Decent Hospital In Bangkok

[kurd]

Looking for a hospital (private) not government.

Have been using Rama 9 hospital but wife stayed overnight for some minor reason and got charged 16000bt for not a lot of treatment. Saw the bill which just looked like a lot of add ons to pad total.

Heard from someone else who was charged 62000 bt for three nights. Again not a serious injury or desease. They just suggested he stay for observation.

Anybody know of a decent hospital which doesn't pad the bills?

Thanks.

[Morakot]

Have a look at this site; it shows a range of different private hospitals.

http://medithai.net/

[Stradavarius37]

All private hospitals pad the bill - because they are private (i.e. "for profit")

[Sheryl]

Moving this to the health forum where it better belongs.

In answer to your question,

1. There are some not for profit private hospitals in Thailand where you are much less likely to encounter this. St. Louis being my favorite. Bkk Christian also not bad, though since they revised their website it is no longer possible to look up doctor qualifications (or anything else, unless you read Thai fluently -- no longer an English option). St Louis website has some quirks to it but you can in fact get listing of docs by specialty and review their qualifications.

That said, I strongly advise choosing the doctor rather than the hospital. I like St Louis very much as an institution -- good, no-frills health care -- and there are some excellent doctors there, but as with everyplace there are also some mediocre and even bad ones. So do your homework.

2. You always need to review bills in Thailand and question items that don't look right. At a restaurant, hotel, and yes, hospitals too.

[maxme]

Vejthani, BNH, Smittivej or Bumrungrad they are fine. Not that cheap i can tell.

[Backwoods]

I have been in Praram 9 hospital several times in lat 2 years for heart condition. I get treated great in CCU as well as private room where wife sleeps on couch and we are never charged extra. The staff was great, very attentive and made me really comfortable!

[arkom]

Siriraj just opened their private hospital next to the government one. The building and facilities are very nice, I would say on par with the other top private hospitals. My girlfriend went to see for treatment and met with one of the head doctors (he is a professor at Siriraj medical school). Consultation, x-rays and medication came out to about 1500 THB.

Both of us were surprised as we were expecting it to be around 5000 THB like other private hospitals. And service was really good.

The website is www.siphhospital.com

Edited June 7, 2013 by arkom

[Sheryl]

Thanks for that feedback as I was wondering about costs there. The website deems to emphasize luxury so gives the impression inpt care would be quite expensive. The website is also useless in terms of finding out what docs are available when. Hopefully they will improve it as there is no doubt that Siriraj has some of the finest medical minds in Thailand and a means of directly accessing those who don't have private practice elsewhere would be a godsend.

[overherebc]

Thanks for that feedback as I was wondering about costs there. The website deems to emphasize luxury so gives the impression inpt care would be quite expensive. The website is also useless in terms of finding out what docs are available when. Hopefully they will improve it as there is no doubt that Siriraj has some of the finest medical minds in Thailand and a means of directly accessing those who don't have private practice elsewhere would be a godsend.

Don't know wheren you're based but I've used Bangkok/Rayong a couple of times.

Last time I went on my back in the shower and the first thing to hit the floor was the back of my head. when my wife got me awake again she took me to Bkk/Rayong and I had a scan 20 minutes later which thanfully showed no bleeding inside my skull, just a big pidgeons egg on the outside.

Cost was somewhere in the region of 6000 baht.

I call that a bargain.

[macleans]

Siriraj just opened their private hospital next to the government one. The building and facilities are very nice, I would say on par with the other top private hospitals. My girlfriend went to see for treatment and met with one of the head doctors (he is a professor at Siriraj medical school). Consultation, x-rays and medication came out to about 1500 THB.

Both of us were surprised as we were expecting it to be around 5000 THB like other private hospitals. And service was really good.

