Vietnam: What is the medical examination and health check-up price range at public hospitals under Circular 21/2023/TT-BYT?

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• What is the medical examination and health check-up price range at public hospitals in Vietnam under Circular 21/2023/TT-BYT?
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• What is the structure of prices of medical examination and treatment services in Vietnam?

What is the medical examination and health check-up price range at public hospitals in Vietnam under Circular 21/2023/TT-BYT?

Pursuant to the provisions of Appendix 1 promulgated together with Circular 21/2023/TT-BYT, the medical examination and health check-up price range at public hospitals in Vietnam is specified as follows:

What is the payment of medical examination fees in case a patient is advised to be hospitalized for inpatient treatment services to meet medical requirements in Vietnam?

Pursuant to the provisions of Article 5 of Circular 21/2023/TT-BYT as follows:

Guidelines for application of medical examination prices

The number of times of use of and prices of medical examination services shall be determined as follows:

1. If a patient comes to an outpatient department to receive his/her health check-up and then is advised to be hospitalized for inpatient treatment services to meet medical requirements, the payment of medical examination fees shall comply with regulations in Clause 3 of this Article. In case where that patient does not register at the outpatient department but receives medical examination and inpatient treatment services at other clinical departments according to medical requirements, he/she is not required to pay medical examination fees.

2. With respect to healthcare establishments having specialized exam rooms in clinical departments, if a patient registers at outpatient departments and receives medical examination at these specialized exam rooms, it is considered that he/she uses medical examination services provided by outpatient departments. Calculation of costs and the number of times of use of medical examination services shall follow instructions given in Clause 3 of this Article.

3. At the same time of use of medical examination services at a healthcare establishment (maybe on the same day or for objective reasons or medical requirements, medical examination services have not yet been finished in the first day and shall be continued in the next day), if a patient needs to come to another department after visiting the first department, the price of the second or later time of use of medical examination services shall be 30% of the price of the single time of use of medical examination services and the maximum amount of payment of medical examination costs shall not be 2 times greater than the price of the single time of use of medical examination services.

4. If a patient visits a healthcare establishment where he/she has used medical examination services and received medicines, but then finds abnormal signs and immediately returns to that healthcare establishment within the same day to check his/her health again, this use of medical examination services shall be considered as the second or later time of use of medical examination services within the same day. The payment shall be made according to instructions given in Clause 3 of this Article;

Thus, in case a patient comes to an outpatient department to receive his/her health check-up and then is advised to be hospitalized for inpatient treatment services to meet medical requirements, the payment of medical examination fees shall comply with the following regulations:

At the same time of use of medical examination services at a healthcare establishment (maybe on the same day or for objective reasons or medical requirements, medical examination services have not yet been finished in the first day and shall be continued in the next day), if a patient needs to come to another department after visiting the first department, the price of the second or later time of use of medical examination services shall be 30% of the price of the single time of use of medical examination services and the maximum amount of payment of medical examination costs shall not be 2 times greater than the price of the single time of use of medical examination services.

What is the structure of prices of medical examination and treatment services in Vietnam?

Pursuant to the provisions of Article 3 of Circular 21/2023/TT-BYT as follows:

Structure of prices of medical examination and treatment services

The price range of medical examination and treatment services referred to this Circular shall be set on the basis of direct costs and salaries in order to ensure medical examination, care and treatment services provided to patients and implementation of technical healthcare services. To be specific:

1. Direct costs constituting the price of medical examination service:

a) Costs of clothes, head covers, face masks, bed sheets, cushions, foam mattresses, mats, office stationery, gloves, cotton, bandages, rubbing alcohol, gauze pads, saline solutions, and other consumables which serve medical examination;

b) Costs of electricity, water bills; fuel; disposal of domestic and medical wastes (in a liquid or solid form); laundry, drying, disinfection of fabrics and appliances used for examination; cleaning and environmental hygiene services; sterilization and disinfection supplies, chemicals used for examination;

c) Costs of repair and maintenance of facilities and equipment, purchase of replacements for property, appliances and instruments, including air conditioners, computers, printers, dehumidifiers, fans, desks, chairs, beds, cabinets, lights and other toolkits necessary for examination activities.

