MEDICAL SITUATIONIN VIETNAM NGO QUY CHAU MD, Ph.D, Assoc.Prof Deputy Director Bach Mai Hospital Hanoi - Vietnam
Vietnam • Red river delta region • North east region • North west region • North central coast region • South central coast region • Central highlands region • North east south region • Mekong river delta region
Population, social and economic environment indicator Source: Health statistics yearbook 2006 – Ministry of Health
Medical problem before 1990 • Medical system has downgraded • Material reduce • Health expenditure was limited • Few number of medical station in rural area, absence medical station in some commune. • Health worker distribute unequal e.g. Central highland region: 2.7 Health worker/ commune Red river delta region: 5 Health worker/ commune • Knowledge of health worker in rural area was low. • Policy in favor for health worker was unconsidered. • Ratio of bed in use: 30 – 40%
Consequences • Diseases (malaria cause 300 person died in 1991-1992) • Patient seem to belittle medical system in local and concentrate in cities • Health worker only interested in working in provinces and cities • The quality of primary care was restricted
Government policy to improve rural medical system • Medical insurance policy (1992) • Hospital fees (1989) • Ordinance to practice private medicine and pharmacy (1993) • National ordinance about pharmacy • Decision to improve medicine in rural area (1994) • Use State budget to support health worker in rural area • Improvement medical infrastructure and medical equipment, especially in rural area • Increase budget for health
Health achievement • Medical system in rural area are improve both quantity and quality • The whole country has: 10748 commune health center • All commune has health center • Health workeris increasing in number and quality • Medical equipment is innovative • Primary care is improving
State health budget by years Unit: billion VND Source: Health statistics yearbook 2006 – Ministry of Health
Percentage of health insurance participation of population are increasing. (%) Source: Health statistics yearbook 2006 – Ministry of Health
Beds in health facilities by years 1986 – 2006 (No. of beds per 10000 inhabitants) Source: Health statistics yearbook 2006 – Ministry of Health
Drug expenditure per capita Source: Health statistics yearbook 2006 – Ministry of Health
State health budget by category 2006 Source: Health statistics yearbook 2006 – Ministry of Health
Health facilities & beds by level 2006 Source: Health statistics yearbook 2006 – Ministry of Health
Health personnel by provincial, district, communal level Source: Health statistics yearbook 2006 – Ministry of Health
Health situation at communal level 2006 CHC: Commune Health Center Source: Health statistics yearbook 2006 – Ministry of Health
Pharmaceutical production and trading Source: Health statistics yearbook 2006 – Ministry of Health
Equipment up to 31/12/2006 Note: Including equipment of government health facilities belong management locals. Source: Health statistics yearbook 2006 – Ministry of Health
Health proposal for consideration • Central hospitals are overloaded cause patients still do not have confidence in local medical system. • Improve primary care, quality and convenient of rural medical system. • Renew content and programme education • Encourage investment in traditional medicine • Upgrade medical infrastructure and equipments
Healthcare Informatics in Vietnam • Ministry of Health started to develop LAN and WAN networks in hospital and schools of medicine • Currently deploying successful applications and software packages in hospital and medicine schools • Some leading research projects, such as Teleradiology, have recently been carried out by the Institute of Information Technology and the National Center for Natural Science and Technology • Growing collaboration between Vietnamese researchers and international scientists, engineers and practitioners
Healthcare Informatics in Vietnam • Telemedicine recently use in Vietnam • Only have in few Central Hospital • Remote medicine is not yet common technical in Vietnam • Video Conference System is use to exchange medical information, experience and to hold a consultation • Mostly between Central hospitals or with foreign hospitals
Healthcare Informatics in Vietnam • Lack of equipments • Network infrastructure is not adequate to the demand • Lack of technical staff in manage and use equipments • Investment in remote medicine is still unappreciated • Manager still not recognize telemedicine are very meaningful for training and researches in order to reduce expense and bring benefit to doctors and patients
BMH telemedicine equipments Video communication device IPELA - SONY with high video and high speed network connection. This is a multi point videoconferencing device with H.323 protocol.
BMH telemedicine equipments VIDAR Digitizer machine, using this device we can scan X ray and CT scanner film with high quality images.
BMH telemedicine equipments COOLSCOPE- NIKON Coolscope is a microscope can be connected to the system by an IP address. It provides high solution pathological image and transfer them through the network.
VPN ROUTER Beside our system has some extra devices: switch, VPN router, transducer, projector etc. Network line is fiber cable with 2 Mbps bandwidth suitable the medical conference. DATASOLUTION BOX
By using the telemedicine system, we have organized different international medical conferences between BMH, International Medical Center of Japan, Sydney university, National Taiwan University Hospital, Medicine & Pharmacy University of HoChiMinh city.