\M\ HIEN cufu KHOA HOC
NHAN THIJrc, THUC HANH VE THONG TUYEN VA C H U Y I N TUYEN BAO HIEM Y TE CUA NGUdl CAO TUOI TAI 4 XA THUOC HUYEN KIEN XUONG TJNH THAI BINH NAM 2017
TOM TAT
Muc tiiu: Md Id nhan thuc, thgc hanh vS thdng hiyin vd chuyin tuyln bdo hilm y te cua ngudi cao tudi tgi 4 xa thupc huyen KiSn Xuang tinh Thai Bhih nam 2017. Soi tugng nghien cihi: Ngudi cao tudi (NCT) dang sinh sdng tgi dja ban nghiin cuu. Phuong phap nghien clhi: Phuang phdp djch te hpc md ta qua cu$c diiu tta cdt ngang kSt hgp dinh tinh vd dinh lugng. Ket qua nghien clhi: Cd 53,6% NCT khdng bilt vl quy djnh thdng tuyin khdni, ehua benh bao hiSm y tS; 12,9% NCT khdng bill ve , quy djnh m^t sd ddi tugng BHYT dugc thanh todn phi v ^ chuyen khi chuyin tuyln. Sd lan kham, chua benh thdng hiyin trung binh trong nam qua cda NCT la 1,34 ± 0,6 lan.
Tu khda: Khdm, chira benh; ngudi cao tudi; bdo hiem y ti; Thdi Binh.
SUMMARY:
AWARENESS AND PRACTICE OF THE ELDERLY ON HOSPITAL SELECTION WHEN SEEKING FOR HEALTH CARE SERVICES COVERED BY HEALTH INSURANCE IN 4 COMMUNES, KIEN XUONG DISTRICT, THAI BINH PROVINCE IN 2017
Objective: Describe the awareness and practice of the elderly on hospital selection when seeking for health care services covered by health insurance in 4 communes, KienXuongdistrict,ThaiBinhprovince in 2017. Method:
The cross-sectional descriptive study combined by both quantitative and qualitative methods. Results: 53.6% of the elderly do not know about the regulations on hospital selection when seeking for health care services covered by healtii insurance; 12.9% of the elderly do not know
Nguyen OCc Ttianh', Nguyen Hd My', Nguyen Vdn Tien\
Phqm Trudng Sdn', Phan Thu Nga' about the regulation on payment of some speeitic health insurance beneficiaries for hospital reference fee when referred from a district hospital to a higher-level one.
The average nmnber of visits of the elderly who selected another hospital at ihe same level when seeking for health care services covered by health insurance in the previous year was 1.34 ± 0.6 times.
Key words: Medical examinatton and treatment;
elderly; health Insurance; Thai Binh.
I. D^T VAN DE
Theo dg hao cua Liln hgp qudc, gid hda dan sd la mdt ttong nhung xu hudng dan sd quan ttgng nhat cda thi ky 21 [6], [7]. Sd lilu thdng ke dan sd cho thdy \^St Nam dang d cudi cda thdi ky "qud dd ddn sd", so vdi cac nude ttong khu vgc va tren thS gidi, thdi gian dl Viet Nam chudn bi ddn nhdn ddn sd gid ngdn han rat nhiSu.
Theo sd lieu cua Tdng cue Thdng kS nam 2015, cd nude cd khoang 9,5 tnSu ngudi cao tudi (NCT), chiSm 10,4%
dan sd. Nhung du bdo den nam 2030, ty Ie nay se tang Iln 18% va din nam 2050 Id hon 30% [4].
Hien nay phdn ldn ngudi cao tudi chua cd thdi quen di kiim tta sdc khoe dinh ky, nhieu ngudi khdng biit minh cd benh hoac biit ed benh nhung khdng tudn thu theo dung hudng dan diSu tri. Vile su dung djch vg y te cua NCT thudng hi ban che, dgc bipt la ddi vdi ngudi cao ludi d nhimg vung ndng thdn khdng cd the bao hilm y te.
Trong khi cac nude phdt triin cd t^ IS ngudi dan tham gia bao hiim y ti la 99% -100% thi d Viet Nam mdi dgt cd 76% nam 2015. Ddng lim y la ty 11 NCT cd the bao hiim y ti chi dgt 60% Id cgc ky ddng lo nggi cho cdng tac cham sdc sdc khde [8].