2. Direct costs constituting the price of the per-day bed service:

a) Costs of clothes, head covers, face masks, blankets, bed sheets, cushions, foam mattresses, mosquito nets, mats; office stationery; gloves used for examination, injection and infusion, cotton, bandages, alcohol, gauze pads, sterile saline solutions and other consumables for daily use in medical care and treatment activities (including costs of change of wound covering bandages, post-surgery dressings for inpatients, except in case where patients are entitled to payments exceeding the per-day bed price specified in Clause 4 and 5 of Article 7 herein); electrodes, ECG cables, blood pressure measuring armbands and SPO2 sensor cables used in patient monitoring systems at emergency care and intensive care beds.

b) Costs referred to in Points b and c of Clause 1 of this Article that are paid for care and treatment of patients under medical requirements.

c) Costs of medicines, qualified blood and blood products, intravenous fluids and other medical supplies (except for the aforesaid medical supplies); syringes, hypodermic needles, dispensing needles used in injection, infusion and feeding; catheters, connecting tubes, extension tubes used in electric syringe infusion pumps, infusion pumps used for injection and infusion activities; oxygen supplies, oxygen nasal cannulas, oxygen masks (except in case where breathing equipment is indicated for patients), which have not yet been listed in the price structure of per-day bed service, shall be paid on the basis of patients’ actual uses.

3. Direct costs constituting the price of medical service:

a) Costs of clothes, head covers, face masks, bed sheets, cushions, foam mattresses, mats, fabrics; office supplies; medicines, intravenous fluids, chemicals, consumables and replacement supplies used during the period of implementation of medical services and techniques;

b) Costs referred to in Points b and c of Clause 1 of this Article that are paid for implementation of medical services and techniques under medical requirements.

4. Costs for wages and salaries which constitute the prices of medical examination, per-day beds and other medical services and techniques:

a) Salaries based upon salary scale, grade or job title, allowances, contributions under state policies applied to public service providers and statutory pay rate prescribed in the Government's Decree No. 24/2023/ND-CP dated May 14, 2023 on statutory pay rate for officials, public employees and the armed forces;

b) Regular task allowances or allowances paid in case of operations or surgeries under the Prime Minister’s Decision No. 73/2011/QD-TTg dated December 28, 2011 on particular policies of subsidies paid to officials, public employees and employees working for public healthcare establishments, and allowances paid for prevention and control of epidemics.

5. Costs for wages or salaries constituting the prices of services referred to in Clause 4 of this Article shall not include state budget-funded expenses stipulated in the following documents:

a) Policies on preferential allowances, attraction allowances, benefits and other incentives applicable to medical officials, public employees, employees under employment contracts, and military medical workers directly performing medical tasks in state-owned healthcare establishments in areas with extremely difficult socio-economic conditions;

b) Policies on attraction allowances, seniority allowances, some benefits and travel expenses applicable to officials, public employees and salaried persons working as members of armed forces (people's army and people's public security) in areas with extremely difficult socio-economic conditions;

c) Specific policies on allowances paid to officials and public employees working for Huu Nghi hospital, Thong Nhat hospital, Hospital C – Da Nang affiliated to the Ministry of Health, Central Health Protection Centers 1, 2, 2B, 3 and 5, Department A11 of Military Central Hospital 108 and Department A11 of Military Hospital of Traditional Medicine;

d) Policies on job-specific allowances.

Thus, the structure of prices of medical examination and treatment services in Vietnam includes:

- Direct costs constituting the price of medical examination service;

- Direct costs constituting the price of the per-day bed service;

- Direct costs constituting the price of medical service;

- Costs for wages and salaries which constitute the prices of medical examination, per-day beds and other medical services and techniques