Circular No. 02/2004/TT-BYT guiding the implementation of health care work for the elderly

CIRCULAR OF THE MINISTRY OF HEALTH

GUIDELINES FOR IMPLEMENTING GERIATRIC HEALTH CARE WORK

Pursuant to Article 14, Article 15, and Article 16 of the Elderly Ordinance No. 23/2000/PL-UBTVQH dated April 28, 2000, assigning tasks to the Health Sector,

Pursuant to Decree No. 30/2002/NĐ-CP dated 26/3/2002 of the Government stipulating and guiding the implementation of certain provisions of the Elderly Ordinance;

Pursuant to Decree No. 20/2003/NĐ-CP dated 20/10/2003 of the Government amending Article 9 of Decree No. 30/2002/NĐ-CP dated 20/10/2003;

Pursuant to Decision No. 1613/BYT-QD dated 15/5/2003 of the Government stipulating the functions, tasks, powers, and organizational structure of the Ministry of Health;

The Ministry of Health hereby issues guidelines for implementing geriatric health care work as follows:

This technical regulation sets out technical requirements, testing methods, sampling procedures; management requirements; responsibilities of organizations and individuals producing, trading, and importing cigarettes.

1. Elderly persons receiving health care under this Circular are citizens of the Socialist Republic of Vietnam or Vietnamese elderly residing abroad and foreign elderly residing in Vietnam from the age of 60 onwards. Old age often comes with poor health and illness; about 95% of elderly people have diseases. On average, an elderly person suffers from 2.69 illnesses, mainly chronic non-communicable diseases, thus their deepest wish is to live healthily, receive health care, and be treated when sick. This is a legitimate demand of the elderly, requiring attention from all sectors, levels, and society.

2. Elderly persons are entitled to primary health care and priority in medical examination and treatment at healthcare facilities.

3. Local People's Committees at all levels are responsible for ensuring health care benefits for the elderly in their locality. The health sector is responsible for professional and technical aspects of elderly health care.

II. ORGANIZATION AND MANAGEMENT OF HEALTH CARE FOR ELDERLY PERSONS
AT PRIMARY LEVEL

Local People's Councils and People's Committees at all levels are responsible for directing the health sector to coordinate with relevant sectors to develop plans and implement health care programs for the elderly in their locality according to the following requirements:

1. Organize campaigns to disseminate physical exercise routines and health promotion practices, especially preventive measures against common diseases among the elderly.

2. Organize regular health check-ups to establish health records for the elderly. Annual health check-ups should be conducted, gradually establishing networks of family doctors and home health care services for the elderly.

3. Establish various forms of elderly clubs such as: health maintenance clubs, outdoor health clubs. Depending on conditions and needs, localities may organize clubs for those suffering from chronic diseases like diabetes, asthma, hypertension, heart disease, kidney-nephrological diseases, cataracts, etc.

4. Prioritize investment in community-based rehabilitation programs for disabled elderly to prevent and recover from complications due to injuries, accidents, cerebrovascular diseases, chronic diseases, occupational diseases, etc.

5. Establish volunteer networks to provide home health care for the elderly, particularly the poor and lonely elderly without support. Encourage retired health workers to participate as volunteers or train volunteers in essential knowledge for elderly health care, including self-care activities in daily life, especially for those with post-stroke, accident, or cardiovascular disease sequelae, social communication activities, and self-healthcare.

III. MEDICAL EXAMINATION AND TREATMENT FOR ELDERLY PERSONS

1. Organization of medical examination and treatment network for elderly persons:

a) Geriatric Institutes are responsible for:

Conducting research and applying scientific and technological advancements in three fields: clinical geriatrics, basic geriatrics, and social geriatrics, proposing measures to improve the quality of elderly health care. Male.

Implementing professional and technical guidance in elderly health care nationwide. Organizing inspections of procedures, professional standards, and equipment provision for lower-level geriatric facilities to ensure post-illness functional recovery exercises for the elderly.

Serving as specialized centers for geriatric diseases.

Cooperating with Hanoi Medical University and other medical training institutions to offer undergraduate and graduate education in geriatrics. Compiling teaching materials and disseminating knowledge on elderly health care.

b) Level I and II general hospitals: Establish geriatric departments and separate consultation rooms for elderly patients in outpatient departments.

c) Specialized hospitals (excluding pediatric hospitals): Must organize medical examinations for elderly patients in outpatient departments; when elderly patients require inpatient treatment, hospitals must provide thorough reception and attentive care, avoiding bed-sharing.

d) District, County, City, and Provincial General Hospitals: Should allocate beds for elderly patients in clinical departments and organize medical examinations for elderly patients in outpatient departments.

