Background: Health insurance card dispensation and free-charge health care service for children under 6 years old is a great policy implemented by the Government of Viet Nam, but up to now there were little studies to evaluate this problem. Objectives: 1) To discover the situation of the health insurance card dispensation and free-charge health care service provided for children under 6 years of age at communal level. 2) To analyze the advantages/disadvantages and opportunities/challenges of these works to propose several measures for improvement. Subjects and method: The semi-quantity cross-sectional study was conducted at 3 provinces, which includes Bac Giang, Ha Noi and Quang Tri. One district was selected randomly from each province and 2 communes were selected from each district. Total of 6 communes were involved in the study. Results. Procedures for card dispensation and drug supply were complicated. The number of children under-6, that had no health insurance card was highest in Quang Tri (12.5%-26.2%), followed by Ha Noi (3.0%-4.3%). Some 15% of children had not visited the communal health centers for illness. The insurance-covered drug list in communal health centers has been limited to 36 kinds of drug, not enough for the proper treatment of diseases. Communal health centers in Quang Tri have a lack of doctors and essential equipment. The health insurance cards were not used in 44.7% of health facility visits of children under 6. Conclusion: The policy of free-charge health insurance for under 6 children can be strengthened by improvements in insurance card and drug dispensation procedures, increase the number of drugs in the insurance-covered drugs list, assign doctors to the communal level and strengthen the medical equipment for CHCs.
Health insurance ; Under-6 children

Aims: Evaluating more fully the forms of daytime consulting department and give some recommends to improve this model. Settings: 6 hospitals at central, provincial and district level. Method: Prospective description and assessment. Subjects: Hospital and department leaders and patients. Results: Daytime treatment department should be expanded and strengthen base on close relationship with in-patient departments, patient selection to reduce the patient load at in-patient department and apply to every level and professional departments. For daytime in-patient bed: in-patient departments should be arranged into special area with simple and flexible organization and management. It should require minimal material facilities and budget and appropriate to patients who live near from the hospital, reduce the nighttime in-patient load and apply to every level and speciality
Beds ; Equipment and Supplies, Hospital

A study was carried out persons with health insurance at 23 commune health station (CHS) in Sãc S¬n district during 7-12/2000. The result has shown that the rounds of consultation in a day was higher 5.3 times than this in B×nh D­¬ng province and higher 4 times than this in the country. The average cost of a consultation was as half as this of district hospital. The cost of consultation in CHS accounted for a half of total cost of consultation at CHS and district hospital. There was no complication within duration of study. 80% of patients agreed this model of consultation. Total number of patients coming to district hospital and local general hospital were significantly reduced.
Insurance, Health ; Therapeutics ; solutions

A retrospective, descriptive and cross-sectional study was carried out in 40 cadres related to Social Insurance, Heath Department, District hospital, community health centers and 384 patients with health insurance cards. Results: the number of patients who have health insurance card receiving health services is increasing. The average cost/medical examination for patients with health insurance is between 3400 VND and 10700 VND, much lower than that for patients without health insurance. This difference makes patients with health insurance worried about taking medical examination at community health centers. The medical examination time/card/year decreases rapidly. Although the medical examination time/card/ health insurance/year increases, overspending is not significant. Taking medical examination with health insurance at community health centers not only is convenient but also reduces the cost for patients. In addition, it helps to popularize about health insurance policy, increase the access to community health centers. Most of patients with health insurance want to regularly check-ups at community health centers (93.1% and 97.8% at Soc Son district and Dong Anh district, respectively).
Insurance ; Diagnosis ; Therapeutics