title: The promises and perils of hospital autonomy: reform by decree in Viet Nam.
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.
authors: Department of Asian and International Studies, City University of Hong Kong, Tat Chee Avenue, Kowloon, Hong Kong Special Administrative Region. Electronic address: jdlondon@cityu.edu.hk.
authors: Jonathan D
authors: JD
authors: London
mesh_terms: D036262:Empirical Research; D018166:Health Care Reform; D006779:Hospitals, Public / Q000458:organization & administration*; D006801:Humans; D017009:Professional Autonomy; D014744:Vietnam
keywords: Decentralization; Governance; Health Sector; Health policy; Hospitals; Viet Nam