Department of Asian and International Studies, City University of Hong Kong, Tat Chee Avenue, Kowloon, Hong Kong Special Administrative Region.
Soc Sci Med. 2013 Nov;96:232-40. doi: 10.1016/j.socscimed.2013.07.009. Epub 2013 Jul 30.
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.
本文采用“决策空间”框架研究了越南医院自主权的影响，该框架考察了医院如何利用其增加的自由裁量权以及产生的效果。分析表明，自主权的实施与收入的增加、员工薪酬的提高以及基础设施和设备投资的增加有关。但自主权的实施也与更昂贵和更密集的治疗方法有关，而这些方法对越南政府提出的全民优质医疗保健目标的贡献尚不确定。区医院自主权的影响则不那么显著。尽管存在一定的局限性，但该分析为越南医院自主权的早期阶段提供了重要的见解。
