Getting Incentives Right? The Impact of Hospital Capitation Payment in Vietnam
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Updated: Mar 28, 2026

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Published on: March 28, 2025
Ha Thi Hong Nguyen1, Sarah Bales2, Adam Wagstaff3
1Health, Nutrition, and Population Global Practice, The World Bank, Washington, DC, USA.
Abstract:
This paper evaluates the impact on cost and utilization of a shift from fee-for-service to capitation payment of district hospitals by Vietnam's social health insurance agency. Hospital fixed effects analysis suggests that capitation leads to reduced costs. Hospitals also increased service provision to the uninsured who continue to pay out-of-pocket on a fee-for-service basis. The study points to the need to anticipate unintended effects of payment reforms, especially in the context of a multiple purchaser system. Copyright © The World Bank Health Economics © 2015 John Wiley & Sons, Ltd.
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