Need for hospital economics

A hospital is an institution offering residential, investigatory and out-patient therapeutic care. Hospital economics is, therefore, the efficient running of a hospital or a medical center to provide the maximum medical facilities within a balanced budget. This is required more in case of our government-run civil and military hospitals, where budget is always a limiting factor. In our country, the government and civilian budget is only 1% of the total budget in health care which is too little. Frugal management of a hospital both in-door and out-door affairs bring close to hospital economics.
In the United States, hospital insurance is prevalent and the insurance of the private hospitals is all the more important. In the United Kingdom, the total health and social security system is free for all the UK citizens including the immigrants. But they have to pay 33% as tax at the source and also some percentage of income as social security deduction. Hospital economics has gained some momentum in USA as total health care is not free and the brunt is borne by the majority of the poor masses, who cannot bear the exorbitant cost of medical care, and expensive operations. Out of three, one child is born of Ceserean section.
The aim of this article is to provide ideas to expand our health services both in the public and private sectors to the needy patients, who have no access to modern methods of treatment. This is also applicable to the district hospitals in far-flung areas, as has been experienced by me, while I was working as a surgical specialist at the District Headquarter Hospital, Gilgit, for about three years.
The following are some one of the most important factors for cost-effective hospital management. These may help us to achieve the goals aimed at and reduce the cost of hospital management as well.
Use of antibiotics: Judicious use of antibiotics may be done according to the culture and sensitivity tests. Un necessary use of antibiotics is detrimental. Antibiotics may be prescribed in only infective conditions of a patient. Spurious drugs should be avoided, especially in seriously ill patients, where it could be lethal. Time is the most important factor, it should not be lost sight of.
Use of asepsis: As compared to antisepsis, use of antibiotics is not preferable in surgery. Antibiotic is not a short cut to asepsis. Both can supplement each other. Proper sterilization techniques in operation theatre thereby reduces the cost of antibiotics.
Prevention of diseases: Vaccination programmes and the public health measures, especially drinking water and sewerage disposal, family planning, screening of blood for HB, HAPC and Hiv including malaria eradication programmes, typhoid and worm infestation causing anemia and malnutrition.
Readiness for disasters and calamities: These include bomb-blasts, earth quakes, famines, floods, epidemics and gastro-enteritis and cholera. The cost of living is too high for a lower or middle class persons to bear the cost of medical and surgical treatments. The health budget is lost in costly management, pilferage and spurious drugs should be curtailed. Hospitals have to keep themselves in readiness to cope with all such man-made and natural calamities.
Medical insurance: Medical insurance is comparatively a new concept in our society. It should be appreciated and encouraged as the cost of living is soaring high and there is no budget for medical treatment. Comprehensive coverage of family members by providing low cost medical cards for short and long treatment is to be popularized by modern marketing techniques to save their budget.
Ambulant surgery: Like dentists doing dental surgery under local anesthesia do not have to admit a patient, surgery of hernia, hydrocele, toe-nail, reduction of fractures and plaster, cleft-lip, cysts, lumps and bumps can be done without having to admit a patient. Cataract and other eye-surgeries, vasectomy and tubal ligation may also be done.
Day care surgery: Day care ward is open from 9 a.m, to 5 p.m. Here the categories of operation, which include: hemorrhoids, hernia, nasal septal defects, spina bifida, manipulation of spine and shoulder and other different joints, DNC under general anesthesia.
Camp surgery: in ophthalmology not only in cities but also in desert areas, cost effective, charitable, surgical and medical camps can be held by the different specialists to provide services to the poor at their door steps. It has been tried by PMA Hyderabad and in the interior of Sindh. Such camps should be encouraged to provide service to the needy people. Pharmaceutical companies and NGOs can also help by providing funds and medicines.
Un-necessary fund generation: Some of our private hospitals go after un-necessary investigatory tests, operations and hospitalization of a patient, in order to generate funds. In some maternity homes, instead of giving time for natural birth, doctors rush for a caesarian, just to make money for their maternity homes.