What are the rules for application of hospital stay prices in medical aid stations in communes in Vietnam from November 17, 2023?
What are the rules for application of hospital stay prices in medical aid stations in communes in Vietnam from November 17, 2023?
Rules for application of hospital stay prices in medical aid stations in communes are specified in Article 4 of Circular 22/2023/TT-BYT:
Rules for application of medical service prices in medical facilities contracted to provide medical services covered by health insurance
1. For institutes with patient beds, medical centers providing medical services that are licensed to serve functions of hospitals, classed medical centers in districts providing medical services, apply the prices by hospital of the same class.
2. For health protection and care clinics for public officials in provinces, cities not affiliated to general hospitals in provinces and central-affiliated cities, apply the service prices issued by class II hospitals.
3. For unclassed medical facilities, army medical clinics, civil-military medical clinics, military infirmaries, infirmaries, private polyclinics and specialty clinics, apply the prices issued by class IV hospitals.
4. For regional polyclinics:
a) If regional polyclinics are licensed to serve functions of hospitals or fall into the cases specified in clause 12, Article 11 of the Government’s Decree No. 155/2018/ND-CP dated November 12, 2018 on amendments to certain articles related to the business and investment conditions under state management of the Ministry of Health, apply the prices for medical services issued by class IV hospitals;
b) If only providing emergency medical response and medical services for outpatients, apply the prices for medical services issued by class IV hospitals. If permitted by the Department of Health to have patient beds, the price for an outpatient bed shall be equal to 50% of the price for hospital stay of type 3 inpatient bed of class IV hospitals. An outpatient can only be confined to a bed for maximum 3 days for each medical treatment. Payment for medical examination service is not required if the price for outpatient bed is paid.
5. For medical aid stations in communes and towns, medical aid stations in companies, agencies, organizations, schools and civil-military medical aid stations:
a) Apply the prices for medical services issued by the medical aid stations in communes.
b) Apply the medical procedure price that is equal to 70% of such price specified in Appendix III enclosed herewith.
c) If having patient beds as decided by the Health Department, apply the price which is equal to 50% of the price for hospital stay of type 3 inpatient bed issued by class IV hospitals. An outpatient can only be confined to a bed for maximum 3 days for each medical treatment. Payment for medical examination service is not required if the price for outpatient bed in commune medical aid stations is paid.
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Thus, according to the above regulations, hospital stay prices are applied to medical aid stations in communes according to the following regulations:
- If having patient beds as decided by the Health Department, apply the price which is equal to 50% of the price for hospital stay of type 3 inpatient bed issued by class IV hospitals.
- An outpatient can only be confined to a bed for maximum 3 days for each medical treatment. Payment for medical examination service is not required if the price for outpatient bed in commune medical aid stations is paid.
What are the rules for application of hospital stay prices in medical aid stations in communes in Vietnam from November 17, 2023?
What are the direct expenses included in prices for hospital stay in Vietnam?
In Clause 2, Article 3, Circular 22/2023/TT-BYT stipulates the direct expenses included in prices for hospital stay
- Expenses incurred on patient clothing, scrubs, medical cap, surgical mask, blanket, bedspread, pillow, mattress, curtain, mat; stationery; medical gloves used in examination, injection and infusion, cotton wool, bandage, alcohol, gauze, brine and other supplies used in daily caring and treatment (including the expense incurred on changing the dressing of a surgical wound or incision of in-patient, except for cases in which such expense is covered in addition to the price for hospital stay as prescribed in clauses 5, 6 and 7 hereof); electrodes, electrocardiogram, blood pressure monitor, SPO2 cables in the course of using patient monitors for emergency beds and intensive care beds.
- Expenses specified in Clause 1b and Clause 1c of this Article shall arise out of care and treatment services provided for patients as professionally required.
- Expenses incurred on medicines, whole blood, standard blood products, intravenous fluids, supplies not mentioned above; types of syringe used in infusion; inserted tubes, tubes connecting to syringe pumps or infusion pumps; oxygen supplies, oxygen nasal cannulas, oxygen masks (except cases in which the medical ventilators are indicated for patients), which are not included in the prices for hospital stay, shall be paid if the above-mentioned tools are used during medical examination and treatment.
What are principles for service price-based payment in Vietnam?
Pursuant to the provisions of Clause 3, Article 24 of Decree 146/2018/ND-CP (amended by Clause 8, Article 1 of Decree 75/2023/ND-CP) as follows:
Service price-based payment
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Payment principles:
a) Health insurance-covered medical examination, daily hospital bed, medical procedure, and test costs, within their insurance coverage scope and coverage rate, shall be paid in accordance with the actual quantity used by the policyholder and the prices set by applicable regulations;
c) If a health insurance policyholder uses drugs, chemicals, or medical supplies that are not included in the health insurance-covered medical prices, or drugs, chemicals, and medical supplies used in medical procedures that have not yet been issued health insurance-covered medical prices, but these items are within the scope and rate of insurance coverage, then the cost of those items shall be paid in accordance with the actual quantity used and the prices set by the law on bidding;
c) The costs of blood and blood products are paid according to instructions of Minister of Health
Thus, the principles for service price-based payment are prescribed as follows:
- Health insurance-covered medical examination, daily hospital bed, medical procedure, and test costs, within their insurance coverage scope and coverage rate, shall be paid in accordance with the actual quantity used by the policyholder and the prices set by applicable regulations;
- If a health insurance policyholder uses drugs, chemicals, or medical supplies that are not included in the health insurance-covered medical prices, or drugs, chemicals, and medical supplies used in medical procedures that have not yet been issued health insurance-covered medical prices, but these items are within the scope and rate of insurance coverage, then the cost of those items shall be paid in accordance with the actual quantity used and the prices set by the law on bidding;
- The costs of blood and blood products are paid according to instructions of Minister of Health
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