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The promises and perils of hospital autonomy

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  • London, Jonathan D.

Abstract

This article investigates impacts of hospital autonomization in Viet Nam employing a “decision-space” framework that examines how hospitals have used their increased discretion and to what effect. Analysis suggests autonomization is associated with increased revenue, increasing staff pay, and greater investment in infrastructure and equipment. But autonomization is also associated with more costly and intensive treatment methods of uncertain contribution to the Vietnamese government's stated goal of quality healthcare for all. Impacts of autonomization in district hospitals are less striking. Despite certain limitations, the analysis generates key insights into early stages of hospital autonomization in Viet Nam.

Suggested Citation

  • London, Jonathan D., 2013. "The promises and perils of hospital autonomy," Social Science & Medicine, Elsevier, vol. 96(C), pages 232-240.
    • Handle: RePEc:eee:socmed:v:96:y:2013:i:c:p:232-240
    DOI: 10.1016/j.socscimed.2013.07.009
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    References listed on IDEAS

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    Cited by:

    1. Edwine W Barasa & Anthony M Manyara & Sassy Molyneux & Benjamin Tsofa, 2017. "Recentralization within decentralization: County hospital autonomy under devolution in Kenya," PLOS ONE, Public Library of Science, vol. 12(8), pages 1-18, August.
    2. Jinsong Geng & Hao Yu & Yingyao Chen, 2016. "Preparing for the introduction of hospital autonomy in Laos: an assessment of current situation and suggestions for policy-making," International Journal of Health Planning and Management, Wiley Blackwell, vol. 31(2), pages 148-166, April.
    3. Myriam de Loenzien & Clémence Schantz & Bich Ngoc Luu & Alexandre Dumont, 2019. "Magnitude and correlates of caesarean section in urban and rural areas: A multivariate study in Vietnam," PLOS ONE, Public Library of Science, vol. 14(7), pages 1-14, July.
    4. Nguyen, Ha Thi Hong & Bales, Sarah & Wagstaff, Adam & Dao, Huyen, 2013. "Getting incentives right : an impact evaluation of district hospital capitation payment in Vietnam," Policy Research Working Paper Series 6709, The World Bank.

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