The website is www.siphhospital.com

The room rate for the deluxe room type (the cheapest one) is 6,700 baht per night (inclusive of meals, nurse visits, but not sure whether it already includes doctor visits though). Looks quite decent to me.

http://www.siphhospital.com/en/patient-services/room-services/deluxe-room.html

[Sheryl]

That is just the room rate and will not include doctor nor any of the medical treatment (mes, IVs etc). It's quite high. The rooms are great, but many people would prefer a more modest option which they don't seem to have. They start at "de luxe" and go up from there.

[TallGuyJohninBKK]

Room names aside, one thing the OP should be aware of is that in Thai private hospitals, whether they are the modest or the most expensive ones, they typically have a range of several different types and prices of inpatient rooms.

You'll get the same doctor, but the inpatient room price can vary dramatically depending on what level of room you choose or are placed in. That choice can have a big impact up or down on how much you're going to pay for an inpatient visit.

At the more upscale privates, even the lowest level/price rooms often will be private or perhaps two people to a room. It's usually the size of the rooms, whether they have sitting/sleeping areas for family, other non-medical amenities that drive the price differences.

At the more economy privates like St. Louis, as I recall, at the low price end of the spectrum, they have multi patient "ward" rooms, maybe with 4 or 6 people per, and then go up in room and price from there.

When I checked with St. Louis a few months ago, I was quoted a farang rate as follows for room, nursing, meals, service:

--1610b per night for 6 person ward.

--2480b per night for a twin room.

--4000b per night for a private room.

I'm sure what Sheryl says above about St. Louis is true and there are some good doctors there. Unfortunately, after a series of outpatient visits there for myself and my wife in different departments and different doctors, we had some very poor care/diagnosis rendered. So at this point, they're pretty much off my list.

Part of the problem, as Sheryl and I have exchanged views on here before, is that it's often very difficult for a farang patient with a particular problem to get any good idea going in of what doctor you are well-advised to see at a particular hospital. Although, looking for an MD who's been educated and/or trained outside Thailand is a good start -- that is, IF the hospital's website lists doctors' CV data. Some do, many don't.

On the other hand, in a series of visits with different departments and different doctors over the same period of years, I've had pretty much nothing but very good experiences with doctors at BNH Hospital in the Silom area. Unfortunately, it's also considerably more expensive than St. Louis. Last time I checked, BNH nightly rates for inpatient care ranged from 8K to 22K, just covering room, food, nursing and service charge.

Ideally, I wish I could find a place that pretty consistently had the caliber of doctors I've found at BNH with the cost structure I've found at St. Louis... But that's probably just a dream...

PS - I too will be interested to hear and learn more about Siriraj's new private venture.

On a related point, I can simply offer that a few months back, my wife had reason to get some outpatient care at Ramathibodi Hospital, which is one of the best government hospitals in BKK located near Victory Monument. Just for kicks, I inquired then about their inpatient rates for farangs, and was quoted nightly rates very considerably above their Thai patient rates, and even higher than the rates of a private like St. Louis.

Edited June 8, 2013 by TallGuyJohninBKK

[arkom]

It seems like some people are starting to go to Siriraj's private hospital more. She has to go back for a checkup and apparently the queue is fairly long, up to 2 weeks!!

However she is willing to wait as she feels they do a more thorough checkup. She went to a couple private hospitals Paolo Memorial and Phayathai and the doctors all said the same thing about her condition, and have her a bunch of antibiotics that we can get at any pharmacy.

However after a month there was no improvement, so she decided to give Siriraj a try and have a different realist then the others. Gave the proper medication and condition is definitely improving.

Edited June 8, 2013 by arkom

[TallGuyJohninBKK]

Phyathai and Paolo hospitals have long been owned by the same company, but more interestingly, that company was sold back in 2010 to another company that already was the largest hospital chain in Thailand, and one of the largest in Asia -- Bangkok Dusit Medical Services (BGH), whose flagship hospital is Bangkok General.

A lot of people here probably aren't aware that many of the private hospitals that operate in BKK under entirely different names are in fact owned by the same company. Is that good for medical care and affordable care??? Not sure....

