Circular No. 50/2014/TT-BYT dated December 26, 2014, classification of surgeries, medical procedures and personnel norms applied to operations, medical procedures

• Official number: 50/2014/TT-BYT
• Legislation Type: Circular
• Organization: The Ministry of Health
• Signer: Nguyen Thi Xuyen
• Issued Date: 26/12/2014

MINISTRY OF HEALTH ------------	SOCIALIST REPUBLIC OF VIETNAM Independence – Freedom – Happiness -----------------
No.: 50/2014/TT-BYT	Hanoi, December 26, 2014

CIRCULAR

CLASSIFICATION OF SURGERIES, MEDICAL PROCEDURES AND PERSONNEL NORMS APPLIED TO OPERATIONS, MEDICAL PROCEDURES

Pursuant to governmental Decree No. 63/2012/NĐ-CP dated August 31, 2012 defining the functions, tasks, entitlements and organizational structure of the Ministry of Health;

Pursuant to Decision No. 73/2011/QĐ-TTg dated December 28, 2011 issued by the Prime Minister regulating a number of specific allowances given to officials, civil servants, employees working at public health facilities and anti-epidemic allowances;

At the request of the Director General of the Management Department of Diagnosis and Treatment,

The Minister of Health hereby issues this Circular to regulate the classification of surgeries, medical procedures and personnel norms applied to every operation, medical procedure.

Article 1. Governing scope

1. Attached herewith is the List on the classification of surgeries, medical procedures in accordance with 26 specializations.

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Article 2. Requirements for Classification of surgeries, medical procedures

Surgeries, medical procedures shall be classified according to:

1. Difficulty and complication of the surgery or medical procedure.

2. Level of danger to the life of patients.

3. Necessary health utilities, tools, equipment to be used in the surgery or medical procedure.

4. Necessary number of people involving in the surgery or medical procedure.

5. Duration of the surgery or medical procedure.

Article 3. Classification of surgeries, medical procedures

1. Special surgeries, medical procedures

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b) Specialized medical utilities, tools, equipment are required.

c) The number of people involving in surgeries, medical procedures specified in Appendix 01 herein is required.

d) The average duration is 3 – 4 hours or longer.

2. Class-I surgeries, medical procedures

a) Class-I surgeries, medical procedures are relatively complicated , life-threatening, requiring high professional qualifications, techniques from the health practitioners, mostly carried out at central- and provincial-level health facilities.

b) Specialized medical utilities, tools, equipment are required.

c) The number of people involving in surgeries, medical procedures specified in Appendix 01 herein is required.

d) The average duration is 2 – 3 hours or longer.

3. Class-II surgeries, medical procedures

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b) Only common medical utilities, tools, equipment are required.

c) The number of people involving in surgeries, medical procedures specified in Appendix 01 herein is required.

d) The average duration is 1 – 3 hours or longer.

4. Class-III surgeries, medical procedures

a) Class-III surgeries, medical procedures are mostly carried out at district-level health facilities. Class-III surgeries and medical procedures are less dangerous to patients’ life than those of Class II.

b) Only common medical utilities, tools, equipment are required.

c) The number of people involving in surgeries, medical procedures specified in Appendix 01 herein.

d) The average duration is 1 – 2 hours or longer.

Article 4. Application of the categorization of surgeries, medical procedures

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Article 5. Personnel norms applied to every surgery, medical procedure application

1. Maximum attendants to a surgery or medical procedure shall be based on the categorization of surgeries, medical procedures and medical specializations as prescribed in Appendix 01 attached herewith.

2. In case of difficult, complicated surgeries, medical procedures such as transplant of tissues, human body parts, open heart surgeries and other surgeries, medical procedures, which require the more participants than that specified in Clause 01 of this Article, the Heads of health facilities shall consider and make the decision. Surgery allowances shall be paid according to the actual number of participants and limits applied to corresponding positions.

3. Assignment of specific tasks to every participant to a surgery, medical procedure shall be decided by the Head of the health facility.

