'Govt spends Tk 1.28 lakh for each Covid-19 patient; at pvt hospital patient pays double'

The Covid-19 treatment cost is abnormally higher in the private hospitals than the public healthcare facilities, revealed a study.

The major differences were found in the diagnosis and medicine cost which -- according to experts -- were due to not following the national Covid-19 treatment protocol.

The government has been spending, on an average, Tk 1.28 lakh for the treatment of a Covid-19 patient in general beds and 4.08 lakh in intensive care unit (ICU), according to the study by Health Economics Unit (HEU) of the health ministry.

In case of private Covid-19 hospitals, the cost is much higher -- around Tk 2.42 lakh in general beds and around Tk 5.09 lakh in ICU beds -- which is completely met by the patients.

The HEU conducted the study in assistance with Department of Economics of Dhaka University.

"The expenses for diagnosis and medicine are abnormally higher in private hospitals than the public facilities. It indicates the national treatment protocol for Covid-19 is not being followed properly," Dr Md Nurul Amin, director research of the HEU who led the study team, told The Daily Star today.

Under the study, the expenses behind 31,147 patients in general beds and 2,918 in ICU beds of four public and two private Covid-19 dedicated hospitals were analysed.

The patients took treatment during April-December at public hospitals and October-December at private hospitals last year.

"We have not included the expenses the patients bore for their own transportation, food and more. This includes only the cost inside the hospitals during treatment period," Dr Amin said.

The government expenses for Covid-19 patients in public hospital include -- 36.4 percent on salaries of doctors, nurses, other healthcare workers and hospital employees; 18.4 percent on accommodation; 15.8 percent on medicine, 2.4 percent on diagnosis; 15.4 percent on oxygen and PPE; 4.8 percent on food; 4.3 percent on services; and 1.9 percent on equipment.

Dr Amin said, "Of the total cost, 23.7 percent is related to the accommodation, food and transportation of doctors, nurses and supporting staff that had been withdrawn by the government since September 2020. So the treatment cost at public hospitals will be lower now."

The Covid-19 treatment is free in the government hospitals. Despite this, each patient on an average needed to spent around Tk 6,400 at general beds and 33,000 at ICU for diagnosis and medicine expenses, researchers said.

At private hospitals, a Covid-19 patient spends the most -- around 30 percent of the total expenditure -- on medicine, almost double than that at public hospitals.

The diagnosis cost was 17.7 percent of the total expenses in private hospitals -- over seven times higher than the diagnosis cost in public hospitals.

Other expenses include -- 20.5 percent on cabin or bed charges, 5.7 percent on doctors and 26.1 percent on other related services.

SHORTER STAY, BIGGER EXPENSES

Researchers have found that the average duration of stay of a Covid-19 patient at a private hospital is shorter than at a public hospital.

A Covid-19 patient in general bed at a government hospital receives treatment for an average 10 days while it is 6.52 days at a private hospital.

Similarly, a Covid-19 patient in the ICU bed at a government hospital receives treatment for an average eight days while it is 7.39 days at a private hospital.

But the cost is much higher in private hospitals.

The average daily cost in a general bed and ICU in a government hospital is Tk 12,811 and Tk 51,006 respectively.

In private hospitals, on the other hand, the average daily cost is Tk 37,128 for general bed, and Tk 68,885 for ICU bed.

If the expenses outside hospitals are included, the expenditure would be more.

Fatema Begum, a woman from Dhaka's Mirpur brought her Covid-19 infected elderly father to DNCC's Covid-19 dedicated hospital from the ICU of Birdem Hospital last week.

Talking to this correspondent on the DNCC hospital premises, Fatema said, "We have already spent more than Tk1.5 lakh in one day -- mostly for medicine, ICU rent and diagnosis. We cannot bear the cost at Birdem."

"It is an ethical issue. The national treatment protocol is developed by experts from both government and private healthcare sectors. The private hospitals should follow it," Prof Dr Ahmed Abu Saleh, chairman of microbiology department at the Bangabandhu Sheikh Mujibur Rahman Medical University (BSMMU) told The Daily Star.

"Otherwise, the government bodies like Bangladesh Medical and Dental Council as well as the health directorate should look into it," Prof Saleh added.