An elderly patient with loss of consciousness was admitted in a corporate
hospital in NCR. The patient’s hospital stay was for less than 48 hours and the
total bill amounted to more than one lakh.
Let’s take a look at just a very small part of the bill – biochemistry.
Among other lab investigations (and other modalities), the patient underwent
kidney profile, liver function tests, lipid profile and thyroid profile. The
total cost of these tests was Rs 9780/-.
Two questions arise:
1. Is this not overpricing?
2. Were they necessary?
The charges of IPD may sometimes be even much higher than the OPD charges,
especially if they are billed as express charges.
The practice of doing “profiles” needs to be deliberated. Why do lipid
profile at admission when the patient may not be fasting? Why do T3 and T4 when
the screening test is TSH? Why do LFT when the screening test is SGPT?
Only those investigations that are essential should be done at first,
bearing in mind the clinical signs and symptoms the patient presents
with. The further investigations can then proceed in a stepwise manner.
This is the rationale of the Choosing Wisely initiative, a US-based
health educational campaign, which calls upon leading medical specialty
societies and other organizations to identify tests or procedures commonly used
in their field whose necessity should be questioned and discussed with
patients. More than 70 such societies have published more than 400
recommendations of overused tests and treatments that clinicians and patients
should discuss.
It was only last year that the case of exorbitant overcharging by Gurgaon
Fortis hospital for the treatment of a seven-year-old dengue patient had hit
the headlines and become the talk of the nation.
Much has been spoken about the high costs of health care since then.
Yet nothing seems to have changed.
The scenario has only worsened, it has not improved.
On the other hand, the hospitals have starting saying that ICU means Rs
50,000 per day cost and with ventilator, one lakh per day.
The cost of reagents in this case may not be more than few hundred rupees
but the cost of corporate culture can be exorbitant.
Dr KK
Aggarwal
Padma Shri Awardee
President
Elect Confederation of Medical Associations in Asia and Oceania (CMAAO)
Group Editor-in-Chief
IJCP Publications
President Heart Care
Foundation of India
Immediate
Past National President IMA
very nice blog sir ,in this high cost medicine treatment you explained very well what necessary and what are not.And thanks for sharing such a valuable information.
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