Reduce over-routing, limit costs

(Baonghean) -In recent years, along with the implementation of the project “Improving medical ethics in medical examination and treatment facilities”, Nghe An Health Sector has focused on directing and investing in developing specialized techniques to access many new techniques at medical facilities. Thereby contributing to reducing the number of patients going beyond the prescribed level and reducing the cost burden for the people.

Brain tumor surgery at Nghe An General Hospital.

As one of the leading provincial hospitals, Nghe An General Hospital has always been highly appreciated for its practical contributions to public health care and is striving to become a hospital in the North Central region. The hospital has set a goal of developing 10 new techniques per year and has exceeded the target, introducing 25-30 new techniques into medical examination and treatment. Currently, at the hospital, knee arthroscopic surgery and cervical spine trauma surgery are no longer difficult techniques but have been performed proficiently. Techniques such as laparoscopic surgery, kidney cyst surgery, bladder stone lithotripsy, prostate fibroids, gastric and colorectal resection of abdominal tumors, laser lithotripsy, basic endoscopic surgery for nasal polyps, sinusitis, and eye surgery using new technology have become routine and have been transferred to lower-level hospitals. 2014 was the third year that the hospital focused on developing techniques related to the chest such as open heart surgery, coronary stents, patent ductus arteriosus, pulmonary valvuloplasty, and pacemaker placement. By the end of 2013, 167 patients with congenital heart disease had been saved. Even in small departments such as the ENT department, all techniques at the central level have been performed, typically treating congenital deafness by replacing the ossicles in the ear.

Constantly learning new techniques, the hospital regularly sends staff and doctors to receive specialized and advanced training at major hospitals in and outside the country, holds online consultations on difficult cases with leading central experts; explores, researches, creates, and applies advanced techniques to medical examination and treatment. For example, at the Provincial Science and Technology Innovation Award in 2013, doctors Duong Dinh Chinh, Nguyen Tat Thang, and Nguyen Van Huong at the General Hospital of Friendship were awarded the Second Prize with two highly effective projects: "Treatment of cerebral vascular malformations by endovascular intervention" and "Treatment of gastric cancer by endoscopic surgery with lymph node dissection"... A new technique successfully mastered means that many patients do not have to be transferred to the central level, reducing the financial burden.

Mr. Tang Dinh Hung, 49 years old in Dien Nguyen commune, Dien Chau district, a patient with a brain tumor who had life-saving surgery by doctors at the Department of Surgery - Neurology - Spine of the Friendship General Hospital, expressed: "Before the surgery, I could not move, my eyesight was poor, and the back of my head was aching. After 2-3 days of surgery using the new method using the Navigation positioning system, I was able to sit up and do light activities, my mind was clearer, and my health recovered well. Luckily, the surgery was at the provincial hospital, otherwise it would have been too expensive to go to Ho Chi Minh City." Master, Doctor Le Thi Thanh Tra, Head of the General Planning Department of the General Hospital of Friendship said: “On December 6, 2013, with the support of the 198 Hospitals of the Ministry of Public Security and Belgian experts, the Hospital successfully performed the first kidney transplant. The kidney donor was Ms. Vo Thi Huong, born in 1966 in Block 7, Nghi Thuy Ward, Cua Lo Town. The recipient was Hoang Van Hoa, born in 1988 - Ms. Huong's son. This is a success for the hospital because currently not many hospitals in Vietnam can do this.

Although it has only been in operation since August 8, 2011, the Oncology Hospital has quickly become a regional nuclear specialty hospital. Since its establishment, the Oncology Hospital has successfully performed many complex techniques at the central level such as: Successful surgery for lung tumors, mediastinal tumors, esophageal tumors; Gastrectomy, total gastrectomy with lymph node dissection; Colon resection surgery; Liver segment resection surgery... In June 2013, the Oncology Hospital successfully performed the first bone marrow transplant for Hoang Thi Hang, 22 years old, in Trung Thanh commune, Yen Thanh district. Patient Hoang Thi Hang was diagnosed with malignant lymphoma.

After that, the patient was treated at Nghe An Oncology Hospital using traditional methods, including chemotherapy. After meeting all the conditions for facilities, the hospital successfully performed a bone marrow transplant for Ms. Hang. On January 18, 2014, Ms. Hang was discharged from the hospital, her health recovering well. Associate Professor, Doctor, Colonel Nguyen Trung Chinh, Senior Advisor of Nghe An Oncology Hospital, said that bone marrow transplant is the most advanced, modern and effective method in cancer treatment in the world and Vietnam today. Especially for blood cancers such as: acute leukemia, chronic leukemia, bone marrow failure, malignant lymphoma. The transplant time for a case lasts about 4 hours, the patient only feels similar to a blood transfusion, so they can watch TV normally while having the transplant. After the transplant, the patient does not need to use anti-rejection drugs, the remission rate after 5 years will reach 80 - 90%, while other methods such as surgery, chemotherapy or radiotherapy have a success rate of only 50 - 60%. Nghe An Oncology Hospital is the first provincial hospital to successfully implement bone marrow transplantation.

Nghe An Obstetrics and Pediatrics Hospital has been very successful in open heart surgery. Doctor Phan Van Tu, Director of the Obstetrics and Pediatrics Hospital, said: The hospital has introduced open heart surgery into routine surgery and strives to successfully treat about 40% - 50% of children with congenital heart disease by 2014. In parallel with receiving the transfer of open heart surgery techniques, the hospital is receiving the technique of treating blood cancer (also known as acute leukemia) in the maintenance phase from the National Children's Hospital (ie using maintenance drugs, because childhood cancer has many different pathological aspects and treatment methods than cancer in adults).

The implementation of Project 1816 of the Ministry of Health on technical support for the grassroots health sector has created positive changes. At the Northwestern Regional General Hospital, Vinh City Hospital, Nghi Loc, Yen Thanh, and Dien Chau District General Hospitals, endoscopic surgery has been performed proficiently and has become routine. Not stopping at waiting for the upper levels, the lower level hospitals have proactively approached new science and technology, Doctor Tang Viet Ha, Director of the Northwest Regional General Hospital said: "Currently, the hospital has also skillfully applied some difficult techniques, ensuring to serve the needs of on-site medical examination and treatment for people in the districts in the region such as: brain surgery, extracorporeal lithotripsy... To meet the increasing demand for medical examination and treatment of the people, the hospital has invested in purchasing modern equipment in many forms from state capital, as well as implementing socialization work. Besides, we have sent staff for specialized training at the central and provincial levels...".

Doctor Bui Dinh Long, Director of Nghe An Department of Health said: With the goal of becoming a high-tech medical center of the North Central region, since 2010, the research and application of science and technology in medical examination and treatment has been promoted by the industry. Since 2010, provincial and district hospitals have successfully applied many high-tech techniques in treatment and diagnosis. In which, priority is given to developing science and technology in the fields of: Disease prevention, treatment, and rehabilitation. Strongly applying information technology in hospital management, all medical examination and treatment units must be responsible for selecting and developing new techniques suitable for approved technical divisions. Taking the quality of public health care services as a measure of medical ethics of medical staff; Focus on training, attracting and developing medical human resources in both general and specialized directions, training doctors for all levels, meeting the needs of caring for, protecting and improving people's health in all situations, meeting the task of developing the medical career in the short and long term; Hospitals focus on training to deploy technical categories according to the roadmap, focusing on training high-quality human resources by sending young, capable staff and arranging them into professional and technical teams to study domestically and abroad.

Thanh Son - Tu Thanh