A number of hospitals around the country were reported to have abused the health insurance fund. (Photo: anninhthudo)Hanoi (VNS/VNA) - Vietnam Social Security (VSS) hasreported that many hospitals have been found abusing the health insurance fundin the first six months of this year.
According to data from the health insurance informationsystem, there were as many as 83.8 million check-ups of health insurance cardholders with total payment of 46.9 trillion VND (2.23 billion USD).
Some provinces were reported to have overspent from the fund.Quang Ninh, Khanh Hoa, Tien Giang, Dong Thap and Bac Lieu provinces reportedlyused over 56 percent of the year’s allocation, Thanhtra (Inspectorate) online newspaper reported.
In the first half of 2018, the health insurance fund has paidfor thousands of patients with high costs. Nearly 4,700 patients were paidbetween 200 to 300 million VND.
In particular, some patients with blood diseases treated atthe National Institute of Hematology and Blood Transfusion, NationalPaediatrics Hospital had been paid 2.8 billion VND by the health insurancefund, of which drugs for special treatment costs 2.7 billion VND.
Apart from some special cases, the data showed abnormaltrends in health insurance participation in many hospitals, mostly inappendicitis treatment, said Dam Hieu Trung, deputy director of VSI’s centre ofhealth insurance assessment and multi-level payment in the northern region.
Over the last six months, the General Hospital in Vinh Phuc provincerecorded 371 cases of peritoneal appendicitis, while 147 cases were recorded atBac Giang province’s Luc Ngan General Hospital and 86 cases at the generalhospital in Krong Pac district of Dak Lak province.
"These are abnormal numbers in the treatment of thisdisease," he said.
VSS checked medical records of these facilities and found allexamined patients in general hospitals in Dak Lak, Binh Duong, and Bac Giangprovinces did not suffer peritoneal appendicitis and several cases were alsodiscovered in other hospitals.
Trung said peritoneal appendicitis is a complication when thepatient suffers from appendicitis but is hospitalised late.
The cost of surgery for appendicitis is only 1.4 million VND,while peritoneal appendicitis costs double.
Thus, for each case of peritoneal appendicitis, the facilitywill ‘seek benefits’ of about 1.4 million VND from the health insurance fund.After inspection, VSS refused to pay for such cases, he said.
Health insurance abuse was becoming more widespread,increasing the cost of medical service and having a negative impact on thehealth insurance fund, said Trung.
He said some healthcare facilities advised patients toconduct unnecessary medical tests. Others have increased hospital fees byadding more beds to allow unnecessary hospitalisations.-VNS/VNA
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