Circular No. 9/BYT-TT guiding the organization of hospital beds at health stations, factories, and schools pursuant to Decision No. 15-CP dated January 14, 1975 of the Council of Ministers

CIRCULAR

NUMBER 9/BYT-TT OF JUNE 25, 1980 GUIDING THE ORGANIZATION OF BEDS AT HEALTH STATIONS IN ENTERPRISES AND SCHOOLS ACCORDING TO
RESOLUTION NUMBER 15-CP OF JANUARY 14, 1975
NO. 25-CP JANUARY 21, 1981 OF THE COUNCIL OF MINISTERS

Resolution number 15-CP of January 14, 1975 of the Council of Ministers has set forth the direction for improving the health care network in various sectors as follows: "gradually and firmly implement the unified management of health facilities under other sectors into the health sector..." and stipulates that... AT For enterprises where transportation is inconvenient and far from hospitals, health stations at enterprises are permitted to have a certain number of beds for timely and on-site service to the health needs of workers and staff. These beds shall enjoy hospital bed standards.

Based on the above direction, the development of beds and observation beds at grassroots health stations should follow the direction:

- Increase beds and observation beds at facilities managed by the health sector;

- Gradually reduce the number of beds and observation beds at facilities still managed by other sectors to facilitate their integration into the health sector in the future while still ensuring the required number of beds and observation beds according to the needs of those sectors.

However, due to current practical difficulties, it is difficult to develop and expand outpatient clinics and beds at local treatment facilities within a short time, thus enterprises and schools still face many difficulties in providing medical examination and treatment services for cadres, workers, employees, and students.

After reaching consensus with the State Planning Commission, the Government Organization Board, the Ministry of Finance, and the Ministry of Internal Trade, the Ministry of Health issued this circular to guide the uniform organization of beds at enterprise and school health stations as follows.

I. TASKS, ORGANIZATION, AND STAFFING
BED SERVICE

1. Duties:

In addition to the basic tasks of grassroots health stations already recorded in Resolution 15-CP and the ten immediate tasks outlined in Document No. 1386-BYT/TC, beds at health stations are assigned the following tasks:

a. Primary emergency care (for stations far from hospitals, district general outpatient clinics, with inconvenient transportation);

b. Care, monitoring, and treatment of patients with acute diseases, sudden onset of chronic diseases requiring inpatient treatment; continuing treatment of patients referred back from higher-level hospitals due to lack of beds;

c. Organizing isolation, care, monitoring, and treatment of patients with mild infectious diseases not requiring hospitalization but needing isolation and monitoring to prevent complications;

d. Normal delivery assistance (for health stations located far from local obstetric units of the health sector).

With the activities defined above, health stations with beds must strive to fully perform their tasks, reduce average days of treatment, limit unnecessary transfers to hospitals; conversely, they must promptly identify and transfer patients requiring higher-level care for emergency treatment; absolutely not treating patients beyond the station's capacity.

2. Organization:

Beds at grassroots health stations are part of the station and are not organized as separate units like former infirmaries and do not form independent units, and are directly managed and directed by the head of the health station.

Based on Resolution 15-CP, all observation beds with infirmary and station bed standards are uniformly named as hospital beds and must be included in annual planning targets. These beds currently apply only to enterprises, factories, construction sites, forestry companies, exploration survey teams, and organizations with equivalent business production characteristics, central-affiliated universities, vocational and specialized secondary schools, worker training institutions located locally (hereinafter referred to as central enterprises and schools).

To suit the capabilities, tasks, and organizational management scale of beds within a health station, the minimum number of beds prescribed is 5, and the maximum is not more than 25 beds; approximately one bed for every 200 workers in enterprises, and one bed for every 300 students and workers in schools. Special units concentrated in remote areas far from upper-level health facilities, with inconvenient transportation, and difficult emergency transport, if confirmed by the provincial or municipal health department as needing priority beds, may be granted additional beds based on the number of dependents accompanying the unit's cadres, workers, and students, and the emergency needs of the local population, as guided by Circular No. 42-BYT/TT dated November 6, 1976.

3. Staffing:

In addition to the basic staffing of health stations already specified in Circular No. 14-BYT/TT (or regional general outpatient clinics specified in Circular No. 15-BYT/TT), the aforementioned beds are allowed additional staffing for bed service at a ratio of 0.5 staff per bed. This staffing is mainly for professional technical treatment services; therefore,后勤保障服务的组织应基于单位的共同后勤保障服务组织，如行政管理、膳食供应、厨房等，以精简卫生站的编制。对于获得床位指标的企业和学校，卫生站（包括承担基层医疗卫生任务的编制和服务床位的编制）的全部编制统一纳入该行业的卫生事业编制。

AT for enterprises and schools approved with bed quotas, the entire staffing of the station (including the staffing of the station performing primary healthcare tasks and the staffing serving beds) is uniformly counted into the healthcare staffing of that industry.

