Tuesday, September 24 2019


New rule reduces child patient overload

Update: October, 15/2014 - 08:08
But under the new rule, genuine emergency cases sent from local hospitals are treated first at city-level hospitals and then transferred back to their hometown if further treatment can be done there.— Photo laodong

by Gia Loc

HCM CITY (VNS) — Patient admissions at HCM City's two paediatrics hospitals have reduced substantially following a regulation issued by the Ministry of Health in April that aimed to reduce overloading at city-level hospitals.

As part of a broader regulation on patient transfers, the ministry has allowed city-level hospitals to send seriously ill patients back to their provincial hospitals following emergency treatment in the city.

"Treatment at local hospitals helps patients' relatives reduce costs such as accommodations and travel. Also, each child often has two or three relatives who can take care of them during their hospital stay," said Dr Nguyen Minh Tien, head of the intensive care unit at HCM City's Paediatrics Hospital No 1.

Patients who have chronic disorders or more serious illnesses are often transferred by local hospitals to city-level hospitals in emergency cases. In addition, many families in provinces continue to have more trust in treatments at city-level hospitals.

Prior to the ministry's regulation, if patients' families travelled to the city for treatment, the hospital could not turn them down if they wanted repeated treatments.

But under the new rule, genuine emergency cases sent from local hospitals are treated first at city-level hospitals and then transferred back to their hometown if further treatment can be done there.

Because of patient overloading, the Paediatrics Hospital No 1 sometimes does not have an available breathing machine for emergency cases, according to Tien.

The intensive care unit often treats patients with spinal muscular atrophy, encephalitis or those with brain damage caused by complications from hand, foot and mouth disease. These patients need to use respiratory equipment on a regular basis.

"The intensive care unit doctors had to wait 12 hours one time to have a machine for a patient with severe dengue fever. Luckily, he was OK," he said.

Patients who only needed breathing machines should be transferred back to their provincial hospitals because they had the machines as well, Tien said, adding that the skills of doctors at provincial hospitals had improved in recent years.

Dr Tang Chi Thuong, deputy head of the city's Department of Health, said the ministry regulation had created a legal basis for city-level hospitals to transfer patients to local hospitals for permanent treatment.

"Provincial and city hospitals and patients have benefited from this," Thuong said.

For example, a two-year-old boy who suffered from a rare congenital cardiovascular disorder had to have surgery and then use a Continuous Positive Airway Pressure machine at Paediatrics Hospital No 1.

After treatment, the hospital doctors sent information on the boy's treatment regimen and disease history to the Hospital for Obstetrics and Paediatrics in the Mekong Delta province of Ca Mau.

"He has now recovered and no longer needs the breathing machine," said Dr Le Mong Thuy of Ca Mau Hospital.

In addition, doctors at the provincial hospitals speak with their city counterparts regularly about patients' treatment.

In another case, a six-year-old boy from the Mekong Delta Province of An Giang was transferred to the local Paediatrics Hospital after complications from hand, foot and mouth disease in September 2011. He needed to use a breathing machine only.

"The boy is better and uses a breathing machine one hour each night," said Duong Thanh Long, deputy head of the An Giang Paediatrics Hospital, adding that "his parents now trust his hospital's doctor."

Tien of HCM City's Paediatrics Hospital No 1 said the boy would not have recovered as quickly if he had remained in HCM City.

As for other transferrals, the Dong Nai Paediatrics Hospital admitted 343 children with nephrotic syndrome and 248 with thalassemia after they were treated initially at Paediatrics Hospital No 2 in HCM City.

Dr Le Tan Ky Phi of Phu Yen Province's Obstetrics and Paediatrics Hospital said he supported the patient transfer but pointed out that it was difficult to persuade parents to trust local hospitals.

Thuong said that it was important that city doctors explain the benefits of getting treatment in their locality or province.

"The (local) hospitals will also get more experience by doing this," Thuong said, adding that it would enhance the provincial hospitals' reputations as well. — VNS

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