Thông tư 35/2011/TT-BYT

CIRCULAR

GUIDANCE ON HEALTHCARE FOR OLD PEOPLE

Pursuant to the Law on Elderly people dated November 23, 2009;

Pursuant to the Law on Medical examination and treatment dated November 23, 2009;

Pursuant to the Government's Decree No. 188/2007/ND-CP dated December 27, 2007, defining the functions, tasks, powers and organizational structure of the Ministry of Health;

The Ministry of Health provides guidance on healthcare for old people as follows:

Chapter 1.

HEALTHCARE FOR OLD PEOPLE AT MEDICAL FACILITIES

Article 1. Contents of healthcare for old people at medical facilities

The contents of healthcare for old people at medical examination and treatment facilities (hereinafter referred to as medical facilities) include the contents mentioned in Article 12 of the Law on Elderly people and the following contents:

1. Inpatient and outpatient care specified in the Law on Medical examination and treatment and the Law on Health insurance.

Combination of modern medicines and traditional medicines in medical examination and treatment for old people specified in the Circular No. 50/2010/TT-BYT dated December 31, 2010 of the Minister of Health on combination of modern medicines and traditional medicines in medical examination and treatment.

2. Preventive healthcare for old people.

3. 3. Training for geriatric staff.

4. Scientific research, application of scientific or technological advances to preventive healthcare, diagnosis, treatment, rehabilitation, and health improvement for old people.

5. Direction, support, and transfer of expertise and technologies from hospitals at higher levels to hospitals at lower levels.

6. Cooperation in experience of preventive healthcare, diagnosis, treatment, rehabilitation, scientific research, and training in geriatric with international organizations, other countries, and foreign individuals.

Article 2. Responsibility for provision of healthcare for old people at medical facilities

Medical facilities must adhere to the contents of healthcare for old people mentioned in Article 1 of this Circular, in particular:

1. Central Geriatric Hospital shall:  

a) Be considered the top-level hospital specialized in diagnosis, treatment, rehabilitation, and health improvement for old people.

b) Provide instructions, transfer expertise and technologies to hospitals at lower levels nationwide.

c) Conduct scientific research in basic gerontology, clinical gerontology, and social gerontology.

d) Provide continuous training and advanced training in gerontology; cooperate with educational institutions specialized in healthcare in compiling documents and providing instructions on gerontology practice.

dd) Propose development of a nationwide healthcare network for old people to the Ministry of Health.

2. General hospitals, specialty hospitals (except for paediatrics hospitals), traditional medicine hospitals that have 50 hospital beds or more must provide inpatient beds and separate examination rooms for old people. Hospitals are encouraged to establish a geriatric department whenever possible in terms of facilities, equipment, and manpower to satisfy demands for medical examination and treatment of old people.

3. Health stations of communes, wards and towns (hereinafter referred to as local health stations):

a) Provide medical examination and treatment for old people within their competence.

b) Provide medical examination and treatment for lonely old people according to Clause 2 Article 13 of the Law on Elderly people.

4. Other medical facilities shall provide medical examination and treatment for old people in accordance with Article 1 of this Circular within their competence.

Chapter 2.

COMMUNITY HEALTHCARE FOR OLD PEOPLE, MANAGEMENT OF CHRONIC DISEASES

Article 3. Contents of community healthcare for old people

1. Disseminate knowledge about exercising, health improvement, and prevention of diseases, especially common diseases in old age. The method of dissemination shall vary according to the local conditions, such as documents, books, fliers, banners, mottos, seminars, talk-shows, and other means of mass media.

2. Provide old people with instructions on disease prevention, treatment, and self care.

3. Organize health check-ups to monitor old people’s health. Encourage the establishment of a network of community physicians and provision of healthcare services at home for old people.

4. Provide periodic health check-ups for old people at least once per year.

5. Provide medical examination and treatment for old people at local health stations and their residences.

6. Provide rehabilitation for old people that are disabled to prevent and eliminate the sequelae due to injuries, accidents, cerebrovascular accident diseases, chronic diseases, occupational diseases, and other diseases.

