Bumrungrad Costs Of Op

[chiang mai]

I am delighted (I think) to tell you that I finally had my long awaited angioplasty this weekend at Bumrungrad and it all went really well. First rate treatment in pleasant surroundings, super attentive care by a great team of nurses in CCU and a completely painless procedure at the hands of Dr Arram. Entered CCU at 9:0 am on Saturday and was released from the same at midday on Sunday feeling very well indeed. The icing on the cake? Paying the bill!

The estimate for the procedure was 320,000 to 380,000 baht hence I paid a 320,000 baht deposit when I checked in on Saturday. On Sunday when I checked out I paid the actual bill as presented, 147,900 baht and the difference was refunded immediately, I was amazed but obviously really pleased. Let me hear no more about how expensive Bumrungrad is, the Bupa (Spire Group) hospitals in the UK quoted £11,000 for the same procedure and I seriously doubt they could begin to compare to the standards of care I received this weekend.

(angioplasty involves inserting a stent or small supporting tube in the coronary arteries that control blood flow to the heart and is used to reduce symptoms caused by blockages to the arteries that lead to heart attack and/or stroke)

Edited June 9, 2008 by chiang mai

[lopburi3]

Have to ask why you paid a 100% deposit prior to receiving services? Was this just on your own or policy?

[chiang mai]

Have to ask why you paid a 100% deposit prior to receiving services? Was this just on your own or policy?

It seems to be standard practice at Bumrungrad, cover all potential costs before service is delivered - I don't have health insurance and am fortunate enough to be able to afford to pay the fees as they arise and suspect I may receive a discount as a result, not sure.

[Tywais]

It seems to be standard practice at Bumrungrad, cover all potential costs before service is delivered -

Strange because I didn't make any pre-payment when I had double cataract surgery there a few years ago. Perhaps too many patients trying to skip out on paying?

[chiang mai]

It seems to be standard practice at Bumrungrad, cover all potential costs before service is delivered -

Strange because I didn't make any pre-payment when I had double cataract surgery there a few years ago. Perhaps too many patients trying to skip out on paying?

If you had health insurance coverage (?) I would guess that the insurance company indemnifies the patient for coverage. If you did not have insurance coverage they must have relied on other factors to guarantee payment/reduce risk of non-payment, your job perhaps? From what I have observed I think it would be pretty difficult to "do a runner" from Bumrungrad since patients are escorted everywhere, even to the cashier at check out time.

[Sheryl]

I think most of the hospitals make it a practice to quote a bit on the high side for the obvious reason that people are always happy if the bill comes to less than anticipated but may get angry/complain if it is much more. Except in cases where the hospital has established a fixed price, the actual costs for anything will vary greatly. according to length of stay, medications required etc.

In your case CM you obviously did extremely well, requiring only a 24 hour stay total, which would have lowered the cost all the more. Congratulations!

[chakatee]

The difference in the price might also find it's reason in the place where the obstruction was found and the type of stent therefore used. If the surgeon for that specific place decided to put a bare metal stent (not worse as a drug eluting stent, just different: stronger but not drug eluting) in stead of a planned DES, this decision alone might already save you a serious amount of THB.

Is just a possible theory for this big price difference though since it (luckily) wasn't me who underwent this

If they really put in a DES for that price, then you really got a bargain.

Good luck anyway!

[ThaiPauly]

IF I didn't know you I would say you were a troll CM

That is truly remarkable. A REFUND

I am a "Regular"at the same hospial, I have had a couple of small ops there and they have wanted to take an imprint of my Credit Card before proceeding, but I would imagine that here is a price ceiling on that. After say 100,000 Baht they probably want cash...who would pay if the op went wrong and you died ? God forbid They must have a contingency for that l

When I had a CAT Scan last year I had to pay for that in advance though.

However at the CM Ram up here , you are probably aware that you are assigned a nurse or nursing assistant who follows you everywhere if you are having to see multiple doctors, (in the case of a health check for example ) and a whacking great numbered card that you have to carry everywhere with you, just to make sure you don't run out on your tab.

