This paper examines the correlation between cost of health facilities and population at
provincial level in Vietnam. A major cause of the services quality and cost problems in health
care today is that payment systems encourage volume-driven health care rather than valuedriven
health care. Under the current Vietnam health care payment systems, physicians,
hospitals and other health care providers have strong financial incentives to contain cost,
deliver more services to more people but are often financially penalized for providing better
services and improving health. Research has shown that more services and higher spending do
not result in better outcomes; indeed, they often produce exactly the opposite result. In order
to fix the right price and use the right payment system, governments often look at producing
costing studies, such as the cost of running a facility type, cost of services, cost of program and
others. All kinds of costing can be adapted based on either the population size, number of
patients or complexity of services delivered. This study linked cost (expenditures?) with
population and assessed the impact of cost of service delivery, on the practice patterns of
providers and its productivities in primary health care mainly at the provincial levels in Vietnam.
The results support the notion that costing studies can only be regarded as a start point in
considering wider issues of financing health care services and its management. Five provinces
have been chosen for piloting their facilities at a primary care level. One of the findings shows
that the reported activity levels in the public provider network are low when compared to other
countries and international standards. This could reflect both inefficiencies and insufficiencies
in the financial management structure of the facilities. Both cases will need to be rectified. If
efforts do not lead to acceptable levels of service quantity and quality by population size, the
cost of any expended resources would be high. A rectified costing system per capita that links
population to providers’ payment at provincial level would provide a better future financing
model - for achieving Universal Health Coverage in Vietnam. Some risk adjustment and reward
for health service productivity might be an added value and a viable alternative to current
practices.