Get ac­quainted with ben­e­fits of day hospi­tal care

The Star Early Edition - - OPINION&ANALYSIS - Bibi Goss-Ross Bibi Goss-Ross is a group op­er­a­tions man­ager at Ad­vanced Health Lim­ited.

SOUTH Africans are faced with the con­stant in­creases in the cost of liv­ing and an ail­ing econ­omy, forc­ing con­sumers to cut down on spend­ing across the board. For a small per­cent­age of the pop­u­la­tion, health care costs are cov­ered by med­i­cal aid, but only an es­ti­mated 16 per­cent of South Africans have such cov­er­age while the rest rely on an al­ready over­bur­dened health care sys­tem.

Con­tin­u­ing down­ward pres­sure on the econ­omy is push­ing even those with med­i­cal cover to ei­ther re­duce it, or out­right ter­mi­nate their mem­ber­ship just to make ends meet, leav­ing more and more South Africans vul­ner­a­ble.

While there are sev­eral fac­tors con­tribut­ing to the in­crease in pri­vate health care costs, in­clud­ing the volatile ex­change rate and its im­pact on the cost of im­port­ing med­i­cal equip­ment, the ris­ing costs of med­i­ca­tion, doc­tors’ fees, the in­creas­ing av­er­age age of prin­ci­pal mem­bers on the schemes, the big­gest cul­prit is pri­vate hos- pital costs.

Ac­cord­ing to the Coun­cil for Med­i­cal Schemes’ 2014/15 re­port, hospi­tal fees con­sti­tute the bulk of fees paid by med­i­cal schemes with to­tal hospi­tal ex­pen­di­ture amount­ing to 37.6 per­cent, of the R124.1 bil­lion that med­i­cal schemes paid to all health care providers in 2014.

This was an 11.6 per­cent in­crease in ex­pen­di­ture on hos­pi­tals from the pre­vi­ous year and this trend has not abated.

Whether we like it or not, the re­al­ity is that health care costs in SA – es­pe­cially pri­vate hos­pi­tals – have be­come too ex­pen­sive. The com­pound hospi­tal cost es­ca­la­tion of 15 per­cent per an­num is un­af­ford­able and is not sus­tain­able in our health care en­vi­ron­ment.

But what most South Africans are not aware of is that there are op­tions which can have a di­rect bear­ing on hos­pi­tal­i­sa­tion ex­penses.

Some 70 per­cent of sur­gi­cal pro­ce­dures, cur­rently done in acute hos­pi­tals, can safely be per­formed in a day surgery fa­cil­ity.

Day hos­pi­tals across the world are trans­form­ing the sur­gi­cal ex­pe­ri­ence for mil­lions of pa­tients by pro­vid­ing them with a more con­ve­nient al­ter­na­tive to acute hospi­tal based surgery, achiev­ing the high­est qual­ity stan­dards and pos­i­tive pa­tient ex­pe­ri­ences, with the up­swing of cost ef­fec­tive­ness.

In South Africa, day hos­pi­tals of­fer sig­nif­i­cant op­por­tu­ni­ties to im­prove the ef­fi­ciency of pri­vate hos­pi­tal­i­sa­tion.

Lo­cally, only about 13 per­cent of all sur­gi­cal pro­ce­dures are at­tended to in day hos­pi­tals, an ex­tremely low fig­ure com­pared to the al­most 70 per­cent in­ter­na­tional util­i­sa­tion of day hos­pi­tals.

The po­ten­tial to in­crease the use of day hos­pi­tals is sig­nif­i­cant, bring­ing clear ben­e­fits to both pa­tients and med­i­cal schemes.

Sev­eral fac­tors in­flu­ence the cost model of day hos­pi­tals: no large cater­ing fa­cil­i­ties, no ICU or spe­cialised the­atre, no overnight beds to cater for and no af­ter hour staff costs, no emer­gency unit and more rea­son­able per minute the­atre fees com­pared to an acute fa­cil­ity.

Pa­tients can get value for money and an in­creas­ing num­ber of med­i­cal schemes are ad­vo­cat­ing day hos­pi­tals for same-day short-stay surgery.

We see syn­ergy be­tween day hos­pi­tals and acute fa­cil­i­ties which should fo­cus on ill, long-stay pa­tients need­ing the care, sup­port and nec­es­sary en­vi­ron­ment avail­able at a large hospi­tal fa­cil­ity.

We’ve moved on since the early 1980s where day case surgery was more fo­cused on den­tal care and mi­nor pro­ce­dures.

These days any pa­tient not re­quir­ing an overnight stay and is rel­a­tively healthy, can be op­er­ated on in a day hospi­tal.

The evo­lu­tion of health care has changed all this and in ad­vanced health day hos­pi­tals, var­i­ous dis­ci­plines are catered for, rang­ing from plas­tic surgery, gy­nae­co­log­i­cal, gen­eral, or­thopaedics, urol­ogy, max­illo­fa­cial surgery and a num­ber of den­tal and oph­thalmic pro­ce­dures.

The case and ben­e­fits in favour of the model for ad­mit­ting health­ier pa­tients in need of same-day surgery are ev­i­dent.

Day hos­pi­tals across the world are trans­form­ing the sur­gi­cal ex­pe­ri­ence for mil­lions of pa­tients by pro­vid­ing them with a more con­ve­nient al­ter­na­tive to hospi­tal based surgery, achiev­ing the high­est qual­ity stan­dards and pos­i­tive pa­tient ex­pe­ri­ences cost ef­fec­tively. It’s time for South Africans to take ad­van­tage of the many ben­e­fits of this op­tion.

In South Africa day hos­pi­tals of­fer sig­nif­i­cant op­por­tu­ni­ties to im­prove the ef­fi­ciency of pri­vate hos­pi­tal­i­sa­tion. It’s time to take ad­van­tage.

PHOTO: DAVID RITCHIE

Health care costs in South Aftica, es­pe­cially pri­vate hos­pi­tals, have be­come too ex­pen­sive, but there is an al­ter­na­tive, says the writer.

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