Why can't Nghe An Dermatology Hospital examine and treat patients with health insurance?

The "fatal blow" called the Covid-19 pandemic

Nghe An Dermatology Hospitalwas established on September 23, 2019, according to Decision No. 3731/QD-UBND of Nghe An Provincial People's Committee on the basis of upgrading from Nghe An Provincial Center for Leprosy and Dermatology.

According to the decision, the Hospital is a public health service unit at the provincial level, grade 3, under the Nghe An Department of Health, under the professional and technical direction of the Department of Health and the Central Dermatology Hospital.

Nghe An Dermatology Hospital has a scale of 50 beds, 2 rooms and no more than 6 departments. The hospital performs the function of preventing and examining, treating leprosy, sexually transmitted diseases, skin diseases, and cosmetic skin surgery.

On June 1, 2020, the People's Committee of Nghe An province issued Decision No. 1674/QD-UBND on granting autonomy and self-responsibility for performing tasks, organizing apparatus, personnel and finance toNghe An Dermatology Hospital2020-2022 period (Autonomy in regular expenditure belongs to group 2).

Due to the Covid-19 pandemic, Nghe An Dermatology Hospital has almost no patients, and its revenue has hit rock bottom. Photo: Thanh Chung

“The establishment of the hospital brings a lot of joy and expectation to the Nghe An Health sector and the staff of the unit. For the Health sector, the Dermatology Hospital is the final piece of the system of specialized hospitals in Nghe An. Changing the main task from prevention to treatment will help improve the lives of the hospital staff,” said a leader of the Nghe An Dermatology Hospital.

After being established, Nghe An Dermatology Hospital began its first steps of development: In February 2020, the Hospital gradually moved its headquarters from No. 142, Le Hong Phong Street to No. 130, Le Hong Phong Street, Truong Thi Ward, Vinh City.

Also in this month, the hospital was approved for its technical list and granted an operating license. The hospital gradually began to complete its apparatus and facilities and aimed to sign a contract with an insurance agency to provide health insurance examination and treatment for people...

In 2021, the Hospital recruited 8 more doctors, 3 nurses, 1 laboratory technician, 1 administrative officer, 1 accountant, 1 environmental engineer, 1 hospital quality management officer; increasing the number of employees working at the unit from 19 to 35 people.

The hospital has also established 2 departments and 3 specialized departments including: General Administration Department, Line Planning Department, Examination Department, General Treatment Department and Pharmacy - Medical Supplies Department (including a paraclinical testing department).

In the joy of its first faltering steps, Nghe An Dermatology Hospital was dealt a fatal blow called Covid-19. This pandemic has left the hospital with almost no income (only about 10 patients per day).

During the epidemic, the hospital faced many difficulties as it only carried out epidemic prevention and control work but could not perform medical examination and treatment. The hospital's revenue during this period was not enough to pay salaries to staff.

From February 2020 to April 2022, revenue hit rock bottom, Nghe An Dermatology Hospital had no funds to purchase equipment and facilities. Construction of the hospital was basically halted...

Not meeting the conditions to sign a health insurance medical examination and treatment contract

When the Covid-19 epidemic was controlled and gradually stabilized, Nghe An Dermatology Hospital restarted its construction and development. However, at this point, after more than 2 years of establishment, the hospital's facilities and equipment are still not much different from when it was the Center for Leprosy Prevention and Dermatology. The hospital does not have enough conditions to implement the technical categories of a grade 3 provincial specialized hospital.

Nghe An Dermatology Hospital Pharmacy has been closed for 4 months now. Photo: Thanh Chung

In addition, the development process is seriously hindered by internal problems. Nghe An Dermatology Hospital lacks solidarity; there are cadres and employees who lack a constructive spirit, “the outside hand is longer than the inside hand”; there are cadres who do not work, perform the assigned functions and tasks; there are cadres who resign…

Therefore, the Dermatology Hospital could not buy chemicals to operate the biochemical testing machine; encountered many difficulties in building and completing the hospital to sign a health insurance examination and treatment contract in 2022.

