RISKS AND BENEFITS OF PRIVATE HEALTH-CARE - EXPLORING PHYSICIANS VIEWS ON PRIVATE HEALTH-CARE IN HO-CHI-MINH-CITY, VIETNAM

As in a number of other low- and middle-income countries, the health s ector in Vietnam is transforming with a rapid shift from fully state r un and financed health care towards more private financing and deliver y of health care. This development has been particularly noticeable in the largest city in the country, Ho Chi Minh City, where a majority o f physicians now are practising in private clinics and where the priva te health care sector is an increasingly popular option for people. Wh ile the private sector is an important part of the health care system in Vietnam, few data are available on the characteristics and quality of private health care services. This case study describes some aspect s of the re-emerging private health care sector in Ho Chi Minh City, V ietnam, from the view of 27 private and non-private physicians. The pa per explores physicians' reasons for going private, physicians' notion s of patients' health care preferences, and physicians' views on poten tial influence of financial incentives on characteristics of private h ealth care. The characteristics of private health care are discussed i n relation to a context of private health care characterised by a full y patient-financed fee-for-service payment system, weak regulatory mec hanisms, and a public health care system (government-run and -financed health care) that operates under resource constraints. Issues to cons ider when attempting to steer private health care in Vietnam in a dire ction where it can optimally contribute to public health, are discusse d while considering the interplay between authorised private practitio ners, private pharmacies, the informal private sector, and the public health care sector. (C) 1998 Elsevier Science Ireland Ltd. All rights reserved.