Hanoi (VNS/VNA) - Clinics in communes have improved their healthcareservices and facilities to attract more local people and reducepatient overloads at city and province-level hospitals.

Foryears commune-level clinics had poor reputations and few patients, but thatimage has changed.

Theclinic of Tan Hoi commune in Hanoi’s suburban district of Dan Phuong is anexample.

Inrecent years, local people have been going to the commune clinic when theyhave health problems instead of the city hospitals as before.

Everyday, the clinic receives people for vaccinations, pregnancy checks,to pick up medicine or those hospitalised due to accidents, according to doctorTran Thi Mai Huong, head of the clinic.

Asone of the outstanding commune-level clinics of Hanoi, Tan Hoi Clinic hascontributed to improving the quality of primary healthcare for people in thecommune, attracting more and more patients and creating trust in localmedical examination and treatment.

“Thenumber of patients who have come to check their health and get medicaltreatment in the clinic has increased year by year,” said Huong.

“Lastyear, the clinic provided medical examinations for more than 10,000 people,doubling the numbers in previous years,” the doctor said.

“Sofar, we have given monthly health checks and medicine for 597 patients withhypertension and 145 patients with diabetes. In the first eight months of thisyear, the number of the two groups of patients remarkably increased fromprevious years,” the doctor said.

“Themain reason for increasing trust of the people in the commune clinic was thatthe qualifications of medical workers and quality of medical services have beenimproved, and people can now come to the nearest place for medicalexamination and treatment, and the full cost of examination and treatment iscovered by health insurance,” she added.

Expandingthe medicine and medical techniques covered by health insurance hasalso helped attract more patients to the clinic.

TheTan Hoi Clinic has been approved for nearly 1,100 medical techniques and 140kinds of medicines.

Similarly,the clinic in Minh Chau commune of suburban Ba Vi district with nine doctors and20 well-equipped departments has attracted more patients in recent years.

DoctorChau Le Thi Loc, the clinic’s head, said since applying the family medicinemodel, local people had more trust in the clinic.

Everymonth, the clinic received 400 patients, double the figure of previousyears, said Loc.

Theclinic can offer 80 percent of examination and treatment techniques of thebasic medical package service on the health insurance list.

Accordingto Hanoi’s Health Department, since last year, the city had launched 456standardised clinics in communes, reaching 95.19 percent of the target.

Thecommune-level health establishments are fully invested in terms ofinfrastructure, medical equipment and human resources which has helped localpeople access quality medical services and help localities carry out preventivehealthcare.

Thedepartment’s statistics showed that the total number of patients at thesegrassroots-level clinics was more than 900,000 for the first eight months thisyear, equal to 248 patients per month per facility.

Medicalexperts have said the grassroots healthcare system is the foundation of thenational health system and if the grassroots system is done well, it canmeet 70 per cent of common healthcare needs.

Communeclinics are responsible for providing primary healthcare services includingpreventive medicine, medical examination and treatment, reproductivehealthcare, supplying essential drugs, and community health management.

Vietnamhas set a target that by 2025, over 90 percent of the population will havehealth management records, 95 percent of commune, ward and town healthestablishments will carry out preventive medicine and provide treatment of somenon-infectious diseases such as hypertension and diabetes, and by 2030, morethan 95 percent of the population will have health management and 100 percentof grassroots clinics will be able to treat some non-infectious diseases.

Thisis a goal that requires considerable efforts, including the role of expandinghealth insurance coverage at grassroots healthcare facilities.

Effective use of health insurance

Accordingto doctor Huong, the major difficulty for commune clinics at present is a lackof human resources.

Inaddition, examination and counselling for early detection of diseases forpeople with risk factors have not been widely implemented because they are notyet covered by health insurance, she said.

Thepayment for health insurance is still difficult and new techniques areonly covered up to 70 percent.

“Ifthe issues were solved, the local people would be examined and treated in theclinics which would help reduce the transfer to upper-level hospitals,” Huongsaid.

Toimprove the quality of grassroots healthcare, the Ministry of Health will stepby step reform the payment method, issue and update the basic health servicepackage in accordance with the health insurance fund and State budget.

Currently,the ministry is surveying 26 commune clinics of eight provinces andcities in the northern, central and southern regions to pilot a medicalprogramme.

Underthe programme, the clinics will work in a family medicine form that all localpeople will have their health supervised and get medical examinations at leastonce a year.

Thedelivery of medicines to treat chronic diseases such as diabetes, hypertension,HIV/AIDS, tuberculosis at the clinics is one of the priorities of theministry to reduce the patient overload for higher-level hospitals and cuttravel costs and increase treatment compliance of patients.

Toimprove the treatment of grassroots-level healthcare establishments andencourage people to buy health insurance, the ministry issued a circularregulating the lists and rates of insurance payment for pharmaceuticalproducts, bio-products and radioactive drugs

Underthe circular, 61 new drugs were added to the list of insurance payment to meetthe treatment needs and suitable for the development of the pharmaceuticalindustry

Theministry has increased the rate of insurance payment for six new drugs tofacilitate patients with health insurance cards to increase access to medicinesat the clinics.

Accordingto experts, to strengthen healthcare services covered by health insuranceat commune clinics, the health sector must focus on reforming the healthcarepayment mechanism covered by health insurance.

Thepayment reform should not regulate the percentage of health insurance fundsused at clinics but implement capitation payments, issue a basic health servicepackage at the communal level, strengthen management and treatment of chronicdiseases, especially for those diagnosed at higher levels, and comply with theministry’s treatment protocol.

Interms of infrastructure facilities, clinics should be invested with housing andequipment under the standardised model as well as develop common software tomanage information about clinics’ activities and people's health records./.