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FINANCIAL & SOCIAL SUPPORT – PATIENT WITH SCI IN VIET NAM EQUITY FUND (EF) MODEL. Truong Thi Ngoc Anh Project Coordinator 8 th ASCoN, 20-22 NOVEMBER 2009 Katmandu - Nepal. Outline…. General introduction Statistic 2006-2009 Outcomes Challenges. General introduction.

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financial social support patient with sci in viet nam equity fund ef model

FINANCIAL & SOCIAL SUPPORT – PATIENT WITH SCI IN VIET NAMEQUITY FUND (EF) MODEL

Truong Thi Ngoc Anh

Project Coordinator

8th ASCoN,

20-22 NOVEMBER 2009

Katmandu - Nepal

FINANCIAL SUPPORT- PATIENT WITH SCI IN VIET NAM- EQUITY FUND MODEL

outline
Outline…
  • General introduction
  • Statistic 2006-2009
  • Outcomes
  • Challenges

FINANCIAL SUPPORT- PATIENT WITH SCI IN VIET NAM- EQUITY FUND MODEL

general introduction
General introduction

Health accessibility FOR PATIENT with SCI

In Viet Nam

a few years ago

0.0$

Health care

Why?

FINANCIAL SUPPORT- PATIENT WITH SCI IN VIET NAM- EQUITY FUND MODEL

slide4

Cont…

Health insurance

is very poor

Because

  • Family economy change
  • rapidly after injury:
  • - Longer hospitalization
  • - Surgery cost
  • Living cost in big city is high
  • Head of household are male
  • Population
  • 80% of patients are poor before
  • accident
  • No subsidies from
  • government
  • to people with SCI

FINANCIAL SUPPORT- PATIENT WITH SCI IN VIET NAM- EQUITY FUND MODEL

slide5
Cont…

Q: how to help?

  • Patient with SCI discharge very early without finishing treatment program
  • Influence to progression of rehabilitation when patient and family can’t afford to some basic practical needs such as a good diet for pressure sore healing or bowel management

FINANCIAL SUPPORT- PATIENT WITH SCI IN VIET NAM- EQUITY FUND MODEL

slide6
Cont….
  • To answer, Equity Fund was born 2006 in Spinal Unit of HCM Rehabilitation hospital to help patient with SCI can remain their stay in the hospital until complete their treatment program.

Q: How does EF work?

FINANCIAL SUPPORT- PATIENT WITH SCI IN VIET NAM- EQUITY FUND MODEL

slide7
Cont….

Financial mechanism

Patient

Ministry of Health

3- Payment of reduced fees

Association

1- Subsidies

4- Compensation

Hospital for the Care

and Rehabilitation of Professional Diseases

Equity Fund

Administration

7- Savings

5- Op. costs

6- Financing from extra services

Reserved fund

Staff

Logistics

2- External financing

Donors

FINANCIAL SUPPORT- PATIENT WITH SCI IN VIET NAM- EQUITY FUND MODEL

slide8
Cont….

Administrative mechanism

SCI person

In-charge

During the first 48tiếng

For all SCI patients

Poverty identification

Socio – Eco status

Heads of HH, average income,

edu.received, ,insurance

Supporting levels

30% - 50% - 70%

“very poor” – “poor” –

“nearly poor” “better off”

FINANCIAL SUPPORT- PATIENT WITH SCI IN VIET NAM- EQUITY FUND MODEL

slide9
Cont….

Equity Fund Beneficiaries

SCI Patients identified “Poor / Vulnerable” from the poverty identification

Supporting package: bed fees, medical care, medicines, devices, physiotherapy and occupational therapy sessions

Supporting grants for the poor SCI patients

3 supporting levels: 70%, 50%, 30%

Patients with Insurance cards, having support from other parties, having compensation - not eligible for EF support

Capable adjusting support levels provided during hospitalization

Coordination board double check data

FINANCIAL SUPPORT- PATIENT WITH SCI IN VIET NAM- EQUITY FUND MODEL

slide10

Cont….

Financing sources

-Promoting equity in medical care

- Enhancing accessibility to rehabilitation care, targeted for the poor

Spinal Unit: monthly contribution with 15% income generated from services and bed fees

Donors: regular contribution for the reserve fund

Strengthening the financial cooperation of parties

Insisting the contribution of partners

Promoting the fundraising strategy

FINANCIAL SUPPORT- PATIENT WITH SCI IN VIET NAM- EQUITY FUND MODEL

statistic 2006 2009 hcm city and nt kh dn provinces
Statistic 2006-2009 (HCM City and NT-KH-DN Provinces)

FINANCIAL SUPPORT- PATIENT WITH SCI IN VIET NAM- EQUITY FUND MODEL

slide12
Cont….

FINANCIAL SUPPORT- PATIENT WITH SCI IN VIET NAM- EQUITY FUND MODEL

slide13
Cont….

FINANCIAL SUPPORT- PATIENT WITH SCI IN VIET NAM- EQUITY FUND MODEL

outcomes
Multiplied to 3 provinces KH, DN and PY since May 2007 after implemented successfully in HCM 2006-2007.

Integrated into the hospital structure at the provincial level

Good cooperation with partner at provincial level- target of beneficiaries is more appropriated

Living cost is lower

Outcomes

FINANCIAL SUPPORT- PATIENT WITH SCI IN VIET NAM- EQUITY FUND MODEL

slide15
Cont…..

Hien oi, Try!!!

Nguyen Tan Hien – from Spinal unit of Da Nang Sanatorium. He was a 1st year student of Economical University. On the way home, he fell down when going over a pot-hole and had C6C injury. Now he has the remark “positive A+” in the unit. He plays sport, draws pictures, and many of his masterpieces were highly evaluated and sold.

In December 2007, he joined the training of “Skills in accessing and psychological advising for SCI patients” in Nha Trang.

He is considered as the potential seed for the position “peer counselor” for Spinal unit Da Nang.

Comprehensive rehabilitation

FINANCIAL SUPPORT- PATIENT WITH SCI IN VIET NAM- EQUITY FUND MODEL

slide16

Challenges

  • Human resource: Third-party cooperation for social work: social service-> not sustainable if the project closed or no financial support.
  • Time limitation due to combination of work: PT- Social worker
  • Not accepted officially from the local authority to integrate into personnel policy of the hospital. No salary, not clear job description
  • Considered as a temporary tools when the health insurance system is still not a comprehensive service yet to the whole population

FINANCIAL SUPPORT- PATIENT WITH SCI IN VIET NAM- EQUITY FUND MODEL

challenges
Challenges
  • Additional funding needed – donor identification: failed in social worker role
  • Along with economic development of the country, the health insurance is getting improved and most of people have been covered by the government

=> require an adjustment as well as a new orientation of EF in a new context of Viet Nam (new criteria: food support, wheelchair support, aid-devices, basic home adaptation-> social inclusion oriented.

FINANCIAL SUPPORT- PATIENT WITH SCI IN VIET NAM- EQUITY FUND MODEL

slide18
Thanks for your attention

FINANCIAL SUPPORT- PATIENT WITH SCI IN VIET NAM- EQUITY FUND MODEL

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