1. Khoa Yte cong cdng Ihrdng D?ii hpc Y Dwgc Thai Binh.
Tdc gia chinh: NguySn Due Thanh, sdt: 0912357575, email: [email protected] 2. TViroTig Cao d^ng Y ti Thai Binh.
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Huyin Kiin Xuang cd ty le ngudi dan tham gia BHYT chiim 53% [5], thuc ttgng nhdn tiiuc, thgc hanh cda NCT vi mOt sd quy dinh cua Luat BHYT ra sao.
Nham tim hlSu vdn de ndy, chdng tdi tien hdnh nghiin cdu vdi rage tiiu:
M6 td nhgn thiic, thuc hdnh ve thong tuyen vd chuyen tuyen bdo hiim y ti cua ngu&i cao tuoi tgi 4 xa thugc huyin Kien Xuang tinh Thdi Binh nam 2017.
II. DOI TlTgiNG VA PHU'ONG P H A P N G H I £ N CUtJ
2.1. Dia diim, thdi gian, doi tugng nghien cihi - Dja dilm nghien cdu: 4 xa thupc huy|n Kiln Xuong, tinh Thdi Binh, bao gdm: thi ttdn Thanh Nl, Xa Bmh Mmh; xa Binh Nguyln, xa Vii Tdy.
- Ddi tugng nghiin cuu:
+ Nghien cuu djnh lugng: NCT hien dang sinh sdng tai dia bdn nghiin cuu.
+ Nghiin cdu djnh tinh: Trgm trudng Trgm y tl; NCT tai 4 xa.
- Thdi gian nghiSn cdu: Nghiin cdu dugc thuc hiln tii 1/2017-12/2017
2.2. Phu'ong phap nghiin c(hi 2.2.1. Thiet ki nghiin ciin
Nghien cdu dugc tiin hdnh theo phuong phdp djch tS hoc mo td thdng qua cupe dieu tra eat ngang cd phan tich, kSt hgp nghiin cuu djnh lugng va djnh tinh
2.2.2. Cd mdu vd phuffng phdp chgn mau a/ Cd mdu
* Nghien cuu djnh lugng:
. P ( l - P ) n = Z^
d^
Thay vao cdng thuc, tinh dugc ca mau tdi thilu cdn cho nghiin cdu Id 465 NCT
* Nghien cuu dinh tinh: Phdng vin sdu 4 Tram trudng Trgm y ti vd 8 NCT tgi 4 xa
b/ Phuong phdp chpn mdu:
* Nghiin cdu dinh lugng
+ Chpn xa: Chpn chu dich 4 xa theo tiiu chuin sau:
- 2 xa dgi dien cho khu vuc thj trin, ven thi ttdn: THj ttan Thanh NS, xa Binh Minh.
- 2 xa dgi dien cho khu vgc xa thi ttan: xa Binh Nguyln vd xa Vu Tdy
+ Chpn NCT: Tgi mdi xa dugc chpn, chdng tdi l(ip danh sach tat ca cac thdn, sau dd lien hdnh bde tham ngiu nhiin 1 thdn dl bat dau dilu tra. Sau do lap danh sach NCT ttong dp tuoi 60 ttd lln tai thdn dd. Chpn ngdu nhiin theo hmh thdc bde tham dS phdng van doi tugng ddu tiSn ciia xa. Ap dung phuang phdp "cdng liSn cing" dl chpn doi tugng tiep theo cho din khi phdng vdn dd sd dii tupng cho mdi xa.
* Nghiin cdu djnh tinh: Tai mdi xa nghien cdu, tiin hanh phdng vdn sau Trgm trudng vd NCT ddu tiln v^
ngudi cuoi cung dieu tta.
2.3. Phuong pbap thu thap thdng tin Thdng tin dugc thu th$p bang phuang phdp phong vdn thdng qua bg phiSu dieu tra va hudng dan ph6ng van sau. Xay dgng bp phiiu diiu tta, hudng ddn diiu tta phd hgp vdi muc tiSu nghien cuu. Bp cau hdi nay dugc xdy dung dua vdo muc tiiu nghien cdu va d^a trSn nhirng ndi dung qui djnh vl cham sdc sdc khoe ngudi cao tudi dugc ban hdnh trong Luat Ngudi Cao tudi sd 39/2009/QH12 vd Luat Bdo hiim Y li sua dii, bd sung nam 2014 [2], [3].