On February 16, 2022, Nghe An Dermatology Hospital issued Document No. 73/BVDL to Nghe An Department of Health and Nghe An Provincial Social Insurance regarding creating conditions for the hospital to sign a contract for medical examination and treatment under Health Insurance in 2022.

On February 18, 2022, Nghe An Department of Health issued Document No. 673/SYT-NVY on medical examination and treatment under Health Insurance at Nghe An Dermatology Hospital to Nghe An Provincial Social Insurance. In this document, the Department of Health commented: Nghe An Dermatology Hospital is qualified to organize medical examination and treatment under Health Insurance with the form of organization of activities being outpatient and inpatient medical examination and treatment under Health Insurance. Payment of medical examination and treatment costs under Health Insurance at public hospitals of class III... The Department of Health requested Nghe An Social Insurance to consider and supplement the signing of a contract for medical examination and treatment under Health Insurance for Dermatology Hospital in 2022.

On May 9, 2022, Nghe An Social Insurance issued Official Dispatch No. 717/BHXH-GĐBHYT regarding the signing of a health insurance medical examination and treatment contract in 2022. The dispatch stated that "Nghe An Dermatology Hospital is not qualified to sign a health insurance medical examination and treatment contract in 2022"...

After receiving this Official Dispatch, Nghe An Dermatology Hospital continued to issue Official Dispatch No. 253/BVDL with the content of explanation and request for Nghe An Social Insurance to check and compare the registration file for medical examination and treatment under Health Insurance according to legal regulations.

On August 4, 2022, Nghe An Provincial Social Insurance issued Document No. 1401/BHXH-GĐBHYT to Nghe An Dermatology Hospital. Nghe An Provincial Social Insurance stated: “After reviewing the records provided by the Hospital and comparing them with the prescribed documents, Nghe An Provincial Social Insurance announced that Nghe An Dermatology Hospital is not qualified to sign a health insurance medical examination and treatment contract in 2022 according to the provisions of Clause 2, Article 17, Decree No. 146/2018/ND-CP and the provisions of Decree No. 155/2018/ND-CP dated November 12, 2018 of the Government amending and supplementing a number of articles related to investment and business conditions under the State management of the Ministry of Health”.

With the guidance, support and assistance of Nghe An Provincial Social Insurance, Nghe An Department of Health and medical examination and treatment units in the province, Nghe An Dermatology Hospital has now completed its organizational structure, personnel and necessary material conditions to be eligible to sign a contract for medical examination and treatment under Health Insurance.

The hospital has purchased chemicals to get the testing system working again. Photo: Thanh Chung

Mr. Huynh Phuc Son - Director of Nghe An Dermatology Hospital said: After the Head of the Department of Pharmacy - Medical Supplies of the Hospital resigned, Nghe An Department of Health mobilized a pharmacist (from Vinh City General Hospital), with a Pharmacy practice certificate to work at the Hospital for 6 months. Currently, the Department of Pharmacy - Medical Supplies has been operating stably; chemicals have been purchased to make the testing system work again.

Next, the Hospital is working with the Organization Department and the Department of Health to appoint a strengthened pharmacist who can work long-term at the Hospital. After the Department of Pharmacy - Medical Supplies is stable, the Hospital will separate the testing department from the Department of Pharmacy - Medical Supplies, establish the Department of Paraclinical in accordance with the requirements of the regulations, Nghe An Provincial Social Insurance

At this time, with the support of the Department of Health and hospitals, Nghe An Dermatology Hospital is continuing to complete the unfinished essential facilities, purchase missing equipment... and sign contracts for ambulances and diagnostic imaging.

Mr. Huynh Phuc Son stated: It is expected that in March 2023, Nghe An Department of Health and Nghe An Social Insurance will appraise and re-appraise the establishment of the Paraclinical Department to proceed to sign a contract for medical examination and treatment under Health Insurance, ensuring the rights of patients.