Risks and benefits of private health care: exploring physicians' views on private health care in Ho Chi Minh City, Vietnam.
As in a number of other low- and middle-income countries, the health sector in Vietnam is transforming with a rapid shift from fully state run and financed health care towards more private financing and delivery of health care. This development has been particularly noticeable in the largest city in the country, Ho Chi Minh City, where a majority of physicians now are practising in private clinics and where the private health care sector is an increasingly popular option for people. While the private sector is an important part of the health care system in Vietnam, few data are available on the characteristics and quality of private health care services. This case study describes some aspects of the re-emerging private health care sector in Ho Chi Minh City, Vietnam, from the view of 27 private and non-private physicians. The paper explores physicians' reasons for going private, physicians' notions of patients' health care preferences, and physicians' views on potential influence of financial incentives on characteristics of private health care. The characteristics of private health care are discussed in relation to a context of private health care characterised by a fully patient-financed fee-for-service payment system, weak regulatory mechanisms, and a public health care system (government-run and-financed health care) that operates under resource constraints. Issues to consider when attempting to steer private health care in Vietnam in a direction where it can optimally contribute to public health, are discussed while considering the interplay between authorised private practitioners, private pharmacies, the informal private sector, and the public health care sector.
Lönnroth
K
K
University of Göteborg, Vasa Hospital, Göteborg, Sweden. knut.lonnroth@socmed.gu.se
Thuong
L M
LM
Linh
P D
PD
Diwan
V
V
D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D004465:Economic Competition / Q000639:trends; D005260:Female; D019981:Health Care Sector / Q000639:trends*; D006291:Health Policy / Q000191:economics / Q000639:trends; D006801:Humans; D008297:Male; D008875:Middle Aged; D010820:Physicians / Q000523:psychology*; D017149:Private Sector / Q000191:economics; D011332:Privatization / Q000191:economics; D014744:Vietnam