2.4. Cac phirong phap han che sai so Hgn chi bdng cdch id ehdc t$p hudn ky ludng, thong nhat cdch ghi nhgn sd lipu cho loan bp diSu tra viSn tnnic khi tiSn hdnh nghien edu. Giam sat qud trinh dieu ha nghiin cdu. Cac philu diiu tra dugc ldm sgch trudc Idii nhgp vao may vi tinh.
2.5. Xu- Iy si lieu ' Sd lieu sau khi diSu tta dugc bang phdn mSm EPI-
DATA, phdn mim SPSS 22.0 di xd ly vdi cac test tiling kl y hoc, gia tri p< 0,05 dugc coi Id cd ^ nghia thing k£.
III. KET QUA NGHlfeN cXfV
Kien thuc BiSt Khong biSt
Bdng 3.1. T) le ngirdi cao tuSl biet ve thdng tuyin khdm chua b^nh bdo hiem y ti THCS trft xu6ng (n = 279)
SS lir^rng 119 160
Tylf(%) 42,7 57,3
Tren THCS (n-57) SS lir^g
37 20
TJ1?(%) 64,9 35,1
Chung (n = 336) SSlu^ng
156 180
TJ It (%) 46,4 53,6
P
<0,05
100
S 6 3 (44) - Tiiang 05-06/2018 Website; yhoccongdoQg vnNCT biSt vj quy dinh thong tuyin KCB BHYT xu6ng vi 64,9% NCT khac, sir khac bi?t CO y nghia thSng ehilm ty le 46,4%; 42,7% NCT co hoc vSn ni THCS tro k6 vol p<0,05.
Bdng 3.2. Ty IS ngirdi cao tuoi biSt vS tuyen thdm khdm bdo hiim y ti dp dung quy dinh thdng tuyin
Tuyln
"Riyen x3, huyen Kh6ng biet
THCS trft xu6ng(n-119) S6 luvng
100 19
Tyle(%) 84,0 16,0
Tren THCS (n - 36) S6 lirong
34 3
Tyle(%) 91,9
8,1
Chung (n = 156) So Itf^g
134 22
Tyle(%) 85,9 14,1 NCT biit tuyin tiiam khdm BHYT dp dung quy djnh THCS ttd xuong va 91,9% d NCT khdc. Cd 14,1% NCT thong tuyen Id tuyen huyen va tuyln xa chiim ty Ip cao khdng biit vi vin di ndy.
nhit (85,9%), ttong do chiim 84,1% d NCT cd hpc vin
Bang 3.3. Ddnh gid cda ngirdi cao tudi ve quy dim
Danh gia Rat thuan tien ThuSn tien Binh thuong Khong thuan tien
G^n trung tSm (n = 79) S6 lirgng
34 41 4 0
Tyl?(%) 43,0 51,9 5,1
0
thdng tuyen bdo hiem y te Xa trung tam (n = 77)
Solirtrng 26 46 5 0
Tylf(%) 33,8 59,7 6,5
0
Chung S6 lirgng
60 87 9 0
n -156) TJ ll (%)
38,5 55,8 5,8
0 Co 38,5% va 55,8% NCT datlh gia quy dinh th6ng o nh6m NCT song xa tnmg tam huygn cho tang tat thuan tuyln BHYT rit thuan tien va thuan tien cho ngufti dan, tien chiSm 33,8% va 59,7% cho r^ng thuan tien. Khong trong do o nhom NCT s6ng gin trung tSm huy^n cho rang co ai cho riing quy dinh thong tuyen \k khfing thuan tien t^t thuin tien chilm 43,0% vi 51,9% cho rgng thuan tien, voi nguoi dan.
