Hyderabad: Ever escalating costs of accessing healthcare facilities in private sector and rising out of pocket expenditure to meet the healthcare needs of individual families appear to be fuelling the rise of number of persons visiting government hospitals in the State.
While the quality and service of healthcare facilities at public healthcare institutions has always remained debatable, what has remained quite indisputable is the fact that the cost of healthcare in private sector has continued to rise steadily.
Perhaps, that is also a vital reason why the teaching hospitals in Telangana, between January and December of 2018, registered a massive increase in the number of patients accessing healthcare facilities. Overall, the 20 teaching hospitals under the jurisdiction of Director of Medical Education (DME) in the State received a whopping 10 lakh additional patients in the outpatient departments.
Similarly, the number of major surgeries that are taken-up at all the tertiary government hospitals in the State has also risen exponentially from 77,000 surgeries in 2017 to 84,000 surgeries in 2018 and close to 28,000 additional minor surgeries. While the sanctioned bed strength for the 20 teaching hospital is 9,204 beds, the total number of inpatients in the last two years has hovered over six lakh, a key indicator that fuels the argument for adding more beds and create medical infrastructure in the State.
Another reason for the rise in patients at State-run hospitals is because of the impoverishment that sets-in after incurring out of pocket healthcare expenses.
In an analysis of the data presented by National Sample Survey Organisation (NSSO) between 1994 and 2014 throughout the country, published in the British Medical Journal, the researchers from Public Health Foundation of India (PHFI) said nearly 55 million people in India were impoverished after incurring expenditure to buy medicines alone.
Expensive cost of medicare, even at small and medium-sized private healthcare establishments has not helped. According to the PHFI study, majority of households in India bear significant financial burden on account of medical treatment. Since both government funding and social health insurance contributions are insufficient to meet the healthcare needs of households, over three fourths of all healthcare payments are paid out of pocket.
While expensive healthcare in private healthcare sector has driven patients to State-run hospitals, the latter has struggled with overcrowding, shortage of beds, infrastructure, human resource and improving quality of healthcare services.
Caesarean sections matter of concern in TS
For the past few years, in order to get a grip on Infant and Maternal mortality rates, there has been a concerted effort on the part of health authorities to encourage healthcare workers take-up natural deliveries and cut down on the number of caesarean sections.
According to National Family Health Survey (NFHS-4), Telangana has highest Caesarean rates in the entire country. Close to 58 per cent of pregnant women undergo C-sections in Telangana followed by Andhra Pradesh, which is at 40 per cent.
Going by the statistics available with in the 20 teaching hospitals in the State, the C-section has continued to pose a challenge and hovers between 43 per cent and 44 per cent of deliveries.
In 2017, the Government Maternity Hospital, Petlaburj took up 6,841 C-sections while there were 10,345 normal deliveries. In 2018, between January and December, the number of C-sections taken-up at Petlaburj maternity hospital were 7,107 deliveries while natural deliveries were 10,786.
The divide between private and public health institutions too is quite visible. In the State, the C-section rate in private hospitals is 75 for 100 live births while in public health institutions it is 40.6.
The health officials have recognised this high trend of C-sections in Telangana and have categorised it as ‘a matter of concern and alarm’. Ideally, according to WHO the C-section rate in tertiary maternal care centres should be less than 15 per cent.