(1) Problems of health services efficiency
Curative care is much less efficient with regard to its capacity in making people
healthy, compared to promotive and preventive care. Besides, for the curative service
system itself, inefficiency is found in terms of, for example, drug overutilization
(from the community level up to the medical specialist level), irrational technological
use, and wasteful spending. Around 55 percent of the public health budget was
spent on curative services, 19 percent was spent on health promotion and 12 percent
on disease prevention (29).
(2) Problems of investment in hospital beds
According to the 1995-1999 reports on health resources surveys conducted by
the Bureau of Health Policy and Plan, MoPH hospitals have a bed-occupancy rate
of 83 percent, compared with the rate of less than 40 percent at for-profit private
hospitals. This clearly indicates an oversupply of beds in the private sector (Table
1.6).
1.4.3 Problems of the quality of service systems and service standards
In the public and private sectors, the problems are different in terms of the
quality and standards of services which do not meet consumers’ expectations. This
is due to a lack of systems for quality inspection/assurance and service accreditation.
The provisions of the Medical Facilities Act are outdated. The holistic care system
for emergencies is inefficient. The issues most complained about are personnel’s
manner and rapidity in service delivery. The problems are slightly more serious in
the public sector than in the private sector. The problems specific to the public sector
include patient’s inconvenience and discrimination, while those in the private sector
are related to prices, skills and morality (Table 1.7).