HL7 Vietnam VN Core FHIR Implementation Guide

Bộ Hướng dẫn Triển khai Core FHIR cho Việt Nam
0.8.0 - Draft for Community Review Viet Nam cờ

Bộ Hướng dẫn Triển khai Core FHIR cho Việt Nam - Draft for Community Review (v0.8.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

: Phạm vi hưởng BHYT — Vietnam Insurance Scope CodeSystem

Active tại thời điểm 2026-03-21

Bản thô ttl | Tải xuống


@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

# - resource -------------------------------------------------------------------

<http://hl7.org/fhir/CodeSystem/vn-insurance-scope-cs> a fhir:CodeSystem ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:Resource.id [ fhir:value "vn-insurance-scope-cs"] ;
  fhir:Resource.language [ fhir:value "vi"] ;
  fhir:DomainResource.text [
     fhir:Narrative.status [ fhir:value "generated" ] ;
     fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: CodeSystem vn-insurance-scope-cs</b></p><a name=\"vn-insurance-scope-cs\"> </a><a name=\"hcvn-insurance-scope-cs\"> </a><p>This case-sensitive code system <code>http://fhir.hl7.org.vn/core/CodeSystem/vn-insurance-scope-cs</code> defines the following codes:</p><table class=\"codes\"><tr><td style=\"white-space:nowrap\"><b>Code</b></td><td><b>Display</b></td><td><b>Definition</b></td><td><b>English (English, en)</b></td></tr><tr><td style=\"white-space:nowrap\">1<a name=\"vn-insurance-scope-cs-1\"> </a></td><td>Trong phạm vi hưởng BHYT</td><td>Thuốc/DVKT/VTYT nằm trong danh mục được quỹ BHYT chi trả. Mức hưởng tùy đối tượng (80-100%). Theo QĐ 3176/QĐ-BYT, PHAM_VI = 1.</td><td>Within insurance coverage (in formulary)</td></tr><tr><td style=\"white-space:nowrap\">2<a name=\"vn-insurance-scope-cs-2\"> </a></td><td>Ngoài phạm vi hưởng BHYT</td><td>Thuốc/DVKT/VTYT nằm ngoài danh mục BHYT — người bệnh tự chi trả 100%. Theo QĐ 3176/QĐ-BYT, PHAM_VI = 2.</td><td>Outside insurance coverage (not in formulary)</td></tr><tr><td style=\"white-space:nowrap\">3<a name=\"vn-insurance-scope-cs-3\"> </a></td><td>Ngoài danh mục nhưng được BHYT chi trả theo NĐ 70/2015/NĐ-CP</td><td>Thuốc/DVKT ngoài danh mục thông thường nhưng được BHYT chi trả cho đối tượng quân đội, công an, cơ yếu theo NĐ 70/2015/NĐ-CP, NĐ 74/2025/NĐ-CP và quy định BHYT hiện hành. Theo QĐ 3176/QĐ-BYT, PHAM_VI = 3.</td><td>Outside formulary but covered for military/police/cipher per Decree 70/2015</td></tr></table></div>"
  ] ;
  fhir:DomainResource.extension [
     fhir:index -1 ;
     fhir:Extension.url [ fhir:value "http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-legal-basis" ] ;
     fhir:Extension.valueCoding [
       fhir:Coding.system [ fhir:value "http://fhir.hl7.org.vn/core/CodeSystem/vn-legal-document-ref-cs" ] ;
       fhir:Coding.code [ fhir:value "L-51-2024" ]
     ]
  ], [
     fhir:index -1 ;
