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AIIMS slashes cardiac surgery cost by a fifth

Less use of disposables,shorter hospital stay help bring down costs

Written by Pritha Chatterjee | New Delhi |
August 18, 2013 12:51:31 am

The All India Institute of Medical Sciences (AIIMS) has succeeded in slashing its rates for cardiac surgeries by as much as 15-20 per cent for general ward patients.

Sample this: in 2004 the cost of repairing a hole in the heart was Rs 45,000; now it costs Rs 40,000. Bypass surgery,which used to cost Rs 60,000,is done for Rs 52,000. Two types of surgeries for congenital heart diseases — heart defects that are present since birth — now cost Rs 40,000 and Rs 52,000 respectively against the older rates of Rs 50,000 and Rs 55,000.

Surgery for total anomalous pulmonary venous connection (TAPVC),another congenital heart defect,now costs Rs 50,000 against Rs 60,000.

The cost of surgical repair of conduits and valves has also been brought down to Rs 55,000 from

Rs 65,000. Diagnostic tests such as cardiac X-rays and CT scans are also cheaper. Procedures like angioplasty are cheaper by Rs 5,000 to Rs 7,000.

The premier medical institute has achieved this by cutting down on disposables used during the surgeries and with doctors pushing the envelope of precision during surgeries,which has cut down on patients’ hospital stay and complications resulting in less use of hospital equipment and other resources,doctors said.

“We reviewed our use of disposables and realised that since we buy materials in bulk,our costs are much less. Also,our doctors have succeeded in cutting patients’ hospital stay. So,on the one hand,we have reduced the use of disposables like sutures. On the other hand,we have succeeded to contain complications… so less resources are being used,” Dr Balram Airan,chief of Cardiothoracic and Vascular Surgery (CTVS),said.

Increased surgical precision,in procedures like ‘anastamosis’ or joining together two branches of blood vessels,has reduced bleeding rates,a step that has helped doctors cut

the use of disposables such as sutures (used to stitch up an incision) and cut costs.

Doctors realised they were saving a substantial amount of money on disposables,so they simply decided to transfer the benefits to the patients.

The decision has already invited the wrath of suppliers. Suture companies that supply AIIMS have already complained that they won’t be able to sustain the supplies at existing rates.

“We will negotiate with the suppliers. We are also opening fresh tenders for disposables so that we have more competition to keep costs low,” Dr Airan said.

The whole process,according to doctors,began with a proposal by the administration to make heart surgeries free of cost. Dr Airan pointed out that it was not practical.

“We would have needed additional funds of up to

Rs 40 crore and the patient load would have gone up tremendously. Even now,we are neck-deep in surgeries,and our eight operation theatres and ICUs are constantly falling short. So,we decided to maintain the rates for private ward

patients and reduce it for general ward patients,”

Dr Airan said.

Package rates at AIIMS are currently prevalent only in the cardiology and neurological sciences departments,where patients pay a lumpsum at the beginning of the procedure instead of being sent to buy consumables required for surgeries before the procedure.

This mode of payment was started in the mid-1990s. “Instead of a standard one-size for all packages,now we have revamped the system so that patients can choose certain consumables for instance the artificial valve they desire,” a senior official in the administration explained.

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