Last week, the family of a Covid-19 patient from Santrampur in Mahisagar district who was admitted to a private hospital in Vadodara and died after three days on oxygen support in an isolation room was billed Rs. 1.84 lakh — of which, Rs. 5,000 was shown as expenditure on 20 PPE kits used to attend to the patient. While the family cleared the bill, it raised the question about affordable treatment at private hospitals for Covid19.
“Apart from the isolation room charge of Rs. 10,000 per day, we were also charged close to Rs. 30,000 for five visits by three doctors and four visits by Resident Medical Officer, nurse, special diet charge and so on. The medicines were additional. We admitted our patient on Saturday late evening last week and he passed away Monday night after attempts to resuscitate him failed. The private hospitals are certainly not going to be affordable for any person with even decent savings or insurance policies to fall back on,” the family told this newspaper.
Dr. Darshan Banker of the hospital concerned said the charges were in accordance to the services provided. “The PPE kits we use are of Level 3 which are used in isolation facilities and cost about Rs 2,500 each. The patient was admitted from Saturday evening to Tuesday morning and 20 PPE kits are a nominal number that were needed by various doctors and staff attending to him. Treatment at private hospitals will certainly come at a cost because we are also providing services of that kind from housekeeping to diet consultation,” said Dr. Banker.
But given the need to bring private hospitals on board in the coming weeks in order to ensure affordable treatment to the increasing number of Covid-19 cases in the city, the administration sought a proposal from the association hospitals last week.
In its proposal to the Officer on Special Duty Vinod Rao on Thursday evening, the Association of Hospitals and Specialists of Vadodara put forth the mutually decided rates for treatment of Covid-19 patients.
The association has also offered a tentative list of 61 hospitals in two segments — 31 of these are defined as “large corporate level infrastructure facilities” in Segment II and 30 are “without ICU facilities” in Segment I — who have agreed to treat Covid-19 patients, making up a total of 1,027 beds. Of these, 605 beds are in Segment II with 192 ICU beds and 76 beds with ventilators. Segment I hospitals have offered 422 beds in all.
The Gujarat High Court asked the private hospitals in Ahmedabad to offer an additional 10 per cent reduction in the already capped prices. The state government, in its negotiations with the private hospitals had proposed a reduction in price by 30 percent, which the Ahmedabad Hospital and Nursing Homes Association (AHNA) were not agreeable to. During the proceedings, on Friday, the AHNA president Dr Bharat Gadhvi agreed to a 10 per cent reduction in the already capped prices of general and high dependency unit (HDU) wards and another five per cent reduction in the capped ICU ward pricing.
In Ahmedabad, of the total 46 hospitals that the Ahmedabad Municipal Corporation short listed, 42 have signed up.
The Vadodara proposal defines Level 1 bed as that having “available oxygen supply with medical expertise (doctors and nurses) to look after the well-being of the patient.” The second category of ICU Level 1 bed is defined as “beds with multipara monitoring and oxygenation along with the required medical experts” and the ICU Level 2 is “beds with multipara monitoring along with ventilation support of invasive or non-invasive nature and medical experts”.
Segment 1 hospitals will charge Rs. 6,000 per day for Level 1 and 8,500 for ICU level 1 beds, while Segment 2 hospitals will charge for four categories. These include a bed in ward for Rs. 8,500, ICU Level 1 for Rs. 12,500, Isolation + ICU for Rs. 18,000 per day and ventilation support along with isolation and ICU at Rs. 21,500 per day.
The proposal states that the rates put forth include “costs of all medicines except Tocilizumab”, which is an immunosuppressant drug used to treat severe cases of rheumatoid arthritis but has been used as an alternative treatment for critical Covid-19 patients.
The costs also do not include dialysis rates needed by any patient as well as special doctor visit fees and specialized lab tests, the proposal states.
The proposal, however, also lays down three conditions before the administration while offering services. Seeking assurance from the administration, the proposal states, “The hospital will not be sealed if one or more staff test positive. Staff members will not be forced to government quarantine centres against their wishes. Staff members will be allowed free movement from home to workplace and back irrespective of where they reside.”
The condition is significant in wake of the week long closure of the Bhailal Amin General Hospital (BAGH) in Vadodara which saw several staff members testing positive and voluntarily closed down after pressure from various groups in the city, although the civic body did not order any action.
Rao said, “This proposed ceiling of rates is almost all-inclusive and is much better than what is being enforced in by Ahmedabad Municipal Corporation (AMC). Our health teams will inspect these hospitals at the earliest and take decision regarding this offer and notify the empanelling of hospitals along with terms and conditions.” Rao also added that insurance companies have been brought on board to ensure that cashless treatment for Covid-19 is available at the empanelled hospitals in Vadodara.
The administration has also entered into a MoU with two private medical college hospitals in the district under Ma Amrutam Yojana. Rao said, “Dhiraj Medical College Hospital, Pipalia will set aside about 250 beds, and Parul Medical College Hospital, Waghodia will set aside about 150 beds for Covid-19 treatment. Patients eligible under MA Yojana will get absolutely free treatment in these two high-tech private medical college hospitals from Thursday onwards. We will also extend free transportation to patients from the city to these hospitals.”
(with inputs from Sohini Ghosh in Ahmedabad)
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