Why does cataract surgery require a hospital stay in Thailand?

[Bangkok Barry]

2 hours ago, transam said:

My retina fix, Gov hospital, I had a breakdown of charges, the surgeon's fee was in the figures............🤗 

 

I'm sure it was. And I'm sure mine would show 20,000, with his 'tip' not on show. See my post above.

[lopburi3]

7 minutes ago, Bangkok Barry said:

 

Now that's a bizarre scenario, which you made up entirely out of nowhere. Complete fantasy. There was no offer to do it on my back porch. The official government hospital charge is 20,000, but he said he adds a further 5,000 "for himself". That is exactly the words he used to my wife who was with me.

I was just working with the quote.  So he charges 5k above the normal price - this is common when using doctors at government hospitals on a doctor to patient basis (rather then obtaining service from normal queue system/training).  Often there is a special system in place for such activity at larger facilities and set higher payments are made when using.

 

Edit:  Now you are making claim this is an off-book "tip"?  Maybe - but remember government hospitals have freedom to charge foreign customers more (much more) if they wish to do so.

[Bangkok Barry]

1 hour ago, sambum said:

I had my cataract surgery done at a Private Hospital in Surat Thani, and they gave me the choice of an overnight stay or not. I opted to stay -  just in case there were any complications the nurses and doctors were on hand to resolve them, and I had to have a post op check the next morning anyway.

 

That does make sense, but neither the government nor the private hospital are making it an option. Not that they could force me to stay, of course. It would be a 100km round-trip the next day which is no big deal with my wife driving, but to keep them happy and for the reason you say I'll probably decide to stay the night. My whole point, and the reason for this thread, is that absolutely nowhere have I found any mention that it is anything other than an out-patient procedure, and no-one I know who has had the same op has needed to spend more than three hours from arriving to departing.

[Bangkok Barry]

12 minutes ago, lopburi3 said:

I was just working with the quote.  So he charges 5k above the normal price - this is common when using doctors at government hospitals on a doctor to patient basis (rather then obtaining service from normal queue system/training).  Often there is a special system in place for such activity at larger facilities and set higher payments are made when using.

 

Edit:  Now you are making claim this is an off-book "tip"?  Maybe - but remember government hospitals have freedom to charge foreign customers more (much more) if they wish to do so.

I got bad vibes from him too. He was rushing everyone through and spent less than a minute with me, and a further minute when I asked to be checked for glaucoma in one eye. The private hospital said I had it (which I'll deal with after the cataract surgery by going to Khon Kaen as recommended by the Kalasin private doctor) and he said I didn't. I felt I was wasting his time by being there.

[lopburi3]

3 minutes ago, Bangkok Barry said:

I got bad vibes from him too. He was rushing everyone through and spent less than a minute with me, and a further minute when I asked to be checked for glaucoma in one eye. The private hospital said I had it (which I'll deal with after the cataract surgery by going to Khon Kaen as recommended by the Kalasin private doctor) and he said I didn't. I felt I was wasting his time by being there.

By all means avoid anyone you have such vibes from - especially if exam was as brief as you indicate.  If the cataracts are not causing you issues (often they can wait) might want to make glaucoma priority -  as there is no turning back that damage once done.

[richard_smith237]

16 minutes ago, Bangkok Barry said:

That does make sense, but neither the government nor the private hospital are making it an option.

 

Making it an option...   Have you said that you want to be discharged the same day ???...  Have they said no ?

 

If you are not asking the right questions, then you'll just be treated the same as anyone else who doesn't ask questions. 

 

 

16 minutes ago, Bangkok Barry said:

Not that they could force me to stay, of course. It would be a 100km round-trip the next day which is no big deal with my wife driving, but to keep them happy and for the reason you say I'll probably decide to stay the night.

 

No harm in staying the extra night...   unless its something you don't want to do. 

 

 

16 minutes ago, Bangkok Barry said:

My whole point, and the reason for this thread, is that absolutely nowhere have I found any mention that it is anything other than an out-patient procedure, and no-one I know who has had the same op has needed to spend more than three hours from arriving to departing.

