Inadequacies in autonomy in regular expenditure at the Provincial General Hospital

(Baonghean.vn) - After 3 months of implementing autonomy in regular spending, Nghe An Provincial General Hospital encountered many difficulties and problems.

Regarding the current organizational structure of the hospital, it is not suitable for its functions, tasks and operating conditions. Currently, compared to the regulations of the Ministry of Health on the organization of a Grade I general hospital, the hospital is still lacking 9 clinical departments.

While the general policies and regimes in health care still have many shortcomings and lack consistency, many outdated regulations are slow to be renewed, causing many problems in the implementation process.

Regarding the price of medical examination and treatment services, it has not been adjusted appropriately and consistently among patient groups: Health insurance subjects follow the price prescribed in Joint Circular No. 37/2015/TTLT-BYT while the price applied to patients without health insurance is still according to Decision No. 125/2014/QD-UBND. In previous years, the hospital was allocated state budget/bed according to the prescribed norms by the province and also had a source of funding to cover the price difference between the two groups of patients.

However, since 2017, the Hospital has not received state budget funding, while the progress of health insurance coverage is still slow, the price charged to patients without health insurance has not been adjusted in time to the roadmap for increasing the price of medical examination and treatment services. The price difference causes great difficulties for the Hospital when implementing financial autonomy. The Hospital proposes to speed up the implementation of price equality between health insurance and non-health insurance beneficiaries - Master - Doctor Ton That Hau - Deputy Director of the Provincial General Hospital proposed.

Working session scene. Photo: Thanh Le

One difficulty of the unit when implementing autonomy is that the Provincial Hospital is the last level, with very few initial health insurance registrations (nearly 2,200 cards). Health insurance patients coming to the Provincial Hospital for examination and treatment must follow the transfer procedure when it exceeds the capacity of the lower-level health care facility, while the borderline health care facility always tends to retain patients and limit transfer to the higher level.

If a patient goes beyond the provincial level to be examined and treated at a provincial hospital, he or she will only receive 60% of the inpatient treatment costs and will not be covered by health insurance if he or she goes beyond the provincial level for outpatient treatment. This affects the hospital's revenue and the patient's rights when nearly 50% of outpatients at the provincial General Hospital are voluntary patients (without health insurance cards or with health insurance cards but going beyond the provincial level for medical examination and treatment).

Through the Hospital's proposal, it shows that although the determination is high but there are many difficulties, the Hospital has not ensured the factors, and is not suitable for the regular autonomy process. So, should the Hospital implement regular autonomy? - Comrade Nguyen Dinh Huong - Permanent Vice Chairman of the Provincial Farmers' Association said.

Open heart surgery at Nghe An General Friendship Hospital. Photo courtesy

Responding to the issues raised by the members of the Supervisory Delegation, Master - Doctor Nguyen Viet Binh - Head of the Administrative Organization Department, Provincial General Hospital affirmed: Whether the hospital implements autonomy or not is a decision on the number of patients. In order for patients to choose the place to go for medical examination and treatment, the Provincial General Hospital has deployed specialized techniques and continuously improved the quality of medical examination and treatment. The hospital has implemented autonomy in regular expenditures since the beginning of 2017, but up to now, this project has not been approved by the Provincial People's Committee, making it very difficult for the unit.

“Autonomy is an inevitable trend for hospitals, so the Hospital hopes that the Provincial People's Committee will soon approve the project "Autonomy, self-responsibility for performing tasks, organizing apparatus, personnel and finance for the period 2017-2019" for the Hospital to soon apply and implement" - Doctor Nguyen Viet Binh suggested.

In his concluding remarks at the working session, comrade Tran Dinh Toan - Deputy Head of the Provincial People's Council's Legal Committee highly appreciated the results of medical examination and treatment work for the people and the initiative in implementing autonomy of the Provincial General Hospital of Friendship.

He requested the Provincial General Hospital to propagate the implementation of autonomy so that staff and employees can understand it; perfect the unit's operating regulations; review and arrange appropriately, continue to train and develop staff and employees. Attract high-quality human resources to increasingly improve the quality of medical examination and treatment. Regarding the recommendations and proposals of the Hospital, the Supervisory Team will synthesize and recommend to relevant departments, branches and the Provincial People's Committee to soon have solutions to remove the difficulties and obstacles of the unit./.

Thanh Le