The four classes
Vietnam's Ministry of Health puts every public hospital into one of four classes: special, 1, 2 or 3. Special is the top. Class 3 is the lowest class for a hospital. The Vietnamese word is hạng, and English writers also say rank, grade or tier.
The rule is Circular 06/2024/TT-BYT, which the Ministry of Health signed on 16 May 2024. It took effect on 1 July 2024. It replaced Circular 23/2005/TT-BYT, which had run since 2005. A hospital that already held a class under the old circular keeps it until the decision runs out, which is five years from the date on the decision.
The same circular also ranks other health units, such as disease prevention centres and district health centres. Those use classes 1 to 4.
Sources: Ministry of Health, Circular 06/2024/TT-BYT of 16 May 2024, full text with appendices (LuatVietnam); LuatVietnam, Tiêu chuẩn xếp hạng các đơn vị sự nghiệp y tế từ ngày 01/7/2024, 22 May 2024.
How a class is set
A class is a score out of 100. The circular splits the score into five groups. Position, role and duties are worth 10 points. Size and range of work is worth 15. Staff is worth 20. Medical skills and techniques are worth 40. Buildings and equipment are worth 15.
The score then sets the class. Class 1 needs 90 to 100 points. Class 2 needs 70 to under 90. Class 3 needs 50 to under 70. A fourth class, class 4, exists only for prevention and district health units.
Some of the points are plain counts. A general hospital with 1,000 beds or more earns the top 4 points for beds. One with fewer than 300 beds earns 1. Hospitals also earn points for training, for research and for a quality score.
Sources: Ministry of Health, Circular 06/2024/TT-BYT of 16 May 2024, full text with appendices (LuatVietnam).
What makes a hospital special class
Special class is not a bigger score. It is class 1 with a perfect 100 points that also meets a separate list of standards in Appendix 5 of the circular. Each standard is marked pass or fail.
The list asks for a hospital that is the last step in the referral ladder and treats patients from several regions or the whole country. A general hospital needs at least five deep specialties. All heads of clinical and lab departments must hold a doctorate or a second level specialist degree, and 70 percent of treating doctors must hold a postgraduate degree. The hospital must also run modern methods such as CT, MRI, organ transplants and robot-assisted surgery.
Bach Mai Hospital in Hanoi says on its own site that the Ministry of Health recognised it in 2011 as the first fully fledged special-class general hospital in Vietnam.
Sources: Ministry of Health, Circular 06/2024/TT-BYT of 16 May 2024, full text with appendices (LuatVietnam); Bach Mai Hospital, About Us.
Who decides and how long it lasts
Two bodies decide. For special class, the Ministry of Home Affairs makes the decision, based on a proposal from the Ministry of Health. For class 1 and below, the ministry or the provincial People's Committee that runs the hospital makes the decision, then reports it to the Ministry of Home Affairs and the Ministry of Health.
A class decision is valid for five years, or 60 months, from the day it takes effect. After that the hospital must be scored again.
The circular is written for public hospitals. Army and police hospitals and private hospitals may use the same standards to rank themselves, but they are not required to. So a private hospital that says it is "class 1" has not necessarily been placed there by the state.
Sources: Ministry of Health, Circular 06/2024/TT-BYT of 16 May 2024, full text with appendices (LuatVietnam).
Central, provincial and district hospitals
Class is not the same thing as where a hospital sits in the system. An earlier Ministry of Health rule, Circular 43/2013/TT-BYT, sorted health facilities into four levels. Level 1 was the central level. It covered special-class hospitals and class 1 hospitals run by the Ministry of Health.
Level 2 was the provincial level. It covered lower-class hospitals run by the Ministry, plus class 1 and class 2 hospitals run by a provincial health department. Level 3 was the district level. It covered class 3 and class 4 hospitals, district medical centres and clinics. Level 4 was the commune health station.
In short, the biggest public hospitals sit at the top and take referrals from below. The wider framework for hospitals is Law No. 15/2023/QH15, called the Law on Medical Examination and Treatment, which came into force on 1 January 2024.
Sources: Ministry of Health, Circular 43/2013/TT-BYT of 11 December 2013 on technical and professional levels (English text); Law on Medical Examination and Treatment, Law No. 15/2023/QH15 (English text).
What a class tells you, and what it does not
A class tells you how big a hospital is, how it is staffed, how wide its range of work is and what equipment it has, as scored by officials. That helps you guess which hospital can handle a hard or rare case.
It does not tell you how friendly the staff are, how long the wait is, whether English is spoken, or how you will feel about a visit. Private hospitals do not have to hold a state class, so a missing class says little about them.
Before you go, ask the hospital which departments you need, whether they have a foreign patient desk and whether your insurer will pay there. Our healthcare in Vietnam guide and our health insurance in Vietnam guide cover those next steps.
This guide explains how the rules are written. It is not medical advice and it does not tell you where to get care.
Sources: Ministry of Health, Circular 06/2024/TT-BYT of 16 May 2024, full text with appendices (LuatVietnam).
Sources
- Ministry of Health, Circular 06/2024/TT-BYT of 16 May 2024, full text with appendices (LuatVietnam)
- LuatVietnam, Tiêu chuẩn xếp hạng các đơn vị sự nghiệp y tế từ ngày 01/7/2024, 22 May 2024
- Bach Mai Hospital, About Us
- Ministry of Health, Circular 43/2013/TT-BYT of 11 December 2013 on technical and professional levels (English text)
- Law on Medical Examination and Treatment, Law No. 15/2023/QH15 (English text)