This Circular guides the collection of part of hospitalization fees at state health examination and treatment facilities as stipulated in Decision No. 45-HĐBT of 1989, including those who must pay and those exempted from hospitalization fees. The amount collected is determined based on material consumption and medical services.
适用范围
State health examination and treatment facilities; people coming for health examinations and treatments at these facilities
要点
- People seeking health examinations and treatments at state health facilities must pay part of the hospitalization fee (except for those exempted). Article 2.
- Those exempted from payment for health examinations and treatments include persons who have contributed to the revolution, war invalids from Class 1 to Class 4, children under five years old, and other groups. Article 3.
- The amount of hospitalization fees includes costs for material consumption (medicines, blood, intravenous fluids) and bed charges for inpatient treatment at health examination and treatment facilities. Part II.
- Health facilities must organize well the collection of hospitalization fees and distribute the collected funds according to the ratio of 60% for health service expenses, 35% for employee allowances, and 5% submitted to the Ministry of Health or the Department of Health. Part III.
- Outpatient clinics only provide emergency and first aid medicines and some common medications; other types of medicines are purchased by patients with prescriptions. Article 1, Part IV.
🌐 本文件的社会影响
- Increase revenue sources for health facilities, improve patient service conditions.
- Reduce financial burden on the state budget in providing free health examinations and treatments.
- People capable of paying hospitalization fees will need to pay additional money when seeking health examinations and treatments.
- Those exempted from hospitalization fees continue to enjoy free healthcare services.
- Health facilities need to expand pharmaceutical and medical supply services to meet the needs of the public.
❓ 常见问题
Who are eligible for exemptions or reductions in hospitalization fees?
Those exempted from payment for health examinations and treatments include persons who have contributed to the revolution, war invalids from Class 1 to Class 4, children under five years old, and other groups. Article 3.
What is the amount of hospitalization fees?
The amount of hospitalization fees includes costs for material consumption (medicines, blood, intravenous fluids) and bed charges for inpatient treatment at health examination and treatment facilities. Part II.
How must health facilities distribute the collected funds?
60% for health service expenses, 35% for employee allowances, and 5% submitted to the Ministry of Health or the Department of Health. Part III.
What are the regulations regarding medication provision at outpatient clinics?
Outpatient clinics only provide emergency and first aid medicines and some common medications; other types of medicines are purchased by patients with prescriptions. Article 1, Part IV.
When does this Circular take effect?
This Circular takes effect from the date of issuance, which is June 15, 1989.
全文
CIRCULAR
GUIDELINES FOR IMPLEMENTING DECISION NO. 45-HĐBT OF THE STATE COUNCIL ON APRIL 24, 1989 REGARDING THE COLLECTION OF A PORTION OF MEDICAL FEES ISSUED BY THE JOINT MINISTRY OF HEALTH AND FINANCE UNDER DECISION NO. 14/TTLB ON JUNE 15, 1989
To improve patient service conditions, the Ministry of Health and Finance jointly issue guidelines for implementing Decision No. 45-HĐBT dated April 24, 1989 of the State Council regarding the collection of a portion of medical fees as follows:
I - CONTENT AND OBJECTS OF THE COLLECTION OF A PORTION OF MEDICAL FEES
1. Content of the collection of a portion of medical fees:
a) Examination fee.
b) Bed fee for treatment and convalescence.
c) Technical service fee during examination and treatment.
d) Medicine, blood, infusion fee.
e) Laboratory test fee.
g) X-ray film fee.
The aforementioned fees form the basis for calculating the amount to be collected as a portion of medical fees and exemptions for individuals seeking medical care at state health facilities as specified in Points 2 and 3 below.
2. Objects subject to the collection of a portion of medical fees (to be charged 100%):
a) All individuals (except those exempted as specified in Point 3 below) who visit state facilities for examination and treatment according to the prescribed treatment lines by the health sector.
b) All individuals (including civil servants and policy beneficiaries specified in Point 3 below) who seek medical care under the following circumstances:
- Work-related accidents - paid by the employing agency or enterprise.
- Traffic accidents - paid by insurance agencies or by the person violating traffic laws.
- Alcohol intoxication or suicide attempts saved by the individual themselves.
- Assault causing injury - the attacker pays the medical fees.
- Seeking medical care based on personal requests, choosing doctors or medicines, out-of-network, dental work with precious metals, cosmetic procedures.
3. Objects exempt from payment for medical services:
- Persons contributing to the revolution and receiving monthly allowances.
- War invalids from Grade 1 to Grade 4.
- Parents, spouses, or children of martyrs receiving monthly allowances.
- Disabled persons, orphaned children, or elderly people without support.
- Patients with mental illness, leprosy, tuberculosis.
- Ethnic minorities in highland areas (as defined by the Provincial People's Committee).
- Individuals engaged in land reclamation and economic development in new regions, retirees due to loss of working capacity, village and ward officials receiving subsidies, military personnel, students in state vocational schools.
