Low bed occupancy by children in private hospitals, glaring discrepancy between referral and admissions, and lack of data on the use of private hospital beds by children have been identified as key shortcomings of the Capital’s free healthcare scheme. The National Commission for Protection of Child Rights (NCPCR) on Friday released a report on ‘Utilisation of free medical services by children belonging to the Economically Weaker Sections (EWS) in private hospitals in the Capital’.
The report is a rapid appraisal of select medical services (public and private) for children in Delhi between September 2012 and November 2012. The appraisal’s aim was to find out how free beds in private hospitals are being utilised for providing medical services to children in particular. This was done in order to get a basic understanding of the current situation so that policy issues can be highlighted for further in-depth study and analysis.
“All private hospitals registered under the Delhi Government and listed as being mandated to provide free treatment to the EWS in Delhi were contacted as part of the process. Additionally, Apollo Hospital and two large government hospitals catering to children — Kalawati Saran Children’s Hospital (KSCH)and Lok Nayak Jayaprakash Narayan Hospital (LNJP) — were also appraised in order to make comparisons,” said NCPCR member Dr. Vandana Prasad.
The report found that utilisation of EWS beds in private hospitals by children was very low in Delhi compared to the vast numbers utilising public health facilities.
“The number of children admitted under EWS in the last year in the private hospitals (the 24 who responded) was 1,218; number admitted in government hospitals was 27,123 (KSCH) and 8,231 (LNJP) and Apollo had only 252,” noted the report.
The child bed occupancy rate (CBOR) was also found to be very low in private hospitals, with Fortis Hospital at the highest with 25.61 per cent. Of the 16 hospitals which responded to this question, 14 hospitals had a CBOR below 10 per cent. Compared to this, government hospitals had a 100 per cent CBOR, going up to 150 per cent at certain periods of time.
“We also found that referral from government hospitals, especially to those hospitals that offer super-specialty services such as cancer treatment or cardiac treatment, were happening considerably well, potentially constituting up to 44 per cent of those admitted,” said Dr. Prasad.
She said 16 hospitals provided data both for referrals and children admitted, with a total of 493 referrals and 1,116 children admitted to these hospitals. Eight hospitals shared the bulk of referrals and admissions.
“However, glaring discrepancy between referral and admissions was observed — Apollo had 698 referrals and only 252 admissions, and Sir Ganga Ram Hospital had 150 referrals and 57 admissions. This finding raises concerns about continuity of care and seamless transitions for referred children and must be juxtaposed against very detailed directions by the court on procedures for and following referral,” said Dr. Prasad.
The study noted that no consolidated data on diseases/ailments treated as reasons of admission were provided. The bulk of deaths among children were seen to occur in the neonatal period and from sepsis/infection.
The NCPCR has submitted the report to the Delhi Government for follow-up.