A large number of people are seeking medical treatment at the University of Medicine and Pharmacy Hospital in Ho Chi Minh City - Photo: TU TRUNG
This reality poses a major challenge for the healthcare sector: How can we build enough trust among the public to choose treatment at the lower levels of the healthcare system? Only when these hospitals are strong enough in terms of expertise, personnel, and equipment can the pressure on higher-level hospitals be sustainably reduced.
Many tertiary hospitals set records for the number of patients examined.
Following the April 30th and May 1st holidays, Cho Ray Hospital (Ho Chi Minh City) recorded its highest ever number of outpatient visits. On May 6th, the peak day saw a total of 9,021 registered patients seeking medical examination and treatment.
The hospital's Oncology Center also recorded more than 1,131 outpatient visits in a single day, with the hematology clinic having the highest number at 331 patients.
Not only Cho Ray Hospital, but also other tertiary hospitals in Ho Chi Minh City such as People's Hospital 115, Binh Dan Hospital, Ho Chi Minh City Oncology Hospital... have recorded a 10-20% increase in the number of patients. The hospitals attribute this partly to the surge in patients after the holiday, and partly to the quality of tertiary hospitals which has earned the trust of many people.
Statistics from the Ho Chi Minh City Oncology Hospital show that by 2025, the hospital is estimated to have received over 1.08 million outpatient visits, a 22% increase compared to 2024, with over 80% of patients coming from other provinces. The hospital has had to open more clinics and improve its reception procedures.
Meanwhile, in the North, Bach Mai Hospital, a top-tier general hospital in the northern region, is also always crowded before, during, and after the holiday. On average, the hospital receives about 8,000-10,000 patients per day, with approximately 4,300 medical staff working there.
To alleviate overcrowding, starting in 2025, Bach Mai Hospital will offer outpatient services outside of regular business hours, from 5 PM to 9 PM daily. However, overcrowding still occurs in both the health insurance examination area and the on-demand examination area.
Suffering from persistent headaches, Mrs. Nguyen Thi Lan (65 years old, Ninh Binh ) said that even though she paid for the service, it was very crowded. She waited from morning until 2 PM to get a CT scan of her brain, but she still accepted the wait because she trusted the professional quality of the tertiary hospital.
Patients wait for their turn to be examined at Cho Ray Hospital (Ho Chi Minh City) on May 8th - Photo: Xuan Mai
The basic line needs to be improved further.
Speaking to Tuoi Tre newspaper , Dr. Nguyen Hong Minh Phuoc, Deputy Director of the Ho Chi Minh City Oncology Hospital, said that to fundamentally address the situation of patients concentrating at the hospital, it is necessary to implement plans and solutions such as building and developing a regional cancer prevention and control network in the South and establishing regional linkages.
In addition, it is necessary to strengthen regional coordination to implement screening, and promote regional cooperation to improve the quality and effectiveness of diagnosis and treatment of common cancers in each locality.
Furthermore, localities need to strengthen cooperation with Ho Chi Minh City to promote the deployment of advanced medical diagnostic techniques. "We need to focus on improving the efficiency of investment resources, prioritizing development in localities with high demand. Provincial hospitals need to improve their treatment capacity to attract patients to receive treatment at lower-level facilities," said Dr. Phuoc.
In Ho Chi Minh City alone, there have been many plans to upgrade primary healthcare facilities and gateway hospitals in recent times, aiming to help alleviate the burden on higher-level hospitals.
For example, after nearly a year of operating its new facility with an investment of nearly 2,000 billion VND, Thu Duc Regional General Hospital, located at the northeastern gateway of Ho Chi Minh City, has recorded a significant increase in the number of patients in almost all areas of medical examination and treatment.
Dr. Cao Tan Phuoc, Director of Thu Duc Regional General Hospital, said that the number of outpatients previously fluctuated around 3,000 visits per day, but at times it has increased to nearly 4,000 visits per day.
In addition, the hospital receives professional support from many leading hospitals in Ho Chi Minh City such as Binh Dan Hospital, People's Hospital 115, and Children's Hospital 2 in all fields. This has contributed to a significant reduction in the rate of patients being referred to central hospitals compared to before.
