Last-minute referrals from private hosps put pressure on govt facilities

Chennai

This attempt by private hospital managements to keep the death count at their institution low, in turn, puts pressure on the government facilities, said doctors.

In one such case, a 68-year-old man was taken to a private hospital in Kilpauk after suffering a head injury due to a fall. He was tested positive for COVID-19 and had comorbid conditions like hypertension and diabetes, besides developing subdural haemorrhage due to the fall. After treating him in the ICU for two days, the hospital authorities told his kin that his condition was not getting better and that they could not treat him. He was then referred to a government hospital.

It was a struggle to find a bed in government hospitals as either the bed or required medical services were unavailable at Government Kilpauk Medical College Hospital, Government Stanley Medical College Hospital and Government Omandurar Medical College and Hospital. Finally, he was admitted to Rajiv Gandhi Government General Hospital after 24 hours. But the man died soon afterwards.

This is not the only incident when patients in critical condition are sent to government hospitals in the last minute, said sources.

“The symptomatic, high-risk and critical patients are being treated in government hospitals. The private hospitals have the facilities to treat such cases. But of late, most of them in the city refer the critical patients, who are almost on their death bed, to government hospitals, for the sake of the certification,” said Dr P Vasanthamani, dean, Government Kilpauk Medical College Hospital.

Private hospitals have adequate beds to treat COVID-19 cases but they refer patients to already overcrowded government hospitals. More than 4,480 beds have been sanctioned for the COVID-19 patients in 30 private designated hospitals across the State, of which only about 900 are occupied currently.

Recalling another case, a doctor at the COVID-19 ward at Government Stanley Medical College Hospital said that a 64-year-old male patient who had diabetes and hypertension was referred to the hospital just a few hours before his death.

“The patient was on ventilator support and there was no hope of his survival. Instead of continuing treatment or informing the patient’s family of his health condition, the private hospital sent the patient to the government hospital so that they do not own any responsibility. This is becoming common with COVID-19 cases now,” said the doctor.

The authorities at Rajiv Gandhi Government General Hospital and Government Omandurar Medical College Hospital are seeing similar cases.

“COVID-19 cases and deaths are spiking every day, and referrals from private hospitals have also increased. The patients are dumped at government hospitals to ensure that the death statistics did not increase in private hospitals,” said Dr Ramesh, the nodal officer at Omandurar Medical College Hospital.

However, private hospital managements claim inadequate beds and medical facilities and an increase in the number of cases are forcing them to refer those in very critical condition to government hospitals.

The director of a private hospital in the city said that most of them have only a few critical care beds and are thus forced to send critical cases to government hospitals. Even while admitting that government hospitals did not have enough number of beds, he argued that the private hospitals had even lesser number of beds.

“We need to keep COVID-19 patients in isolation. But with lesser beds, it’s difficult to treat all of them. The government should ask the private hospitals to increase the number of beds. Also, we have only minimal staff to take care of critical patients. And now, getting an adequate number of nurses has also become difficult,” he added.

The Indian Medical Association State president Dr CN Raja agreed that private institutions were facing the issue of inadequate beds and facilities, and said critical cases were sent to government hospitals for further management.

When contacted, the Directorate of Public Health and Preventive Medicine Dr TS Selvavinayagam said action would be taken against hospitals if they deny treatment and refer COVID-19 patients in critical condition to government hospitals. “If there are any particular cases of such incidents that are brought to the Health Department, we will take an action against the private hospital responsible,” he said.