Improving the quality of health insurance examination and treatment at grassroots level

After 9 years of organization, Vietnam Health Insurance Day on July 1st every year is an opportunity to promote propaganda and mobilize people to join hands and contribute to the good implementation of the Health Insurance Law with the roadmap to implement universal health insurance, for the health of themselves, their families and the community, for the country's security.

This is also an opportunity to thoroughly grasp and further raise awareness of the position, role and significance of health insurance - an important part of the national health finance policy, one of the methods of socializing health care work through mobilizing people's contributions, along with the support of the State to create financial resources for people's health care activities.

Doctors from the Provincial General Hospital examine a patient. Photo: Phuoc Anh

Along with the implementation of Resolution 21-NQ/TW of the Politburo on strengthening the Party's leadership in social insurance and health insurance work in the period of 2012-2015 and 2020, the communication work on health insurance policies and laws has been promoted by the Social Insurance Agency. Along with the practical role of health insurance in life, people are gradually becoming more aware of the humane nature of health insurance, thereby proactively participating as an effective preventive measure to take care of the health of individuals as well as family members.

Health insurance coverage has grown strongly in the last 5 years. At the end of 2012, the health insurance coverage rate was only 66.8% of the population, but by the end of 2017 it reached 85.6% and is now nearly 87%. The number of households participating in health insurance - the group that is the most difficult to persuade to participate - has also grown significantly continuously in the last 10 years, with each year always higher than the previous year.

If in 2008, the number of participants in household health insurance (also known as voluntary health insurance - according to the provisions of the 2008 Health Insurance Law) only reached 3.67% of the population, equivalent to about 3.1 million participants; by 2017, the participation rate reached nearly 16% of the population, equivalent to about 14.9 million people; then as of March 2018, the number of participants in this group was nearly 15.4 million people.

People's health insurance benefits are increasingly guaranteed, helping people see the practical role of health insurance for the well-being of themselves, their families and society. This is demonstrated by the number of health insurance examinations and treatments continuously increasing over the years, corresponding to the amount of medical examination and treatment costs paid from the Health Insurance Fund.

In 2017, there were 168 million health insurance-covered medical examinations, an increase of 14% compared to 2016, of which the number of outpatient medical examinations was 152.8 million, an increase of 15% and the number of inpatient medical examinations was 15.3 million, an increase of 9% compared to 2016.

Health insurance medical examination and treatment expenses increased by 30% compared to 2016. In 2016, the frequency of medical examination and treatment was 1.9 visits/card/year, in 2017 it was 2.1, in which the frequency of inpatient medical examination and treatment in 2017 increased by 0.01 visit.

Thus, the number of health insurance participants in 2017 increased by 4.036 million compared to 2016, but the number of medical examination and treatment visits increased by 21.085 million.

People participating in voluntary social insurance happily receive the decision to enjoy retirement benefits. Photo: Phuoc Anh

To best serve health insurance participants, the reform of administrative procedures continues to be vigorously implemented by the Social Insurance sector and has achieved important results. The number of administrative procedures has been reduced from 115 to 28.

According to the World Bank's assessment, the index measuring tax and social insurance payment procedures in Vietnam increased in points and ranks the most compared to the previous year, up 14.78 points and 81 ranks, respectively, reaching 86th place out of 190 (ranked 167th last year).

The industry's management information technology system has been gradually built in a synchronous and modern manner; a large database of participants, the process of paying and receiving social insurance, health insurance examination and treatment has been built and centrally managed with information from more than 92 million people, 24 million households participating in health insurance, and 13 million social insurance participants.

There is also data on collection, issuance of books, cards, finances, records, and administrative procedures for transactions between the Social Insurance agency and units, connecting with about 13,000 medical facilities and employers.

Up to now, Vietnam Social Security has provided 14 online public services at level 3 and level 4; the number of registered and performed electronic transactions is over 236 thousand units and enterprises; completed computerization of management and storage of 4.5 million social insurance benefit records.

With continuous efforts, at the end of 2017, Vietnam Social Security was recognized, ranked 2nd out of 20 ministries and branches in terms of information technology application readiness index, up 18 places compared to the previous year.

Implementing the Prime Minister's direction, Vietnam Social Security has organized centralized drug bidding nationwide. Through centralized bidding, reputable and quality drug suppliers have been selected, contributing to reducing drug prices by thousands of billions of VND, promoting the effective use of the Health Insurance Fund, and ensuring the rights of health insurance participants.

With the theme of this year's Vietnam Health Insurance Day being "Improving the quality of health insurance examination and treatment at the grassroots level", before, during and after this important holiday, Vietnam Social Security continues to promote health insurance communication, guiding health insurance participants to examine and treat health insurance at grassroots health facilities to receive timely health care, reducing administrative costs. At the same time, coordinate with the health sector to improve the quality of health services at grassroots levels, reform administrative procedures, promote the application of information technology, gradually issue electronic health insurance cards... to help health insurance participants access services easily and conveniently right at the grassroots level, for the goal of sustainable development of universal health insurance./.