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Doctor laments difficulty when 'ECG must be 15 minutes' to be paid by health insurance

Doctor laments difficulty when 'ECG must be 15 minutes' to be paid by health insurance

From Tuổi Trẻ · (12m ago) Vietnamese Critical tone

Translated from Vietnamese, summarized and contextualized by DistantNews.

TLDR

  • Doctors are facing difficulties with health insurance payments due to new Ministry of Health guidelines on the minimum time required for medical procedures.
  • Specifically, electrocardiograms (ECGs) are now required to take at least 15 minutes, a duration significantly longer than the actual procedure time.
  • The Ministry of Health states these timeframes are reference points for standardizing professional practice and ensuring patient safety, not strict legal requirements for insurance claims.

A recent directive from Vietnam's Ministry of Health, aimed at standardizing medical procedures, is inadvertently creating significant hurdles for healthcare professionals and potentially impacting patient care. The core of the issue lies in the newly stipulated minimum times for various medical techniques, including electrocardiograms (ECGs), which are now mandated to last at least 15 minutes for insurance reimbursement. This requirement stands in stark contrast to the reality of performing an ECG, which typically takes no more than 5 minutes.

Tuy nhiên, trong đợt cập nhật quy trình kỹ thuật lại không chỉ có điện quang mà còn một loạt các quy trình về xét nghiệm hóa sinh, tuần hoàn, hô hấp... Tất cả đều bị các quy định cứng về thời gian chưa phù hợp. Ví dụ như điện tâm đồ phải thực hiện trong ít nhất 15 phút. Đọc kết quả Holter ECG, Holter huyết áp phải tối thiểu 30 phút... trong khi thực tế việc làm điện tâm đồ thông thường không quá 5 phút, đọc các kết quả holter không quá 10 phút.

— A doctor working at a hospital in Nghe AnExplaining the difficulties caused by the new Ministry of Health guidelines on procedure times.

This discrepancy is causing considerable frustration among doctors, who fear that rigidly adhering to these timeframes could lead to unnecessary delays for patients and, more critically, risk the rejection of insurance claims. The Ministry's previous adjustments, such as revising the time for X-rays from a minimum of 6 minutes to a broader range of 1-10 minutes, offered some flexibility. However, the new, seemingly arbitrary, minimums for procedures like ECGs and Holter monitor readings (requiring a minimum of 30 minutes) are proving problematic.

Theo đó, thông số thời gian trong các hướng dẫn quy trình kỹ thuật chỉ là thời gian trung bình mang tính tham khảo, được xây dựng nhằm chuẩn hóa thực hành chuyên môn, bảo đảm an toàn người bệnh và nâng cao chất lượng dịch vụ.

— Leader of the Department of Medical Examination and Treatment Management, Ministry of HealthClarifying the purpose of the time parameters in the technical procedure guidelines.

In response to these concerns, the Ministry of Health has clarified that the specified times are intended as professional references for standardizing practice and ensuring patient safety, rather than rigid, legally binding criteria for insurance claims. They emphasize that actual procedure times can vary based on patient complexity, staff expertise, and available equipment. The Ministry urges that insurance claim evaluations should consider the overall medical record, the appropriateness of the procedure, adherence to professional steps, and the diagnostic value of the results, rather than solely focusing on these time benchmarks. This clarification aims to alleviate the pressure on healthcare providers and ensure that insurance payments are processed based on comprehensive assessments rather than potentially misleading time metrics.

Thời gian thực hiện thực tế có thể thay đổi tùy từng bệnh nhân, mức độ phức tạp của ca bệnh, trình độ nhân lực, điều kiện trang thiết bị và mức độ tự động hóa tại mỗi cơ sở y tế.

— Leader of the Department of Medical Examination and Treatment Management, Ministry of HealthExplaining the factors that influence actual procedure times.
DistantNews Editorial

Originally published by Tuổi Trẻ in Vietnamese. Translated, summarized, and contextualized by our editorial team with added local perspective. Read our editorial standards.