The Impacts of Public Hospital Autonomization : Evidence from a Quasi-Natural Experiment

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dc.creatorBales, Sarah
dc.creatorWagstaff, Adam
dc.date2012-12-07T22:16:11Z
dc.date2012-12-07T22:16:11Z
dc.date2012-07
dc.date.accessioned2026-07-01T01:01:52Z
dc.descriptionThis paper exploits the staggered rollout of Vietnam s hospital autonomization policy to estimate its impacts on several key health sector outcomes including hospital efficiency, use of hospital care, and out-of-pocket spending. The authors use six years of panel data covering all Vietnam s public hospitals, and three stacked cross-sections of household data. Autonomization probably led to more hospital admissions and outpatient department visits, although the effects are not large. It did not, however, affect bed stocks or bed-occupancy rates. Nor did it increase hospital efficiency. Oddly, despite the volume effects and the unchanged cost structure, the analysis does not find any evidence of autonomization leading to higher total costs. It does, however, find some evidence that autonomization led to higher out-of-pocket spending on hospital care, and higher spending per treatment episode; the effects vary in size depending on the data source and hospital type, but some are quite large -- around 20 percent. Autonomy did not apparently affect in-hospital death rates or complications, but in lower-level hospitals it did lead to more intensive style of care, with more lab tests and imaging per case.
dc.formatapplication/pdf
dc.formattext/plain
dc.identifierhttp://documents.worldbank.org/curated/en/2012/07/16511544/impacts-public-hospital-autonomization-evidence-quasi-natural-experiment
dc.identifierhttps://hdl.handle.net/10986/11942
dc.identifierhttps://doi.org/10.1596/1813-9450-6137
dc.identifier.urihttp://hdl.handle.net/123456789/414440
dc.languageEnglish
dc.languageen_US
dc.publisherWorld Bank, Washington, DC
dc.relationPolicy Research Working Paper; No. 6137
dc.rightsCC BY 3.0 IGO
dc.rightshttp://creativecommons.org/licenses/by/3.0/igo/
dc.rightsWorld Bank
dc.subjectBEDS
dc.subjectBIOCHEMISTRY
dc.subjectC-SECTION
dc.subjectC-SECTIONS
dc.subjectCLINICAL GUIDELINES
dc.subjectCLINICAL MANAGEMENT
dc.subjectCOMPLICATIONS
dc.subjectDEATH RATES
dc.subjectDEATHS
dc.subjectDEVELOPING COUNTRIES
dc.subjectDEVELOPMENT POLICY
dc.subjectDIAGNOSIS
dc.subjectDIAGNOSTIC TESTS
dc.subjectDISSEMINATION
dc.subjectDRUGS
dc.subjectENROLLEES
dc.subjectEXPENDITURES
dc.subjectEXPOSURE
dc.subjectFEE SCHEDULE
dc.subjectFINANCIAL MANAGEMENT
dc.subjectFINANCIAL RISK
dc.subjectHEALTH CARE
dc.subjectHEALTH CARE MANAGEMENT
dc.subjectHEALTH CENTERS
dc.subjectHEALTH ECONOMICS
dc.subjectHEALTH INSURANCE
dc.subjectHEALTH INSURANCE COVERAGE
dc.subjectHEALTH ORGANIZATION
dc.subjectHEALTH POLICY
dc.subjectHEALTH SECTOR
dc.subjectHEALTH SERVICE
dc.subjectHEALTH SERVICE DELIVERY
dc.subjectHEALTH SERVICES
dc.subjectHEALTH SYSTEM
dc.subjectHEALTH SYSTEM REFORM
dc.subjectHEMATOLOGY
dc.subjectHOSPITAL
dc.subjectHOSPITAL ADMISSIONS
dc.subjectHOSPITAL AUTONOMY
dc.subjectHOSPITAL CARE
dc.subjectHOSPITAL COST
dc.subjectHOSPITAL COSTS
dc.subjectHOSPITAL MANAGEMENT
dc.subjectHOSPITAL MANAGERS
dc.subjectHOSPITAL OUTPATIENT SERVICES
dc.subjectHOSPITAL STAFF
dc.subjectHUMAN DEVELOPMENT
dc.subjectHUMAN RESOURCES
dc.subjectILLNESS
dc.subjectINCENTIVE PAYMENTS
dc.subjectINCOME
dc.subjectINPATIENT ADMISSION
dc.subjectINPATIENT ADMISSIONS
dc.subjectINPATIENT CARE
dc.subjectLAB TESTS
dc.subjectLEPROSY
dc.subjectLIVING STANDARDS
dc.subjectLOCAL AUTHORITIES
dc.subjectLOCAL GOVERNMENTS
dc.subjectMEDICAL EXAMINATION
dc.subjectMEDICAL EXAMINATIONS
dc.subjectMEDICAL SERVICES
dc.subjectMENTAL ILLNESS
dc.subjectMINISTRY OF HEALTH
dc.subjectOUTPATIENT CARE
dc.subjectPATHOLOGY
dc.subjectPATIENT
dc.subjectPATIENTS
dc.subjectPEDIATRICS
dc.subjectPOLICY CHANGE
dc.subjectPOLICY DISCUSSIONS
dc.subjectPOLICY RESEARCH
dc.subjectPOLICY RESEARCH WORKING PAPER
dc.subjectPROVIDER INCENTIVES
dc.subjectPROVINCIAL HOSPITAL
dc.subjectPROVINCIAL HOSPITALS
dc.subjectPUBLIC ADMINISTRATION
dc.subjectPUBLIC HOSPITALS
dc.subjectPUBLIC POLICY
dc.subjectPUBLIC SERVICES
dc.subjectQUALITY ASSURANCE
dc.subjectQUALITY OF CARE
dc.subjectREHABILITATION
dc.subjectRESPECT
dc.subjectRURAL DISTRICT
dc.subjectSOCIAL HEALTH INSURANCE
dc.subjectSTD
dc.subjectSURGERY
dc.subjectTRADITIONAL MEDICINE
dc.subjectTREATMENT
dc.subjectTUBERCULOSIS
dc.subjectUNIONS
dc.subjectUSE OF RESOURCES
dc.subjectUSER FEES
dc.subjectVISITS
dc.subjectWORKERS
dc.subjectWORLD HEALTH ORGANIZATION
dc.titleThe Impacts of Public Hospital Autonomization : Evidence from a Quasi-Natural Experiment

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