April 25, 2012. Background. Vietnam has excellent health outcomes… Life expectancy U5 mortality rate Maternal mortality rate Public health *Communicable disease …given its development status and spending. History of Health System.

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Health Financing and Delivery in Vietnam

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  1. Health Financing and Delivery in Vietnam Kevin Arts April 25, 2012

  2. Background • Vietnam has excellent health outcomes… • Life expectancy • U5 mortality rate • Maternal mortality rate • Public health • *Communicable disease • …given its development status and spending.

  3. History of Health System Independence (1954 – 1975) Unification (1975 – 1985) DoiMoi (1986 – Present)

  4. Economic Effects of DoiMoi

  5. Health Sector Reforms • Market Mechanisms • Policy Adjustments • 1991: National Target Programs • 1993: Social Health Insurance • 1994: Salary Support • 1995: Fee Schedule + • Supply-Side Subsidies

  6. Recent Reforms 2003: Decision 139 2005: Benefit reform* 2000s: Autonomization*

  7. Challenges and Solutions • Breadth of Coverage • Few Low-Hanging Fruit • Inequities Source: Lieberman and Wagstaff 2009

  8. Challenges and Solutions • Depth of Coverage • Out-of-Pocket • Catastrophic Health Costs Source: Lieberman and Wagstaff 2009

  9. Challenges and Solutions • Rising Cost of Care • Throughput • Case mix • Unexplained Source: Lieberman and Wagstaff 2009

  10. Conclusion Vietnam has high health outcomes on relative and per dollar bases… Due to economic growth and policy interventions… But problems remain with respect to breadth and depth of coverage + cost of care + inequities

  11. Sources International Labor Organization (2006), “Vietnam Social Health Insurance: Current Issues and Policy Recommendations.” Lieberman, Samuel and Adam Wagstaff (2009), “Health Financing and Delivery in Vietnam: Looking Forward, “ The World Bank. Trinh Kuu, Duke (1998), “Vietnamese Health Care,” Stanford Medical Review. The World Bank (2012), “World Development Indicators: Vietnam.” World Health Organization (2011), “Viet Nam: Health Profile.”

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