India is a developing country, with the second largest world population. Ironically, a majority of people live under the poverty line, with meager daily wages. Hence, medical treatment is the luxury of the rich as it is unaffordable by the poor. Often people lose their loved ones due to expensive medical care. Against such a sad background, India has seen exponential growth of finances being diverted to medical care. The total amount of medical expenditure of family has increased from 317% in cities and 363% in rural areas1. For medical care in private hospitals or nursing homes, the cost of investigations has increased by 541% in 2000-2012, in urban areas. Thus, reduction of medical treatment cost is the need of the hour for preventing such exorbitant drain of money.
In this article
Following are the best practices to reduce the cost of treatment:
Reducing unwanted admissions
Cost of admission or readmission to the hospital emergency room is very high and forms a bulk of medical expenditure. Physicians should be careful not to hospitalize for routine or emergency care in case that can be avoided. Accordingly, investigations which are obsolete or not indicated should be discarded.
Use of drugs, which cost a fortune, can be replaced by cheaper, but effective drugs. This is especially required for poor people, because unaffordable drug prices are a common reason for discontinuation of treatment.
Multiple use of surgical equipment
The cost of surgeries, whether a simple or a complicated one is usually very high, and a major chunk of it is spent in procuring surgical equipment. The trend is to have new surgical equipment to each patient, to prevent disease transmission. However, with improving methods of sterilization of surgical instruments, surgical equipment can be re used, without the risk of transmission of diseases.
Defensive medicine means practice followed by health care providers to protect themselves from legal cases of unsatisfied patients. In order to avoid standing in the court of law and prove their point, health care providers, subject the patient to unnecessary investigations and procedures, to complete their medical documentation. This adds up to a huge amount, which wastes the money of a lot of patients to prevent the wrath of some patients. Protecting the physician from false claims by stronger legislature is essential to cut down on the cost of defensive medicine2.
Physicians can do away with the traditional method of charging fees to patients for each visit and instead introduce healthcare packages. This will reduce the medical cost and patients will be keen to follow-up, without being afraid of spending money for each visit.
A financial consultant should be attached to hospitals, nursing homes and private clinics. This will ensure that the physician is aware of the exact direction of flow of finances to and fro, between the doctor and the patients. Accordingly, medicines that are routinely required can be ordered in bulk amongst several practicing physicians, thereby reducing their cost.
Terminal care being given to patients who are critically ill, involves a huge amount of expenditure consisting of drugs, surgical procedures, investigations, life support equipment, physicians visit etc. These are of value when there is a good hope of saving the patient’s life. In case the chances are bleak, this can cause financial ruin for the patient’s family apart from losing their loved one. Hence, instead of prolonging death, practitioners should treat such patients with cost effective, techniques in mind, finally including discontinuation of life support equipment when necessary3. Laws for euthanasia and discontinuation of life support equipment’s should be made and enforced.
At the base of all these techniques lies the motive of the physician. Every physician should give prime importance to the health and quality of life of the patients. In such a scenario, unwanted medical treatment and procedures, drugs prescribed will reduce to a minimum.
Thus reducing medical cost is a vital task, in order to provide quality and affordable treatment to the rich and poor alike.
Contributed by Dr. Rachita Narsaria, MD
1-Subodh Varma. How Indians spend their money. The Times of India.TNN. July 13, 2014.