Alberta, Canada & Hanoi, Vietnam – Until 1989, health care in Vietnam was publically funded, but faced with a limited health care budget, the health care system has since undergone a process of “socialization,” or mobilization of society’s resources towards health care. Socialization of health care has included the creation of private hospitals and clinics and the partial privatization of public hospitals, and has shifted much of health care spending to out-of-pocket spending by patients on a fee-for-service basis.
The socialization of health care has been a long, gradual process, and has had both positive and negative effects on the quality and accessibility of health care in Vietnam. In the article, “Socialization of Health care in Vietnam: What Is It and What are Its Pros and Cons,” Dr. Thanh Nguyen, MD, PhD, MPH, and colleagues discuss these pros and cons of socialization of health care, and what it means for the health care system in Vietnam.
The authors state that the benefits of health care socialization include an increase in available health care funding, lighter workloads for public hospital staff, and an improvement in health care quality through increased access to medical technology. However, the authors go on to highlight the potential for “induced demand,” in which hospitals with the need to generate revenue overuse technology, overprescribe drugs, or keep patients in the hospital when a quick outpatient visit would have sufficed. These strategies have the effect of both increasing the cost of health care and even compromising patient safety, through the over-prescription of antibiotics.
“Currently, the problem of induced demand is only supported by qualitative evidence. Given the significant implications of this problem in terms of cost and quality of health care, it is vital that researchers explore this problem further using both qualitative and quantitative methods.” cautions Dr. Thanh Nguyen, MD, PhD, MPH, lead author on the article and health economist at The Institute of Health Economics in Edmonton, Alberta, Canada.
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