- Parents, spouses, and first and second underage children of civil servants and military personnel. Civil servants within the establishment and long-term contracts.
- Children under five years old.
II - LEVELS OF COLLECTION AND FORMS OF MEDICAL FEE COLLECTION
1. Medical fees consist of two parts:
a) Material cost expenses including medicine, blood, infusions, X-ray films, major and medium surgery service fees - charged based on actual usage for patients and according to state-set prices at the time of medical fee collection; If imported medicines have no state-set prices, they will be calculated based on import prices in foreign currency multiplied by the exchange rate published by the state. (These charges are not included in the daily inpatient fee level).
b) Fees for medical services and inpatient bed fees at healthcare facilities.
The levels of outpatient examination fees and inpatient bed fees at healthcare facilities are set for each treatment line as follows:
|
Serial Number |
Treatment Facility |
One-time Outpatient Examination Fee |
Daily Inpatient Bed Fee |
||
|
Type 3 |
Type 2 |
Type 1 |
|||
|
1 2
3 |
- District Hospital - Provincial/City Hospital and Equivalent Internal, Pediatric, Surgical, Obstetrics (without surgery) (without surgery) Surgical and Obstetrics (with surgery) and Emergency Care - Central Hospital Central Internal, Pediatric, Surgical, Obstetrics (without surgery) Surgical and Obstetrics (with surgery) and Emergency Care 300đ 800đ - Central Hospital |
1,200đ
Supporting staff monitoring one case of acute flaccid paralysis from onset of symptoms to day 60, including specimen collection and transfer according to regulations
Supporting staff monitoring one case of acute flaccid paralysis from onset of symptoms to day 60, including specimen collection and transfer according to regulations
Supporting staff monitoring one case of acute flaccid paralysis from onset of symptoms to day 60, including specimen collection and transfer according to regulations
Supporting staff monitoring one case of acute flaccid paralysis from onset of symptoms to day 60, including specimen collection and transfer according to regulations |
Supporting staff monitoring one case of acute flaccid paralysis from onset of symptoms to day 60, including specimen collection and transfer according to regulations
Outpatient examination fee - only charged once when a patient needs to see multiple specialties within the same hospital.
1,000 VND
1,000 VND
1,000 VND |
-
1,000 VND
2. The above service fee levels are average rates. Localities may adjust these rates higher or lower based on specific circumstances and report to the local People's Committee for approval or to the Ministry of Health for central hospitals.
2. The above service fee levels are average rates. Localities may adjust these rates higher or lower based on specific circumstances and report to the local People's Committee for approval or to the Ministry of Health for central hospitals.
1,500 VND |
-
-
1,500 VND
1,500 VND
2,000 VND
|
³
To align with price fluctuations, when the rice price index in the locality increases or decreases by 20%, hospitals can request permission to adjust the collection levels specified in Point 1, Part II above.
Based on hospital capacity and public health needs, localities may organize medical services according to demand and charge sufficient costs for service provision through contracts and agreed service prices between the hospital and service recipients.
III - DISTRIBUTION AND USE OF COLLECTED MEDICAL FEES
1. Healthcare facilities must effectively organize medical fee collection, record all income and expenditures according to current budget accounting regulations, and report fully to the local finance authority but retain the collected medical fees for use and distribution by the health sector as follows:
a) 60% to supplement the health service budget of the unit. This covers all material costs that the hospital has prepaid for patients such as medicines, blood, infusions, X-ray films, etc., which need to be replenished to continue serving patients.
b) 35% to reward and incentivize staff with high responsibility, affection for patients, and successful completion of tasks.
c) The remaining 5%, central healthcare facilities submit to the Ministry of Health; local healthcare facilities submit to the Department of Health to support other facilities unable to collect medical fees.
1. To align with the medical fee collection system, from now on, outpatient clinics (excluding Vietnam-Soviet Friendship Hospital, Thong Nhat Hospital, and high-level departments of Da Nang Hospital) will only provide emergency and common medications. Other medications will be purchased by patients based on prescriptions.
2. Healthcare facilities should expand pharmaceutical and medical supply sales to meet the selection needs of all individuals.
IV - IMPLEMENTATION
Where conditions permit, trial health insurance systems or contracts for medical services with both state-owned and private healthcare organizations can be implemented, establishing local health assistance funds or grassroots health funds to assist patients unable to pay a portion of medical fees.
2. Healthcare facilities need to expand pharmaceutical and medical supply sales services to meet the medication and medical supply selection needs of all individuals.
In areas with appropriate conditions, health insurance systems or contracts for medical examination and treatment with both state-owned and non-state-owned healthcare organizations may be implemented, and local or grassroots healthcare assistance funds may be established to assist patients who are unable to pay part of their medical expenses.
This Circular takes effect from the date of issuance. During implementation, if there are difficulties or obstacles, localities and healthcare facilities are requested to report them in writing for the relevant ministries to study and make supplements and amendments.
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