Has the quality of medical examination and treatment increased?

Although the increase in medical examination and treatment prices is considered not to have much impact on people, patients want an increase in hospital fees, which means an increase in the quality of medical examination and treatment, ensuring adequate medicine and medical supplies as well as the rights of health insurance participants.

Many hospitals increase medical examination and treatment prices

Recently, the Ministry of Health issued Circular 21/2024/TT-BYT stipulating the method of pricing medical examination and treatment services and adjusting medical examination and treatment prices according to the basic salary level prescribed in Decree 73/2024/ND-CP. From now until December 31, 2024, medical examination and treatment facilities must approve medical examination and treatment prices in accordance with the authority prescribed by the Law on Medical Examination and Treatment.

Checking in for medical examination and treatment at Hanoi Children's Hospital. Photo: Thanh Hai

The Ministry of Health said that the basic salary increased from 1.8 million VND to 2.34 million VND from July 1, so medical facilities are adjusting medical examination and treatment prices according to this level. To date, the Ministry of Health has approved medical examination and treatment prices for 25 hospitals according to the new basic salary level. Medical examination and treatment prices only adjust the salary factor from the basic salary level, the co-payment part (at 20% and 5%) does not increase much.

Up to now, at the following hospitals: Bach Mai, Agricultural General Hospital, Central Dermatology, Central Hematology and Blood Transfusion, Central Tropical Diseases, Cho Ray (Ho Chi Minh City)... Examination fees have been adjusted from 42,100 VND to 50,600 VND/visit. Emergency resuscitation beds at special-class hospitals have increased from 509,400 VND to 599,400 VND/bed/day, and type 1 beds from 273,100 VND to 327,100 VND/visit/day. Consultation fees to determine difficult cases (experts/case, only applicable to cases where experts from other units are invited to consult at the medical facility) remain at 200,000 VND/visit.

On the other hand, hospitals also adjusted thousands of technical services. At Bach Mai Hospital, nearly 10,000 technical service prices were adjusted... The National Institute of Hematology and Blood Transfusion adjusted more than 1,000 technical categories. Or at Cho Ray Hospital (Ho Chi Minh City), more than 6,000 technical service prices were adjusted, technical services performed by anesthesia excluding drug costs. Thong Nhat Hospital (Ho Chi Minh City) adjusted more than 7,000 services.

 

The Law amending and supplementing a number of articles of the Law on Health Insurance, which has been passed by the National Assembly, has many outstanding new points that bring benefits and convenience to health insurance participants. In particular, the Law stipulates that the Ministry of Health evaluates the reasonableness of providing health insurance services. This is the basis for the Vietnam Social Security sector to carry out health insurance appraisal work...
Deputy General Director of Vietnam Social Security Nguyen Duc Hoa

It can be seen that when medical examination and treatment costs increase according to the basic salary, it will help hospitals have a source of revenue and expenditure. Regarding the impact on people, the Ministry of Health assesses that this adjustment does not have much impact on people. According to the Ministry of Health, the health insurance fund is capable of balancing this price adjustment. This is due to the difference in revenue and expenditure of the health insurance fund every year (cumulative balance in 2023), at the same time, the health insurance fund revenue increases due to the adjustment of the basic salary, which is often earlier than the adjustment of the price of medical examination and treatment services.

Regarding health insurance participants, the Ministry of Health said that the poor, ethnic minorities, and social policy beneficiaries are 100% covered by health insurance so they are not affected. The subjects have to co-pay at the rate of 20% or 5% (meaning health insurance covers 80 - 95%), the co-payment increase is not much and can be paid because the income of the subjects is also increased according to the basic salary.

How are people without health insurance cards affected?

With the cost of medical examination and treatment increasing according to the basic salary, many people are concerned about the quality of medical services; the burden of medical examination and treatment costs when sick will be heavier. Many opinions say that the increase in medical examination and treatment service prices according to the basic salary will greatly affect the people.

Provincial and district hospitals are less affected because most patients have health insurance. However, most patients (if not too poor) often go to the central hospital for medical examination and treatment, which is very expensive. If you use health insurance outside the hospital, you will get a partial discount, but sometimes the examination takes 2 days to complete, so you have to pay extra for food and accommodation.

