‘No mandatory hospitalisation’

Procedures require less time now, ministry tells insurance providers

PETALING JAYA: Health Insurance providers should do away with mandatory admissions at hospitals – as a requirement for medical claims – because many procedures can be done within a day now.

Most public hospitals now carry out minimal invasive surgeries which require shorter hospitalisation to maximise the use of resources and reduce cost.

But insurance companies do not reimburse patients who are not admitted as a matter of policy.

Health Ministry director-general Datuk Dr Noor Hisham Abdullah said insurance companies may not understand the concept of Day Care Procedures or Day of Surgery Admission – where patients come in on the day of the surgery and are discharged either the same day or the day after.

Previously a patient would be admitted two days before a procedure and discharged after two days – making it a total of five days which may not be necessary, he added.

“We want insurance companies not only to reimburse but encourage day care procedures. This is the message we want to send to them,” he said after delivering his opening remarks at the Ramsay Sime Darby Health Care Group Specialists Conference.

While some companies are considering the move, he said, others were reviewing their process after engaging with the Health Ministry.

Resources are limited at both public and private hospitals, he said, adding that Malaysia wanted to have 2.5 beds for every 1,000 people instead of the current ratio of 1.9:1000.

Currently public hospitals have 40,000 beds and there are another 20,000 at private hospitals.

The 16,000-bed shortfall for Malaysia’s 30 million people, he said, could be eased with day care services.

He said public hospitals already have the infrastructure and know how but only 10% of all operations are carried out under day care unlike 70% in the United States and 60% in Britain and Germany.

“We are still behind. The best centre we have is in Ipoh where between 40% and 45% of procedures are carried out under day care.”

Dr Noor Hisham wants other public and private hospitals to step up day care procedures.

He cautioned against the practice of patients dictating how long they wanted to stay in hospital for minor procedures – such as a removal of a lump in the breast – because they had insurance coverage.

“It’s not the patient’s choice to stay longer because a private hospital is not a hotel,” he said.