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Ex-Ante Evaluation (for Japanese ODA Loan)January 29th, 2019
Viet Nam has a three-tiered public medical system comprising of primary (Commune/District Level), secondary (Provincial Level) and tertiary (Central Level) levels. Hospitals operate on a referral system wherein patients are referred between hospitals, being sent to the medical facility deemed most appropriate to treat their ailment or injury. However, due to each province’s lack of budget, the many hospitals that are below the provincial level endure insufficient facilities and equipment, as well as shortfalls in both the quantity and quality of medical staff. This results in poor reliability in lower-level hospitals which has led to the current problem of patients concentrating at central-level hospitals in urban areas. Among central-level hospitals nationwide, Cho Ray Hospital in Ho Chi Minh City, which covers the southern region, continues to carry a bed occupancy rate of around 140%, causing not only a decline in the quality of medical services but also dysfunction of the referral