Regarding this issue, Tran Thi Trang, Director of the Health Insurance Department, Ministry of Health, said that there is no country that does not have a referral mechanism. If people with mild illnesses keep going to higher-level health care facilities, it will lead to overload. Thus, if people with common illnesses, serious illnesses, and critical illnesses all go to higher-level facilities, they themselves will be affected.

This situation will unintentionally reduce the quality of treatment due to the higher risk of complications and risks. In addition, if mild illnesses are also taken to higher levels, the patient will not only waste time but also increase social costs, travel costs, and increase the cost of the health insurance fund.

Currently, service quality is a matter of survival for hospitals. Therefore, hospitals affirm that regardless of price increases, hospitals always improve the quality of medical examination and treatment services to meet patient satisfaction. According to experts, increasing medical examination and treatment service prices according to the basic salary is the driving force to rapidly increase the coverage of universal health insurance.

However, whether increasing the price of medical services will increase the number of people participating in health insurance or not depends on the efforts of the authorities and the people. In fact, the current health insurance coverage rate in our country is over 93%, the remaining group without health insurance cards (about 7-8% of the population) only affects the payment according to the price of medical examination and treatment services. Therefore, the Ministry of Health encourages people to actively participate in health insurance to enjoy many benefits when receiving medical examination and treatment.

Minister of Health Dao Hong Lan emphasized that adjusting the health insurance price is not an increase in individual costs but depends on the adjustment of the basic salary. Currently, the Government has adjusted the basic salary to increase by 30%, leading to an increase in the health insurance premium for most groups of subjects. This is also the basis for the Ministry of Health to adjust the price of medical services to be calculated correctly and sufficiently, contributing to improving the quality of medical services.

Previously, many hospitals said that it was necessary to "correctly and fully calculate" the price structure of medical examination and treatment services to help hospitals have resources to invest in improving hospital quality. Associate Professor, Dr. Dao Xuan Co - Director of Bach Mai Hospital said that on average, the medical examination and treatment unit serves about 6,000 - 8,000 patients per day, even more than 8,000 patients.

The costs included in the price of medical examination and treatment technical services include 7 elements. However, currently, most hospitals only calculate 4/7 components, the costs of infrastructure depreciation, equipment, major repairs, fixed asset depreciation, asset maintenance and repair, scientific research training costs, and management costs are not included in the price of medical examination and treatment technical services.

At Bach Mai Hospital, the price of medical services is only calculated based on 4/7 factors. Most of the services at the hospital are charged according to the Health Insurance rate established nearly 20 years ago, so they are outdated. For example, the current ultrasound service at the hospital costs 49,500 VND, but other facilities have built a price structure that takes into account all factors, and they charge from 200,000 - 300,000 VND...

This shows that, along with doing a good job in regular medical examination and treatment, when public hospitals provide medical examination and treatment according to demand, some people will not have to go abroad for medical examination and treatment, which will save resources for the people and the country. The Ministry of Health also believes that when hospital fees are calculated correctly and fully, hospitals will have resources to invest in equipment, infrastructure, and improve the quality of medical examination and treatment services. Correct and full hospital fees will gradually reduce people's out-of-pocket expenses.

 

Increasing the price of medical services according to the basic salary is basically acceptable. With a benefit rate of 80% and a co-payment rate of 20%, with a bed price of about 270,000 VND, the patient will pay 54,000 VND; when it increases to 327,000 VND, people will have to pay more than 65,000 VND, an increase of more than 10,000 VND.

However, it is important to ensure adequate medicine and medical supplies for treatment. Recently, when receiving treatment at K Hospital, patients still have to go out to buy medicine and supplies even though they are covered by health insurance. Therefore, when increasing health insurance premiums and hospital fees, it is important to ensure the rights of health insurance participants.

Ms. Nguyen Huong Giang (47 years old, Bac Tu Liem district, Hanoi)

Source: https://kinhtedothi.vn/hang-nghin-dich-vu-y-te-tang-gia-chat-luong-kham-chua-benh-co-tang.html