Chonnan orders NHSO to solve the problem of clinic referrals in Bangkok and appoints a committee to investigate warm community clinics that do not comply with standards. Send it to the Quality Control Committee for investigation. If the complaints are not reduced, further legal action will be taken.
April 25, 2024 Dr. Jadej Thamthatcharee, Secretary-General of the National Health Security Office (NHSO). Discusses the use of gold patents in the Bangkok area. As for patients who have a warm community clinic as a primary service unit in the new Model 5, NHSO District 13, Bangkok The guidelines for disbursement of services in the national health insurance system (30 baht gold card) of primary care units have been adjusted. (Warm Community Clinic) is a lump sum payment per head, which is a budget allocated in advance for the clinic to manage itself, from the original model 5 or payment according to the list of services (Fee Schedule), which is paid by NHSO pays the clinic based on the service performance. All of this is in line with a proposal from the Warm Community Clinic that submitted a letter to the Minister of Public Health and NHSO to resolve the issue of disbursement guidelines.
This new approach is called the use of the new Gold Patent Model 5 (OP New Model 5), with warm community clinics as primary service units. and has a public health service center as its host In case of illness, treatment should be started at the primary care unit first. If it exceeds its potential The Warm Community Clinic must be referred to a referral hospital for further treatment. As for the referral hospital, NHSO has coordinated with all hospitals under the government sector in Bangkok, whether under the Ministry of Public Health. Ministry of Defense Royal Thai Police Network of hospitals in the group of medical institutes of Thailand and Bangkok Become a referral hospital to care for patients in the Bangkok area.
It must be emphasized that This new approach is based on the principles of patient care based on the principles of the National Health Insurance System, emphasizing the provision of public health services at the primary level. and patients are referred as needed. Therefore, there is no impact on patient referrals. Patients who need to be referred will be referred to higher capacity hospitals. Therefore, in the matter of the referral form Hospital that receives patients There is no need for the patient to return to the clinic to get a referral slip.
“Before adjusting to this new approach NHSO has already rehearsed and explained to the clinics and referral hospitals that they are doing the same. Service unit that receives patients There is no need for the patient to return to the clinic to get a referral slip. To confirm that the clinic will pay you NHSO already has a mechanism that can pay. In the case of having the original delivery slip, use the same as before. Whichever one is out, use that one. No need to call back. There is no need to change it again,” Dr. Jadet said.
Secretary-General of the NHSO added that However, when the operation began Instead, it was found that many people had complained about receiving public health services in the Bangkok area through the NHSO hotline 1330, including submitting complaints directly to the Minister of Public Health for correction. The most common problems such as clinics refusing to issue referral orders in all cases, clinics allowing patients to transfer their rights to other clinics, clinics calling patients who already have a referral card back to start receiving new orders, clinics issuing referral slips only once. per time or per disease Determining the date and time for issuing a referral form to make it difficult for patients, patients exceeding their capacity but the clinic does not refer them, not sending patients to referral hospitals Instead, they were sent to service units in their network, were billed by clinics or set up donation boxes claiming that NHSO did not have the money to pay them.
Dr. Jadet said From this problem Minister of Public Health Dr. Chonnan Srikaew has ordered NHSO is rushing to solve this problem. NHSO has been asking for cooperation from clinics to proceed according to the established guidelines for some time. But it was found that people still suffered. NHSO therefore set up a committee to investigate and find out the facts. and when complete information is obtained and faults are found It will be forwarded to the Public Health Service Quality and Standards Control Committee. If it is found that it does not provide convenience to the people May be canceled as a service unit in the national health insurance system.
“NHSO is required to take measures according to Sections 57 and 59 of the National Health Security Act 2002 by collecting information on non-compliance with service standards. Send it to the Quality and Standards Control Committee. in setting up an investigation committee And if the complaints do not decrease, we will proceed with legal procedures,” Dr. Jadet said.
Secretary-General of the NHSO said that in order for people in the Bangkok area Access to health services according to rights and continuously NHSO has coordinated with private clinics that are interested in becoming service units in the health insurance system. Meanwhile NHSO has publicized information to prepare for finding a new warm community clinic. To prepare if the service unit of the clinic in question is canceled and if the people suffer You can report it to NHSO hotline 1330 24 hours a day to expedite problem solving.
Tags: Chonnan orders NHSO fix issues referral forms Bangkok appoint committee examine clinics follow standards
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