The Legal Framework for Ensuring Recurrent Expenditure Funding for Grassroots Public Hospitals: Evidence from Son La Province

Financial autonomy enhances the initiative and accountability of public hospitals in resource utilization. However, grassroots-level public hospitals in mountainous areas face significant constraints in covering recurrent expenditures due to local socio-economic conditions, population size, patient demographics and limited revenue-generating capacity. Using doctrinal legal analysis combined with a case study of Son La Province, this article argues that classifying hospitals according to their financial autonomy primarily based on revenue-expenditure balancing does not fully reflect the costs required to maintain essential healthcare service capacity in disadvantaged areas. The article therefore proposes refining the classification of financial autonomy and clarifying the allocation of financial responsibilities between the State and public hospitals.