     fhir:Extension.url [ fhir:value "http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-legal-basis" ] ;
     fhir:Extension.valueCoding [
       fhir:Coding.system [ fhir:value "http://fhir.hl7.org.vn/core/CodeSystem/vn-legal-document-ref-cs" ] ;
       fhir:Coding.code [ fhir:value "ND-188-2025" ]
     ]
  ] ;
  fhir:CodeSystem.url [ fhir:value "http://fhir.hl7.org.vn/core/CodeSystem/vn-insurance-scope-cs"] ;
  fhir:CodeSystem.identifier [
     fhir:index -1 ;
     fhir:Identifier.system [ fhir:value "urn:ietf:rfc:3986" ] ;
     fhir:Identifier.value [ fhir:value "urn:oid:2.25.161089673617632664299011809196868855799.16.46" ]
  ] ;
  fhir:CodeSystem.version [ fhir:value "0.8.0"] ;
  fhir:CodeSystem.name [ fhir:value "VNInsuranceScopeCS"] ;
  fhir:CodeSystem.title [ fhir:value "Phạm vi hưởng BHYT — Vietnam Insurance Scope CodeSystem"] ;
  fhir:CodeSystem.status [ fhir:value "active"] ;
  fhir:CodeSystem.experimental [ fhir:value "false"^^xsd:boolean] ;
  fhir:CodeSystem.date [ fhir:value "2026-03-21"^^xsd:date] ;
  fhir:CodeSystem.publisher [ fhir:value "Omi HealthTech / VN Core FHIR Community Initiative"] ;
  fhir:CodeSystem.contact [
     fhir:index -1 ;
     fhir:ContactDetail.name [ fhir:value "Omi HealthTech / VN Core FHIR Community Initiative" ] ;
     fhir:ContactDetail.telecom [
       fhir:index -1 ;
       fhir:ContactPoint.system [ fhir:value "url" ] ;
       fhir:ContactPoint.value [ fhir:value "https://hl7.org.vn" ]
     ], [
       fhir:index -1 ;
       fhir:ContactPoint.system [ fhir:value "email" ] ;
       fhir:ContactPoint.value [ fhir:value "info@hl7.org.vn" ]
     ]
  ], [
     fhir:index -1 ;
     fhir:ContactDetail.name [ fhir:value "Omi HealthTech (OmiGroup)" ] ;
     fhir:ContactDetail.telecom [
       fhir:index -1 ;
       fhir:ContactPoint.system [ fhir:value "url" ] ;
       fhir:ContactPoint.value [ fhir:value "https://omihealthtech.vn" ]
     ], [
       fhir:index -1 ;
       fhir:ContactPoint.system [ fhir:value "url" ] ;
       fhir:ContactPoint.value [ fhir:value "https://omigroup.vn" ]
     ], [
       fhir:index -1 ;
       fhir:ContactPoint.system [ fhir:value "email" ] ;
       fhir:ContactPoint.value [ fhir:value "info@hl7.org.vn" ]
     ]
  ] ;
  fhir:CodeSystem.description [ fhir:value "Danh mục phạm vi hưởng bảo hiểm y tế (trường PHAM_VI).\nXác định thuốc/DVKT/VTYT nằm trong hay ngoài danh mục do quỹ BHYT chi trả.\nCăn cứ: QĐ 130/QĐ-BYT (18/01/2023), sửa đổi bởi QĐ 4750/QĐ-BYT (29/12/2023) và QĐ 3176/QĐ-BYT (29/10/2024).\nTham chiếu:\n- **Luật 51/2024/QH15** — 27/11/2024 — sửa đổi Luật BHYT, hiệu lực 01/7/2025\n- **NĐ 188/2025/NĐ-CP** — ban hành 01/7/2025, hiệu lực 15/8/2025 — hướng dẫn thi hành Luật BHYT\n- **NĐ 74/2025/NĐ-CP** — 31/3/2025 — sửa đổi quy định thanh toán TBYT/đối tượng đặc biệt\n- NĐ 70/2015/NĐ-CP — nền tảng lịch sử cho đối tượng quân đội, công an, cơ yếu.\nNguồn dữ liệu: OHP Data Processor (production mapping)."] ;
