Why is Viet Nam Spending So Many Resources in its Hospital Sector? And What Can be Done About it?
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Washington, DC: World Bank
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Viet Nam’s health system faces persistent overcrowding in its hospitals, despite decades of reform and substantial investments. This paper examines the drivers and consequences of Viet Nam's hospital-centric health system and proposes evidence-based strategies for reform. Drawing on national data, efficiency analyses, and international comparisons, the report finds that high hospital bed occupancy rates are not due to a lack of infrastructure but rather to inefficient utilization patterns, including high inpatient admissions, prolonged lengths of stay, and inadequate primary health care (PHC). These inefficiencies contribute to poor financial sustainability, excessive out-of-pocket payments, and insufficient quality of care, notably through high rates of hospital-acquired infections. The study identifies key system weaknesses—such as, unaccountable hospital financial autonomy, neglect of PHC, and fragmented care pathways—and outlines practical reform options. These include payment system reforms, accountability mechanisms, PHC strengthening, and better governance of hospital investments. The findings call for urgent, coordinated policy action to realign incentives, improve service delivery, and ensure that Viet Nam’s health resources deliver value, quality, and equity.
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HOSPITAL EFFICIENCY, VIET NAM, HEALTH FINANCING, PRIMARY HEALTH CARE, STRATEGIC PURCHASING, HOSPITAL REFORM