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People receive medicine from health insurance at Thong Nhat Hospital – Photo: NGUYEN CONG THANH
Ms. Nguyen Thi Thu Hang, Deputy Director of Ho Chi Minh City Social Security, said the regulations apply to hospitals at the provincial / municipal level, while in central hospitals, patients are only entitled to 40% health insurance.
The hospital is overloaded
Specifically, if the patient is hospitalized at Cho Ray Hospital, 175 Military Hospital, Central Dental Hospital, and Thong Nhat Hospital without a referral letter, only 40% of medical insurance will be paid. Patients with emergency medical insurance or a referral letter still receive payment of 100% of the benefit rate.
The representative of the Hospital of Medicine and Pharmacy of the University of Ho Chi Minh City said that the hospital currently has about 900 beds. When not communicating with the provincial health insurance, this hospital is always in a state of overload, without beds. Currently, every day the hospital has to transfer about 20 hospitalized patients to other hospitals for treatment because the hospital does not allow patients to stay in bed.
Therefore, by implementing the provincial level of health insurance, more patients go to the hospital for treatment, the pressure on the hospital will increase. And when the hospital is out of bed, the hospital has to transfer the patient to another hospital for further treatment.
For hospitals where there are not many patients coming for treatment, by connecting the provincial health insurance, these hospitals have just prepared more, such as the amount of drugs and equipment … And the Hospital of the University of Medicine and Pharmacy of Ho Chi Minh City cannot receive more hospitalized patients so the hospital does not have to prepare more.
Beneficial patients
As for society, by connecting the provincial health insurance, patients enjoy better conditions for medical treatment, people have the right to choose according to their needs.
Provincial hospitals must change themselves, invest in people, processes and techniques to attract people to stay for local treatment. Therefore, in the long run, the health system will develop synchronously.
According to Mr. Diep Bao Tuan, Deputy Director of the Ho Chi Minh City Oncology Hospital, on January 1, 2021, the insured patients will be informed at the provincial level, but the leaders of the Ho Chi Minh City Oncology Hospital Minh have yet to fully anticipate the patient’s situation. How will increase the next province of treatment in this hospital. Previously, many patients in the province still went to the Ho Chi Minh City Cancer Hospital for inpatient treatment, but now they no longer have the gland.
If the patient goes to the Oncology Hospital continues to increase, it will be difficult for this hospital because the hospital is always overloaded for many years.
These visits by provincial patients to higher-level hospitals will make it difficult for both higher-level hospitals and provincial hospitals. The top-level hospital will be too crowded, while the provincial hospital will have few patients coming in for treatment.
At present, the Ho Chi Minh Oncology Hospital has adequate human resources as it is preparing for Ho Chi Minh Oncology Hospital facility 2, but facility 2 has not yet been implemented synchronously, yet hospital treatment has not been implemented.
During the Covid-19 season, the Oncology Hospital embraces the patient, the patient is also afraid of hospital treatment, so the hospital is not in a state of overload as before. This only happened during the Covid-19 season. Currently, the Cancer Hospital, as well as many other hospitals in the city, await specific instructions from the Ho Chi Minh City Department of Health and Social Security on the provincial route of insured patients.
Needs a coordinating role
“More guidance is needed to coordinate and avoid overcrowding in crowded hospitals, and when the patient is overloaded, the quality of medical examination and treatment is not good. In Thailand, in the case of illnesses. Referred patients, the receiving hospital , the patient will discuss with the hospital the registered patient for the initial treatment, so that the service is no different, the patient will be transferred back to the original hospital, avoiding excessive concentration in one place “- said Mr. Nguyen Ta Tinh , Director of Phu Tho Provincial Social Insurance.
Currently in the North there are a number of heavily invested provincial hospitals such as Phu Tho General Hospital, Quang Ninh Provincial General Hospital … While in the South, it is clear whether medical examination and treatment in many diseases Hospital in Ho Chi Minh City without referral, patients will feel “safe” than a medical examination in the province of origin. But the Ho Chi Minh City hospital is heavily overloaded, if more uncoordinated referrals emerge, the hospital will be difficult to manage.
“All hospitals have to improve their professional quality, improve the quality of diagnosis and treatment, in addition to investing more equipment, changing the spirit of service attitude. Innovation will keep the disease going. Because now there is real competition between hospitals at the same level, “commented Mr. Tinh.
No innovation, no patient retention
The director of the Tuyen Quang Provincial General Hospital, Pham Quang Thanh, was quite confident before starting to open the health insurance line (with hospitalized patients) at the provincial level. According to Mr. Thanh, in 2020 the hospital has invested in equipment, has a 1.5 tesla MRI scanner, monitors to monitor patients, has sent staff to the school …
“We have implemented between 70 and 80% of the services of the grade 1 general hospital, by 2020 we will implement three more services of special class hospitals, namely, knee replacement, coronary stent placement in acute myocardial infarction . and biocement pump for patients with spina bifida. In 2021 we will implement some more techniques in cancer treatment, “Thanh said.
The hospital has drastically changed in terms of facilities, repairing medical and operative examination areas, prohibiting doctors from receiving “envelopes” from patients and their families in parallel with the renewal of their income. doctors, attracting quality human resources.
“We still have patients from Yen Bai province, Ha Giang province, but our ambition is to do well so that patients from the province can receive medical examination and treatment in the province. Central hospital, not their province” – shared the Mr. Thanh.
By 2020, around 3,000-4,000 Tuyen Quang patients should be referred to the central level. With investments in 2020 and services to be rolled out in 2021, Thanh believes the number of referrals will be reduced.
“You must do well to retain patients, at this time all hospitals must do well to attract” – said Mr. Thanh.
This is also something that Mr. Nguyen Ta Tinh, Director of Social Security of Phu Tho thinks. According to Mr. Tinh, by connecting the insurance route to the provincial level, people will be more advantageous, especially for chronic diseases and in terms of geographic location. Patients will help with travel and continue to enjoy the appropriate level of health insurance.
