Why the cost of COVID-treatment is high
All hospitals handling Covid19 patients have to maintain very high levels of infection control, deploy at least 2.5 times more staff and take care of their stay, food and medical care if they fall sick
NATHEALTH, which has submitted a representation on ‘COVID Package Pricing’ to Satyendar Kumar Jain, Health Minister, Government of NCT, has mentioned several reasons for the high cost of care for COVID and non COVID patients.
The reasons attributed by NATHEALTH are:
• Additional staff due to shorter shifts, quarantine policy post roster duty, staff getting infected during treatment and impact of PPE’s etc. on the safety and health of HCW’s and their families. It thus takes 1.75 to 2.5 times of usual staff to treat COVID patients.
• Costs towards boarding, lodging and transportation of staff on duty and off duty, but under quarantine. This is necessary to protect families of HCW’s. In addition, free testing and treatment of HCW’s when infected, adds to the cost of operations.
• Cost towards Personal Protective Equipment (PPE). As a per FICCI study, 3-5 PPE is required per patient. Further, the price of common items like surgical mask has gone up by 80% due to surge in demand.
• Free treatment being provided to patients from economic weaker sections
• Unviable Schedule of Charges: Hospitals are treating patients sponsored by the Central and State Government on CGHS 2014 tariff, which was valid till 2016. Similarly, the rates of public sector insurance companies (GIPSA) have not been revised since 2016, forcing hospitals to work on unviable prices for a large segment of patients. The hospitals end up cross-funding the losses from other patient segments.
• Non-payment of PPE cost by CGHS and GIPSA
• Shallow penetration and coverage of insurance among general population exposing individual households to catastrophic expenditure for tertiary care.
Max Healthcare, which has issued clarification on its pricing structure for COVID patients, has stated, “Most people forget that the Covid 19 pandemic has led to a huge increase in the cost of care due to factors peculiar to this highly virulent disease that our team of healthcare workers is treating at an extraordinary risk to themselves and their own families. “
It mentions that all hospitals handling Covid19 patients have to maintain very high levels of infection control, deploy at least 2.5 times more staff (to account for temporary attrition because of quarantine and infection) and take care of their stay, food and medical care if they fall sick. They also have to source high-quality PPE’s for healthcare workers (HCWs) on frontline duty. While the staff wears full Personal Protective Equipment (PPE’s), there is a possibility of being infected through an inadvertent exposure.
“The disease progression too varies hugely from patient to patient and the treatment modalities are hugely variable. The patient stay in the hospital is quite long with intermittent spells in ICU’s and often on ventilators. Both these lead to significant additional costs compared to non-Covid patients.
Covid-19 patients require round the clock monitoring due to which the number of healthcare workers required to manage these patients is much higher,” it added.
It points out that in most Covid hospitals, the usual staff shift is for 6 hours, not the usual 8 hours. This means we need to deploy 25% more nurses and doctors to take care of Covid 19 patients. Requirements for doctors, nursing, paramedical and other staff is 2.5 times the normal due to more shifts. “There is a 14-day quarantine period for them post this extended duty, in addition to 7 days that they get to spend with their families after the quarantine period is over. Nurses and trained medical work force are in short supply and we are doing our best to manage with the resources we have,” it stated.