The influence of market economics on primary health care in Vietnam

Article Abstract:

Extensive economic reforms in Vietnam are affecting the organization and delivery of primary medical care. As part of the transition to capitalism in the 1990s, the government eliminated full subsidies for medical care and legalized private medical practice. Patients with the financial means must pay user fees and copayments for care. The quality of primary care is deteriorating in commune health clinics, which were once the principle mode of health care delivery. Most patients in these clinics are poor and they see a physician in only 10% of cases. The unregulated private sector provides increasing quantities of medical services, attracts affluent patients, and offers generous supplementary income to public sector physicians. Market reforms spur advertising for foreign medical products and nonessential drugs which must be scrutinized by the Vietnamese. The increased availability of unproven drugs and technologically-advanced medical equipment jeopardizes equitable distribution of health care resources.

Medical care, Economic policy, Vietnam, Capitalism, Vietnamese, Vietnamese (Southeast Asian people)

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Origins and clinical relevance of child death review teams

Article Abstract:

The development of child death review teams at the local and state level could reduce the number of deaths from child abuse. Approximately 2,000 children die each year in the US from child abuse, and half are under one year old. But the involvement of multiple agencies that do not necessarily communicate with one another makes it difficult to prevent these deaths. Los Angeles County started the first child death review team in 1978, which included law enforcement officials and health care professionals. By Apr 1992, these groups existed at the state or local level in 21 states. Most include representatives from the coroner's office, police departments, district attorney's office, social service agencies and health departments. One of the goals of Healthy People 2000 is to empower child death review teams in 45 states by the year 2000.

Investigations, Patient outcomes, Mortality, Children, Teamwork (Workplace), Child abuse, Social services, Social service

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