Health transfers Centre Commune Dual functional FSS Health responsibility Station Private clinic FSS FSS Private FSS FSS hospital Other Budgetary FSS FSS Ministry transfers Hospital Budgetary transfers - global budget and line item budget Global budget is a commonly used mode of payment to public providers. It is a fixed amount allocated in advance for all expenditures, usually on an annual basis. It gives autonomy to health mangers to reallocate across budget lines as they deem necessary and it also holds them fully accountable for use of funds and performance. Line-item budget is allocation from government health authorities to health care facilities for some specific budget lines (equipment, salaries, drugs, etc.) or prevention and promotion programs. Allocating of funds across line items is not allowed unless approval is received from the central authorities and managers have limited accountability for use of funds and performance, except for ensuring that each budget line item is fully expended. In Vietnam, the government is still a major provider of health care and it is the main health care insurer of health care services through Vietnam Social Security. Public health care providers receive government budget directly from health authorities at central or provincial level. According to the Law on State Budget, Provincial People Councils have full authority over the allocation of provincial health budget to all health facilities in a province. Calculation of provincial health budget is mainly based on input factors and it is regulated by Decision No. on promulgating the principles, criteria and norms for allocation of 46/2016/QĐ-TTg recurrent government budget for year 2017-2020. In line with Decision 46/2016/QĐ-TTg, total budget for health in each province is calculated based on population using the per capita health budget norm adjusted by geographical factors with some additional weight for mountainous and remote areas. The calculation of budget is mainly based on input factors, either number of beds for hospitals or number of staff for preventive health facilities. Budget norm per bed is usually adjusted by type of a hospital (general hospital, specialty hospital, etc.). Additionally, some other factors can be used in allocating government budget depending on local context such as level of revenue from fees, size of a hospital, etc. In practice, allocation of health budget in localities mainly depends on availability of funds; it is not based on health care needs or
Health Centre transfers Commune Health Station Dual functional responsibility FSS Private clinic FSS FSS Private hospital FSS FSS Other Ministry Hospital Budgetary transfers FSS FSS Budgetary transfers - global budget and line item budget Global budget is a commonly used mode of payment to public providers. It is a fixed amount allocated in advance for all expenditures, usually on an annual basis. It gives autonomy to health mangers to reallocate across budget lines as they deem necessary and it also holds them fully accountable for use of funds and performance. Line-item budget is allocation from government health authorities to health care facilities for some specific budget lines (equipment, salaries, drugs, etc.) or prevention and promotion programs. Allocating of funds across line items is not allowed unless approval is received from the central authorities and managers have limited accountability for use of funds and performance, except for ensuring that each budget line item is fully expended. In Vietnam, the government is still a major provider of health care and it is the main health care insurer of health care services through Vietnam Social Security. Public health care providers receive government budget directly from health authorities at central or provincial level. According to the Law on State Budget, Provincial People Councils have full authority over the allocation of provincial health budget to all health facilities in a province. Calculation of provincial health budget is mainly based on input factors and it is regulated by Decision No. 46/2016/QĐ-TTg on promulgating the principles, criteria and norms for allocation of recurrent government budget for year 2017-2020. In line with Decision 46/2016/QĐ-TTg, total budget for health in each province is calculated based on population using the per capita health budget norm adjusted by geographical factors with some additional weight for mountainous and remote areas. The calculation of budget is mainly based on input factors, either number of beds for hospitals or number of staff for preventive health facilities. Budget norm per bed is usually adjusted by type of a hospital (general hospital, specialty hospital, etc.). Additionally, some other factors can be used in allocating government budget depending on local context such as level of revenue from fees, size of a hospital, etc. In practice, allocation of health budget in localities mainly depends on availability of funds; it is not based on health care needs or