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… • General introduction • Statistic 2006-2009 • Outcomes • Challenges FINANCIAL SUPPORT- PATIENT WITH SCI IN VIET NAM- EQUITY FUND MODEL

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

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

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

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

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

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

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

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

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

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

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

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 • 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

Thanks for your attention FINANCIAL SUPPORT- PATIENT WITH SCI IN VIET NAM- EQUITY FUND MODEL

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