Transfers Of Patients To Thai State Hospital Refused

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HEALTH CARE

Transfers to state hospital refused

PONGPHON SARNSAMAK,

CHULARAT SAENGPASSA

THE NATION

BANGKOK: -- State-run hospitals are starting to refuse transfers of acute patients from private hospitals due to the Social Security Office (SSO)'s new financial management system.

"All beds in medical schools and state hospitals are no longer available for SS [social security] members who are referred from a private hospital," Dr Suradej Waleeittikul, deputy secretary-general of the SSO, said yesterday.

The financial management programme called "diagnosis related groups" for patients with critical conditions and serious diseases went into effect in January.

Over 9 million employees have registered as members of the scheme and about 90 private hospitals nationwide have registered as healthcare providers under the scheme.

An employee will be assigned a state or private hospital as the prime provider.

Previously, private hospitals received Bt2,400 per year from the SSO for each SS member assigned to them. Then, the hospitals would manage this budget by themselves.

However, the SSO found that some private hospitals did not provide medical treatment to social security patients or transferred them to another hospital to receive better treatment because they wanted to save their budget. This was a major problem for patients in accessing healthcare under the scheme.

"If they transfer patients to other hospitals, that means they spend some of the money under the per capita subsidy to pay the other hospital for the patients' medical expenses," he told The Nation in an interview.

Under the new programme, the SSO will directly pay a private hospital for the cost of treatment for an inpatient with a critical condition.

But after the implementation of the new financial management programme, many private hospitals transferred a lot of patients to medical schools or state hospital as they could no longer shoulder the financial burden for a referral case.

Some medical schools and state hospitals are now starting to deny medical treatment for those patients transferred from private hospitals because they do not have enough beds for emergency cases.

"I don't want to say the medical schools or other state hospitals are now refusing to receive patients under social security and transferred from private hospitals. I would rather say that they do not have enough beds for patients," he said.

"They can no longer provide medical treatment for patients with acute conditions who are transferred from a private hospital as they still have a lot of patients who also have been waiting for medical treatment. They also don't want to be blamed for bad service," he said.

The SSO will talk with all hospitals registered with it including private hospitals to find a solution for this problem.

"We don't want them to transfer patients to medical schools or other hospitals if they can still provide medical treatment for their patients," he said.

"If they still transfer patients to receive medical treatment to other hospitals even though they can provide treatment for the patients, we will recall our money back from them or seek other financial punishment for them," he added.

-- The Nation 2012-03-21

[alant]

Similar to many places in the world where healthcare costs are under pressure and insurers and providers are looking for any loophole or opportunity to defer costs away from their cost centre. The resultant action may prove detrimental to the patient.

[Pib]

Money, money, money.

[bedouin1990]

Shades of America! As a (prematurely) retired surgeon, I smell the malodorous "dumping syndrome." Hospitals, and their medical staff-some of whom have a financial interest in the hospital- will obfuscate and lie to get money-losing patients onto the referral hospitals. What is often forgotten is that healthcare businesses, like other businesses, have to at least break even and preferably make a profit to fund wage increases, overhead increases and the purchase of the latest technology. The great advances is medical technology in the last 40 years has been extremely expensive.They are both saving yet prolonging life so more expenses will be incurred in the future. It is a never ending upward spiral.

Thailand has a 2 tiered medical system (as does America). Yet it has far fewer resources to fund some type of Universal Care. From the information given, I think the government has taken the right approach here. Those who take the guaranteed sum per patient, are obligated to live with it. Or opt out. Just look at what Medical Tourism has become in Bangkok-wildly profitable.

[anterian]

A world wide problem, in the UK many hospitals are finding it is cost effective to pay for patients to be treated in Eastern Europe.

[kruangfaifar]

Money, money, money.

Obviously times are a changing. A couple of years back I was hospitalised in a private hospital with a serious illness and I was allowed to transfer to a government hospital when my medical insurance cover ran out. I had a nice room with cable TV where I stayed for a month before being discharged. I then had about 2 months outpatient treatment. It saved me over 100,000 Baht in medication and physiotherapy costs alone and the standards were good. Those days have obviously passed now.

[TeddyFlyfisherDavis]

I like that "under the scheme"....It's a scheme allright...All about the money...

[hellodolly]

Shades of America! As a (prematurely) retired surgeon, I smell the malodorous "dumping syndrome." Hospitals, and their medical staff-some of whom have a financial interest in the hospital- will obfuscate and lie to get money-losing patients onto the referral hospitals. What is often forgotten is that healthcare businesses, like other businesses, have to at least break even and preferably make a profit to fund wage increases, overhead increases and the purchase of the latest technology. The great advances is medical technology in the last 40 years has been extremely expensive.They are both saving yet prolonging life so more expenses will be incurred in the future. It is a never ending upward spiral.

Thailand has a 2 tiered medical system (as does America). Yet it has far fewer resources to fund some type of Universal Care. From the information given, I think the government has taken the right approach here. Those who take the guaranteed sum per patient, are obligated to live with it. Or opt out. Just look at what Medical Tourism has become in Bangkok-wildly profitable.

Yes you are rite when you say

"The great advances is medical technology in the last 40 years has been extremely expensive.They are both saving yet prolonging life so more expenses will be incurred in the future. It is a never ending upward spiral."

The money they spend on some of the new technologies could be better spent helping people with less unique symptoms.

I have been in some wards where people sit around waiting to die just sit in a wheelchair all day long. The idea of a quality life has gone out the window and been replaced with a longer one even though it is nothing but pain and no hope for a future. I even recall one patient being strapped to a potty chair.

Why spend so munch on time and equipment to allow ones to get to that state of condition? It is not as if it is money that could not be spent to help others to live a productive life.

[animatic]

The Thai law of unintended and unexpected consequences strikes again.

'For every politicians action, there is an inverse and worsening, unexpected reaction.'

They do one thing they think will help, but not having thought it through completely, or listened to those who have because they don't have seniority, suddenly the find it is not working as expected, to the point of doing the opposite of what was intended...

Bravo yet again.

Edited March 22, 2012 by animatic