Biiu do 3.1. Ty If ngirdi cao tuM blit quy dinh m^t so doi tirpmg bdo hiim y ti dirpic ihanh todn phi chuySn tuyen (n=336)
100 80 60 40 20 0
Tyle%
6,2 12,7 Biit
93 g E3 Tir THCS trd- xuong 87,3 r-, T„Sn Turc
Khdng biet
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Theokilquattinhbay taiBiludd 3.1,chicd6,2% BHYT dugc thanh todn phi van chuyin khi chuyin NCT cd hgc vdn td THCS trd xudng vd 12,7% NCT cd tuyin. Khdng cd sg khdc biSt gida hai nhdm trinh d§
hpc vin tten THCS biit vi quy dinh mpt sd ddi tugng hoc vdn.
Bdng 3.4. Ty le ngu&i cao tuoi biet ve cdc nhdm doi tugng dugc thanh todn phi chuyen tuyen
Kiln thuc Ho ngheo
Co cdng voi CM, cuu chiln binh Than nhan ngutti CO c6ng Huong tro cap BTXH hang thang Ddn tpc thieu so
Khong biet
THCS trft xulng (0-23) So lugng
16 14 6 1 1 3
Tyl|(%) 69,6 60,9 26,1 4,3 4,3 13,0
Trln THCS (n = 8) S6luwng
5 5 2 1 1 1
TJle(%) 62,5 62,5 25,0 12,5 12,5 12,5
Chung (n-31) s l lirgng
21 19 8 2 2 5
TJ1?(%) 67,7 61,3 25,8 6,5 6,5 12,9 NCT biit nhdm dugc thanh toan phi van chuySn khi 1125,8% va ty 11 NCT chpn nhdm ngudi dugc hucragtig chuyin tuyin BHYT la ngudi nghSo hay ngudi cd cdng cap bao ttg xa hgi va ddn tpc Ihiiu sd deu chiim 6,5%.
vdi each mang chiim ly lp la 67,7% va 61,3%. NCT cho Cd 12,9% NCT khdng biit nhdm ddi tugng BHYT dupe rdng Id than nhan ngudi cd cdng vdi cdch mang chiim t^ hudng quy dinh ndy.
Bdng 3.5. Ty If ngu&i cao tuoi sir dgng bdo hiim y ti khi khdm, chiea benh trong 1 ndm qua
Kiln thirc C6 Khong
60 - 74 lu6i (n = 242) So lirgng
229 13
Tyle(%) 94,6
5,4
> 75 tuoi (n - 94) sd lirgng
82 12
Tylf(%) 87,2 12,8
Chung (n=336) So lirgng
311 25
Ty le (%) 92,6%
7,4%
P
<0,05 Bang 3.5 cho ta tiidy cd 92,6% NCT cd the BHYT su - 74 tudi chiim 94,6% va d nhdm hi 75 ttiii ttd len chiim dung BHYT khi KCB ttong 1 nam qua, d nhdm NCT tii 60 87,2%. Su khdc biet cd y ngMa tiling kl giua hai nl
Biiu do 3.2. Ty If ngu&i cao tudi khdm, chiea binh thong tuyin trong 1 1 0 0 . T y l ? % , . o, * 94,8
« qua (n=311)
81,5 • Biet quy dinh didng
tuyin
B Khdng biit quy dinh tiidng tuyin
Cd tiidng tuyin Khdng thong tuyen
Trong nam qua, da sd NCT khdng di KCB thdng biit quy dinh tiidng tuyin chiim 5,2%. Sg khac biet c6^
tuyin. Ty lp thdng tuyin khdm, chua bSnh d nhdm biit nghta thing ke vdi p <0,05.
quy dinh tiidng ttiyin chiim 18,5% vd d nhdm NCT khdng 1 n o I ^** ^ **** • "^^"^ 05-06/2018
I Websile: yhoccongdong.vn
Bdng 3.6. Ly do khdm, chira binh thong tuyin cua ngu&i cao tudi
Ly do Thuan tien Thai do cua CBYT tit Chuyen mon CBYT gioi Cap dm
Gan trung tim (n = 13) So lirgng
5 1 6 3
Ty le (%) 38,5
7,7 46,2 23,1
Xa trung tam (n = 19) s l lirgng
6 4 12 1
Tyl|(%) 31,6 21,1 63,2 5,3
Chung(n = 32) S o l u ^ g
11 5 18 4
TylH'M 34,4 15,6 56,3 12,5 Da sd NCT trong nghiin cdu chgn kham, chiia bpnh lien di lai (34,4%), ttong dd chilm 38,5% d nhdm gdn thong tuyin vi cdn bg y ti cd chuySn mdn gidi (56,3%), trung tam huyen vd 31,6% d nhdm xa trung tam huypn.