Article 4. Responsibility for provision of community healthcare for old people

1. Responsibility of the People’s Committees of communes:

a) Cover the costs of traveling from the local health station to the old people residences incurred by the health professionals that provide healthcare services for old people that are lonely and too sick to go to a medical facility.

b) Cover the costs of traveling incurred by lonely old people that have to go to medical facilities as requested by the local health station.

c) The allowance for traveling cost mentioned in Point a and Point b Clause 1 of this Article is specified in the Circular No. 21/2011/TT-BTC of the Ministry of Finance dated February 18, 2011 on management and use of budget for initial healthcare for old people at the homes, commendation, celebration of longevity and well-being of old people.

2. Responsibility of local health stations:

a) Provide community healthcare for old people in accordance with Article 3 of this Circular.

b) Send health professionals to the residences of old people that are lonely and too sick to go to a medical facility.

c) Make annual estimate of budget for healthcare for local old people, including periodic health check-ups mentioned in Clause 4 Article 3 of this Circular; submit it to a competent authority for approval in accordance with the Circular No. 21/2011/TT-BTC of the Ministry of Finance dated February 18, 2011 on management and use of budget for initial healthcare for old people at the homes, celebration of longevity and well-being of old people.

3. Families and relatives of old people must take care of them, cooperate with volunteers and health professionals in providing healthcare for old people.

4. Old people must take care of themselves, cooperate with volunteers and health professionals in providing healthcare for themselves.

5. Retired health professionals are encouraged work as volunteers or participate in provision of training in healthcare for old people for volunteers.

Article 5. Cooperation with elderly associations of communes, wards and towns

Elderly associations of communes, wards and towns (hereinafter referred to as local elderly associations) must cooperate with the People’s Committees and health stations at the same level in providing community healthcare for old people, including:

a) Advise the People’s Committees of communes, cooperate with local health stations in establishing a network of volunteers to provide healthcare for old people at their homes.

b) Establish social clubs for old people such as health clubs, exercise clubs, etc. Depending on the demands of old people, local elderly associations shall cooperate with local health stations in forming clubs for patients of common chronic diseases such as diabetes, hypertension, cardiovascular diseases, chronic obstructive pulmonary disease, bronchial asthma, cognitive decline, and other common diseases.

Article 6. Management of chronic diseases in old people

1. General hospitals, specialty hospitals, and other hospitals must keep a log of the chronic diseases in old people in the medical records of old people.

2. Local health stations must keep a log of the health and chronic diseases of local old people using the forms provided by the Ministry of Health.

Chapter 3.

IMPLEMENTATION

Article 7. Responsibility of Medical Examination and Treatment Department - The Ministry of Health

Medical Examination and Treatment Department must cooperate with other Departments of the Ministry of Health, Inspectorate of the Ministry of Health, Central Geriatric Hospital, and relevant units in providing instructions on and inspecting the implementation of this Circular.

Article 8. Responsibilities of provincial Services of Health

1. Provide the People’s Committees of provinces with advice on formulation of the plan for healthcare for old people in their provinces in accordance with this Circular, direct local health units to provide healthcare for old people.

2. Make annual estimates of budget for healthcare for old people in accordance with Circular No. 21/2011/TT-BTC of the Ministry of Finance dated February 18, 2011 on management and use of budget for initial healthcare for old people at the homes, celebration of longevity and well-being of old people, then submit them to competent authorities for approval.

3. Cooperate with other Services, agencies, and elderly associations in implementing the plan for healthcare for old people.

Article 9. Responsibilities of Central Health Communication and Education Center

Central Health Communication and Education Center must cooperate with Central Geriatric Hospital in making and implementation a plan for dissemination of medical knowledge among old people.

Article 10. Reference terms

In case the regulations referred to in this Circular are changed or superseded, the new ones shall prevail.

Article 11. Effect

1. This Circular takes effect on December 01, 2011.

2. The Circular No. 02/2004/TT-BYT dated January 20, 2004 on guidance on healthcare for old people is abolished from the effective date of this Circular.

The difficulties that arise during the implementation of this Circular should be reported to the Ministry of Health, Medical Examination and Treatment Department for guidance or amendment.