The thing is though for them to have put a system like this in place people MUST have done a runner after receiving treatment before

You must be delighted to have had a refund, I hope that you are makining a good recovery mate

[PhilHarries]

If you had health insurance coverage (?) I would guess that the insurance company indemnifies the patient for coverage. If you did not have insurance coverage they must have relied on other factors to guarantee payment/reduce risk of non-payment, your job perhaps? From what I have observed I think it would be pretty difficult to "do a runner" from Bumrungrad since patients are escorted everywhere, even to the cashier at check out time.

They must do as, apart from going to and fro between examinations/tests etc, I was never escorted not even to the cashier. I even managed to slip out a couple of afternoons down the road to a beer bar but stuck to soda water, didn't want to push my luck.

[Irene]

chiang mai,

was it done with a stent? i thought a stent, drugged or non-drugged could have caused 100,000 and doctor's fee, another 90,000 baht. there must be something explainable.

[chiang mai]

chiang mai,

was it done with a stent? i thought a stent, drugged or non-drugged could have caused 100,000 and doctor's fee, another 90,000 baht. there must be something explainable.

Indeed it was a stent, a very long one, 2.7 cms (I even have the DVD of the procedure showing the stent being inserted in case I want to relive the experience!). I have no idea whether it was a drug elluting stent or not since I have this agreement with Dr Arram that he is the subject matter expert and I am the patient hence he made all decisions on this subject without consulting me.

The cost breakdown of the Bumrungrad bill shows 66,000 baht for medical supplies and this includes the stent. Doctors fees were 35,000 and the next largest sum was 25,000 for use of the cath lab. 9,000 for medicine, 5,800 for a room in CCU and 4,400 for nursing services - then it's minor amounts for the remaining items. Compared to the costs I have heard of from others for this procedure I reckon I got away very inexpensively - my neighbor paid 1.2 mill baht for the same procedure here in Phuket some two years ago!

[chakatee]

As I thought, no way a drug eluting stent for that amount.

So you were "lucky" that they had to put a bare metal stent, as I said stronger but higher risk of re-occlusion with the years passing by.

And about your friend paying 1.2mill for "the same procedure": you can buy a 2-bedroomhouse for 1 mill (or less) or "the same house" for 30 mill (or up). Believe me, the procedure (and the stents used) will not have been "the same". Allthough I wonder how many (even drug eluting) stents he must have gotten ending up with a 1.2 mill baht bill.

Anyway, also with a DES but even more with a bare metal one: decrease your risk for re-occlusion: adjust your diet, control your sugar and cholesterol, don't smoke, do excercises, reduce stress, take the medicines prescribed to you and regularly have a check-up. And most important: good luck.

[chiang mai]

As I thought, no way a drug eluting stent for that amount.

So you were "lucky" that they had to put a bare metal stent, as I said stronger but higher risk of re-occlusion with the years passing by.

And about your friend paying 1.2mill for "the same procedure": you can buy a 2-bedroomhouse for 1 mill (or less) or "the same house" for 30 mill (or up). Believe me, the procedure (and the stents used) will not have been "the same". Allthough I wonder how many (even drug eluting) stents he must have gotten ending up with a 1.2 mill baht bill.

Anyway, also with a DES but even more with a bare metal one: decrease your risk for re-occlusion: adjust your diet, control your sugar and cholesterol, don't smoke, do excercises, reduce stress, take the medicines prescribed to you and regularly have a check-up. And most important: good luck.

I think Dr Arram's view on the issue of DES stents is that the medicine in such stents runs out after three months and the risk period of restenosis is around six to nine months. In my particular case I had been taking Plavix and Aspent for almost one and a half years before having the angioplasty and he did not believe that a DES would offer any additional risk reduction. He went on to explain that the issue of DES or not is currently very contentious amongst cardiac surgeons with most coming down against DES for the reasons already mentioned plus high costs. Agreed that smoking, exersise , diet and stress all need to be managed and again, in my case, they are all well under control.

[Irene]

chiang mai,

Thank you for the info. I had mine done about seven years ago at the same hospital, the total bill amounted to Baht 400,000. A year ago, it cost my relative about the same sum. (We were also released the next day after the op). In one article on medical hubs in this part of the world, Thailand was quoted as half a million baht equivalent, almost the same price as Singapore. Yours must be most competitive and your Dr. Aram must be most generous. Or, is this the new trend of pricing? It is real good to know.