trang do chiem 46,2% d nhdm gan tnmg tam huypn va NCT kham, chua benh thdng tuyln vi tinh trang cdp cdu 63,2% d nhdm xa tnmg tam huypn. Tiip theo Id vi thugn chiim ty 11 thdp nhdt (12,5%).
Bieu do 3.3. Ty li ngu&i cao tuoi chuyin tuyin khdm, chiea binh trong 1 ndm qua (n=311) Tyif%
21,6 p<0,05
10.4
78,4 89,6 ' • Gan irung tam huy|n
^' Xa trung tdm huy^n
Cd Khdng
Trong nam qua, da sd NCT khdng di chuyen huyen la 21,6% vd d nhdm sdng xa trung tdm huypn tuyin khdm, chua benh. Ty le chuyin tuyin kham, chiSm 10,4%i. Sg khac biet cd y nghia thdng kS vdi chiia benh d nhdm ddi tugng sdng gan trung tam p <0,05.
Danh gia Chuatot
Tit Rit tot
Bdng 3.7. Ddnh gid cua ngircd cao tudi vi khdm, chiea benh bdo hiem y te Gan trung tam (1) (n = 231)
s l lugng 40 178 13
Ty le (%) 17,3 77,1 5,6
Xa trung tam (2) (n = 234) So lugng
13 203 18
Tyle(%) 5,6 86,8
7,7
hlfn nay Chung (n - 465) Sllugng
53 381 31
Ty le (%) 11,4 81,9 6,7
ftm
<0,05
Cd 81,9% NCT ddnh gia vile kham, chua binh vacd ll,4%chuatdt(17,3%idnhdmgantrungldmhuySn BHYT hien nay da dugc thgc hipn lot (77,1% d nhdm gdn vd 5,6% d nhdm xa trung tam huyen). Su khac bipt cd y trung tam huyen va 86,8% d nhdm xa ttung tdm huyen), nghia thing kS vdi p<0,05.
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Bdng 3.8. Ly do ngudi cao tuii cho rang vifc khdm, chiea bfnh bdo hiimy ti chua tit Lydo
Thai dp vol BN BHYT kem Thulc khong tit va day dii Thii tuc phien ha Khic (Ghi ro)
Sl lugng (n - 53) 25 35 22 5
TJle(%) 47,2 66,0 41,5 9,4
Ly do chd ySu cua viec khdm, chua bpnh BHYT chua rang thai dp cda can bp y tS vdi benh nhan BHYT kim chiem tdt Id do tiiuic khdng tit vd ddy dd chiem 66,0%. Ty le cho 47,2%. Va cd 41,5% cho rdng tiiu tuc khdm BHYT phiinhi
Hpp 3.1: Nhimg bat cap khi thanh todn bdo hiem yte
"...Khi ndm dieu trf tgi bfnh vien chiing toi phdi ung tru&c mgt so tien khd l&n, ngay lgi th&i diem do chung toi khong thi CO duac. Cd nhiing ldn sau khi ra vien thanh todn toi dug'c trd tiin ve, nhu vdy thu tuc hai phien hd...."
NCT, nam, 63 tuoi
"...Toi gid roi, thu&ng khi thanh todn Id con chdu thanh todn cho nhung toi thdy chiing no di thanh todn ldu ldm, mdi m&i thdy tr& lgi. Toi cho Id do thu tuc thanh todn co nhieu bu&c .... "
NCT, nir. 68 tudi H§p 3.1 thi hiln y kiin cua NCT vi nhung bit cap gian (5/8), bin cgnh dd mdt sd y kiln phan nan vS viec ttong thanh todn BHYT. Mot sd y kiin cho rang vi|c phdi dng trudc tien kham, chua benh cho co sd y tl dii thanh todn kham, chiia b|nh BHYT tuang doi mat thdi ed BHYT.
