The number of persons relying on government hospitals for haemodialysis has gone up in Chennai, particularly during the pandemic.
Dialysis services have become accessible like never before, the key reasons being expansion of existing facilities in the government sector and coverage under the Chief Minister’s Comprehensive Health Insurance Scheme (CMCHIS), say doctors.
When the COVID-19 pandemic struck, dialysis services continued uninterrupted at a number of facilities — both in government hospitals and centres run by NGOs and the Greater Chennai Corporation (GCC). It was during the thick of the pandemic that major government hospitals started to see a steady flow of COVID-19 patients requiring dialysis referred from private institutions.
It was the Rajiv Gandhi Government General Hospital (RGGGH) that set up a dedicated unit with 10 machines for patients on dialysis who were COVID-19 positive. The hospital received patients from 75 institutions, including private hospitals and from adjoining districts, N. Gopalakrishnan, director of Institute of Nephrology, RGGGH, said.
“During the COVID-19 pandemic, we faced a dual challenge — taking care of our regular dialysis patients and providing dialysis for patients with COVID-19 referred from other centres as well. We crossed 1,500 patients with COVID-19, the maximum in the country. We did not say ‘No’ to anyone,” he said.
A sophisticated and expensive treatment has been made accessible for the common man, he said. A total of 1,238 patients in Chennai — 614 in government and 624 in empanelled private hospitals — are being covered under CMCHIS for dialysis.
“Tamil Nadu has been the forerunner in taking free dialysis to the common man through CMCHIS. At RGGGH, we have 3,100 dialysis sessions a month for 240 patients. This number is progressively on the rise,” he said.
The Tamil Nadu Government Multi Super Speciality Hospital (TNGMSSH), which has 40 machines, accounts for one of the highest number of dialysis sessions of 2,000 a month in the city.
“Dialysis services continued uninterrupted during the pandemic. Those who turned COVID-19 positive were referred to RGGGH and later given special care,” S. Jayalakshmi, professor and head, Nephrology, TNGMSSH, said.
As of today, the hospital has 215 patients. “The demand for dialysis is increasing,” she said. More people preferred the government sector due to good services.
On an average, about 40 persons underwent dialysis daily at Government Stanley Medical College (SMC) Hospital. “The number of patients has been slowly rising. Initially, there were fewer machines and resource constraints. We have made enormous improvements in the last few years. There is an increase in the number of machines and number of dialysis centres,” M. Edwin Fernando, professor and head, Nephrology, SMC. The hospital at present has 30 machines.
He said a huge number of persons were referred for dialysis after centres were shut due to fear during the first wave of COVID-19. Patients on dialysis and COVID-19 positive from north Chennai were accommodated at SMC where a dialysis unit was created inside the COVID-19 ward.
As against 400 dialysis sessions a month in January 2019, the Government Kilpauk Medical College (KMC) Hospital does more than 1,000 dialysis sessions every month, T. Balasubramaniyan, professor and head, Nephrology, KMC, said.
“The numbers have steadily risen in the last five years. The government spends ₹8,000 for every eight dialysis sessions. Persons who are covered under CMCHIS can walk into a government hospital for dialysis. The quality and service has improved over the years,” he said.
During the pandemic, many patients started to come from private hospitals due to exorbitant charges ranging from ₹3,000 to ₹6,000 per session, which was three to four times more than the normal charges, Dr. Balasubramaniyan said.
“The government hospitals did not decline any patient with COVID-19 who did not have CMCHIS on humanitarian grounds,” he added.
The city has a significant presence of NGOs in delivering dialysis services. “During the pandemic, dialysis was not stopped for even one day... As the number of people needing dialysis is unfortunately on the increase, the GCC and the government are opening up more dialysis units and patients are benefiting with free dialysis through the CMCHIS and PMJAY schemes,” Latha Kumaraswami, managing trustee of TANKER Foundation, that runs eight dialysis units in Chennai — six along with GCC, Rotary and Free Masons and two with Rotary alone — catering to 445 patients.