 

I could be wrong, but I don't think its an 'out-patient procedure' (*like going to and getting an ingrown toenail dealt with)...  I think procedures such as this are considered a 'day case' where you are 'admitted' and will have a recovery room etc..  its then up to you how long you want to spend recovering and of course they advise based on caution and why wouldn't they.

 

 

As I see it and similar issues - much of the decision can come down to what you want. 

[Bangkok Barry]

19 minutes ago, richard_smith237 said:

No harm in staying the extra night...   unless its something you don't want to do. 

 

I don't. The bed is rock hard, based on previous experience there. I slept on the couch instead. And bearing in mind that the surgery would probably be in the afternoon it leaves many hours to be bored in my room. I'd rather be bored at home (assuming limited ability at first to watch tv or use a computer).

20 minutes ago, richard_smith237 said:

I could be wrong, but I don't think its an 'out-patient procedure'

 

A couple of minutes with Google says that it is. Not one item I found said anything different.

[Bangkok Barry]

27 minutes ago, richard_smith237 said:

Have you said that you want to be discharged the same day ???...  Have they said no ?

 

I did, and they said I need to.

[Bangkok Barry]

51 minutes ago, lopburi3 said:

By all means avoid anyone you have such vibes from - especially if exam was as brief as you indicate.  If the cataracts are not causing you issues (often they can wait) might want to make glaucoma priority -  as there is no turning back that damage once done.

 

I'm doing the opposite. I'll get both cataracts done within maybe a month and then will deal with the glaucoma. That's a 'slow burner' that takes many years to progress. It hasn't been a significant problem by any means, and the second doctor said I don't even have it. A month delay isn't a problem

[richard_smith237]

1 hour ago, Bangkok Barry said:

 

I don't. The bed is rock hard, based on previous experience there. I slept on the couch instead. And bearing in mind that the surgery would probably be in the afternoon it leaves many hours to be bored in my room. I'd rather be bored at home (assuming limited ability at first to watch tv or use a computer).

 

Then tell them that - just say you don't want to stay over night - My guess is the response will be nothing more than an..."Oh... ok then"....

 

1 hour ago, Bangkok Barry said:

A couple of minutes with Google says that it is. Not one item I found said anything different.

 

Yep...  You will be admitted as its is a surgical procedure, but you can be treated on an out patient or inpatient basis (Depending on your perforce to have a recovery room over night).

 

Thus the 'admitted part' vs out-patient and in-patient is somewhat of a grey area, its sometimes just called 'same day surgery' to avoid the ambiguity - the outpatient vs inpatient part simply determines if an overnight stay is required and thus, preferences rather than requirements can also come into it. 

 

 

In your shoes - if you don't want to - just tell them you want to go home after a few hours.  IF the hospital objects, I'd want to know on what grounds ?? (are they digging for the extra money etc ?).

 

Also - Insurance coverage - some only covers Inpatient treatment, thus, the wording could cause an issue with the policy - if admitted, make sure they put 'inpatient' on the forms (even if you don't stay over night  - if your insurance only covers IPD).

[richard_smith237]

1 hour ago, Bangkok Barry said:

1 hour ago, richard_smith237 said:

Have you said that you want to be discharged the same day ???...  Have they said no ?

 

I did, and they said I need to.

 

Did they give any explanation as to why ??? Your age etc, additional health risks ?

 

 

 

[Bangkok Barry]

5 minutes ago, richard_smith237 said:

 

Did they give any explanation as to why ??? Your age etc, additional health risks ?

 

 

 

 

No. Just their rule. The cost of 1700 for a private room isn't an issue, comfort is. And it isn't a great hospital. When I was there with food poisoning there was no water one day as the pump failed and they carried water to my room in buckets, and the emergency call button didn't work. Someone could die in that room and no-one would know the hospital was at fault.

[Bangkok Barry]

11 minutes ago, richard_smith237 said:

Also - Insurance coverage - some only covers Inpatient treatment, thus, the wording could cause an issue with the policy - if admitted, make sure they put 'inpatient' on the forms (even if you don't stay over night  - if your insurance only covers IPD).

 

I don't have insurance. At 75 the cost far outweighs what I'd probably need to pay in future years. I keep the money for when I might need it, rather than give away large sums each year for nothing in return. The 50,000 for the two surgeries isn't a problem.