Hop 3.2. Mong muon di bdo hiem y te ddp ung tot viic khdm, chiea bfnh cho ngu&i cao tudi tgi trgm y te xa
"...Cdc ban ngdnh cdp tren nen cung cdp day dii hogc ho tra trang thiet bi, danh muc thuoc BHYT cho trgmyte tuang duang v&i bfnh vien tuyen huyen de chiing tot co the phgc vg vifC CSSK cho ngu&i ddn not chung vd ngucri cao tuoi ndi riing ...."
Tru&ng Trgm y te xa, nii ...Ca quan BHYT cdp tren nen thanh quyit todn kip th&i theo timg thdng hogc timg quy cho trgm y te de chung toi CO the ddm bdo tot vdn di CSSK cho ngu&i cao tuoi...."
Tru&ng Trgm y te xd, nam
Hpp 3.2 thi hipn y kiln cda trudng ttam y te xa ve nhung mong mudn dii vdi chmh sdch BHYT di ddp dng tdt viee KCB vd thanh loan BHYT. Cdc y kiin tieu biiu eua Trudng Trgm y te cho rang nin cung cap them trang thiit bi cho Tram y tk xa (4/4 y kiin); thanh todn ddy du quj khdm BHYT kip thdi, nhanh chdng cho tram (3/4 y kiin).
IV. BAN LUAN
Vdi viec thdng tuyin, ngudi dan cd Ihl BHYT thuan lgi hon rdt nhiiu ttong vipc tiip can cac dich vg kham,
chda b^nh BHYT, dgc biet thuan lgi ddi vdi cdc trudng hgp ngudi lao dpng khi phai di chuySn cdng vipc td dia phuang nay sang dja phuong khac hoac ngudi vl him thay ddi noi cu tru. Cd 38,5% va 55,8% NCT ttong nghiin ciiu ddnh gid quy dinh thdng tuyin BHYT rdt thugn tifn vS thudn tien cho ngudi dan, ttong dd d nhdm NCT song gSn trung tdm huyen cho rdng rdt thugn lien chiim 43,0% vi 51,9% cho rdng thuan tipn, NCT sdng xa ttung tdm huy^
cho rdng rdt tiiuan tiln chiim 33,8% va 59,7% cho rdng thudn tiln.
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s o 3 (44) - Thang 05-06/2018 Website: yhoccongdong vnVdi quy dinh thdng tuyin, cac ca sd KCB bdt budc phai ddi mdi phong cdch phuc vg, dau tu vl ca sd vgt chdt, nhan luc nham ndng cao chdt lugng KCB di thu hut ngudi benh, lay ngudi bpnh lam trung tdm. Thdng tuyln da Idm tang muc dp hap ddn cda chinh sdch BHYT, thu hut ngudi dan tham gia BHYT vd thuc ddy md rgng ddi tugng tham gia BHYT. N.lm 2016, sd ngudi tham gia BHYT tiieo hd gia dmh la 11.530.389 ngudi, tang 37,4% so vdi nam 2015 cho thdy ngudi dan da tin tudng va nhan thay lgi ich cua chmh sach BHYT. Ddng thdi, thdng tuyln tgo nSn sg cdng bdng han ttong cung dp dich vg kham, chua bprtii BHYT giiia ca sd y ti cdng va tu [1].
Trong nam qua, da sd NCT khdng di KCB thdng myln. Ty le thdng tuyln khdm, chua benh d nhdm bill quy dinh thdng tuySn chilm 18,5% vd d nhdm ngudi cao tudi khdng biet quy dinh thdng tuySn chiem 5,2%.
Su khdc biet cd y nghia thong kl vdi p <0,05 (biiu dd 3.2). Theo nghiSn cdu cda chung tdi trong nam qua, da sd ngudi cao tudi khdng di chuyin tuySn khdm, chda benh.
T^ 1| chuyin tuyen kham, chiia benh d nhdm ddi tiigng song gan trung tdm huyen Id 21,6% va d nhdm sdng xa Irung tdm huyen chilm 10,4%.
