CHOOSING A HOSPITAL
When a health crisis strikes, one’s mind is generally too clouded to take a rational decision about choosing a hospital. So, it makes sense to select a hospital when one is in good health, says Sarita D’Souza
Charles was riding a bike with a bag strapped around its front when the strap broke and the bag landed in front of the bike. Charles fell from the bike, with excruciating pain in his leg, indicating a possible broken leg. His wife, Jenny, now had to deal with the question ‘Where should she take him for medical treatment…’
It is best to choose a hospital when you are healthy and do not need the services of one rather than wait for an emergency to arise, which necessitates hospital admission. If you want to decide which hospital to go to during an emergency, the best time to make that decision is when you are well.
CHOOSING HOSPITALS
What factors would you keep in mind when choosing a hospital? According to Dr Amit Dias of Goa Medical College, “Choosing a hospital may be a difficult task for most patients. It may be a good idea to consult your family doctor before choosing a hospital for any condition as it will be a balance between hospital cost, quality of services, expertise of the doctors, comfort available (private room/ general ward/AC rooms and other facilities), convenience of family members, insurance cover etc. A hospital with a good doctor is always the best bet. But everyone may think like you and you may get token number 100 at the OPD!”
Dr Dias adds, “One should be cautious of a hospital with several reports of nosocomial infections (hospital acquired infections) and irregular staff.
If the condition is not serious, like a common cold, the choice of the hospital may not matter much. However, for an emergency such as a stroke (brain attack), myocardial infarction (heart attack), trauma, it is necessary to shift the patient immediately to a hospital that has facilities for early intervention. This means that besides considering a good facility, one must also consider the distance and time taken for travel.”
Studies have indicated that patient preferences for hospitals are influenced by several factors, some of which are listed below:
NATURE OF CARE REQUIRED
Does the hospital have experience and successful outcomes with your condition? ‘General’ hospitals deal with routine conditions while ‘specialty’ hospitals focus on handling certain conditions (such as ‘heart conditions’) or certain groups (such as ‘children’ or ‘women’). If you have a chronic heart condition, you would do well to choose a hospital with more expertise in handling these cases than others.
PROXIMITY TO HOME
How accessible is the hospital? While the distance of the hospital from your home is an important consideration, you need to keep in mind the nature of care required. In case of an emergency at home, where it is critical to get the person admitted immediately, or in case of hospitalization for a longer period of time, nearness to your home is an important consideration. For planned treatment at a hospital, you would need to also consider other factors like the nature of care and whether the hospital is included in your insurance cover.
INFRASTRUCTURE
What is the kind and quality of physical and people infrastructure? Availability of the equipment and infrastructure required for medical treatment is another consideration that is to be kept in mind. While some hospitals do refer patients to other facilities for the specific infrastructure, the nature of your condition and the immediacy of access to the medical equipment would need to be kept in mind. Infrastructure would also include the levels of hygiene and processes in place to control infection at the hospital.
ATTENDING DOCTOR AND CARE
Is your doctor attached to the hospital? Sometimes the decision of which hospital to choose is driven by your doctor and whether he offers his/her services at the hospital. If your decision is influenced by the doctor who would be treating you, you would do well to check if your doctor attends to patients at the hospital. Sometimes, doctors offer their services at a large branded hospital as well as at the next best hospital. The choice between the two hospitals would be influenced by your cost considerations.
COSTS AND HEALTH INSURANCE COVERAGE
Does your health plan cover care at the hospital? In case of cashless facility, the hospital is required to be listed with the insurance company and the Third Party Administrator, to enable you to avail of the facility. If you are going in for a planned surgery, you would need to do your homework before deciding on the hospital.
The cost assessment is particularly important if you are paying from your pocket or in cases where you need to make the payment and obtain reimbursement from your insurance company.
If you choose a hospital well, you could make the most of the limited sum insured. If you choose a hospital that offers healthcare of equivalent quality at a reasonable rate, this claim of a lower amount would help keep the next year’s renewal premium under check, as your previous year’s claim is considered in determining your subsequent premium rate.
QUALITY AND ACCREDITATION
Does the hospital meet quality standards? How well does it check and improve on its own quality of care? Patient care involves clinical care and support activities like requisition of tests, medicines, nurse doctor coordination, infection control, training, etc. These need to run in a coordinated manner to provide the best experience to the patient and relatives. A quality-conscious hospital defines and documents all such activities and organises necessary staff training.
A good hospital would respect the rights of the patient and his family and have in place adequate processes to provide information about the proposed treatment, expected outcome, possible risks and estimated costs, and focus on quality in investigations, surgical services, medication, infection control and regular.
If you do not wait till an emergency to make the decision of the hospital you would like to go to, you would be better prepared to deal with the situation, should it ever arise.
[Sarita D’Souza is a faculty at the Marian Institute of Healthcare Management and can be contacted at sdsouza@marianinstitute.in]