Circular 46/2016/TT-BQP stipulates the classification of medical examination and treatment technical levels, which involves categorizing health facilities into groups with similar professional expertise and organizing them within a system in descending order.
Article table of contents
The system of medical examination and treatment facilities under the management of the Ministry of National Defense is classified into 4 technical expertise levels equivalent to 4 levels of medical examination and treatment (KCB) of health insurance (BHYT).
Level 1 equivalent to central-level medical examination and treatment facilities
Includes: (1) Special-grade hospitals; (2) Grade I hospitals under the Ministry of National Defense (Military Hospital 175, Traditional Medicine Institute of the Military); (3) Grade I hospitals under the Military Medical Academy (Military Hospital 103, Le Huu Trac National Institute of Burns).
Level 2 equivalent to provincial, centrally-run city-level medical examination and treatment facilities
Includes: (1) Grade I hospitals under the General Department of Logistics (Military Hospital 354, Military Hospital 105; Military Hospital 87); (2) Grade I hospitals under the Department of Military Medicine: Institute of Radiology and Oncology of the Military; (3) Grade I hospitals under military regions, corps (Military Hospital 110/Military Region 1, Military Hospital 17/Military Region 5, Military Hospital 7A/Military Region 7, Military Hospital 121/Military Region 9; Military Hospital 211/Corps); (4) Grade II military hospitals; Grade II military-civilian hospitals.
Level 3 equivalent to district, district-level town, provincial city-level medical examination and treatment facilities
Includes: (1) Military medical posts; military-civilian medical posts; (2) Treatment teams; (3) Grade III, Grade IV, or unrated military hospitals and military-civilian hospitals; (4) Branch hospitals of level 2 hospitals not located in the same district, district-level town, provincial city; (5) General clinics under Grade I, Grade II military preventive medicine facilities; (6) General clinics; specialized clinics; multi-specialty departments under hospitals or under military regions and equivalents; (7) Military-civilian health centers; Ban Co Yeu Post Clinic of the Government of Vietnam.
Level 4 equivalent to commune, ward, commune-level town-level medical examination and treatment facilities
Includes: (1) Battalion-level unit military medicine; (2) Military medicine of equivalent battalion-level units with doctors, physician assistants, including: independent companies, border posts, islands without medical posts, warehouses, stations, battlefields, DK platforms; (3) Military medicine of departments under the Ministry of National Defense; regimental, brigade, division military medicine; military medicine of academies, schools; military medicine of defense factories, enterprises; (4) Military medical teams with in-patient beds; (5) Military-civilian health stations; military-civilian clinics.
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The registration of medical examination levels is the responsibility of the units and military medical examination and treatment facilities. The units will contact and register with higher-level medical examination facilities to send their officers, soldiers, and employees for medical examination and treatment when ill or to transfer patients upon indication; that is to register for higher technical expertise levels in ascending order from level 4 to level 1. However, the following principles must be ensured:
- Convenience for soldiers, workers, and public employees of national defense, and members of cipher organizations when going for medical examination and treatment;- Convenience for units in managing the number of personnel and health management;- Compatibility with the hierarchical treatment system of the Military Medicine sector;- Compatibility with the organizational system of the Army units from battalion-level to the Ministry of National Defense;- Compatibility with the geographical area where the unit is stationed.
Circular 46 stipulates that it is possible to register for higher levels if approved by the medical examination and treatment facility – where the unit chooses to register the level, and the decision of the unit commander at the regimental level and equivalent or higher.
For upgrading the medical examination level from lower to higher levels, it will follow the order from level 4 up to level 1 but may upgrade if one of the following cases is met:
- Emergencies in areas where upgrading levels is more convenient than sticking to the designated level;- Severe acute illness, surpassing the treatment capability of the immediate higher level or requiring high-level techniques.
In the case of downgrading from higher to lower levels after stable treatment but requiring consolidation treatment or at the patient's or legal representative's request; transfer to a medical examination facility at the same level as per professional requirements or the patient's, legal representative's request.
For soldiers not participating in BHYT but receiving medical care at civilian facilities, the cost settlement shall follow Decision 105/2008/QD-BQP concerning the settlement of medical examination costs for soldiers, workers, and public employees of national defense when receiving medical care at civilian facilities.
Circular 46 also stipulates the initial BHYT medical examination registration for non-commissioned officers, soldiers, and cipher students receiving living expenses. Non-commissioned officers, soldiers, and cipher students receiving living expenses are registered for initial BHYT medical examination at the medical examination facilities managed by level 3 and level 4 units. If wanting to register for levels 1 and 2 or civilian district, provincial medical examination facilities, the conditions are (i) The unit station and the medical examination facility must be in the same district, district-level town, provincial city or adjacent area; (ii) The consent of the unit commander at the regimental level or equivalent and higher is required.
For detailed regulations on technical expertise levels of medical examination; registration and medical examination level transfer for subjects managed by the Ministry of National Defense, see Circular 46/2016/TT-BQP effective from May 18, 2016.
