Household utilization and expenditure on private and public health services in Vietnam
Household utilization and expenditure on private and public health services in Vietnam
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DOI：
10.1093/heapol/17.1.61
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发表时间：
2002-03-01
影响因子：
3.2
通讯作者：
Larsen, U
中科院分区：
文献类型：
--
作者：
Ha, NTH;Berman, P;Larsen, U
越南于1989年将私人提供卫生服务合法化，作为该国调动资源和提高卫生系统效率的手段之一。在其合法化十年后，私营部门广泛扩大了其活动，成为越南人民保健服务的重要提供者。然而，鲜为人知的是，它的整体目标的卫生系统在Vietnam.本文评估私人医疗保健提供者的作用，通过研究私人家庭的利用模式和经济负担，与公共服务相比。我们发现，私营部门提供了越南所有门诊接触的60%。在使用私人门诊医疗服务方面，教育、性别或居住地没有差异。尽管有证据表明富人比穷人更多地使用私人护理，但这一发现在所有收入群体中并不一致。私营部门特别为幼儿服务。此外，同时有几个生病成员的家庭中的人更多地依赖私人医疗而不是公共医疗，而那些患有严重疾病的人往往较少使用私人医疗而不是公共医疗。私人保健服务给家庭带来的经济负担大约是公共保健服务提供者的一半。药品支出占家庭总支出，特别是保健支出的很大比例。这些研究结果要求迅速认识到私营部门是越南卫生系统的关键参与者。卫生系统政策应尽可能调动私营部门对卫生系统目标作出积极贡献，并减少私营部门发展的负面影响。
The private provision of health services in Vietnam was legalized in 1989 as one of the country's means to mobilize resources and improve efficiency in the health system. Ten years after its legalization, the private sector has widely expanded its activities and become an important provider of health services for the Vietnamese people. However, little is known about its contribution to the overall objectives of the health system in Vietnam.This paper assesses the role of the private health care provider by examining utilization patterns and financial burden for households of private, as compared with public, services. We found that the private sector provided 60% of all outpatient contacts in Vietnam. There was no difference by education, sex or place of residence in the use of private ambulatory health care. Although there was evidence suggesting that rich people use private care more than the poor, this finding was not consistent across all income groups. The private sector served young children in particular. Also, people in households with several sick members at the same time relied more on private than public care, while those with severe illnesses tended to use less private care than public. The financial burden for households from private health care services was roughly a half of that imposed by the public providers. Expenditure on drugs accounted for a substantial percentage of household expenditure in general and health care expenditure in particular. These findings call for a prompt recognition of the private sector as a key player in Vietnam's health system. Health system policies should mobilize positive private sector contributions to health system goals where possible and reduce the negative effects of private provision development.