Att Thongtang, chief executive of the Phyathai Hospital Group and Paolo Memorial Hospital Group, both under the BGH umbrella, said the parent has already added three hospitals, in Khon Kaen, Udon Thani and Chiang Mai provinces.

The move is part of BGH’s strategy of becoming the No.1 hospital group in Asia and third in the world within three years.

It is now the second-largest hospital group in Asia-Pacific by market capitalisation and fourth in the world.

In 2010, the Health Network Group controlled by Wichai Thongtang sold the Phyathai and Paolo Memorial hospital chains to BGH for 12.6 billion baht. BGH also operates the Bangkok, Samitivej, BNH hospital chains.

Revenue for BGH last year reached 48.8 billion baht, up from 37.8 billion in 2011, for a net profit of 7.94 billion, up from 4.39 billion.

http://asean-business-news.com/thailand/uncategorized/bgh-plans-to-add-six-more-hospitals/

By one count, the Bangkok Dusit Group now owns something like 25 separate private hospitals in Thailand:

BNH in Bangkok

Phyathai I, II and III in Bangkok

Paolo Memorial Hospitals in Ladprao BKK, Phyathai BKK, Sriracha and Samut Prakan

Samitivej Hospitals in Sukhumvit BKK, Srinakarin BKK and Sriracha

And then Bangkok Hospital Group's own long list of hospitals:

Bangkok, Thailand

Bangkok Heart Hospital
Bangkok Hospital
Bangkok Hospital Prapadang
Wattanosoth Hospital

Eastern Thailand

Bangkok Hospital Chantaburi
Bangkok Hospital Pattaya
Bangkok Hospital Rayong
Bangkok Hospital Trat

Northeastern Thailand

Bangkok Hospital Pakchong
Bangkok Hospital Ratchasima

Southern Thaialand

Bangkok Hospital Hat Yai
Bangkok Hospital Phuket
Bangkok Hospital Samui

Western Thailand

Bangkok Hospital Hua Hin

And apparently two hospitals in Cambodia as well:

Royal Angkor International Hospital
Royal Rattanak Hospital

http://www.phukethospital.com/Health-Network/Hospital-Affiliated.html

And then there's been this move going on with Bumrungrad Hospital as well, which has led to speculation of another future merger:

Bangkok Dusit Medical Services Upgrades Stake In Bumrungrad Hospital
03/13/2012| 09:09pm US/Eastern

Bangkok Dusit Medical Services PCL (>> Bangkok Dusit Medical Services PCL), Asia-Pacific's second-largest listed hospital operator by revenue, said Wednesday it has bought an additional 6.05% of Bumrungrad Hospital PCL (>> Bumrungrad Hospital Public Co Ltd).

After the transaction Bangkok Dusit Medical's ownership of Bumrungrad Hospital rises to 20.28%, the company said without providing further details.

Another news report I saw on this acquisition above said it already made Bangkok Dusit the largest single shareholder in Bumrungrad, albeit not a majority owner.

http://www.4-traders.com/BANGKOK-DUSIT-MEDICAL-SER-6496978/news/Bangkok-Dusit-Medical-Services-Upgrades-Stake-In-Bumrungrad-Hospital-14215694/

Ahh...it's even higher than 20% now, and here's the list from Bumrungrad's own website as of end 2012:

List of the Company’s 10 major shareholders as at 28 December 2012 is as follows:
Rank Major Shareholders Number of shares* Shareholding**
(%)
1.
Bangkok Dusit Medical Services PCL.
174,350,200 shares
23.88%

http://bh.listedcompany.com/shareholdings.html
.

Edited June 9, 2013 by TallGuyJohninBKK

[Sheryl]

Despite being owned by the same company, these hospitals differ considerably in their management styles, overall "ethos", cost and standard of care. Some of the latter is due to location i.e. it is hard to get top specialists to work in the provinces.