Article 6. Implementation

1. This Circular takes effect as of 15 February 2015.

2. Decision No. 1904/1998/ QĐ-BYT dated 10 August 1998 issued by the Minister of Health promulgating the categorization list of surgeries, medical procedures and Decision No. 2590/2004/ QĐ-BYT dated 30 July 2004 issued by the Minister of Health issuing the list of medical procedure categorization entitled to allowances as defined in Decision No. 155/ QĐ-TTg dated 30 July 2003 issued by the Prime Minister which amends, supplements a number of specific allowances given to governmental officials, civil servants in the health sector shall expire since the date this Circular takes effect.

Article 7. Implementation responsibilities

1. Director General of the Management Department of Diagnosis and Treatment shall take charge and cooperate with the related agencies to give instructions, organize and inspect the implementation of this Circular carried out the health facilities.

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3. Based on the categorization List of surgeries and medical procedures, the Heads of health facilities shall have the surgical and/or medical procedure allowances paid to the attendants involving in surgeries, medical procedures and similar skills as defined in Decision No. 73/2011/QĐ-TTg dated 28 December 2011 issued by the Prime Minister which prescribes a number of specific allowances applied to governmental officials, civil servants, employees working for public health facilities and anti-epidemic allowances.

During the implementation, if case of any difficulties and/or entanglements, related agencies, organizations and individuals shall report timely to the Management Department of Diagnosis and Treatment, Ministry of Health for guidance and resolution./.

KT. P.P. THE MINISTER
VICE MINISTER




Nguyen Thi Xuyen

APPENDIX No. 1

MAXIMUM PERSONNEL NORMS APPLIED TO SURGERIES AND MEDICAL PROCEDURES
(attached with Circular No. 50/2014/TT-BYT dated 26 December 2014 issued by the Minister of Health)

No.

...

...

...

Department

Maximum number of participants in surgery

Special

Class-I

Class-II

Class-III

1

Recuperation, emergency and detoxification

...

...

...

7

6

5

2 key surgeons

5 assistant surgeons

1 assistant

2 key surgeons

4 assistant surgeons

1 assistant

...

...

...

4 assistant surgeons

1 assistant

1 key surgeon

3 assistant surgeons

1 assistant

2

Endocrinology

8

7

...

...

...

5

2 key surgeons

5 assistant surgeons

1 assistant

2 key surgeons

4 assistant surgeons

1 assistant

1 key surgeon

4 assistant surgeons

...

...

...

1 key surgeon

3 assistant surgeons

1 assistant

3

Pediatrics

8

6

6

6

...

...

...

4 assistant surgeons

1 key anesthesiologist

1 assistant anesthesiologist

1 assistant

1 key surgeon

3 assistant surgeons

1 key anesthesiologist

1 assistant

1 key surgeon

...

...

...

1 key anesthesiologist

1 assistant

1 key surgeon

3 assistant surgeons

1 key anesthesiologist

1 assistant

4

Tuberculosis (surgery)

8

...

...

...

6

5

1 key surgeon

4 assistant surgeons

1 key anesthesiologist

1 assistant anesthesiologist

1 assistant

1 key surgeon

3 assistant surgeons

...

...

...

1 assistant anesthesiologist

1 assistant

1 key surgeon

3 assistant surgeons

1 key anesthesiologist

1 assistant

1 key surgeon

2 assistant surgeons

1 key anesthesiologist

...

...

...

5

Dermatology

8

6

5

3

1 key surgeon

4 assistant surgeons

1 key anesthesiologist

...

...

...

1 assistant

1 key surgeon

2 assistant surgeons

1 key anesthesiologist

1 assistant anesthesiologist

1 assistant

1 key surgeon

2 assistant surgeons

1 key anesthesiologist

...

...

...

1 key surgeon

1 assistant surgeons

1 key anesthesiologist

6

Endocrinology

7

6

6

6

...

...

...

3 assistant surgeons

1 key anesthesiologist

1 assistant anesthesiologist

1 assistant

1 key surgeon

2 assistant surgeons

1 key anesthesiologist

1 assistant anesthesiologist

1 assistant

...

...

...

2 assistant surgeons

1 key anesthesiologist

1 assistant anesthesiologist

1 assistant

1 key surgeon

2 assistant surgeons

1 key anesthesiologist

1 assistant anesthesiologist

1 assistant

...

