Getting Incentives Right? The Impact of Hospital Capitation Payment in Vietnam
研究了越南社保机构将医院支付方式从按项目付费改为按人头付费后，对成本和医疗服务利用的影响，发现按人头付费降低了成本，但医院增加了对自费患者的服务量，提示需防范支付改革的意外后果。
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.