What are current guidelines for determining the number of day for inpatient treatment to be used as a basis for paying hospital stay price in Vietnam?

What are current guidelines for determining the number of day for inpatient treatment to be used as a basis for paying hospital stay price in Vietnam?

In Clause 1, Article 6, Circular 39/2018/TT-BYT has instructions for counting the number of day for inpatient treatment to be used as a basis for paying hospital stay price:

a. The number of days for inpatient treatment shall be equal to the discharge date minus (-) the hospitalization date then plus (+) 1: apply to the following cases:

- The seriously-ill patient is undergoing inpatient treatment in a hospital but there is no sign of illness recovery or such illness becomes worse who requires hospital discharge or referral to upper level hospital.

- The patient that undergoes medical emergency treatment in an upper level hospital but still requires inpatient treatment is transferred to a lower level hospital or to another medical facility.

b. The number of days for inpatient treatment is equal to the discharge date minus (-) the hospitalization date, apply to the remaining cases.

c. For the case in which the patient is admitted to the hospital and is discharged from such hospital on the same day (or discharged on the following day), such day shall be counted as a treatment day if the treatment lasts for more than 4 hours but less than 24 hours. Except the case in which the patient is transferred directly to the emergency department not through examination department and undergoes less than 4-hour-treatment (including cases of hospital discharge, hospitalization, referral or dead) and get the prices for medical examination, medicine purchase, medical supplies and medical procedures paid by the insurance agency excluding the hospital stay price for intensive care.

d. For the case in which the patient is admitted and discharged from the hospital after undergoing less than 04-hour treatment, such patient shall get the price for medical examination, medicine purchase, medical supplies and medical procedures paid by the hospital, excluding the hospital stay price for inpatient bed.

What are current guidelines for determining the number of day for inpatient treatment to be used as a basis for paying hospital stay price in Vietnam? (Image from the Internet)

What are regulations on quarterly payment and final accounts for the hospital stay price by the social insurance agency to the medical facility in Vietnam?

In Clause 16, Article 6, Circular 39/2018/TT-BYT stipulates quarterly payment and final accounts for the hospital stay price by the social insurance agency to the medical facility as follows:

a. The number of bed used in a quarter (year) shall be equal to the total days of inpatient treatment in a quarter (year) divided (:) by total days in a quarter (365 days in a year), in which days of inpatient treatment shall be calculated in the following principle: 2 days lying in the stretcher, folding bed or bed shared by two patients shall be counted as one day of inpatient treatment, and 3 days lying in the bed shared by 3 or more patients shall be counted as one day of inpatient treatment.

b. In case the beds used in a medical facility in a quarter is less than or equal to 120% of the assigned one, 100% of prices for bed use shall be paid according to the number of day for hospital stay and the prescribed price.

c. In case the beds used in a medical facility in a year is more than 120% of the assigned one, such medical facility and the social insurance agency shall reach an agreement on payment as follows:

- The quarterly bed occupancy rate (hereinafter referred to as bed occupancy rate) shall be equal to (=) the number of bed used in a quarter divided (:) by the number of beds used in 2015 (the year preceding the year in which patients are permitted to use their health insurance in the hospital that is not the one registered in their insurance card) and multiplied by 100%. In case the bed occupancy rate determined according to the above-mentioned method:

+ is less than or equal to 130%, the health insurance agency shall pay the medical facility 100% the price for bed use according to the number of day for hospital stay and the prescribed price.

+ is more than 130% but not exceed 140%, the health insurance agency shall pay the medical facility 97% of the price for bed use according to the number of day for hospital stay and the prescribed price.

+ is more than 140% but not exceed 150%, the health insurance agency shall pay the medical facility 95% of the price for bed use according to the number day for hospital stay and the prescribed price.

+ is more than 150%, the health insurance agency shall pay the medical facility 90% of the price for bed use according to the number of day for hospital stay and the prescribed price.

d. For the case in which the medical facility is always overloaded due to objective reasons such as extension of administrative boundaries and an increase in number of initial registration of medical services, the Health Department shall take responsibility to send a report to People's Committee of provinces for considering and increasing patient beds as well as job positions for medical service quality assurance.

dd. For the case in which the medical facility puts reformed, extended or new construction items or works into operation without any approval for additional patient beds from competent authorities, the Health Department and social insurance agency shall mutually agree that the number of additional patient beds in this area shall count towards the designed number of bed approved by competent authorities for the purpose of making payment in accordance with regulations in this clause.

How much does a required in-patient treatment stay day provided by a state medical examination and treatment facility cost in Vietnam?

In Section 2, Appendix 1, Price range of medical examination services, on-demand hospital bed days attached to Circular 13/2023/TT-BYT on on-demand in-patient treatment stay day prices are as follows:

Note:

- In-patient treatment stay day day price upon request does not include medication costs or medical technical services;

- In case of inviting domestic or foreign human resources for health examination and consultation: the unit may collect hospital bed prices according to the agreement between the medical examination and treatment facility and the service user.

Best regards!