The Impacts of Public Hospital Autonomization: Evidence from a Quasi-Natural Experiment
This 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'...
Gespeichert in:
| 1. Verfasser: | |
|---|---|
| Format: | Elektronisch E-Book |
| Sprache: | English |
| Veröffentlicht: |
Washington, D.C
The World Bank
2012
|
| Online-Zugang: | Volltext |
| Zusammenfassung: | This 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 |
| Beschreibung: | 1 Online-Ressource (43 p) |
| DOI: | 10.1596/1813-9450-6137 |
Internformat
MARC
| LEADER | 00000nmm a2200000zc 4500 | ||
|---|---|---|---|
| 001 | BV048265572 | ||
| 003 | DE-604 | ||
| 007 | cr|uuu---uuuuu | ||
| 008 | 220609s2012 |||| o||u| ||||||eng d | ||
| 024 | 7 | |a 10.1596/1813-9450-6137 |2 doi | |
| 035 | |a (ZDB-1-WBA)NLM010332294 | ||
| 035 | |a (OCoLC)1334027585 | ||
| 035 | |a (DE-599)GBVNLM010332294 | ||
| 040 | |a DE-604 |b ger |e rda | ||
| 041 | 0 | |a eng | |
| 049 | |a DE-12 |a DE-521 |a DE-573 |a DE-523 |a DE-Re13 |a DE-19 |a DE-355 |a DE-703 |a DE-91 |a DE-706 |a DE-29 |a DE-M347 |a DE-473 |a DE-824 |a DE-20 |a DE-739 |a DE-1043 |a DE-863 |a DE-862 | ||
| 100 | 1 | |a Wagstaff, Adam |e Verfasser |4 aut | |
| 245 | 1 | 0 | |a The Impacts of Public Hospital Autonomization |b Evidence from a Quasi-Natural Experiment |c Adam Wagstaff |
| 264 | 1 | |a Washington, D.C |b The World Bank |c 2012 | |
| 300 | |a 1 Online-Ressource (43 p) | ||
| 336 | |b txt |2 rdacontent | ||
| 337 | |b c |2 rdamedia | ||
| 338 | |b cr |2 rdacarrier | ||
| 520 | |a This 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 | ||
| 700 | 1 | |a Wagstaff, Adam |4 oth | |
| 700 | 1 | |a Bales, Sarah |4 oth | |
| 776 | 0 | 8 | |i Adam Wagstaff |a The Impacts of Public Hospital Autonomization |
| 856 | 4 | 0 | |u https://doi.org/10.1596/1813-9450-6137 |x Verlag |z kostenfrei |3 Volltext |
| 912 | |a ZDB-1-WBA | ||
| 943 | 1 | |a oai:aleph.bib-bvb.de:BVB01-033645766 | |
Datensatz im Suchindex
| _version_ | 1812671727071657984 |
|---|---|
| adam_text | |
| adam_txt | |
| any_adam_object | |
| any_adam_object_boolean | |
| author | Wagstaff, Adam |
| author_facet | Wagstaff, Adam |
| author_role | aut |
| author_sort | Wagstaff, Adam |
| author_variant | a w aw |
| building | Verbundindex |
| bvnumber | BV048265572 |
| collection | ZDB-1-WBA |
| ctrlnum | (ZDB-1-WBA)NLM010332294 (OCoLC)1334027585 (DE-599)GBVNLM010332294 |
| discipline | Wirtschaftswissenschaften |
| discipline_str_mv | Wirtschaftswissenschaften |
| doi_str_mv | 10.1596/1813-9450-6137 |
| format | Electronic eBook |
| fullrecord | <?xml version="1.0" encoding="UTF-8"?><collection xmlns="http://www.loc.gov/MARC21/slim"><record><leader>00000nmm a2200000zc 4500</leader><controlfield tag="001">BV048265572</controlfield><controlfield tag="003">DE-604</controlfield><controlfield tag="007">cr|uuu---uuuuu</controlfield><controlfield tag="008">220609s2012 |||| o||u| ||||||eng d</controlfield><datafield tag="024" ind1="7" ind2=" "><subfield code="a">10.1596/1813-9450-6137</subfield><subfield code="2">doi</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(ZDB-1-WBA)NLM010332294</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(OCoLC)1334027585</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-599)GBVNLM010332294</subfield></datafield><datafield tag="040" ind1=" " ind2=" "><subfield code="a">DE-604</subfield><subfield code="b">ger</subfield><subfield code="e">rda</subfield></datafield><datafield tag="041" ind1="0" ind2=" "><subfield code="a">eng</subfield></datafield><datafield tag="049" ind1=" " ind2=" "><subfield code="a">DE-12</subfield><subfield code="a">DE-521</subfield><subfield code="a">DE-573</subfield><subfield code="a">DE-523</subfield><subfield code="a">DE-Re13</subfield><subfield code="a">DE-19</subfield><subfield code="a">DE-355</subfield><subfield code="a">DE-703</subfield><subfield code="a">DE-91</subfield><subfield code="a">DE-706</subfield><subfield code="a">DE-29</subfield><subfield code="a">DE-M347</subfield><subfield code="a">DE-473</subfield><subfield code="a">DE-824</subfield><subfield code="a">DE-20</subfield><subfield code="a">DE-739</subfield><subfield code="a">DE-1043</subfield><subfield code="a">DE-863</subfield><subfield code="a">DE-862</subfield></datafield><datafield tag="100" ind1="1" ind2=" "><subfield