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The health sector reform programme which began in Vietnam in 1989 in order to improve the efficiency of the health system has altered the way in which Vietnamese hospitals operate. The programme put the spotlight on input savings. This study aims to examine the relative efficiency of hospitals during the health reform process and assess - by looking at the relative efficiency of hospitals - the effects of the regulatory changes. The study employs the DEA two-stage approach referring to data from 101 general public hospitals over the period 1998-2006. The study revealed that there was evidence of improvement in the productivity of Vietnamese hospitals over the period 1998-2006, with a progress in total factor productivity of 1.4% per year. Furthermore, the differences in hospital efficiency can be attributed to both the regulatory changes and hospital-specific characteristics. The user fees and autonomy measures were found to increase technical efficiency. Provincial hospitals were revealed to be more technically efficient than their central counterparts and hospitals located in the North East, South East and Mekong River Delta regions performed better that hospitals from other regions.