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The Ministry of Health has just issued Circular 22/2023/TT-BYT (Circular 22) regulating the unified price of health insurance (HI) medical examination and treatment services between hospitals of the same rank nationwide and providing guidance on the application of prices and payment of medical examination and treatment costs in some cases. Many medical services have been adjusted to increase prices, helping hospitals increase revenue from HI, contributing to improving the quality of patient care, but patients also have more worries.
Adjusting prices of many medical services
In her hand are dozens of receipts showing the hospital fees of nearly 100 million VND that Ms. Truong Dung Hanh (living in Thu Duc City, Ho Chi Minh City) had to pay for her husband's broken leg surgery due to a work accident at Cho Ray Hospital. Ms. Dung Hanh said that she had saved this money after many years of working as a worker, but it was only enough to cover the first payment. Every time the price of medical services increases, her worries are compounded. The previous time the price of medicine increased, now the hospital fees have increased, each treatment costs tens of millions of VND, so she can only try her best to get there.
According to Deputy Minister of Health Nguyen Duc Luan, Circular 22 took effect from November 17, the prices of many medical services at hospitals of the same rank were adjusted up. Specifically, the price of medical examination at special-rank hospitals such as Cho Ray, Bach Mai, Viet Duc, Hue Central... increased from 38,700 VND/time to 42,100 VND/time. Not only central-level hospitals, but the price of medical examination at commune health stations was also raised from 27,500 VND/time to 30,100 VND/time.
Meanwhile, for class I hospitals, the price of medical examination per visit increased from 38,700 VND to 42,100 VND; class II hospitals from 34,500 VND to 37,500 VND and class III hospitals from 27,500 VND to 30,100 VND. Along with the adjustment of medical examination prices, the price of a treatment bed day at medical examination and treatment facilities also increased according to the provisions of Circular 22. Accordingly, the price of an emergency resuscitation bed at a special class hospital is 509,400 VND/day (an increase of 51,400 VND); class I is 474,700 VND/day (an increase of 47,700 VND); class II is 359,200 VND/day (an increase of 34,200 VND)...; the lowest price is a hospital bed at a commune health station at 64,100 VND/day. For some specialized specialties such as organ transplant, bone marrow transplant, stem cell transplant, the new bed price for these specialties at special-class hospitals is 867,500 VND/day (an increase of 85,500 VND).
According to the Ministry of Health's assessment, the price of health insurance services in Circular 22 is built on the basis of direct costs and salaries. In which, direct costs include: clothes, hats, masks, bedding; electricity, water, cleaning costs; costs of repairing and maintaining houses, equipment... Salary costs include: salary according to the salary scale, allowances prescribed by the State; regular allowances, surgery and procedure allowances according to the Prime Minister's decision. Therefore, with the adjustment of health insurance hospital fees (increased by about 10%) according to Circular 22, hospitals will have additional revenue from health insurance to improve the quality of medical services for patients.
Must improve service quality
Although many medical services have been adjusted to increase prices, according to the representative of the Ministry of Health, Circular 22 does not affect or impact the group of subjects participating in health insurance, which are the poor, ethnic minorities, and social policy subjects because this is the group of subjects whose medical examination and treatment costs are 100% covered by the health insurance fund. For subjects who have to co-pay 5%-20% of health examination and treatment costs under health insurance, the impact is not much, but the increase is not much, they can afford to pay because their income increases according to the basic salary.
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CT scan at Ho Chi Minh City Oncology Hospital |
According to records at medical facilities, immediately after Circular 22 took effect, many hospitals immediately applied new medical service prices and implemented measures to improve the quality of medical services, reform administrative procedures, reduce overload and inconvenience for patients. Leaders of Cho Ray, Thong Nhat, and 115 hospitals said that Circular 22 was issued on the basis of the basic salary adjusted from VND 1,490,000 to VND 1,800,000 from July 1, 2023, and this is also a step-by-step adjustment of medical service prices in the direction of correct and sufficient calculation.
With Circular 22, from commune health stations to hospitals at all levels, there will be additional revenue from health insurance, which means more funding and resources to invest in equipment, infrastructure and expertise. People will have access to many high-tech services right in their localities, contributing to reducing the burden on higher levels. Associate Professor, Dr. Dao Xuan Co, Director of Bach Mai Hospital, said that although the prices of many health insurance services have increased, in essence, patients benefit because the price of health services is adjusted in the direction of correct and full calculation, which will gradually reduce people's "out-of-pocket" spending, ensuring the rights of health insurance participants; sick people who have to go to the hospital are respected, placed in the right position as the ones paying for the services, and the hospital is the one serving.
Circular 22 also adjusts the prices of about 2,000 medical services, such as: the price of a simple ultrasound according to the new regulation is 49,300 VND/time (old price was 43,900 VND), the highest is intravascular ultrasound or coronary artery flow reserve measurement FFR with the price of 2,023,000 VND/time (old price was 1,998,000 VND); the price of a conventional X-ray is 53,200 VND/time (old price was 50,200 VND); the price of a 64-row to 128-row CT Scanner with contrast agent is 1,712,000 VND/time (old price was 1,701,000 VND).
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