Prior to the op, I never exercised except for golf. The blockage was caused by that omission. Since the op, I promised myself to exercise everyday for an hour on the treading mill or bicycle to prevent restenosis. With a quarterly visit for a check up, so far it has been most satisfying with hardly any illnesses. There has never been time lost on health issue. Just to remind you that after the op, the battle is not over, it is a life long watch since we are now above normal risk. I wish you luck.

[chiang mai]

It's interesting how people view themselves following this type of surgery, you think in terms of higher risk whilst I view myself as having lowered the risk substantially. I look back at what has happened and realize immediately that had I not been living in Asia when I decided to go for a health exam some two years ago, this problem may never have been detected - almost certainly it would not have been had I still been living in the UK since I was always symptom free and the problem was only detected because of the cardiac stress test results. Once I did find out about the problem I began treatment with drugs and set about changing my lifestyle substantially, I stopped smoking, eat more healthy food, visit the gym three/four times each week etc. Today I reckon I have an excellent chance of beating this problem, much more so than others who remain undiagnosed and that's a huge chunk of society. I will surely die of something at some point but I would wager large sums it will not have anything to do with clogged arteries.

[lopburi3]

my neighbor paid 1.2 mill baht for the same procedure here in Phuket some two years ago!

I have to seriously question that - a single non-drug stint operation should be in the range you were charged at the best hospitals. If someone paid more than a million I strongly suspect there was a lot more involved - he may have ended up having just a stint but did he perhaps have a heart attack that had to be treated first? I know my neighbor paid over one million several months ago but he was very near death when admitted to Bangkok Hospital Heart center (which is very high priced I believe).

There is an open listing of costs at one hospital on this website page:

http://www.vejthani.com/web-english/pricelist-cardiac-en.php

[chiang mai]

my neighbor paid 1.2 mill baht for the same procedure here in Phuket some two years ago!

I have to seriously question that - a single non-drug stint operation should be in the range you were charged at the best hospitals. If someone paid more than a million I strongly suspect there was a lot more involved - he may have ended up having just a stint but did he perhaps have a heart attack that had to be treated first? I know my neighbor paid over one million several months ago but he was very near death when admitted to Bangkok Hospital Heart center (which is very high priced I believe).

There is an open listing of costs at one hospital on this website page:

http://www.vejthani.com/web-english/pricelist-cardiac-en.php

Indeed the person in question did have a heart attack and the subsequent angioplasty was performed for that reason. Having said that the heart attack was apparently not life threatening and the subsequent stenting process did involve the use of drug eluting stents. Apparently a majority of the costs involved in this particular case were attributable to stent and physician costs.

[Irene]

chiang mai,

You are right in a way that in having it treated and more awareness and daily doses would lower the chance from those undetected. But according to medical world, once you have clogged arteries, there is likely to be a recurrence though not necessarily at the same spot. So deterrence is necessary for our type of people.

[tartempion]

I was hospitalised at Bumrungrad after a myocardial infarct, may 2000

Spent 11 days, invoice 202.048 baht, paid by insurance company and transferred with homeland cardiologist to my home university hospital, renowned for their cardio expertise.

Invoice shows cardiac catherisation 22k and cardiac investigation 5200, I suppose these are related. I guess the catherisation (angioplasty exam) was requested by my insurance company to decide on the subsequent action to undertake (in my case repatriation by cardiologist they sent over to Bangkok!)

Bumrungrad diagnosis was I would need triple bypass.

Home university hospital performed coronary angiography again and implemented two stents, one normal and one DES in a worldwide study on effects on DES stents. Subsequently I had two more coronary angiography checks (one each year) paid by the DES providing company.

Whatever the cost was at my home uni (paid by social security - misplaced that invoice) I remember the normal stent to be invoiced at 50K baht.

Interesting to note that two of Bumrungrad's cardiologists (one of them took care of this patient) were trained in angioplasty at my home university and I was asked to say hello to Dept Chief prof De Werf who lift an eyebrow when I told him Bumrungrad's diagnosis of needing triple bypass

Seems early 2000 was high days for bypass operations at Bumrungrad though.

And lifestyle? Stopped smoking, one hour bicycle every day, cholesterol down to 129

Edited June 15, 2008 by tartempion

[stickman]

A guy had this procedure done two weeks ago in Chiang Mai. the cost was 400,000 baht.

Edited June 15, 2008 by Maestro
URL removed as per forum rules - Maestro