[sambum]

2 hours ago, Bangkok Barry said:

 

That does make sense, but neither the government nor the private hospital are making it an option. Not that they could force me to stay, of course. It would be a 100km round-trip the next day which is no big deal with my wife driving, but to keep them happy and for the reason you say I'll probably decide to stay the night. My whole point, and the reason for this thread, is that absolutely nowhere have I found any mention that it is anything other than an out-patient procedure, and no-one I know who has had the same op has needed to spend more than three hours from arriving to departing.

 

Yes, my op took about 40 minutes - totally painless procedure, and the best money I ever spent. It was like looking at things in a room with a 40 watt bulb and swapping it to a 100 watt bulb!

[Bangkok Barry]

6 minutes ago, sambum said:

 

Yes, my op took about 40 minutes - totally painless procedure, and the best money I ever spent. It was like looking at things in a room with a 40 watt bulb and swapping it to a 100 watt bulb!

 

I love it!!

[riclag]

 My satangs worth.

I had cataract surgery on both eyes 1 year apart from each other ( no significance with waiting one whole year) at the clinic here in Sakon.

The Dr was the head eye Dr at the govt hospital , and also has a fully staffed operating clinic here.He spoke very good English and went to school for his craft in the states!

He never recommended staying at the hospital overnight .

Another occurrence,

I wanted a  mole biopsy procedure at the same hospital, the specialist said he could do it outpatient but a week later he called and changed his mind and wanted me to stay several days while getting many standard tests (heart, lungs, aids) I found that odd and thought he was spreading the wealth to the Hospital departments.

I tried a private hospital in Udon, they did a outpatient procedure  , in and out in 3 hours.

 

Many people have come to your aid with goodwill. Good for you.

 

Good luck in what you decide!

 

 

 

 

[riclag]

3 hours ago, Bangkok Barry said:

I got bad vibes from him too. He was rushing everyone through and spent less than a minute with me, and a further minute when I asked to be checked for glaucoma in one eye. The private hospital said I had it (which I'll deal with after the cataract surgery by going to Khon Kaen as recommended by the Kalasin private doctor) and he said I didn't. I felt I was wasting his time by being there.

The same happened to me at the hospital in Sakon , A rushed exam! The eye department was packed with people.

My wife said better to go to his clinic, where he could spend time exploring & explaining!

She was correct!

He thought I could wait a little bit longer, he thought my cataract was 5% but I didnt like the halos and spikes coming from light fixtures!.
So…

 

 

[richard_smith237]

1 hour ago, Bangkok Barry said:

1 hour ago, richard_smith237 said:

 

Did they give any explanation as to why ??? Your age etc, additional health risks ?

 

No. Just their rule. The cost of 1700 for a private room isn't an issue, comfort is. And it isn't a great hospital. When I was there with food poisoning there was no water one day as the pump failed and they carried water to my room in buckets, and the emergency call button didn't work. Someone could die in that room and no-one would know the hospital was at fault.

 

Yeah.. I get you...    Their insistence on you staying overnight is a little odd given the procedure. 

 

I'm a few weeks into recovery from an operation - given the time of the Op (4pm) staying over night was not an option. 

Had I pushed it, I could have had an op on a different day in the morning and not stay over night... 

As it turned out I was offered the opportunity of staying a second night, which I took as I'd asked for far stronger pain-killers and some solid sleeping tablets as I was 'hurtin' rather a lot....   

 

Anyway... As mentioned, clearly its not a cost thing, perhaps a 'caution' thing given your years which is never a bad thing.

I guess we'd all rather they air on the side of caution and offer great care rather than kick us out...  

 

But.... as you mention, the standard of care varies...   for 1700 baht a night, those sort of hospitals usually expect someone else to stay in a room with you to help out... Where as the 13,500 baht a night rooms are a lot more attentive. 

 

Best of luck with the Op anyway... Sure it'll go smoothly and within months you'll have also done the glaucoma jobby and will be identifying the moon-landing sites with the naked eye !!!

 

 

 

 

 

 

 

[Bangkok Barry]

17 minutes ago, riclag said:

My wife said better to go to his clinic, where he could spend time exploring & explaining!

 

I did see him at his clinic.

