Hanoi Department of Health recommends strict management of provincial transfers and restriction of going beyond the line

However, the cost was VND 8,230,750 million, accounting for 50.5% of the total cost incurred at medical examination and treatment facilities, an increase of 347,124 visits and an increase of VND 1,458,190 million compared to the same period in 2022.

Among the out-of-province patients coming to the central and city hospitals in Hanoi for examination and treatment, there are many patients with common diseases that can be treated well in the provinces such as Phaco surgery, pterygium, cesarean section... or patients with chronic diseases without complicated complications that can be managed and treated at the grassroots medical level such as diabetes, hypertension...

Hanoi Department of Health recommends management of quality of recruitment to limit excess recruitment 1 — The reason why patients tend to go to Hanoi for medical treatment is because the quality of primary health care facilities does not meet the needs of medical examination and treatment (illustrative photo - TL).

Medical examination and treatment facilities are financially autonomous, associated with the current fee-for-service payment method, leading to many medical examination and treatment facilities still having a situation of widely prescribing inpatients, prescribing to the hospital for mild patients who can be examined and given outpatient medication, prolonging the treatment period, prescribing widely, exceeding the necessary level for testing, diagnostic imaging, functional testing and medical services in health insurance examination and treatment, which is increasingly common and complicated...

Therefore, Hanoi proposed that the Ministry of Health submit to the Government for consideration of regulations on cross-provincial medical examination and treatment to limit the number of patients crossing provincial lines, causing overload at higher-level hospitals while grassroots health care cannot attract patients.

The Ministry of Health shall promptly revise and issue a Circular regulating the list of technical services and technical and economic norms to ensure consistency with the list of service prices and compliance with the provisions of the Law on Medical Examination and Treatment on the decentralization of medical examination and treatment facilities;

Issue a circular guiding medical examination and treatment, rehabilitation, and palliative care at home, along with instructions on collection levels and service prices.

There are instructions on payment for medical examination and treatment costs, remote consultation; instructions on regulations for day treatment beds, how to calculate norms and payments with specialists.

The Hanoi Department of Health also recommended that the Vietnam Social Security comprehensively direct the correction of data, issuance and re-issuance of health insurance cards for patients whose health insurance medical examination and treatment card information does not match their identification documents.

Add a function to warn patients who are present at another facility on the health insurance communication software when patients register for medical examination and treatment at a medical facility.

Or propose to lock health insurance card benefits if the patient does not fully fulfill the patient's obligations (sign the payment termination papers) or intentionally undergoes medical examination and treatment at many facilities at the same time (due to the policy of not keeping the insurance card).

Implementing Circular 48/2017/TT-BYT dated December 28, 2017 regulating the transfer of electronic data in the management and payment of medical examination and treatment costs under health insurance, which includes the content stipulating the responsibility of the Department of Health: "Exploiting and using the electronic database on the Health Insurance Assessment Information Portal and the Medical Data Receiving Portal of the Ministry of Health to serve management work according to assigned functions, tasks and decentralization.

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