...

...

Surgery

8

8

7

7

1 key surgeon

3 assistant surgeons

1 key anesthesiologist

2 assistant anesthesiologists

...

...

...

1 key surgeon

3 assistant surgeons

1 key anesthesiologist

2 assistant anesthesiologists

1 assistant

1 key surgeon

2 assistant surgeons

1 key anesthesiologist

2 assistant anesthesiologists

...

...

...

1 key surgeon

2 assistant surgeons

1 key anesthesiologist

2 assistant anesthesiologists

1 assistant

8

Burns

8

7

...

...

...

6

1 key surgeon

3 assistant surgeons

1 key anesthesiologist

2 assistant anesthesiologists

1 assistant

1 key surgeon

2 assistant surgeons

1 key anesthesiologist

...

...

...

1 assistant

1 key surgeon

2 assistant surgeons

1 key anesthesiologist

2 assistant anesthesiologists

1 assistant

1 key surgeon

2 assistant surgeons

1 key anesthesiologist

...

...

...

1 assistant

9

Tumors

7

7

5

5

1 key surgeon

3 assistant surgeons

...

...

...

1 assistant anesthesiologist

1 assistant

1 key surgeon

3 assistant surgeons

1 key anesthesiologist

1 assistant anesthesiologist

1 assistant

1 key surgeon

2 assistant surgeons

...

...

...

1 assistant

1 key surgeon

2 assistant surgeons

1 key anesthesiologist

1 assistant

10

Obstetrics

8

6

...

...

...

6

1 key surgeon

4 assistant surgeons

1 key anesthesiologist

1 assistant anesthesiologist

1 assistant

1 key surgeon

3 assistant surgeons

1 key anesthesiologist

...

...

...

1 key surgeon

3 assistant surgeons

1 key anesthesiologist

1 assistant

1 key surgeon

3 assistant surgeons

1 key anesthesiologist

1 assistant

11

...

...

...

6

6

5

5

1 key surgeon

3 assistant surgeons

1 key anesthesiologist

1 assistant

1 key surgeon

...

...

...

1 key anesthesiologist

1 assistant

1 key surgeon

2 assistant surgeons

1 key anesthesiologist

1 assistant

1 key surgeon

2 assistant surgeons

1 key anesthesiologist

...

...

...

12

Otorhinolaryngology

8

6

6

6

1 key surgeon

4 assistant surgeons

1 key anesthesiologist

...

...

...

1 assistant

1 key surgeon

2 assistant surgeons

1 key anesthesiologist

1 assistant anesthesiologist

1 assistant

1 key surgeon

2 assistant surgeons

1 key anesthesiologist

...

...

...

1 assistant

1 key surgeon

2 assistant surgeons

1 key anesthesiologist

1 assistant anesthesiologist

1 assistant

13

Odonto-stomatology

8

...

...

...

7

6

1 key surgeon

4 assistant surgeons

1 key anesthesiologist

1 assistant anesthesiologist

1 assistant

1 key surgeon

3 assistant surgeons

...

...

...

1 assistant anesthesiologist

1 assistant

1 key surgeon

3 assistant surgeons

1 key anesthesiologist

1 assistant anesthesiologist

1 assistant

1 key surgeon

3 assistant surgeons

...

...

...

1 assistant

14

X-ray

6

1 key surgeon

...

...

...

1 key anesthesiologist

1 assistant anesthesiologist

1 equipment operator

15

Endoscopy, interventional diagnosis

6

5

...

...

...

4

1 key surgeon

3 assistant surgeons

1 key anesthesiologist

1 assistant

1 key surgeon

2 assistant surgeons

1 key anesthesiologist

1 assistant

...

...

...

1 assistant surgeon

1 key anesthesiologist

1 assistant

1 key surgeon

1 assistant surgeon

1 key anesthesiologist

1 assistant

16

Micro-surgery

...

...

...

15

(2 shifts):

2 key surgeons

8 assistant surgeons

1 key anesthesiologist

2 assistant anesthesiologists

2 assistants

...

...

...

2 key surgeons

8 assistant surgeons

1 key anesthesiologist

2 assistant anesthesiologists

2 assistants

17

Endoscopic surgery

...