đ) Rehabilitation hospitals must continue to be built and strengthened according to Decision No. 966/BYT dated May 30, 1999 of the Minister of Health regarding the operational content of Rehabilitation Hospitals; allocate an appropriate number of beds for elderly patients' care and functional recovery. Collaborate with the Department of Labor, Invalids, and Social Affairs to implement convalescent care benefits for elderly persons who have contributed to the country.

e) Commune Health Stations are responsible for managing the health of and providing primary health care for elderly persons in their locality. In cases where disabled elderly persons living alone fall ill but do not seek medical treatment at designated locations, the commune health station head shall dispatch medical personnel to examine and treat them at their residence or report to the local People's Committee to arrange transportation to medical facilities.

2. Treatment Work

Medical examination and treatment for elderly patients shall be carried out according to the professional and technical hierarchy, with emergency cases being transferred to the nearest healthcare facility.

Medical examination and treatment facilities must prioritize pre-examination for elderly patients (after emergency cases).

Gradually organize the management of chronic diseases for the elderly according to programs and projects to be able to detect and handle promptly when abnormal developments occur. Develop plans to prevent and treat chronic diseases. Strengthen rehabilitation work for elderly patients after acute hospital treatments and guide continued treatment at home.

Combine traditional medical treatment methods with modern medicine, develop non-drug treatment methods, especially at primary healthcare levels for elderly patients.

IV. FUNDS FOR PRIMARY HEALTH CARE AND MEDICAL EXAMINATION AND TREATMENT OF THE ELDERLY
AND EXAMINING AND TREATING ELDERLY PATIENTS

1. Funds for health check-ups to establish health monitoring books for the elderly, regular health check-ups organized by localities, and initial health care activities for the elderly shall be borne by the locality.

2. Funds for medical examination and treatment:

a) Persons holding mandatory health insurance cards or voluntary health insurance cards shall have their medical examination and treatment costs covered by the Social Insurance Fund in accordance with laws on health insurance.

b) Persons eligible for free medical examination and treatment under poverty relief programs shall have their medical examination and treatment costs covered by the Poor People's Health Care Fund in accordance with Decision No. 139/2002/QD-TTg dated October 15, 2002 of the Prime Minister regarding medical examination and treatment for the poor and Circular Joint No. 14/2002/TTLT-BYT-BTC dated December 16, 2002 of the Ministry of Health and the Ministry of Finance guiding the implementation of the aforementioned Decision.

c) Elderly persons aged 90 years and above shall enjoy health insurance benefits as stipulated in Circular No. 24/2003/TT-BLDTBXH dated 06/11/2003 of the Ministry of Labor, Invalids and Social Affairs guiding the implementation of Decree No. 120/2003/NĐ-CP dated 20/10/2003 of the Government.

3. Persons without health insurance cards as specified in point 2 above shall bear the cost of medical examination and treatment themselves.

4. Encourage domestic and foreign organizations and individuals, families of the elderly to purchase health insurance cards for the elderly.

5. Localities need to establish a Health Care Fund for the Elderly to support health care and medical examination and treatment for the elderly.

V. IMPLEMENTATION

1. At provincial, district, and commune levels, organize a Health Care Committee for the Elderly headed by local government leaders, with the Health Department as the executive body, and participation from the Finance, Labor, Invalids and Social Affairs Departments, related sectors, and representatives of the Elderly Association, Red Cross, Fatherland Front, Farmers' Union, Women's Union to ensure and maintain health care activities for the elderly in the locality. To unify health care activities, the Health Care Committee for the Elderly should be integrated into the Initial Health Care Committee of the locality.

2. The Provincial Health Departments have the responsibility to advise the Provincial People's Committees on developing elderly health care plans throughout the province in accordance with this Circular and direct county-level and commune-level health services in participating in elderly health care within their respective jurisdictions.

3. The Treatment Department is responsible for coordinating with relevant Departments, Inspectors of the Ministry of Health, the Gerontology Institute, and related units to guide, direct, inspect, and audit the implementation of this Circular.

4. The Health Education and Communication Center will cooperate with the Gerontology Institute to disseminate knowledge on elderly health care.

5. This Circular takes effect fifteen days after its publication in the Official Gazette. During implementation, if there are any difficulties, units and localities must report to the Ministry of Health (Treatment Department) for consideration, resolution, or amendment and supplementation as appropriate./.