Although having beds, health stations remain primary healthcare facilities, and must prioritize the basic tasks recorded in Resolution 15-CP and the ten immediate tasks of enterprise, agency, and school health stations outlined in Document No. 1386-BYT/TC dated April 24, 1978. They must effectively carry out preventive health and epidemic control work, manage individual health within the unit, and strengthen outpatient treatment at home. Health stations with beds must absolutely not concentrate all station staffing solely on treatment work.

II. CONDITIONS, PROCEDURES FOR APPLYING FOR BED QUOTAS AND SEQUENCES FOR ANNUAL BED PLANNING
BEDS

1. Conditions:

a. Must officially establish a health station as stipulated in the circular...

b. Must have treating doctors and nurses and have staffing for hospital beds (outside the basic staffing of a regular health station);

c. Must have housing and equipment to deploy hospital beds;

d. Must complete all procedures to apply for hospital bed quotas to be officially recorded in the annual national plan quota;

2. Registration Procedures:

a. Based on the conditions and quantity standards of cadres, workers, employees, and students mentioned in Section I, the unit located in which locality shall directly register with the local Department of Health;

b. The local Department of Health shall examine whether there is a real need for hospital beds. If it is truly necessary, after checking and comparing the conditions and standards, the Department of Health must issue an agreement and confirmation letter for the unit. The content of the confirmation must clearly state:

- Regarding medical expertise, how many hospital beds are needed,

- Whether the unit applying for hospital beds is located in remote areas far from higher-level healthcare facilities of the local health sector or is concentrated but the local health sector cannot manage due to a lack of hospital beds or organizational conditions at nearby healthcare facilities;

- The organizational form (health station with hospital beds or outpatient clinic with hospital beds), agreement on management division, and designation of the higher-level organization responsible for professional guidance and treatment.

3. Procedure for establishing the annual hospital bed plan:

a. The unit must submit a report along with the confirmation content from the local Department of Health to the unit's main department to establish the financial plan and staffing for the health station with hospital beds in coordination with the Ministry of Health for approval according to the annual plan;

b. Annually, the local Department of Health also has the responsibility to monitor and compile the number of confirmed and agreed hospital beds for enterprises and schools under central agencies located in the locality and report to the Ministry of Health together with the local hospital bed plan;

c. After being officially recorded as a national hospital bed quota, the Ministry of Health will notify the plan to each department for them to allocate the quota to their subordinate units; simultaneously, the Ministry of Health will also notify the Departments of Health to monitor and direct implementation.

III. QUOTA STANDARDS

Based on Decision No. 15-CP of the Council of Ministers and the agreement of the Ministry of Finance in Circular No. 241-HCVX dated September 1979, the hospital beds mentioned in this circular are calculated based on the standard of hospital beds (the lowest level being district hospitals).

For health stations with hospital beds, the aforementioned funds do not include the medical and pharmaceutical fee quota for cadres, workers, and employees stipulated in Decision No. 91-TTG of the Prime Minister.

Specific details about expenditure standards agreed upon by the Ministry of Finance will be provided in additional guidelines.

IV. IMPLEMENTATION

This circular uniformly specifies the organizational form and name of hospital beds at enterprise and school health stations under central agencies located in localities to continue implementing the consolidation and strengthening of grassroots health stations in accordance with the spirit of Decision No. 91-TTG and Resolution No. 15-CP of the Council of Ministers, adapting to current realities. Hospital beds specified in this circular must be recorded in the national plan quota and enjoy hospital bed standards (equivalent to district hospital beds). Additionally, health stations that do not organize hospital beds, if maintaining some observation beds for short-term patient monitoring before transferring to higher levels, still use the usual medical and pharmaceutical fees for cadres, workers, and employees stipulated in Decision No. 91-TTG of the Prime Minister. These observation beds are not included in the national plan quota and do not have a budget standard.

The Ministry of Health respectfully requests all ministries, sectors, provincial people's committees, and centrally-affiliated units to widely disseminate and supervise the rapid consolidation of grassroots health stations, only allowing the establishment of hospital beds at stations where they are truly necessary, avoiding excessive and widespread establishment.

The Ministry also requires local Departments of Health to pay attention to the network of enterprise and school health stations under central agencies located in localities, carefully confirming the number of hospital beds for necessary units, monitoring, and creating conditions for units to quickly implement hospital beds recorded in the national plan quota.

In the short term, local Departments of Health need to organize the dissemination and guidance of the procedures for registering hospital beds specified in this circular for centrally-affiliated units located in localities to adjust and supplement into the 1980 plan.

This circular takes effect from the date of issuance and supplements the joint circulars of the Ministry of Health and the Ministry of Finance No. 32-TT/LB dated December 24, 1974, Circular No. 42-BYT/TT dated November 6, 1976, Circular No. 14-BYT/TT dated May 9, 1977, and Circular No. 15-BYT/TT dated May 17, 1977 of the Ministry of Health.

During implementation, if there are any difficulties, the Ministry of Health requests all ministries, sectors, provincial people's committees, and local Departments of Health to report back to the Ministry of Health for research and supplementation or to request the State to resolve.