...

...

9

8

8

1 key surgeon

4 assistant surgeons

1 key anesthesiologist

2 assistant anesthesiologists

1 assistant

1 key surgeon

...

...

...

1 key anesthesiologist

2 assistant anesthesiologists

1 assistant

1 key surgeon

3 assistant surgeons

1 key anesthesiologist

2 assistant anesthesiologists

1 assistant

1 key surgeon

...

...

...

1 key anesthesiologist

2 assistant anesthesiologists

1 assistant

18

Cosmetic surgery

7

7

6

5

...

...

...

3 key surgeons

1 key anesthesiologist

1 assistant anesthesiologist

1 assistant

1 key surgeon

3 key surgeons

1 key anesthesiologist

1 assistant anesthesiologist

1 assistant

...

...

...

3 key surgeons

1 key anesthesiologist

1 assistant

1 key surgeon

3 key surgeons

1 key anesthesiologist

1 assistant

Medical procedure personnel

...

...

...

Class

Department

Maximum number of participants in a medical procedure

Special

Class-I

Class-II

Class-III

1

...

...

...

6

4

3

2

1 key surgeon

3 assistant surgeons

1 key anesthesiologist

1 assistant

...

...

...

1 assistant surgeon

1 key anesthesiologist

1 assistant

1 key surgeon

1 assistant surgeon

1 assistant

1 key surgeon

1 assistant surgeon

2

...

...

...

6

4

3

2

1 key surgeon

3 assistant surgeons

1 key anesthesiologist

1 assistant

1 key surgeon

...

...

...

1 key anesthesiologist

1 assistant

1 key surgeon

1 assistant surgeon

1 assistant

1 key surgeon

1 assistant surgeon

3

Pediatrics

...

...

...

3

3

3

1 key surgeon

2 assistant surgeons

1 assistant

1 key surgeon

2 assistant surgeons

1 key surgeon

...

...

...

1 key surgeon

2 assistant surgeons

4

Tuberculosis (surgery)

4

...

...

...

2 assistant surgeons

1 key anesthesiologist

5

Dermatology

5

4

2

...

...

...

1 key surgeon

2 assistant surgeons

1 key anesthesiologist

1 assistant

1 key surgeon

1 assistant surgeon

1 key anesthesiologist

1 assistant

1 key surgeon

...

...

...

1 key surgeon

1 assistant surgeon

6

Psychiatry

3

2

1

...

...

...

1 assistant surgeon

1 key anesthesiologist

1 key surgeon

1 assistant surgeon

1 key surgeon

7

Endocrinology

4

4

...

...

...

2

1 key surgeon

1 assistant surgeon

1 key anesthesiologist

1 assistant

1 key surgeon

1 assistant surgeon

1 key anesthesiologist

1 assistant

...

...

...

1 assistant surgeon

1 key anesthesiologist

1 key surgeon

1 assistant surgeon

8

Traditional medicine

3

3

...

...

...

1 key surgeon

2 assistant surgeons

1 key surgeon

2 assistant surgeons

1 key surgeon

1 assistant surgeon

9

Anesthesia - recuperation

...

...

...

4

2

2

1 key surgeon

2 assistant surgeons

1 assistant

1 key surgeon

2 assistant surgeons

1 assistant

...

...

...

1 assistant surgeon

1 key surgeon

1 assistant surgeon

10

Surgery

5

5

...

...

...

3

1 key surgeon

2 assistant surgeons

1 key anesthesiologist

1 assistant

1 key surgeon

2 assistant surgeons

1 key anesthesiologist

1 assistant

...

...

...

1 assistant surgeon

1 key anesthesiologist

1 key surgeon

1 assistant surgeon

1 key anesthesiologist

11

Burns

5

5

...

...

...

3

1 key surgeon

2 assistant surgeons

1 key anesthesiologist

1 assistant

1 key surgeon

2 assistant surgeons

1 key anesthesiologist

1 assistant

...

...

...

1 assistant surgeon

1 key anesthesiologist

1 assistant

1 key surgeon

1 assistant surgeon

1 key anesthesiologist

12

Tumors

...

