Public and private healthcare in Nghe An: Competition for development
Nghe An has a large population and a high and growing demand for medical examination, treatment, and healthcare. This provides a strong foundation for the development of private healthcare, putting pressure on public healthcare to change.
Private healthcare ranks 4th nationwide.
Currently, Nghe An province has 3,720 licensed private medical facilities. Among these are 15 general and specialized hospitals. Private hospitals are concentrated mainly in Vinh City (9 hospitals) and Quynh Luu district (2 hospitals)... The total number of beds in these 15 hospitals is 1,861, accounting for nearly 10% of the province's planned bed capacity.
Over the years, private hospitals have increasingly improved the quality of medical examination and treatment. Many hospitals have invested in facilities, medical equipment, and human resources in a synchronized and modern manner, and have implemented many advanced techniques. Private hospitals not only help reduce the burden on the public healthcare system but also compete directly in attracting patients.
For example, Quang Thanh and Minh An General Hospitals in Quynh Luu district have successfully implemented many advanced techniques on par with public hospitals. Dr. Dau Phi Nam, Director of Minh An General Hospital, said: The hospital has successfully performed many advanced techniques such as skin and muscle graft surgery; endoscopic ureteral stone lithotripsy; hemodialysis; abdominal wall tumor resection; endoscopic tympanoplasty; endoscopic hysterectomy; endoscopic diagnosis of early esophageal, stomach, and duodenal cancer; rectal endoscopy; and cardiovascular ultrasound.
In 2023, the number of patients examined and treated at public and private hospitals in Quynh Luu district was roughly equal: Quynh Luu District General Hospital had 81,952 patient visits; Quang Thanh General Hospital had 89,136 patient visits; and Minh An General Hospital had 73,697 patient visits.
In Yen Thanh district, Bao Son General Hospital has only 11.9% of the number of hospital beds, but the number of patient visits is 58% of that of Yen Thanh General Hospital. In Hoang Mai town, Quang Khoi General Hospital significantly surpasses Hoang Mai Town Medical Center and Quynh Lap Central Leprosy and Dermatology Hospital in terms of patient visits.
In 2023, the Nghe An Health Department conducted an inspection and evaluation of hospital quality and surveyed patient and healthcare worker satisfaction. Non-public hospitals achieved an average score of 3.53 points (highest was 4.4, lowest was 2.79). Meanwhile, the overall average score for public healthcare facilities was 3.42 points (highest was 4.4; lowest was 2.7).
Dr. Nguyen Thi Hong Hoa – Director of the Department of Health, stated: The system of non-public medical and pharmaceutical practice facilities in the province is growing stronger in both quantity and quality; ranking 4th nationwide in scale; and services are becoming increasingly rich and diverse... Nghe An is currently continuing to petition the Ministry of Health to approve the addition of planned beds for non-public hospitals when they meet the regulations; and to encourage the development of non-public facilities in mountainous districts.
Pressure to promote the development of public healthcare.
In 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 to have the total number of hospital beds in non-public hospitals reach 15% of the total number of hospital beds by 2025.
From 2019 to the present, the Provincial People's Committee has approved the investment in 8 projects to build and expand private specialized and general hospitals with a total registered capital of VND 912.42 billion. These projects are currently in the implementation phase. It is expected that by 2025, Nghe An will have 4 more private hospitals in operation. By 2030, at least 3 more new private hospitals will be established and operational, bringing the total number of private hospitals in the province to 22.
The growth of private hospitals is putting significant pressure on public hospitals. In the competition between these two types of hospitals, each has its own advantages. Public hospitals have advantages in terms of brand recognition, technical expertise, and treatment costs. Private hospitals, on the other hand, excel in modern facilities and equipment; basic supply of medicines, medical supplies, and chemicals; proactive approach to attracting human resources; service delivery capabilities; and the ability to access and meet customer needs.
Ms. NTL, 69 years old, from Vinh City, commented: "I often go for check-ups at both public and private hospitals. At public hospitals, I find it quite time-consuming, but the doctors are highly qualified and the treatment costs are lower. At private hospitals, the reception and examination process is very thorough and efficient, however, the service prices are higher. Each place has its own advantages and disadvantages. I still hope that public hospitals will develop further because not everyone has the financial means to receive examinations and treatment at private hospitals."
According to Dr. Le Van Hoan, Deputy Director of Quynh Luu District General Hospital, investment in infrastructure, equipment, and attracting human resources in public hospitals is still limited. Procurement bidding for medicines, supplies, and chemicals still faces many obstacles. Public hospitals suffer quite a few disadvantages due to these systemic issues.
For example, Quynh Luu General Hospital still lacks equipment to implement advanced techniques such as CT scanners, hematology analyzers, ultrasound machines, surgical equipment, and endoscopic systems. There is also a shortage of medicines and medical supplies due to the inability to win bids, such as emergency drugs, cardiovascular drugs, and supplies in the fields of orthopedics and dentistry.
"Quynh Luu General Hospital will have to strive to invest in and develop its strengths; improve facilities; and enhance the spirit and attitude of service... 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," shared Dr. Le Van Hoan.
Private hospitals are in need of highly qualified, specialized personnel with professional licenses, and are willing to offer high salaries to attract them. Meanwhile, public hospitals lack mechanisms to retain and value these professionals. This is a major factor hindering the development of public hospitals, especially at the district level.
Dr. Nguyen Hong Truong, Director of Vinh City General Hospital, suggested: According to current regulations of the Ministry of Health, the price of medical examination and treatment services in public hospitals only calculates 4 out of 7 factors (while in private hospitals, all 7 factors are included). The State needs to quickly calculate the correct and complete price of services so that public hospitals have more resources to retain staff, improve service quality, and gradually reduce out-of-pocket expenses for the people.