"It is impossible to demand the quality of district hospitals like provincial hospitals!"

(Baonghean) -Through the discovery of the "cloning" of test results at Hoai Duc General Hospital (Hanoi), some readers have reported to Nghe An Newspaper that the quality of diagnosis, examination and treatment at some district hospitals in our province is also having problems. Nghe An Newspaper reporters had an interview with Mr. Bui Dinh Long - Director of the Department of Health to clarify this issue.

Routine vaccination for children at Hung Loc Commune Health Station, Vinh City.
Photo: An Vinh

PV:Some readers have reported that there are differences in test and diagnosis results between the district and provincial levels, leading to a diagnosis of one disease at the district level, but a different disease is discovered at the provincial General Hospital. Could you please tell us what is the cause of this?

Mr. Bui Dinh Long:Test results and disease diagnosis depend on many factors, such as blood tests depend on the time of blood collection, blood collection conditions, etc. Diseases also develop over time. In addition, it also depends on objective factors, some other subjective factors such as: blood collection techniques also affect, even two different types of testing machines have different indexes, but the difference is insignificant.

PV:There have been many cases where the district hospital said there were stones, but the provincial hospital said there were no stones?

Mr. Bui Dinh Long:This also depends on many factors.

PV:Is it the doctor's skill or the equipment?

Mr. Bui Dinh Long:Mainly due to the doctor's skill, but also due to the impact of the stone's movement, sometimes it stays in the kidney and during the patient's movement it runs up to the ureter, and from the ureter it runs up to the bladder.

PV:Some opinions say that the quality of medical examination and treatment at the district level is much worse than that at the Provincial General Hospital. What is your opinion on this issue?

Mr. Bui Dinh Long:For common diseases, there is not much difference between district and provincial level, but for difficult and specialized diseases, the difference is obvious. Because district level hospitals are mostly grade 3 hospitals, provincial level hospitals are grade 1 hospitals, the difference in professional capacity is very large. District level hospitals have departments but only at a broad level of specialty, while provincial level hospitals have specialized departments. For example, at district level hospitals, the department of surgery and obstetrics does obstetrics, surgery and trauma, while at provincial level hospitals, there are digestive surgery, urology surgery, etc.

In terms of function and duty, the commune and district levels are for examining and treating common diseases. Treatment of common diseases is not a problem at the district level. As for difficult diseases, there needs to be decentralization, such as gallstones that cannot be cured after 5-7 days of treatment at the district level, then the patient is transferred to the provincial level. In some places, district hospitals only allow one cesarean section, but for 2-3 cesarean sections, the patient must be transferred to the province...

People request that district hospitals be like provincial hospitals, which is difficult and impossible. Serious or minor illnesses must be classified. District hospitals have only invested in examining and treating common illnesses.

PV:So in some common cases like broken arms, broken legs, the plaster cast at the district hospital also has to be re-casted, is it because of the doctor's skill?

Mr. Bui Dinh Long:When a bone is broken, its position may be misaligned, and it is difficult to adjust it even with a single adjustment, even with a local anesthetic. It may also be due to the doctor's skill or pathological factors.

PV:Patients who use health insurance cards for medical examination still feel discriminated against?

Mr. Bui Dinh Long:This is due to the patient's feelings, because currently most of the medical examination and treatment are based on health insurance cards. There are hospitals where about 90% of patients are based on health insurance cards. Examination, treatment, and prescription for people with health insurance cards are always easier than those who use services because they only have to pay 15-20% of the amount.

PV:According to you, what is the current medical ethics problem in Nghe An?

Mr. Bui Dinh Long:The current issue of medical ethics depends on how we evaluate it. In Nghe An, we have made a lot of efforts, although there are still factors that patients believe need to be overcome. Nghe An is also the only province with a medical ethics project that has been implemented since 2004. Compared to before, the medical industry has had more specific standards to strive for, however, each person's perception is different.

PV:Currently in our province there is still a situation where health certificates can be easily purchased without examination?

Mr. Bui Dinh Long:The issuance of Health Certificates has been clearly regulated by the Ministry of Health, according to which only district level hospitals of level 3 or higher are allowed to examine and issue. Recently, there were some clinics that were joint ventures with some driving training centers to issue, that was wrong and we have checked, corrected and banned it. Now the Health Certificate has full specialties so only hospitals can examine.

PV:But according to feedback, at some hospitals you can still "ask" for a health certificate?

Mr. Bui Dinh Long:There are many factors to this, and we are currently working on it.

PV:What advice do you have to help people feel secure in their initial medical examination and treatment?

Mr. Bui Dinh Long:When you detect any abnormalities in your body, you should go for a medical check-up. Early detection makes the disease easier to treat.

Duc Dung (Implementation)