...

...

2

2

2

1 key surgeon

1 assistant surgeon

1 key anesthesiologist

1 key surgeon

1 assistant surgeon

1 key surgeon

...

...

...

1 key surgeon

1 assistant surgeon

13

Obstetrics

4

3

3

3

1 key surgeon

...

...

...

1 key anesthesiologist

1 key surgeon

2 assistant surgeons

1 key surgeon

2 assistant surgeons

1 key surgeon

2 assistant surgeons

...

...

...

14

Ophthalmology

5

5

4

3

1 key surgeon

2 assistant surgeons

1 key anesthesiologist

...

...

...

1 key surgeon

2 assistant surgeons

1 key anesthesiologist

1 assistant

1 key surgeon

1 assistant surgeon

1 key anesthesiologist

1 assistant

1 key surgeon

...

...

...

1 assistant

15

Otorhinolaryngology

5

3

3

3

1 key surgeon

1 assistant surgeon

...

...

...

1 assistant

1 key surgeon

2 assistant surgeons

1 key surgeon

2 assistant surgeons

1 key surgeon

2 assistant surgeons

16

Odonto-stomatology

...

...

...

5

4

4

1 key surgeon

2 assistant surgeons

1 key anesthesiologist

1 assistant

1 key surgeon

2 assistant surgeons

...

...

...

1 assistant

1 key surgeon

2 assistant surgeons

1 assistant

1 key surgeon

2 assistant surgeons

1 assistant

17

Rehabilitation

...

...

...

3

2

1

1 key surgeon

1 assistant surgeon

1 assistant

1 key surgeon

1 assistant surgeon

1 assistant

...

...

...

1 assistant surgeon

1 key surgeon

18

X-ray

5

4

3

2

1 key surgeon

...

...

...

1 key anesthesiologist

1 assistant

1 key surgeon

1 assistant surgeon

1 key anesthesiologist

1 assistant

1 key surgeon

1 assistant surgeon

1 key anesthesiologist

...

...

...

1 assistant surgeon

19

Nuclear medicine

5

4

3

2 key surgeons

3 assistant surgeons

...

...

...

2 assistant surgeons

2 key surgeons

2 assistant surgeons

20

Endoscopy, interventional diagnosis

6

5

4

...

...

...

1 key surgeon

3 assistant surgeons

1 key anesthesiologist

1 assistant

1 key surgeon

2 assistant surgeons

1 key anesthesiologist

1 assistant

1 key surgeon

...

...

...

1 key anesthesiologist

1 assistant

1 key surgeon

1 assistant surgeon

1 key anesthesiologist

21

Functional assessment

4

3

...

...

...

2

1 key surgeon

1 assistant surgeon

1 key anesthesiologist

1 assistant

1 key surgeon

2 assistant surgeons

1 key surgeon

2 assistant surgeons

...

...

...

1 assistant surgeon

22

Hematology – blood transfusion

4

4

3

2

1 key surgeon

2 assistant surgeons

...

...

...

1 key surgeon

2 assistant surgeons

1 assistant

1 key surgeon

2 assistant surgeons

1 key surgeon

1 assistant surgeon

...

...

...

Pathogenic surgeries and pathogenic cytology

3

2

2

1 key surgeon

2 assistant surgeons

1 key surgeon

...

...

...

1 key surgeon

1 assistant surgeon

24

Cosmetic surgery

5

5

4

4

1 key surgeon

...

...

...

1 key anesthesiologist

1 assistant

1 key surgeon

2 assistant surgeons

1 key anesthesiologist

1 assistant

1 key surgeon

1 assistant surgeon

1 key anesthesiologist

...

...

...

1 key surgeon

1 assistant surgeon

1 key anesthesiologist

1 assistant

- With regard to medical procedures related to Anesthesia and Recuperation: If the procedure is carried out independently, the regulations on personnel in the above table shall apply correspondingly. If the procedure is part of a surgery or procedure of another department, the regulations on personnel of such department shall apply

- In case of any medical procedure which requires anesthesia as per professional regulations, and the surgeon also gives anesthesia, allowance for such procedure hall not include the allowance for anesthesia personnel.