Speaking to Tuoi Tre newspaper , Mr. Tang Chi Thuong, Director of the Ho Chi Minh City Department of Health, said that to address the situation where patients think "only going to higher-level hospitals feels safe," the biggest "bottleneck" still lies at the grassroots level of the healthcare system.
Otherwise, this level of healthcare will not be able to fulfill its role as the "gatekeeper" of the healthcare system. Once the trust of the people is gained, bypassing the local healthcare system will no longer be the default option, but will only occur when it is truly necessary for professional reasons.
Graphics: N.KH.
Accurately assessing local needs is crucial for making the right and sufficient investments.
According to Dr. Nguyen Trung Cap, Deputy Director of Professional Affairs at the Central Hospital for Tropical Diseases, the concentration of patients at large hospitals stems from the mechanism allowing people to choose their medical facilities as stipulated in the Law on Medical Examination and Treatment. Simultaneously, the policy of interconnected health insurance also allows for transfers between hospitals of the same level.
"Hospitals with high-quality services and expertise will naturally attract more patients, and vice versa. This mechanism both ensures patients' right to choose and motivates hospitals to continuously improve the quality of their expertise and services," said Dr. Cap.
According to Mr. Cap, to reduce pressure on tertiary hospitals, it is first necessary to accurately assess the actual healthcare needs in each locality. "If the demand for healthcare in a large area exceeds the existing capacity, then the scale of hospital beds, facilities, and medical equipment needs to be adjusted accordingly," Mr. Cap explained.
Besides infrastructure, the issue of healthcare personnel is also a major problem. According to Mr. Cap, in addition to training strategies, appropriate policies are needed to retain high-quality personnel in disadvantaged areas.
According to the Ministry of Health leadership, during the period 2024-2030, the whole country will encourage provincial hospitals and qualified private hospitals to participate as "core hospitals"; and promote the application of information technology and telemedicine in consultations, advice, and treatment.
Furthermore, the Ministry of Health will continue to expand the scale of hospitals, increase the number of beds, and focus on key specialties. Simultaneously, it will implement policies to attract and encourage young doctors to volunteer to work in remote, disadvantaged areas, contributing to improving the capacity of healthcare at the grassroots level.
In this context, investing in and enhancing professional capacity for preventive medicine and primary healthcare is identified as a fundamental and prerequisite factor for the sustainable development of the healthcare sector.
The Ministry of Health also requested that the People's Committees of provinces and cities pay attention to allocating local budgets and mobilizing other legitimate resources to strengthen and develop preventive medicine and primary healthcare, ensuring that the basic healthcare needs of the people are met at the grassroots level.
Health insurance medical expenses are increasing.
According to statistics from the Vietnam Social Insurance, as of the end of April, total health insurance expenditure reached approximately 52,700 billion VND, an increase of 6.7% compared to the same period last year, with more than 61 million medical examinations and treatments.
According to the Vietnam Social Insurance, in recent years, the cost of health insurance-covered medical examinations and treatments has continuously increased both in scale and rate. Currently, the whole country has approximately 164.7 million health insurance-covered medical examinations and treatments annually, with a total expenditure of over 101,000 billion VND.
Avoid taking over, overstepping your boundaries, or failing to perform your duties completely.
According to Mr. Tang Chi Thuong, Director of the Ho Chi Minh City Department of Health, from 2026 onwards, the city's health sector aims to develop and operate a multi-tiered, multi-polar, multi-centered healthcare system to meet the demands of an expanding urban context with 15 million inhabitants.
Accordingly, the city will focus on and invest comprehensively in each level of care, from the initial examination and treatment level handled by primary healthcare facilities; to the basic technical level handled by general hospitals (formerly district-level hospitals); and the highest level, the specialized treatment level handled by general and specialized hospitals at the highest level.
Each healthcare facility needs to be organized and operated according to its role, capabilities, and technical limits within its respective levels of care; avoiding situations where it "overcommits," "exceeds," or "fails to fully perform" its functions.
