Ngo Van Vu from Kien Giang Province recalled that once he had requested a hospital transfer for his child, who had been receiving treatment for glomerulonephritis at a provincial hospital. After many times getting refused for the ground that the current hospital was able to perform similar treatments, he decided to call for a hospital discharge and brought the child to a better hospital in HCMC regardless of the fact that his child would not enjoy the same health insurance rate anymore.
The case of 52-year-old Bui Thi Hanh from Ca Mau Province is quite different. After undergoing a breast cancer surgeon in HCMC Oncology Hospital 2 years ago, she was asked to return for regular health checkups and indicated radiotherapy or chemotherapy. Each time, she had to visit her initial registered hospital of health insurance to request a hospital referral, which took her too much time and effort just to receive full health insurance rights.
Many people annoyedly shared that to be eligible for full health insurance benefits, they have to carry out medical examinations, ultrasounds or X-rays, tests, which are normally not accepted when coming to higher-level hospitals later. Others need to exploit connections to obtain this essential health insurance referral.
Therefore, it has been voiced that such a referral should be eliminated to reduce unnecessary nuisance during treatments. In response, Director Tran Thi Trang of the Health Insurance Department (under the Ministry of Health) shared that omitting such a paper right now is not feasible because then patients will flock to central-level hospitals for their disease treatment, which means overloading work there, not to mention an imbalance in the Health Insurance Fund.
More importantly, as central-level hospitals have to care for serious cases, perform their training and research duties, it is impossible for them also pay attention to mild cases or primary medical care.
The Health Ministry has lately decided to amend and supplement regulations on the output data format to serve management and assessment purposes during the payment of treatment costs and the settlement of related processes. Accordingly, as of April 1, 2024, social insurance agencies and hospitals in the country are going to pilot sending and receiving electronic health insurance referrals and appointment letters. The official implementation will be from July 1, 2024.
This year, the Health Ministry is going to work with the Public Security Ministry and Vietnam Social Security to integrate the above letters into VNeID and VssID apps, for the sake of successful digital transformation and the complete elimination of hard copy versions. When carrying out health-insurance-related procedures, patients only need to display the electronic version on their VNeID or VssID app (with built-in QR codes).
This integration is expected to greatly reduce processing time, offer more convenience for patients and hospitals, support the assessment tasks of social insurance agencies during medical transfers while being able to minimize fraud and forgery.
Deputy Director of HCMC Oncology Hospital Diep Bao Tuan said that a hospital referral is of extreme importance as it has critical medical information and treatment methods previously done on a patient, which saves much valuable time and money. This becomes un inevitable trend in the digital transformation process in Vietnam right now. In addition, the process to approve a referral can help to avoid unnecessary flocking to high-level hospitals, unwanted professional gaps between different hospital levels.
Director Tran Van Khanh of Le Van Thinh Hospital in HCMC added that for a smooth launch of an electronic hospital referral, there must be strong links among medical institutes, long-term strategies and policies to improve the quality of disease treatment in low-level hospitals to minimize unnecessary transfers and ease the mind of local patients.
According to the Ministry of Health, to limit negative issues that arise in applying for a health insurance referral, it is going to review relevant regulations and sanctions to punish any hospitals for administrative violations. It will simultaneously develop more transparent and detailed criteria for hospital transfer.
