Data on hospital beds could help with medical evacuations: insurers
Ontario should allow travel insurers to access its database of available hospital beds, an industry association says, then streamline a complex process that creates uncertainty and can lead to needless delays and tragic results. “(The Ontario database) Criticall is probably a good, first step (that) can be cleared up fairly quickly,” Will McAleer, the president of the Canadian Travel Health Insurance Association, said Friday. When patients in Ontario hospitals decline in a facility not equipped to care for them, doctors phone Criticall Ontario, which matches patients to open and appropriate beds elsewhere. That same system should be available when Ontarians fall ill or sustain injuries abroad, said McAleer, whose association represents travel insurers, brokers, underwriters, re-insurers, emergency assistance companies and air ambulance companies. If Ontario were to give insurers access, it would not be blazing a new trail: British Columbia has already allowed travel insurers access to its database, the B.C. Patient Transfer Network. Doing so could avoid the harm caused to Ontario travellers in countries where medical care is less than optimal, McAleer said.
At least two Ontarians have died this year after being stranded in hospitals abroad. Londoner Stuart Cline died March 3 at a St. Catharines hospital after waiting five days in a Mexican hospital, while Bryan Sockett, 82, died Jan. 19 in a Florida hospital his insurer turned to after the Toronto-area man waited two weeks with pneumonia in a Dominican Republic hospital. It’s not just a lack of access to Criticall Ontario that impedes insurers seeking hospital beds for travellers. “You have to be a pseudo detective,” McAleer said. Before insurers question hospitals about beds, they are expected first to find a specialist who agrees to look after the returning patient. Some doctors are reluctant to take on that responsibility when the patient has already undergone surgery abroad. And even if a physician agrees, the insurer must then seek the blessing of the hospital where that doctor has privileges — and sometimes that hospital says no. “We’ve had doctors who will take on patients only to find out the facility said no because they don’t have a bed,” McAleer said. “The existing process could absolutely
be streamlined.”
In an ideal world, insurers wouldn’t be required to work their way through a list of specialists. Instead, they should be able to phone a single person at each hospital who is designated to determine if there is an available bed. If a suitable bed is available, the hospital would arrange for a doctor to look after the patient’s care. That would leave the insurer free to focus on a patient’s health before they return to Ontario, McAleer said.
“It (would allow) us to focus on what matters most, which is the patient’s care,” he said.
That gaps exist in coverage was acknowledged this week by Health Minister Helena Jaczek after news about Sockett’s death. Jaczek said she wanted to work with the insurance industry and seek improvements and was seeking to meet with the Canadian Life and Health Insurance Association. That association has a mandate that is far broader than just travel insurance, so McAleer hopes the health minister will also seek input from his association, which represents all the entities involved on the front lines.
The insurance company that covered Sockett, Allianz Global Assistance Canada, offered its condolences to his family and described the “complex” process it must follow when seeking an Ontario hospital bed.
“Due to privacy considerations, we unfortunately are unable to provide comment on specific cases. However, we can confirm that in situations where it is necessary to repatriate a Canadian patient who is hospitalized abroad back to Canada, Allianz Global Assistance takes every available measure to secure a receiving bed as soon as one becomes available. We can also confirm that Allianz Global Assistance does not have access to the Criticall Ontario service,” Dan Keon, Allianz’s vice-president of market management, said in an email. It can take as long as several weeks to find a hospital bed in Ontario, he wrote.
He said other factors that can slow a transfer include: patients aren’t allowed to be transferred to hospitals that have a flu outbreak; patients may not be allowed to go to hospitals whose ERs are overflowing; insurers have been asked to limit initial searches to hospitals in certain catchment areas; some patients can only be moved within a limited time frame for medical reasons; and if that window of time is missed, further delays ensue.