"Clearly defining the roles ensures that patients have access to appropriate healthcare services from the outset, reduces unnecessary referrals, and frees up resources for higher-level facilities to focus on advanced, specialized tasks," Mr. Thuong said.
According to current regulations of the Ministry of Health, district/county-level hospitals (basic professional level) are permitted to examine and treat diseases in accordance with their professional capacity, approved list of techniques, and actual conditions.
These conditions typically include: hypertension, diabetes, appendicitis, basic fractures, vaginal delivery, gynecological issues, respiratory illnesses, first aid, and initial resuscitation...
However, not all "district-level" hospitals only treat minor illnesses; if approved by the Department of Health or the Ministry of Health, they may be able to perform more advanced medical procedures.
Why do people from the Mekong Delta travel all the way to Ho Chi Minh City for medical treatment?
Family doctor clinics in Can Tho are being expanded - Photo: T. LUY
A leader of a specialized hospital in Can Tho City acknowledged that people often travel to larger cities for medical examinations and treatment because the local healthcare system has not yet met the needs.
Previously, there was a district hospital system, and if people were dissatisfied with the services at the commune health station, they would go to the district for examination. However, now almost everything is concentrated in the commune/ward health station model – which is built like a hospital with full specialties, a convenient location, and comprehensive health management for the people.
However, the health station is currently managed by the People's Committee of the commune or ward, and because it is a new model, it has not met expectations in many places. Therefore, for the grassroots healthcare model to gain people's trust, it needs good policies that prioritize talented people, create favorable working and living conditions, and provide financial mechanisms for doctors and medical staff; it also needs a management and governance mechanism and investment in modern infrastructure...
Specifically at the specialized hospital level in Can Tho, there are Can Tho General Hospital, SIS Hospital, Oncology Hospital, Can Tho Obstetrics and Gynecology Hospital, Soc Trang General Hospital... a leader of a specialized hospital said that the number of patients coming for examination and treatment at these hospitals remains stable.
According to the Can Tho Department of Health, facing the challenge of finding an operational model for grassroots healthcare, Can Tho is aiming to establish family doctor clinics. The Department of Health is currently conducting further surveys to expand this initiative by establishing six more clinics in eligible localities and units.
Regarding the aspect of increasing people's access to primary healthcare, the Can Tho Department of Health stated that in the coming time, it will advise the city's leaders and the communes and wards to strengthen training, improve capacity, and coordinate the implementation of health programs and projects (investing in infrastructure, supplementing equipment, etc.) for primary healthcare.
Convenient transportation leads to increased demand for healthcare services.
Besides the prestige of large hospitals, there are many other reasons why people bypass their local hospitals.
Returning from Cho Ray Hospital (Ho Chi Minh City) after more than a week of treatment, Mr. Ly Van Vinh said that previously, traveling from Ca Mau to Ho Chi Minh City took more than 8 hours, and the long and difficult journey meant his family often hesitated. "Now, with the smooth highway, it only takes about 5 hours to get there. The convenient travel makes it easier for the family to choose Ho Chi Minh City for medical checkups, tests, surgery, and treatment," Mr. Vinh shared.
Similarly, Ms. Huynh Bich Tuyen, from Thoi Binh commune, shared: "Every year, my family rents a 7-seater car to go to Ho Chi Minh City twice for a general check-up to feel more at ease. Large hospitals have many modern machines and skilled doctors, so we accept the extra cost and time," Ms. Tuyen said.
Meanwhile, Mr. Ly Chien Thang, residing in An Xuyen ward, believes that transportation is convenient because there is a service to transport patients to major hospitals.
In Ca Mau province, a hospital leader stated that the number of patients seeking medical examination and treatment at the facility has remained at an average annual level. According to this leader, the increasing demand for healthcare makes it understandable that people choose to go to higher-level hospitals.
"People have the right to choose where they want to receive medical treatment. From the hospital's perspective, we are constantly striving to invest in equipment and train human resources to improve the quality of medical care and better serve the people," the leader said.
Source: https://tuoitre.vn/benh-vien-tuyen-duoi-can-som-manh-len-20260511090502643.htm
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