|Status of Implementation Progress (Outputs, Activities, and Issues)
Output 1 - Better planning and management of human resources: This output, accounting for 22.4% of the total budget, supports the strengthening of human resources policy, planning, and implementation through the joint committee on health human resources (HHR). It has provided technical inputs to guide the legal and administrative arrangements for establishing and monitoring the registration and licensing of health professionals as mandated by the Law on Examination and Treatment (LET). The LET covers the (i) rights and responsibilities of patients, medical practitioners, and health care institutions; (ii) classification, accreditation, and licensing of health professionals and health care facilities; (iii) operational procedures in health services; and (iv) recording and remedying of medical malpractice. Based on the LET and report on HHR reform, 5 policy issuances were made from 2011 to 2014 to strengthen the legal framework for registration and licensing. Sub-output 1B supports the ongoing study on LET implementation and private health system, as well as the expansion of IT system for registration and capacity building for the National Advisory Council involved in providing guidance on registration and licensing. It also supports the ongoing revision of Circular 41/2011/TT-BYT dated 14 November 2011 to provide guidelines on practice certification for the medical practitioners and operation license of medical facilities. 23 of 30 budgeted activities (66.7%) are or will be completed by December 2015. The remaining 7 activities relate to enhancement of the national registration and licensing system and associated training activities. These will be completed in the extension period.
Output 2 - Higher quality of human resources training: This component accounts for the biggest share of total budget (69.4%). It enhances the capacities of educational institutions for pre-service training and continuing education of the health workforce, including the application of modern teaching and learning methods and transformation of educational institutions into teaching and learning hubs for other institutions. Specifically, this output supports the upgrading of teaching laboratories and equipment in 17 medical colleges, training of about 600 teachers in modern teaching methods, provision of pre-service and in-service training for ethnic minority groups, and conduct of learning exchange programs. It also includes laboratory renovation and upgrading of basic sciences equipment, as well as establishment of e-learning network and national virtual library in the medical sciences. 48 of 51 budgeted activities (94.1%) are or will be completed by December 2015. The remaining 3 activities relate to completion of scholarships and eLearning activities. These will be completed in the extension period.
Output 3- Improved management systems in health service delivery: This output, accounting for 8.2% of the total budget, aims to organize and standardize clinical processes and link them to provider payment mechanism in line with the following policy commitments: (i) development, benchmarking and costing of 20 care pathways in at least 6 hospitals, including at least 3 pathways directly related to medical care for women or primary level, and (ii) formulation of guidelines on provider payment per case associated with care pathways. This output has supported capacity building on care pathway development, clinical coding and hospital costing, monitoring and evaluation, and development of case mix database for MOH team. 24 of 30 budgeted activities (80.0%) are or will be completed by December 2015. The remaining 6 activities relate to costing studies and simulation of the case-based payment model. These will be completed in the extension period. The endorsement of the care pathways by the professional committee established by the MOH Administration of Medical Service is yet to be completed. The preliminary cost outcomes and cost per case covering 30 case types have been produced, and analysis of cost outcomes is continuing. A proposal has been submitted for further in-depth analysis concerning the variation between groups of inpatient having care with and without CPs, and if approved, the activity is expected to commence in Q4 2015.
The extension is needed to allow the simulation and actual implementation of the payment model. The proposal for the simulation has been submitted to PMU/ MoH and now under the approval process and is to be accelerated so the simulation can be conducted immediately.