BTW both Royal Rattanak and Royal Angkor international are joint ventures with Cambodian firms, Dusit does not have full ownership.

[TallGuyJohninBKK]

I agree with your comments, Sheryl, about the various Bangkok Dusit hospitals having different styles and standards.

I think Bangkok Dusit's intention is to have a hospital presence in Bangkok in each of the various market sectors for health care -- Thai and farang, lower cost and premium cost, etc etc.

Unfortunately, it seems the history of a lot of these acquisitions has been that the acquired hospitals were struggling financially and then that led to the takeover by the bigger fish. I know that certainly was the case with the Phyathai acquisition.

The question is, what is Bangkok Dusit doing with all of its various acquisitions to make them more financially viable, since presumably, they're not acquiring them to continue to run financial losses. It's hard to get a sense of those things without having connections on the inside of the hospitals to see how such ownership changes result in subtle and sometimes not subtle changes.

But, FWIW, the recent news about Bangkok Dusit's growing ownership stake in Bumrungrad was enough to start some folks in the Thai government last year start publicly talking about medical monopoly concerns.

Santichai Santawanpas, deputy director-general of the Internal Trade Department, said the private healthcare sector might need to be closely watched. He cited a public hearing held at the end of last month in which criteria on mergers and acquisitions were called for.

Over-concentration of ownership in a particular business rarely results in good long-term outcomes for consumers.

Edited June 9, 2013 by TallGuyJohninBKK

[TallGuyJohninBKK]

Have been using Rama 9 hospital but wife stayed overnight for some minor reason and got charged 16000bt for not a lot of treatment. Saw the bill which just looked like a lot of add ons to pad total.

Heard from someone else who was charged 62000 bt for three nights. Again not a serious injury or desease. They just suggested he stay for observation.

Anybody know of a decent hospital which doesn't pad the bills?

Just back on the OP's post... it really depends on the details of the bill your wife received in terms of being able to judge it reasonable.

For example, you mention she was charged 16,000 for a single night's inpatient stay. But you didn't mention how much of that total was the fixed cost of room+nursing+service charge+food vs. how much may have been doctor fees, medical tests, medications, etc etc.. which are generally always going to be billed in addition to the fixed room charges.

If your post above was referring to Pharam 9 Hospital in BKK, they seem to have room plus nursing charge inpatient rates that range from 5,000 to 11,000 to 15,000 per night (not including meals), depending on the room chosen. So depending on the room and what medical services are provided, a person could pretty quickly reach the 16,000 a night range.

http://www.praram9.com/en/room_rate.php

I've never dealt directly with Pharam 9 Hospital... But in looking through their doctor CV's lately, they do seem to have quite a few Western trained MDs with some pretty good looking credentials.

Edited June 9, 2013 by TallGuyJohninBKK

[taxout]

Do Thai hospitals scale ancillary charges to the room rate? That is, if you stay in a deluxe room will you pay more for an aspirin than if you stay in a standard room?

[TallGuyJohninBKK]

That's an interesting question. Obviously, it depends on the particular hospital, and also I suppose on how you want to calculate things.

For example, if you look at the Pharam 9 room and nursing rates chart below, you'll see that their nursing charges increase generally with the higher priced room categories. Perhaps that's because you get more/better nursing attention in the higher priced rooms, or are they just scaling their nursing fees to fit the room.

One private hospital I know, for example, (not Pharam 9) was setting up new "international patient" wards at significantly higher prices and part of the explanation was that the nursing staff assigned in those wards supposedly was going to be more fluent in English or other languages vs. the regular wards in that hospital.

But back to Pharam 9, same with their food charges, which are higher for the higher rooms. But are you getting better meals in the fancier rooms, or just the same dinner.

As for medicines, there are pills, and then there are PILLS... Recently, I had an outpatient visit to a private hospital where the doctor prescribed a particular medicine. He asked, did I want the Thai locally produced version or the imported brand name version. Before I could ask further, he added, the Thai version cost X per pill and the imported name version cost something like 5 or more times that per pill.