Thuc hipn quy dinh thdng tuySn, ty IS ddn sd tham gia bao hiim y ti gia tang nhanh chdng, dat 81,7% vao nam 2016 [1]. Tuy nhien thdng tuyln ciing mang lai mdt si bat cap nhu tinh ttang lam dgng, true lgi quj BHYT cd xu hirdng ngdy cdng gia lang. Vipc ngudi cd bao hiem di KCB nhiiu ldn ttong ngay, tuin, thang de lay thudc khdng con Id hien tugng ca biet, ca chi thdng tuyin da bpc Id ySu kem cua y ti xa d mgt sd dia phuang.
Nhu vdy, vdn cdn mpt sd khd khan nhat djnh ddi vdi benh nhan cd BHYT ndi chung vd ngudi cao tudi ndi rieng. Nhin td gdc dp la nhiing ngudi trgc tiep chdm sdc silc khde ban ddu cho ngudi ddn, chung tdi cd hdi ttgm
trudng cd nhiing y kiln, nhiing mong mudn gi ddi vdi chinh sach BHYT di dap dng tot vi|c KCB va tiianh todn BHYT. Cdc y kiln tiiu biiu cua Trudng Trgm y ti cho rang nin cung cdp them trang thilt bj cho Trgm y ti xa;
thanh todn day du quy khdm BHYT kip thdi, nhanh chdng cho ttgm.
V. KET L U ^
- Cdn 53,6% NCT khdng bill ve quy djnh thdng hiyin KCB BHYT.
- 12,9% NCT khdng biet ve quy dinh radt so ddi tugng BHYT dugc thanh todn phi vdn chuyin khi chuyin tuyen.
- Ty IS thdng tuyin KCB d NCT bill quy dmh thdng tuyen chiSm 18,5% va d nhdm khdng biSt quy dinh thdng tuyin chilm 5,2%.
- Ty IS chuyen tuySn KCB d NCT sdng gan tnmg ldm huypn la 21,6% vd d xa tmng tam huyen chiem 10,4%..
- 11,4% NCT cho rdng viec KCB hien nay dugc thgc hi|n chua tot, vd ly do chd yiu Id do thudc khdng tdt va ddy du chiim 66,0%.
VI. KHUYEN NGHJ
1. Ca quan BHYT cdn tang cudng cdng tdc truySn tiidng vi chinh sdch BHYT di NCT hiiu ro quyin lgi cua NCT cd tiie BHYT; ddc biet Id cdc quy dinh tiidng ttiyin vd quyln lgi cda NCT khi thdng tuySn, chuySn tuySn.
2. Ngdnh Y ti va chinh quyln dia phuang can ho ttg cdi thi|n ca sd vgt chat, thudc thiSt ySu lai cac ttam y IS xa di cd thi dap dng dugc nhu cdu KCB ban dau cua NCT tgi tuyin xa, gidm tai cho cae ca sd y ti tuyin tten.
3. Cac CO sd y tl cdn ddy mgnh cai each thu tgc KCB BHYT theo hudng thuan lien, gidm phien hd, gidm thdi gian chd dgi, dac biSt ddi vdi NCT,
THAM KHAO
*, 1. Bp Y ti (2017), Bdo cdo ting kit cong tdc ndm 2016 vd phuang hu&ng, nhiem vg, gidiphdp chu yiu ndm 2017.
y 2. Qudc hdi (2009), Ludt Ngudi cao hidi Vipt Nam.
3. Qudc hdi (2014), Ludt sda ddi bd sung mpt sd diiu cda Lugt Bdo hiim y ti, Sd 46/2014/QH13.
4. Tdng cue Thing kl (2015), diiu tta biin dpng ddn sd nam 2015, Nha xudt ban Thong kl, Hd Ndi.
5. Vu Ngpc Huyen vd NguySn Van Song (2014), "Thgc ttang tham gia bdo hiim y ti tg nguySn cda ndng dan tinh Thai Binh ", Tgp chi Khoa hgc vd Phdt triin. t^p 12(sd 6: 853-861).
6. United Nations (2015), World Populaiton Ageing, ^ewYotk.
7. United Nations (2017), World population prospects, the 2017 revision.
8. Dinh Nam (2016), Phdi tdng nhanh ty If ngu&i cao tuoi co bdo hiim Yte, Chinh phu
SO 3 (44) - Thang 05-06/20181 Website, yhoccongdong vn |
