Ho Chi Minh City Implements Three-Tiered Healthcare System to Track Residents' Health Throughout Their Lives

Ho Chi Minh City has implemented a three-tiered healthcare system designed to track and manage residents' health throughout their lives. This new approach aims to build a network that provides continuous care, with each individual citizen at its center. According to Director of the Department of Health, Tang Chi Thượng, the evolution of the city's healthcare system shifts focus from the number of hospitals or advanced techniques to its ability to accompany residents through their entire health journey. This encompasses prevention, early detection, treatment, rehabilitation, and long-term health management. Amidst a growing and aging population, coupled with an increase in chronic diseases, Ho Chi Minh City is reorganizing its healthcare system, the largest in the country, which includes 169 hospitals and over 13,000 medical facilities. The system is structured into three tiers. The first tier is 'Initial Health Care,' serving as the most frequent point of access for residents through health stations, family doctors, and community health teams. Here, proactive management of health, including regular check-ups, vaccinations, risk factor screening, chronic disease management, and mental health care, is conducted at the community level. Previously, the healthcare system primarily waited for people to seek treatment when they were already ill. Now, at this tier, the health sector will proactively manage health throughout the life cycle. Residents will receive regular health check-ups, vaccinations, risk factor screenings, management of chronic diseases, mental health care, rehabilitation, and monitoring right within their communities. Programs for comprehensive health check-ups, electronic health records, and the continuous health care team model that Ho Chi Minh City is implementing are considered important foundations for building a modern initial health care tier. The goal is not to treat more diseases but to help people stay healthier for longer, detect diseases earlier, and reduce hospital admissions. Individuals requiring treatment will be referred to the 'Basic Treatment Tier,' with district general hospitals, gateway hospitals, and provincial general hospitals forming its core. This tier is responsible for addressing the majority of khám chữa bệnh (examination and treatment) needs, from common emergencies, internal medicine, surgery, obstetrics, pediatrics, to rehabilitation and common techniques. According to Mr. Thượng, investing in district hospitals not only aims to reduce overcrowding in central hospitals but also enables residents to access high-quality services close to their place of residence. Developing gateway hospitals in Thủ Đức, Củ Chi, Hóc Môn, along with enhancing the capacity of hospitals in Bình Dương, Bà Rịa, Vũng Tàu after the administrative boundary expansion, creates a sufficiently strong network to handle most local healthcare needs. 'An effective healthcare system is not one with many transfers to central hospitals, but one that best resolves issues at the basic treatment tier,' Mr. Thượng stated. Complex cases or those requiring advanced techniques will be transferred to the 'Specialized Treatment Tier,' where specialized hospitals and top-tier general hospitals of the city are concentrated. However, the role of the specialized tier is not solely to treat difficult cases. It also serves as a center for scientific research, new technique development, personnel training, technical transfer, remote consultations, and professional support for the entire healthcare network. After their condition is stabilized, patients will be transferred back to the basic treatment or initial care tiers for continued rehabilitation and long-term health management. According to Mr. Thượng, the most significant distinction of this model is the connectivity between the care tiers. Each resident has a single health care journey but may pass through multiple medical facilities. What matters is not where treatment is received, but that all facilities participate in patient care based on shared data, professional coordination, and continuous monitoring. Electronic health records, electronic medical charts, referral systems, out-of-hospital emergency care, remote consultations, and digital platforms will be the tools connecting the three tiers into a unified system. Mr. Thượng believes that this multi-tiered orientation not only changes the way medical examinations and treatment are organized but also signifies a paradigm shift for the healthcare sector. The sector is moving from developing individual hospitals to developing the entire system; from focusing on treatment to comprehensive health care; and from a medical facility-centric approach to a citizen-centric one. Information source: VnExpress