[jojothai]

4 hours ago, Bangkok Barry said:

 

I don't have insurance. At 75 the cost far outweighs what I'd probably need to pay in future years. I keep the money for when I might need it, rather than give away large sums each year for nothing in return. The 50,000 for the two surgeries isn't a problem.

Thanks for saying this. Before you posted that insurance was off topic, but if you were to claim on insurance it is very relevant.
I have international insurance from UK and they challenged me for an overnight hospital stay when i had shoulder surgery, the doctor confirmed that it was the correct hospital policy because i had to pumped with antibiotics overnight for any potential infection. Insurance accepted.

I had cataracts in both eyes and another eye retina problem done at Rutnin. Its expensive but then its one of the best eye clinics and my uk insurance accepted it straight away,
They did not require overnight but did require an hour or two (I cannot remember exactly how long) in a daycare bed.

For information of others reading the post. I was claiming on insurance. The hospital initially put "outpatient charge" for the bed charge and I got them to change it to state "day care" which the insurance accepted. My insurance covers day care but not OP.
Rutnin also wanted me to confirm that if i went home there is somebody staying with me should there be any problem.
i had no problem overnight, but needed to go back the next day to remove the eye bandaging and check all was ok.
Going home, it was mid afternoon in bangkok and I remember it was very bright and difficult for the eyes because of the brightness.
Suggest you have a pair of dark glasses.

Another thing to note is that you will need two sets of eyedrops for a few weeks (or combined in one drop according to a person posting).
The hospital charge for the drops was outrageous, i did not know until after that it was double compared to cost outside.

[Jeffrey346]

14 hours ago, thecyclist said:

Any idea what the waiting time ,what they call the " line " , is at that hospital. 

13 k sounds very reasonable. Was quoted 20000 at the Lopburi provincial hospital, where overnight stay is required. The "line"  there is around a month. 

I had both eyes done. 6 months que each time. 

[1sickpuppy]

On 3/11/2024 at 11:36 AM, Bangkok Barry said:

I wrote a few weeks ago about my eye problems and Thailand's Top optician being unable to correct it with new glasses. I received some excellent advice amongst the usual irrelevant comments.

 

As a result of the excellent advice I attended a private hospital for a proper test, where I was told I had cataracts in both eyes and glaucoma in one. Surgery could be done on the cataracts for 25,000 a time. Okay. But I would need to stay overnight (extra charge of course but free food and dark glasses included ).

 

A two-minute Google check revealed every single entry saying that no overnight stay is required. USA, UK, Australia. Nowhere. A friend in Scotland had it done, with tea and biscuits after and then home. In New Zealand, a friend took his father to be seen, in and out in three hours including recovery time. 

 

So I went to see a doctor who has a clinic in Kalasin and who works at the government hospital there. He confirmed the cataracts and said I didn't have glaucoma and my eye pressure was normal. You'd think a government hospital would charge less, but he wanted 20,000 plus an extra 5000 for him. And he also said I needed to stay overnight.

 

What makes cataract surgery so dangerous in Thailand that instead of going home straight away as you do in the rest of the world we have to stay in hospital overnight for observation, I wonder. I guess the answer has to begin with M or maybe B. It's the same thing. And it seems I'll have no alternative but to give in to the system.

 

Then I have to get a third opinion, somehow, on whether I have glaucoma or not.

try a different hospital, they wanted me to get hernia op n stay 3 days, i looked on net they got me another doc out in 2 hours, Mae fah luang good doctors and friendly staff

[lopburi3]

12 hours ago, riclag said:

I wanted a  mole biopsy procedure at the same hospital, the specialist said he could do it outpatient but a week later he called and changed his mind and wanted me to stay several days while getting many standard tests (heart, lungs, aids) I found that odd and thought he was spreading the wealth to the Hospital departments.

Actually there is not much wealth involved if paying Thai rate at a government hospital - but they normally want every condition signed off before surgery so normal to have a long list of different departments doing exams and any finding abnormal having to be explained.    

[mudcat]

One of the reasons for a required over night stay is the hospital can charge the insurance company at their rack rate.  Important if your policy is inpatient only where you might request a itemized estimate.

