Public and private healthcare in Nghe An: Competition for development
Nghe An has a large population, the need for medical examination, treatment and health care is large and increasing. This is the basis for the strong development of non-public health care, creating pressure for public health care to change.
Non-public healthcare ranks 4th in the country
At present, Nghe An has 3,720 licensed non-public medical facilities. Among them, there are 15 general and specialized hospitals. Non-public hospitals are mainly concentrated in Vinh city (9 hospitals), Quynh Luu district (2 hospitals)... The total number of beds in 15 hospitals is 1,861, accounting for nearly 10% of the planned number of beds in the whole province.
In recent years, non-public hospitals have increasingly improved the quality of medical examination and treatment. Many hospitals have invested in facilities, medical equipment, and human resources in a synchronous and modern manner and have deployed many specialized techniques. Non-public hospitals not only help reduce the burden on the public health system, but also compete directly in attracting patients.
For example, Quang Thanh and Minh An General Hospitals in Quynh Luu District have performed many advanced techniques on par with public hospitals. Doctor Dau Phi Nam - Director of Minh An General Hospital said: The hospital has performed many advanced techniques such as skin transfer surgery, covering muscle; endoscopic ureteral lithotripsy; periodic hemodialysis; abdominal tumor resection surgery; endoscopic tympanic membrane repair surgery; endoscopic hysterectomy; endoscopic diagnosis of early esophageal, gastric, and duodenal cancers; rectal endoscopy; cardiovascular ultrasound.
In 2023, the number of patients examined and treated at public and non-public hospitals in Quynh Luu district is similar: Quynh Luu District General Hospital has 81,952 patients examined and treated; Quang Thanh General Hospital has 89,136 patients examined and treated; Minh An General Hospital has 73,697 patients examined and treated.
In Yen Thanh district, the number of beds of Bao Son General Hospital is only 11.9%, but the number of medical examinations and treatments is 58% of the number of medical examinations and treatments of Yen Thanh General Hospital. In Hoang Mai town, the number of medical examinations and treatments of Quang Khoi General Hospital is much higher than that of Hoang Mai Town Medical Center and Quynh Lap Central Dermatology and Leprosy Hospital.
In 2023, Nghe An Health Department organized inspections, evaluated hospital quality and surveyed patient and medical staff satisfaction, non-public hospitals achieved an average score of 3.53 points (highest was 4.4, lowest was 2.79). Meanwhile, the average score of public medical examination and treatment facilities reached 3.42 points (highest was 4.4, lowest was 2.7).
Dr. Nguyen Thi Hong Hoa - Director of the Department of Health said: The system of non-public medical and pharmaceutical facilities in the province is growing in both quantity and quality; the scale is ranked 4th in the country; services are increasingly rich and diverse... Nghe An is currently continuing to propose to the Ministry of Health to approve the addition of planned beds for non-public hospitals when meeting the prescribed conditions; encouraging the development of non-public facilities in mountainous districts.
Pressure to promote public health development
Implementing Resolution No. 20-NQ/TW on strengthening the protection, care and improvement of people's health in the new situation, Nghe An has been making efforts to attract many large investment organizations in the health sector; striving for the total number of beds in non-public hospitals to be equal to 15% of the total number of beds by 2025.
From 2019 to present, the Provincial People's Committee has approved the investment policy of 8 projects to build and expand non-public specialized and general hospitals with a total registered capital of 912.42 billion VND. Up to now, these projects are in the implementation phase. It is expected that by 2025, Nghe An will have 4 more non-public hospitals in operation. By 2030, at least 3 new non-public hospitals will be established and put into operation, bringing the total number of non-public hospitals in the area to 22.
The development of non-public hospitals is creating great pressure on public hospitals. In the competition between these two types, each type has its own advantages. Public hospitals have advantages in terms of brand, technical expertise, and treatment costs. Non-public hospitals are superior in terms of modern facilities and equipment; basic supply of drugs, materials, and chemicals; proactive in attracting human resources; service provision capacity; and ability to approach and meet customer needs.
Ms. NTL, 69 years old, in Vinh city commented: "I often go to both public and non-public hospitals for examination. At public hospitals, I find it quite time-consuming, but the doctors are highly qualified and the treatment costs are cheap. At non-public hospitals, the reception and examination process is very thoughtful and quick, but the service price is higher. Each place has its own advantages and disadvantages. I still hope that public hospitals will develop more because not everyone has the financial means to examine and treat at non-public hospitals."
Doctor Le Van Hoan - Deputy Director of Quynh Luu District General Hospital said: Investment in facilities, equipment, and attracting human resources in public hospitals is still limited. Bidding for the purchase of drugs, supplies, and chemicals still has many problems. Public hospitals have many "disadvantages" due to the problems caused by the mechanism.
For example, Quynh Luu General Hospital still lacks equipment to deploy advanced techniques such as CT scanners, hematology testing machines, ultrasound, surgical machines, and endoscopy systems. There is a shortage of drugs and medical supplies due to the inability to bid for emergency drugs, cardiovascular drugs, and supplies in the fields of trauma, orthopedics, and dentistry.
"Quynh Luu General Hospital will have to make efforts to invest and promote its key strengths; renovate facilities; improve service attitude... Besides its own efforts, public hospitals, especially at the district level, really need resource support from all levels and sectors to invest in equipment and facilities," said Dr. Le Van Hoan.
The non-public hospital system is in need of recruiting highly qualified, specialized and licensed human resources; and is willing to offer high income levels to attract them. Meanwhile, public hospitals do not have a mechanism to retain and promote them. This is the factor that affects the development of public hospitals, especially at the district level.
Doctor Nguyen Hong Truong - Director of Vinh City General Hospital suggested: According to the current regulations of the Ministry of Health, the price of medical examination and treatment services in public hospitals is calculated based on 4/7 service price components (while in non-public hospitals, 7/7 are calculated). The State needs to quickly calculate the correct and full price of services so that public hospitals have more resources to retain human resources, improve service quality, and gradually reduce out-of-pocket expenses./.