Editorial: Patients not ‘at home’ in hospitals

For the majority of the populace, the notion of being hospitalised comes with its own set of anxieties and pre-conditioned fears. In the aftermath of the pandemic, it seems almost everyone is preparing themselves in one way or the other to undergo treatment, but not necessarily a trip to the hospital.
Editorial: Patients not ‘at home’ in hospitals

Chennai

And there’s a good reason for the same, as the cost of treatment for COVID-19 can prove to be quite exorbitant – with private hospitals charging anywhere between Rs 1.5 lakh to Rs 3.5 lakh for a 14-day treatment, as per conservative estimates. To top it off, the Supreme Court of India recently dismissed a plea demanding an upper limit to be fixed on the cost of COVID treatment in such facilities. The Apex Court argued that the prevailing conditions in a state, including the availability of medical facilities, determined the cost of treatment, owing to which imposing a flat rate was not feasible.
The development gains prominence when one considers that the popularity of patient monitoring devices and their availability in the market has witnessed a leap following the spread of COVID-19. And many affected by the virus have chosen to forego the traditional route of being administered medical care at a private or a public hospital and opt for home isolation instead. Apart from the thermometer, portable devices such a pulse oximeter, a digital BP monitor, blood glucose monitor are some of the machines being used by those who have set up a home care facility for COVID patients, along with the appointment of full-time nurses to monitor the individual. It was reported that last month in Mumbai, some of the major hospitals treating critical COVID-19 patients had vacant beds to spare. Cost concerns aside, civic officials attributed part of the availability to patients choosing home isolation. Of the 18,380 COVID beds available, about 66 per cent or 12,303 beds were occupied. The total number of ICU beds which could accommodate 1,278 patients, saw 93 pc occupancy, with 7 pc or 95 beds available. This points to a mind-set shift of the Indian healthcare consumer.
The rush to immediately get admitted after being diagnosed as COVID-positive has also gone down. Many patients are pinning their hopes on treatment in their own homes owing to the familiarity factor. This is also indicative of how individuals with the necessary financial means are viewing home spaces as ‘safe havens’, when compared to the corridors of hospitals that see thousands of patients with different kinds of ailments. Undoubtedly, there is a fear psychosis that has set into people’s minds as they are bombarded with newsreel images of body bags lying unattended next to COVID-affected patients, to the deceased being ferried in wheelbarrows. The idea to keep patients in the vicinity of homes served as a morale booster in times such as these when isolation can exacerbate stress in patients. Now, residential welfare associations across metros have taken the cue and have started putting together such centres within community auditoriums. A housing society in Aurangabad recently converted two empty bungalows into COVID care centres for asymptomatic patients.
Right now, there is a significant stress on India’s healthcare machinery, and home monitoring seems like a makeshift aid to alleviate some of that pressure. But there must be a long-term plan to address the big questions. Stakeholders in the healthcare industry have forecast that India will need to double its number of doctors which presently stands at 15 lakh, as well as double the number of hospital beds, which stands at 1.9 mn to reach a satisfactory level of healthcare delivery.
In the aftermath of the pandemic, it will take the combined strength of policymakers, government and private players to put in place a robust, trustworthy and above all, affordable healthcare ecosystem for the masses. Far from being a privilege, this must be treated as a non-negotiable right.

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