I'd kind of wonder, if you were staying in some hospital's lower priced Thai ward, which medicine are the nurses going to bring to your room, vs. which are they going to bring if you're staying in the Presidential Suite room? I don't know... but I think I can kind of guess.

For other things, though, like medical supplies and such, I'd hope there would be a standard rate separate from the patient's room category, but I don't know. On the other hand, there might well be the usual kind of farang/international patient surcharge applied across the board no matter what room class is chosen.

Again for example, the room rate chart I posted above for Pharam 9 is from the Thai language version of their website. If you look at the same chart on the English version of their web site, you'd see that curiously, the room categories for "private" and "semi-private", which are the lowest priced ones, aren't even listed there.

So all in all, I'd say, there's lots of ways to skin a cat, and the typical patient in a higher priced room is probably going to end up paying more for a variety of other things compared to someone in a lower priced room. In some of those details, you may be paying more because you're getting more. In other areas, probably hard to tell.

Edited June 9, 2013 by TallGuyJohninBKK

[taxout]

Thank you.

I ask because this practice is quite common elsewhere in Asia, where all charges, including doctor's fees, usually go up as the room charge goes up.

For example, here's how the HK Adventist Hospital describes the arrangement:

"In Hong Kong, most hospitals vary their charges according to Room Category (Standard, Semi-Private, Private and VIP). . . . The higher category room, the higher the accompanying charges will be applied. Besides in-house General Practitioners, our hospital does not regulate physician fees which may vary with each doctor and usually according to the room category. . . Ancillary charges such as Operating Room, Cardiac Catheterization & Interventional Center etc will vary according to the room category."

http://www.hkah.org.hk/upload/File/Health_Care_Advisory.pdf

[TallGuyJohninBKK]

WOW... that's an interesting statement, and seems to say that's a common practice among HK hospitals... I don't think I've ever seen anything so explicitly stated like that inside Thailand.

I'm surprised to see them saying that the charge for hospital medical procedures -- which aren't in any way related to the type of room a patient is using -- will vary based on room choice.

[taxout]

Yes, the price for everything, from aspirin on up, will be scaled to the room charge,

As I recall, they were forced to disclose the policy after a small scandal some years ago made it public, though the disclosure is well hidden on their website. It represents a long-time policy, followed by doctors as well as hospitals in Hong Kong, that the more you have the more you can afford to pay.

The Baptist Hospital site sets out the scale explicitly: "Other charges such as tests, operation, treatment procedures, etc. are approximately 15-25% (T), 30-50% (D) and 60-100% (S) higher than the standard rates (G) respectively for the other types of beds."

http://www.hkbh.org.hk/eng/hospital_info_ward_category_charge.php

[Sheryl]

I have never heard of medical care costs varying with the room and as you are usually quoted a price for say surgery before yo uget to the admissions dept to select a room it is hard to see how it could.

Nursing charges definitely do vary though.

And some hospitals charge meals as a separate add-on rather than in the room rate in which case those would also probably vary.

Hospital admissions departments often go to great lengths to push the more expensive rooms, including not telling you about the less expensive options unless you ask - and even then just telling you about the next priciest. I've encountered thia at even the non-profit hosps. In fact they all have lists or books showing the different room rates and often photos to go with showing the difference. Always demand to see the full listing and keep asking if there is a less expensive one.

Many hospitals also have this on their websites.

IMO the top priced rooms are a serious waste of money and what little they offer over the standard ones is hardly worth it. There is of course a difference between a standard private and a standard semi-private in that the latter (at significantly higher price) escapes the inconveniences that having a roommate may carry. But the semi-private also usually have private sofas for an attendant (1 for each bed) and one sometimes lucks out and the other bed is empty. Worth thiunking about.

I would definitely not advise going any higher than the most inexpensive private room.

Sounds like the cases mentioned in the OP may have fallen for "deluxe" rooms.