Hot "brokers" transferring routes at the hospital

Hospital "give up"
At Nghe An Oncology Hospital, there is currently a network of people running transfer procedures. Currently, this network has 2 people: A man named K, about 50 years old, and another man named H, about 40 years old.

The way this line “runs” the hospital transfer procedures is as follows: Every day, Mr. K is always present in front of the examination area of ​​Nghe An Oncology Hospital and searches for and selects “customers” - patients who have not been examined or have been examined at Nghe An Oncology Hospital and want to be examined and treated at Central-level hospitals.

After analyzing the difficulties in transferring routes and transferring health insurance, Mr. K persuaded the patient to pay money to complete the transfer documents. Once the order was "matched", the man named H appeared to receive the documents or lead the patient to another hospital to complete the transfer procedures.

"Brokers" transfer hospitals and routes operating at Nghe An Oncology Hospital. Photo: PV

In the early days of April, the hotline received quite a few “customers”. On the morning of April 2, patient NVKhiem from Dien Chau district went to Nghe An Oncology Hospital to complete the transfer procedures. Due to the large number of patients, Mr. Khiem was not able to complete the procedure.

While waiting outside the clinic, Mr. K approached him again and offered to help him with the job for 3.5 million VND. After agreeing, Mr. K called Mr. H to come and pick it up. When Mr. H arrived, another patient, a kindergarten teacher in Dien Hong commune, Dien Chau, also came to ask for help.

The transfer broker is talking with the patient's family. Photo: TC

As promised, on the morning of April 3, Mr. Khiem was taken by Mr. H to a non-public hospital in Vinh city for examination, then from this hospital transferred to another provincial hospital to complete the transfer documents to a central hospital. When all procedures were completed, in addition to the 3.5 million VND fee for broker H, Mr. Khiem spent an additional 1 million VND on testing fees at 2 hospitals. On the evening of April 3, Mr. Khiem took a bus to Hanoi.

“Previously, broker H had connected with some staff at the hospital to provide quick examination and referral services for patients. After the hospital learned of this information, it disciplined the above staff.”

Doctor Pham Vinh Hung - Deputy Director of Nghe An Oncology Hospital

“Nghe An Oncology Hospital has known about this situation and reported it to the local police several times, but it cannot resolve the issue without “catching them red-handed”. The hospital also cannot push or chase these “brokers” out of the area when the “brokers” say they “came to the hospital to visit relatives”.

Doctor Pham Vinh Hung - Deputy Director of Nghe An Oncology Hospital

According to Dr. Pham Vinh Hung: The reason why "brokers" for transferring hospitals and hospitals appear and have a place to live is because patients always want to be examined at higher quality medical facilities. However, currently, health insurance only implements the connection at district-level medical examination and treatment facilities and has not yet connected at the central level. In order to help patients be transferred to central-level hospitals for treatment, provincial-level hospitals themselves also face difficulties due to regulations.

Specifically: According to the regulations of Vietnam Social Security, hospitals are allowed to deploy and pay health insurance for technical services approved by competent authorities. If within the scope of the approved technical list, the hospital transfers the patient to a higher level, the amount will be deducted from the hospital's health insurance fund.

Portraits and images of the "brokers" involved in hospital transfer procedures were recorded by reporters. Photo: PV

Article 5, Circular 37/2014/TT-BYT dated November 17, 2014 of the Minister of Health guiding the registration for initial medical examination and treatment and referral for health insurance medical examination and treatment clearly states: “Medical examination and treatment facilities transfer patients from lower levels to higher levels when the disease is not suitable for the diagnostic and treatment capacity, technical list of the unit or the disease is suitable but the unit does not have enough conditions to diagnose and treat. Before transferring, the patient must be consulted and have a referral indication”.

According to many officials working in the medical sector: In addition to the reason of being "stuck" with regulations, hospitals themselves currently do not want to transfer patients to other hospitals or levels for fear of reducing revenue. This is the downside of implementing financial autonomy in public hospitals. Entering financial autonomy, hospitals must take full responsibility for the costs of purchasing equipment, consumables, and living expenses for staff.
The trend of patients preferring to transfer to higher levels for better health care and the situation of "brokers" transferring hospitals is also clearly showing a sad reality of medical examination and treatment facilities in Nghe An, which is: The quality of medical examination and treatment, the development of new techniques in some medical examination and treatment facilities is still limited; the transfer of techniques from higher levels to lower levels has not been implemented much, especially in some district and mountainous hospitals. Some medical units still have degraded facilities, poor hygiene conditions in patient rooms, and lack of modern equipment to develop techniques but have not been invested in upgrading.

Pressure to transfer occurs in many hospitals. Illustrative photo

The story of Mr. NVKhiem being transferred to a new hospital thanks to a broker has shown unpredictable consequences: First of all, the patient has to lose money to the broker. Second, with the above unclear transfers, the health insurance fund is wasted because the examination and testing are performed many times. And the biggest loss is the trust of the people...

The transfer of routes can only be carried out when the infrastructure and technical expertise at all levels are improved. Therefore, Nghe An health sector needs to solve two problems: Create conditions for people to be transferred to other levels when medical facilities cannot meet the people's medical examination and treatment needs and improve the quality of medical examination and treatment so that people do not need to be transferred.

Associate Professor, Dr. Duong Dinh Chinh - Director of Nghe An Department of Health said: "To facilitate people in transferring hospitals, in the immediate future, Nghe An health sector is implementing a number of solutions such as directing, inspecting and supervising the implementation of regulations on referrals for medical examination and treatment facilities so that hospitals must base on the patient's condition, the professional capacity of the unit and when unable to treat, they must transfer, avoiding the situation where patients have to go around in circles. At the same time, the medical team must strengthen medical ethics training, uphold the sense of responsibility to ensure the health benefits of patients and should not be affected by objective causes".