 

Scheduled a colonoscopy at our provincial hospital and was given the option of overnight stay prior to the procedure or one day service.  Chose the overnight stay as would not want to get caught short on the hour drive.

[steve187]

On 3/11/2024 at 11:49 AM, ozimoron said:

You don't go home straight away in the rest of the world. In Australia you will spend some time in recovery then under a period of supervision which is not short and finally would have to have a person arrive to collect you who identifies themselves to the hospital staff and signs a declaration that they will stay with you and observe you for 24 hours and warns of criminal penalties for failure to do so. Otherwise you stay overnight.

had mine done in UK, took a bus to the hospital, a short wait for the op, ( they do all left eyes first, then a reposition for the dr to do the rights) fully awake for the op, a cup of tea and a biscuit , wait an hour to be released to a driver/friend, no follow ups other than to see the referring optician, had to wear the plastic eye guard for a few days to sleep.

a year of so later a laser secondary cataract eye op, as my site was going a but blurry again, a 10 minute op in a sitting in a chair looking through a machine.

[Bangkok Barry]

10 hours ago, jojothai said:

Thanks for saying this. Before you posted that insurance was off topic, but if you were to claim on insurance it is very relevant.

The thread was about why an overnight stay is deemed necessary in Thailand, and no mention was made by me about insurance. The room is only 1700. The cost wasn't a factor, only why the hospital wanted me to stay at all.

10 hours ago, jojothai said:

Suggest you have a pair of dark glasses.

Provided free with the room charge, plus food which I might make other arrangements for.

10 hours ago, jojothai said:

The hospital charge for the drops was outrageous, i did not know until after that it was double compared to cost outside.

Normal with any medication. Always cheaper elsewhere.

[Bangkok Barry]

3 hours ago, 1sickpuppy said:

try a different hospital, they wanted me to get hernia op n stay 3 days, i looked on net they got me another doc out in 2 hours, Mae fah luang good doctors and friendly staff

 

I'm up-country where choice is limited. I did also try a government hospital though, same price, same alleged need for a stay.

[Expat68]

I had mine done in Chaing Mai by supposedly the best lady doctor in the city. I think it was roughly 40,000 baht each eye, she told me I could get cheaper but not all lenses are the same. One week between each eye

[riclag]

3 hours ago, lopburi3 said:

Actually there is not much wealth involved if paying Thai rate at a government hospital - but they normally want every condition signed off before surgery so normal to have a long list of different departments doing exams and any finding abnormal having to be explained.    

I thought it was a bit much, to have

Aids counseling for a mole biopsy especially when I dont have aids  .

 

But I understand you’re concerns 

 

[superal]

On 3/11/2024 at 12:40 PM, samtam said:

As others have stated, cataract surgery does not require an overnight stay. However, having had both mine done, first at Rutnin Eye (Bangkok) where the anesthetic procedure caused hemorrhaging, (needle into the eye), I still went home to recover the same day, and administered the requisite drops until I went for a follow up the next week. Given my experience I then had the second eye surgery performed at Samitivej Hospital (Bangkok) with drops anesthetic and went home afterwards. I was picked up by my partner both times, and managed the washing (shower) without getting water anywhere near my eyes. The prices you are quoted seem very reasonable. Rutnin was around THB140,000 and Samitivej around THB75,000 (both eyes normal lenses).

 

My straightforward experience at Samitivej is the norm for these procedures, (as everyone kept telling me before the horror show at the first surgery).

 

Happily everything is OK in both eyes now, and the difference in my sight is dramatically better; I no longer need long distance glasses.

Had both eyes done for cataracts in the UK and was given eye drops as an anesthetic . But an injection into the eye would not be for me . Is that only done in Thailand ?  Both my ops were done in private eye hospitals that treated only eyes . Including pre-op preparation , I was there both times  for 3 hours and then on my way home in a taxi . There after , eye drops 3 times a day for 2 weeks and also a plastic eye patch that was worn at nights to stop any rubbing on the eye . Check up after 1 month .

Thai guy in Bangkok had the cataract op and said he stayed in for one night and home the next day but had no eye drops . My local Thai government hospital does about 14 cataract operations a day , carried out by a lady eye surgeon . Free for Thai but farangs 25,000 baht per eye , including an overnight stay in a non V.I.P. room