What are cases of appropriate referrals in medical examination and treatment covered by health insurance in Vietnam?

What are cases of appropriate referrals in medical examination and treatment covered by health insurance in Vietnam?

Pursuant to Article 11 of the Circular 40/2015/TT-BYT (amended by Clause 2.dd Article 41 of the Decree 146/2018/ND-CP) stipulating cases of appropriate referrals in medical examination and treatment covered by health insurance in Vietnam as follows:

- Each holder of health insurance card who registered for initial medical services at health facilities of communes or polyclinics or hospital of districts may get medical services at health stations of communes, polyclinics or hospitals of districts in the same province.

- Each holder of health insurance card who registered for initial medical services at a health facility of commune may take a referral to a hospital of district, including grade I, II hospitals of district and hospitals of traditional medicine of province (if the hospital of district has no department of traditional medicine).

- Each holder of health insurance card may take a referral from a hospital of district, including grade I, grade II hospital and polyclinic hospital, specialized hospital, specialized institute, specialized center of province, to a specialized center of province or polyclinic hospital, specialized hospital, specialized institute of province at the same level or lower level.

- Emergency cases:

+ A patient shall be given emergency treatment at any health facilities. The doctor or physician assistant receiving the patient shall assess the emergency conditions and record in medical record.

+ After emergency treatment, the patient shall be admitted as an inpatient to the receiving facility or referred to another health facility for continuing treatment at the specialist requirements or referred to the original facility upon his/her rehabilitation.

- In case the referred patient has another disease already, or a disease that is diagnosed apart from the disease specified in the outward referral form, the receiving facility shall give treatment to those diseases within its capacity.

What are cases of appropriate referrals in medical examination and treatment covered by health insurance in Vietnam? - Image from Internet

Who are given priority when taking medical examination and treatment in Vietnam?

Pursuant to Article 3 of the Law on Medical Examination and Treatment in 2023 stipulating principles of provision of medical services as follows:

Principles of provision of medical services

1. Respect, protect, and treat patients equally, and stop stigma or discrimination towards patients.

2. Give priority to have access to medical services to patients in a state of emergency; children aged under 6 years; pregnant women; people with extremely severe disabilities; people with severe disabilities; people aged 75 years or older; people rendering meritorious services to the revolution, depending on the particular characteristics of each medical establishment.

3. Respect, cooperate with and protect practitioners and other persons on duty at medical establishments.

4. Promptly implement and comply with regulations on professional and technical expertise in healthcare.

5. Comply with the code of professional ethics in the practice of medicine approved by the Minister of Health.

6. Ensure equality and fairness among medical establishments.

As regulations above, subjects who are given priority when taking medical examination and treatment in Vietnam are:

- Patients in a state of emergency;

- Children aged under 6 years;

- Pregnant women;

- People with extremely severe disabilities;

- People with severe disabilities;

- People aged 75 years or older;

- People rendering meritorious services to the revolution.

What are State policies on healthcare in Vietnam?

Pursuant to Article 4 of the Law on Medical Examination and Treatment in 2023 stipulating State policies on healthcare in Vietnam as follows:

- The State plays a leading role in promotion of healthcare activities; mobilize social resources needed for delivery of medical services.

- Priority to have access to state budget shall be given to the following activities:

+ Developing medical establishments under the grassroots health care or out-of-hospital emergency care system; concentrate investments in medical establishments in border areas, islands, ethnic minority and mountainous areas, poor areas or extreme poor areas;

+ Delivering healthcare to people rendering meritorious services to the revolution; children, the elderly, people with disabilities, people from poor households, people from near-poor households; people living in border areas, islands, poor areas, extreme poor areas; people with mental illness, leprosy; people suffering Group-A infectious diseases; people suffering group-B infectious diseases specified in the List adopted by the Minister of Health;

+ Further promoting workforce in the health industry, especially personnel working in infectious diseases, psychiatry, anatomic pathology, forensic medicine, forensic psychiatry, resuscitation in emergency medicine, and other subspecialties or branches that need to be preferred to meet socio-economic development needs and conditions over time in accordance with the Government’s regulations;

+ Conducting and applying researches in science, technology and digital transformation in the healthcare industry.

- Promoting public-private partnership; applying investment incentives in the healthcare industry. Medical establishments shall be entitled to incentive loans to invest in improving the quality of medical services; be exempt from corporate income taxes on the undivided portion of income that is retained as their capital investments.

- Investing in healthcare facilities in poor areas, extreme poor areas and not-for-profit medical establishments that are defined as those in the industries and sectors entitled to special investment incentives in the List of industries and professions entitled to investment incentives.

- Carrying out the personnel rotation policy under which practitioners are transferred among state-owned medical establishments.

- Granting special remuneration policies to practitioners.

- Adopting policies for development of human resources in hospital management and administration.

- Promoting the roles of healthcare socio-professional organizations in medical examination and treatment services.

- Upholding and promoting traditional medicine; combining traditional medicine with modern medicine.

- Combining military and civil medicine in healthcare.

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