What does it cost a hospital to do a caesarean-section procedure during pregnancy - Rs 2,500 or Rs 40,000?
And is the Government sure that its healthcare programmes are adequate to cover these medical costs, asks Susmita Chatterjee, the co-researcher of a couple of pilot studies done by the Public Health Foundation of India.
The studies seek to map the cost of surgical procedures and medical services in five different types of hospital, Chatterjee told Business Line. It gives some pointers on the mismatch between what is budgeted by the Government through its RSBY (Rashtriya Swasthya Bima Yojana), for instance, and the actual cost to the medical institution, she said.
The RSBY is the Indian government-funded health insurance and it covers 32.4 million poor families. The message is to highlight the need for a more representative study to be done across different types of hospitals, in the country, so that healthcare could be better financed, she added.
Touching on the challenges in doing a large scale study, she said, there were difficulties in getting data, due to instances of poor record keeping and hospitals being reluctant to share data.
Cost differential
The differences in the cost on c-sections to the different hospitals, for instance, came from the huge indirect cost, that included administrative and support staff etc, balanced out with the volume of surgeries done by the institution. The c-section cost a government hospital Rs 2,500, a private teaching hospital about Rs 7000-plus and a charitable hospital Rs 40,000-odd, she pointed out and this was because the operation theatres were under-utilized in charitable institutions, she explained.
Under the RSBY scheme, for instance, the Government reimburses hospitals a sum of Rs 500 per bed day, but the study found that the cost per bed day differed from Rs 345 to as high as Rs 7,000, she pointed out.
“A hysterectomy charge can vary between Rs 4, 000 to Rs.50, 000 depending on where you go. The absence of standardised cost for different medical services can result this huge variations in charges. Studies like this can play a crucial role in fixing a standard charge for different services,” said PHFI’s Ramanan Laxminarayan, a co-researcher on the study.
The Government’s RSBY scheme supports government-run and private hospitals, which is why it was necessary for Government to know the actual cost of the surgical procedure, before fixing the reimbursement rate, she added.
The studies, done for the period during April 2010 to March 2011, were published recently in the Plos One and BMJ Open journals.