  fhir:CodeSystem.jurisdiction [
     fhir:index -1 ;
     fhir:CodeableConcept.coding [
       fhir:index -1 ;
       fhir:Coding.system [ fhir:value "urn:iso:std:iso:3166" ] ;
       fhir:Coding.code [ fhir:value "VN" ] ;
       fhir:Coding.display [ fhir:value "Viet Nam" ]
     ]
  ] ;
  fhir:CodeSystem.copyright [ fhir:value "Bộ Y tế Việt Nam — QĐ 3176/QĐ-BYT (29/10/2024). Trường PHAM_VI."] ;
  fhir:CodeSystem.caseSensitive [ fhir:value "true"^^xsd:boolean] ;
  fhir:CodeSystem.content [ fhir:value "complete"] ;
  fhir:CodeSystem.count [ fhir:value "3"^^xsd:nonNegativeInteger] ;
  fhir:CodeSystem.concept [
     fhir:index -1 ;
     fhir:CodeSystem.concept.code [ fhir:value "1" ] ;
     fhir:CodeSystem.concept.display [ fhir:value "Trong phạm vi hưởng BHYT" ] ;
     fhir:CodeSystem.concept.definition [ fhir:value "Thuốc/DVKT/VTYT nằm trong danh mục được quỹ BHYT chi trả. Mức hưởng tùy đối tượng (80-100%). Theo QĐ 3176/QĐ-BYT, PHAM_VI = 1." ] ;
     fhir:CodeSystem.concept.designation [
       fhir:index -1 ;
       fhir:CodeSystem.concept.designation.language [ fhir:value "en" ] ;
       fhir:CodeSystem.concept.designation.value [ fhir:value "Within insurance coverage (in formulary)" ]
     ]
  ], [
     fhir:index -1 ;
     fhir:CodeSystem.concept.code [ fhir:value "2" ] ;
     fhir:CodeSystem.concept.display [ fhir:value "Ngoài phạm vi hưởng BHYT" ] ;
     fhir:CodeSystem.concept.definition [ fhir:value "Thuốc/DVKT/VTYT nằm ngoài danh mục BHYT — người bệnh tự chi trả 100%. Theo QĐ 3176/QĐ-BYT, PHAM_VI = 2." ] ;
     fhir:CodeSystem.concept.designation [
       fhir:index -1 ;
       fhir:CodeSystem.concept.designation.language [ fhir:value "en" ] ;
       fhir:CodeSystem.concept.designation.value [ fhir:value "Outside insurance coverage (not in formulary)" ]
     ]
  ], [
     fhir:index -1 ;
     fhir:CodeSystem.concept.code [ fhir:value "3" ] ;
     fhir:CodeSystem.concept.display [ fhir:value "Ngoài danh mục nhưng được BHYT chi trả theo NĐ 70/2015/NĐ-CP" ] ;
     fhir:CodeSystem.concept.definition [ fhir:value "Thuốc/DVKT ngoài danh mục thông thường nhưng được BHYT chi trả cho đối tượng quân đội, công an, cơ yếu theo NĐ 70/2015/NĐ-CP, NĐ 74/2025/NĐ-CP và quy định BHYT hiện hành. Theo QĐ 3176/QĐ-BYT, PHAM_VI = 3." ] ;
     fhir:CodeSystem.concept.designation [
       fhir:index -1 ;
       fhir:CodeSystem.concept.designation.language [ fhir:value "en" ] ;
       fhir:CodeSystem.concept.designation.value [ fhir:value "Outside formulary but covered for military/police/cipher per Decree 70/2015" ]
     ]
  ] .

# - ontology header ------------------------------------------------------------

<http://hl7.org/fhir/CodeSystem/vn-insurance-scope-cs.ttl> a owl:Ontology ;
  owl:imports fhir:fhir.ttl ;
  owl:versionIRI <http://build.fhir.org/CodeSystem/vn-insurance-scope-cs.ttl> .