In a major
move aimed at checking unnecessary medical tests and procedures, the health
ministry on Sunday said it was working on a plan to make it mandatory for all
private hospitals to declare and display the treatment costs of different
diseases.
Jagdish
Prasad, director general of health services (DGHS), told TOI that the
ministry's plan would check overbilling and bring in transparency in the
healthcare sector.Aim is to notify standard
costs for various medical procedures such as angioplasty, coronary bypass
surgery etc. We also plan to categorize hospitals based on quality of services
offered and develop standard treatment costs for each category.
Unwarranted
procedures add to cost
Prasad
said the guidelines will be introduced under the Clinical Establishment
(Registration and Regulation) Act 2010, which was notified recently.
The planned
guidelines would also give a boost to evidence-based approach to treatment,
said Dr Kameshwar Prasad, head of the clinical epidemiology unit of AIIMS.
"Unwarranted procedures and diagnostic tests put extra financial burden on
the healthcare system and cause increased morbidity and mortality. For example,
a person suffering from muscular chest pain does not require angiography.
Still, many hospitals routinely put such patients through this procedure,"
the doctor said.
Experts cite studies showing
rampant use of unnecessary procedures in India. For instance,hormone replacement
therapy is carried out
in post-menopausal women despite
there being no evidence that it reduces cardiac events. Similarly, antioxidant
vitamins are commonly prescribed for reducing cardiovascular disease though
there's no evidence of its efficacy. TheElisa test has till recently been widely
used for diagnosis of tuberculosis. It has since been banned due to its
unreliability.
The
DGHS also said patient treatment cannot be taken as a clinical trial.
"Stem cell therapy is being offered for spine injuries by many hospitals
and patients are charged for that. This despite the fact that there's no proven
effect of the therapy. This can only be stopped through patient awareness and
strict monitoring by government agencies," Prasad said.
AIIMS
is leading a first-of-its kind global initiative to promote evidence-based
healthcare. Said institute director, Dr R C Deka, "Awareness of the latest
evidence-based treatments is necessary. However, treatment costs should also be
borne in mind by doctors while suggesting procedures for patients."Deka
also said overprescription was also leading to immunity against many
antibiotics, a problem that was likely to become serious in the future.
Standardized procedures should help in curbing this trend, he added