code="a">Wagstaff, Adam</subfield><subfield code="e">Verfasser</subfield><subfield code="4">aut</subfield></datafield><datafield tag="245" ind1="1" ind2="0"><subfield code="a">The Impacts of Public Hospital Autonomization</subfield><subfield code="b">Evidence from a Quasi-Natural Experiment</subfield><subfield code="c">Adam Wagstaff</subfield></datafield><datafield tag="264" ind1=" " ind2="1"><subfield code="a">Washington, D.C</subfield><subfield code="b">The World Bank</subfield><subfield code="c">2012</subfield></datafield><datafield tag="300" ind1=" " ind2=" "><subfield code="a">1 Online-Ressource (43 p)</subfield></datafield><datafield tag="336" ind1=" " ind2=" "><subfield code="b">txt</subfield><subfield code="2">rdacontent</subfield></datafield><datafield tag="337" ind1=" " ind2=" "><subfield code="b">c</subfield><subfield code="2">rdamedia</subfield></datafield><datafield tag="338" ind1=" " ind2=" "><subfield code="b">cr</subfield><subfield code="2">rdacarrier</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">This 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</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Wagstaff, Adam</subfield><subfield code="4">oth</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Bales, Sarah</subfield><subfield code="4">oth</subfield></datafield><datafield tag="776" ind1="0" ind2="8"><subfield code="i">Adam Wagstaff</subfield><subfield code="a">The Impacts of Public Hospital Autonomization</subfield></datafield><datafield tag="856" ind1="4" ind2="0"><subfield code="u">https://doi.org/10.1596/1813-9450-6137</subfield><subfield code="x">Verlag</subfield><subfield code="z">kostenfrei</subfield><subfield code="3">Volltext</subfield></datafield><datafield tag="912" ind1=" " ind2=" "><subfield code="a">ZDB-1-WBA</subfield></datafield><datafield tag="943" ind1="1" ind2=" "><subfield code="a">oai:aleph.bib-bvb.de:BVB01-033645766</subfield></datafield></record></collection> |
| id | DE-604.BV048265572 |
| illustrated | Not Illustrated |
| index_date | 2024-07-03T19:59:52Z |
| indexdate | 2024-10-12T04:01:09Z |
| institution | BVB |
| language | English |
| oai_aleph_id | oai:aleph.bib-bvb.de:BVB01-033645766 |
| oclc_num | 1334027585 |
| open_access_boolean | 1 |
| owner | DE-12 DE-521 DE-573 DE-523 DE-Re13 DE-BY-UBR DE-19 DE-BY-UBM DE-355 DE-BY-UBR DE-703 DE-91 DE-BY-TUM DE-706 DE-29 DE-M347 DE-473 DE-BY-UBG DE-824 DE-20 DE-739 DE-1043 DE-863 DE-BY-FWS DE-862 DE-BY-FWS |
| owner_facet | DE-12 DE-521 DE-573 DE-523 DE-Re13 DE-BY-UBR DE-19 DE-BY-UBM DE-355 DE-BY-UBR DE-703 DE-91 DE-BY-TUM DE-706 DE-29 DE-M347 DE-473 DE-BY-UBG DE-824 DE-20 DE-739 DE-1043 DE-863 DE-BY-FWS DE-862 DE-BY-FWS |
| physical | 1 Online-Ressource (43 p) |
| psigel | ZDB-1-WBA |
| publishDate | 2012 |
| publishDateSearch | 2012 |
| publishDateSort | 2012 |
| publisher | The World Bank |
| record_format | marc |
| spellingShingle | Wagstaff, Adam The Impacts of Public Hospital Autonomization Evidence from a Quasi-Natural Experiment |
| title | The Impacts of Public Hospital Autonomization Evidence from a Quasi-Natural Experiment |
| title_auth | The Impacts of Public Hospital Autonomization Evidence from a Quasi-Natural Experiment |
| title_exact_search | The Impacts of Public Hospital Autonomization Evidence from a Quasi-Natural Experiment |
| title_exact_search_txtP | The Impacts of Public Hospital Autonomization Evidence from a Quasi-Natural Experiment |
| title_full | The Impacts of Public Hospital Autonomization Evidence from a Quasi-Natural Experiment Adam Wagstaff |
| title_fullStr | The Impacts of Public Hospital Autonomization Evidence from a Quasi-Natural Experiment Adam Wagstaff |
| title_full_unstemmed | The Impacts of Public Hospital Autonomization Evidence from a Quasi-Natural Experiment Adam Wagstaff |
| title_short | The Impacts of Public Hospital Autonomization |
| title_sort | the impacts of public hospital autonomization evidence from a quasi natural experiment |
| title_sub | Evidence from a Quasi-Natural Experiment |
| url | https://doi.org/10.1596/1813-9450-6137 |
| work_keys_str_mv | AT wagstaffadam theimpactsofpublichospitalautonomizationevidencefromaquasinaturalexperiment AT balessarah theimpactsofpublichospitalautonomizationevidencefromaquasinaturalexperiment |