Ho Chi Minh City is shifting its grassroots healthcare approach to proactively monitor residents' health at home, aiming for earlier disease detection, better management of risk groups, and a reduction in unnecessary hospital visits. Tang Chi Thuong, Director of the Ho Chi Minh City Department of Health, announced this initiative on 20/1, acknowledging the long-standing limitations in grassroots healthcare. Health stations have not consistently served as the public's primary point of contact for medical care. Despite their foundational role in the healthcare system, many currently focus on routine examinations, lacking proactive community health monitoring.

Under the proposed model, each healthcare team will be assigned to a specific area. A team will comprise a family doctor or general practitioner as team leader, a coordinating nurse, a pharmacist or pharmacy assistant for medication management, a public health worker responsible for disease prevention, screening, and immunizations, along with 2-6 community health collaborators. These collaborators will directly manage clusters of households, serving as a vital link between the health station and residents.

Currently, health stations function as an extension of hospitals, primarily offering basic primary healthcare and treating chronic diseases for local residents. People typically visit health stations for fundamental check-ups, which include blood pressure and blood sugar measurements, X-rays if available, and receiving health insurance-covered medications for certain chronic conditions. Patients requiring complex, specialized treatment are then referred to hospitals.

The Ho Chi Minh City Department of Health aims to transform the health station system into "mini-hospitals" within their localities. This initiative seeks to improve the quality of grassroots medical care and foster the family doctor model. This team-based model, extending from health stations to residents' homes for on-site care, eliminates the need for patients to travel, which is particularly beneficial for the elderly and those with chronic illnesses. The home-based model also reduces the burden on the grassroots healthcare system, proactively and effectively monitoring community health. All patient health data will be updated to each individual's Electronic Health Record.

This initiative marks the first time a home-based healthcare model implemented by health stations is being piloted in Vietnam.

For this reason, alongside model innovation, the digital transformation of grassroots healthcare is a mandatory requirement, enabling continuous and systematic health management for residents. "This is a crucial step to bring grassroots healthcare closer to the people, contributing to building a proactive and sustainable primary healthcare system," Thuong emphasized.

From 1/1/2026, 168 commune and ward health stations in Ho Chi Minh City will transition to local government administration, rather than reporting to district health centers as before. These health stations will provide medical examinations and treatment with a full range of medications within the health insurance formulary, while also undertaking the role of primary healthcare for residents in their localities.

Ho Chi Minh City medical staff administer vaccines to residents in the community. *Photo: Thanh Nguyen*

Politburo Resolution 72-NQ/TW assessed that grassroots healthcare has not fully provided primary healthcare services, screening and early disease detection activities remain limited, and public trust in health stations has not been strengthened. Consequently, over-referrals for medical examinations and treatment remain common, even for common illnesses, leading to an overload at higher-level hospitals.

In practice, the role of health stations in managing chronic diseases, providing preventive counseling, and long-term health monitoring for residents has not been fully utilized. The lack of proactive management for risk groups often leads to late disease detection, increasing treatment costs and the burden on the healthcare system.

To address this situation, the Ho Chi Minh City Department of Health proposed innovating the operational model of health stations by deploying "continuous healthcare teams linked to localities". These teams will proactively monitor and manage residents' health directly within the community. Health stations will become the coordinating hub for primary healthcare, linking doctors and medical staff with each residential area, and monitoring the health of households and risk groups.

This model has been successfully implemented in several countries, including Brazil, the United Kingdom, Thailand, and Cuba. A common feature is that health stations proactively manage residents' health across their lifecycles and risk groups, thereby sustainably reducing the burden on higher-level healthcare.

Le Phuong