Putting an end to the problem of non-availability of beds, the Andhra Pradesh government has decided that the allocation of beds in government as well as private hospitals will be monitored by the respective district administration to ensure no person requiring medical attention is turned away. Here are details of how the availability of beds will be monitored and patients accommodated in the state.
How does the AP Government plan to do it?
The government has classified all hospitals in the state into three categories — a) exclusive Covid-19 hospitals which dedicated to the treatment of the pandemic; b) Covid and non-Covid hospitals which will cater to both Covid patients as well as patients requiring treatments for other medical issues and, c) non-Covid hospitals which will only be allowed to treat other patients. If any person exhibiting Covid symptoms arrives at a non-Covid hospital, the government through a GO issued Wednesday has made it mandatory for that hospital to arrange for transferring that person to category A or B hospital immediately. Private hospitals shall be notified by the respective district collectors as to which category the government has classified them and shall remain so until further review and revision based on the evolving circumstances.
The Commissioner of Health and Family Welfare has established a web portal that would enable the district collectors to monitor the number of beds available in all government and private hospitals of A and B category, allocation of beds, their utilisation, deployment of human resources. This would enable rational management of the beds and manpower. The district collectors will also establish appropriate referral system to prevent waiting and overcrowding of patients. If any patient arrives with medical / surgical / obstetric emergency, such patient has to be admitted by category A and B hospitals and treatment should start without waiting for the RT-PCR test result. The patients must be considered as Covid-19 positive, if they have any contact history or symptoms or both, and hospital staff has to take necessary precautions but should not deny treatment under any circumstance. No patient who requires immediate medical attention due to medical issues other than Covid can be turned down by any hospital, treatment should be administered without waiting for the results of the Covid test. Until the patient tests negative, he/she should be treated as a Covid case, the GO states.
How will the allocation of beds happen?
While data on availability of beds in category A exclusive Covid hospitals is available with district collectors, the category B hospitals with more than 70 beds capacity have to earmark a floor or a block or a ward to treat the Covid-19 cases and inform the district collector about the number of beds available. These hospitals must admit and treat a person sent by the district administration or if a patient or patients approach on their own. Precautions like keeping a separate entry to the Covid ward, PPEs for doctors and staff should be provided. Such hospitals can continue to serve non-Covid -19 cases also. If there are more number of patients, the district collectors will direct them to a hospital where a bed is available. The data on availability of beds will also be put out in public domain so that people can find out in which hospitals beds are available.
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How will the government ensure all of them receive treatment?
The government has also fixed rates for treatment at all the hospitals so that patients are not over-charged. While beneficiaries under the Aarogyasi Scheme can avail free treatment which the government will reimburse the hospitals, those hospitals not empanelled under Aarogyasri Scheme can charge the patients as per the rates fixed by the government. The per day charges for non-critical Covid-19 treatment has been fixed at Rs 3,250; Rs 5,480 per day for ICU bed without ventilator and without NIV; Rs 5,980 per day for ICU with NIV; Rs 9,580 per ICU bed with ventilator.
Apart from this, doctors have the right to plan the course of treatment and recommend drugs or anti-viral injections which will be charged separately. All the non-Aarogyasri hospitals must display the “Per day rates” at the reception of the hospitals and provide treatment as per the SOPs, protocols, guidelines issued by the ICMR and the Government of AP. The government will provide PPEs to some designated Covid-19 private hospitals and they cannot charge the patients for that.
Every admission, discharge and death has to be reported the District Medical and Health Officer and every case of death will be subjected to ‘management audit’ to be conducted by a team of doctors of professor cadre to be set up by the Director of Medical Education to verify if there was any negligence in treatment.
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