Private hospitals will have to display treatment costs

October 8, 2012
tp-doctor-apollo-hospital-delhi

New Delhi, October 8: 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.

"Our 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," DGHS Prasad said.

He said suggestions are being sought from all stakeholders, including the corporate-run hospitals, on how the new system can be rolled out.

"We will initially ask each hospital to give their treatment charges, which would help us slot these hospitals into categories," Prasad said. A standard guideline for treating conditions like heart attack, stroke, diabetes, osteoporosis and cancer, is also on the anvil, the senior ministry official said.

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. The Elisa 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.


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News Network
May 19,2020

New Delhi, May 19: The number of coronavirus cases crossed the one lakh mark in the country on Tuesday, while the death toll due to the infection touched 3,163, according to the Union Health Ministry.

A total of 134 deaths and 4,970 COVID-19 cases were reported in the country in the past 24 hours since 8 pm on Monday, it said.

The total number of coronavirus cases has risen to 1,01,139, the ministry said.

The number of active COVID-19 cases stood at 58,802 while 39,173 people have recovered and one patient has migrated, it said.

"Thus, around 38.73 per cent patients have recovered so far," a senior health ministry official said.

The total confirmed cases include foreigners.

Of the 134 deaths reported since Monday morning, 51 were in Maharashtra, 35 in Gujarat, 14 in Uttar Pradesh, eight in Delhi, seven in Rajasthan, six in West Bengal, four in Madhya Pradesh, three in Tamil Nadu, two each in Punjab and Jammu and Kashmir, and one each in Bihar and Telangana.

Of the 3,163 fatalities, Maharashtra tops tally with 1,249 deaths. Gujarat comes second with 694 deaths, followed by Madhya Pradesh at 252, West Bengal at 244, Delhi at 168, Rajasthan at 138, Uttar Pradesh at 118, Tamil Nadu at 81 and Andhra Pradesh at 50.

The death toll reached 37 each in Karnataka and Punjab and 35 in Telangana.

Jammu and Kashmir has reported 15 fatalities due to the disease, Haryana has 14 deaths while Bihar has registered nine and Kerala and Odisha each have reported four deaths.

Jharkhand, Chandigarh and Himachal Pradesh each have recorded three COVID-19 fatalities, while Assam has reported two deaths.

 Meghalaya, Uttarakhand and Puducherry have reported one fatality each, according to the data provided by the ministry.

According to the ministry's website, more than 70 per cent of the deaths are due to comorbidities, the existence of multiple disorders in the same person.

According to the health ministry's data updated in the morning, the highest number of confirmed cases in the country are from Maharashtra at 35,058, followed by Tamil Nadu at 11,760, Gujarat at 11,745, Delhi at 10,054, Rajasthan at 5,507, Madhya Pradesh at 5,236 and Uttar Pradesh at 4,605.

The number of COVID-19 cases has gone up to 2,825 in West Bengal, 2,474 in Andhra Pradesh and 1,980 in Punjab.

It has risen to 1,597 in Telangana, 1,391 in Bihar, 1,289 in Jammu and Kashmir, 1,246 in Karnataka and 928 in Haryana.

Odisha has reported 876 coronavirus infection cases so far, while Kerala has 630 cases. A total of 223 people have been infected with the virus in Jharkhand and 196 in Chandigarh.

Tripura has reported 167 cases, Assam has 107, Uttarakhand and Chhattisgarh have 93 cases each, Himachal Pradesh has 90 and Ladakh has registered 43 cases so far.

Goa has reported 38 COVID-19 cases, while the Andaman and Nicobar Islands has registered 33 infections.

Puducherry has registered 18 cases, Meghalaya has 13 and Manipur has seven cases. Mizoram, Arunachal Pradesh and Dadar and Nagar Haveli have reported a case each till how.

"814 cases are being reassigned to states," the ministry said on its website, adding "our figures are being reconciled with the ICMR".

State-wise distribution is subject to further verification and reconciliation, it said.

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News Network
May 18,2020

The Centre on Sunday extended the COVID-19 lockdown for two more weeks till May 31 with more exemptions as the Centre allowed states more powers for profiling its zones, re-starting of inter-state and intra-state bus travel, plying of autos and taxis and opening of all shops, including in markets but barring those in malls.

Here are the answers to all your questions:

What is 'Lockdown 4.0'?

On March 24, 2020, Prime Minister Narendra Modi announced a 21-day nation-wide lockdown to prevent the spread of the coronavirus outbreak. India follows several countries in its measures to curb the pandemic, which was the first lockdown. Prime Minister then extended the coronavirus lockdown till May 3, which was dubbed as 'Lockdown 2.0'. This lockdown was further prolonged till May 17 which became 'Lockdown 3.0' and now, as the government aims at a staggered re-opening of the country while maintaining the norms such as social distancing, the fourth extension till May 31 is called 'Lockdown 4.0'.

Who issues the guidelines for the lockdown?

The Ministry of Home Affairs (MHA) issues the guidelines for the lockdown.

Are guidelines different during a lockdown compared to normal life?

Well, of course. Guidelines during a lockdown instruct people on all matters from whether you are allowed to leave your house, to whether an MNC is allowed to function and with what percentage of attendance.

Are masks compulsory even now?

Masks are made mandatory in all public places, by the Union Health Ministry. All the states and UTs are to strictly abide by this law. Not wearing masks will attract penalties which are specified by the state.

How would that be determined for an area?

By Lockdown 3.0, all areas of state districts were segregated into containment, red, orange and green zones. In the Lockdown 4.0, states will categorise the areas into red, orange and green zones.

Colourful... but what are red, orange and green zones?

According to the guidelines issued by the Ministry of Health and Family Welfare, states can categorise districts or municipal corporations as red or orange zones.

"States may, however, also choose to categorise a sub-division or ward or any other appropriate administrative unit as red/orange/green zone after detailed analysis at their end, duly taking into consideration the geographical spread of cases, contacts and their zone of influence in terms of disease spread," the ministry said.

With the commencement of the third phase of lockdown, the Union Health Ministry listed 130 districts across the country in the red zone, 284 in the orange zone and 319 in green zones based on the incidence of cases of COVID-19, doubling rate, the extent of testing and surveillance feedback.

Districts were earlier designated as hotspots/red-zones, orange zones and green zones primarily based on the cumulative cases reported and the doubling rate.

A district will be considered under green zone if there have been no confirmed cases of COVID-19 so far or there is no reported case since last 21 days in the district, according to the letter.

Now, what is a buffer zone?

A buffer zone is an area of spread in a 5-kilometre radius (7 Kms in rural areas) of a containment zone.

How do I find out the zone I am in?

You either look at your state or city's municipal corporation pages to avail the zone details. You can also look at your district magistrate's Twitter handle or Facebook account to find out the list of the zone under which your area falls.

Can I leave my home now?

That depends. If you are in a containment zone or a red zone, you may not be allowed to leave your residence. Otherwise, in the other zones, the state governments and the district magistrates will decide upon the level of movement within and outside the zones.

Can I shift from a red zone to an orange or green zone?

You cannot. The residents of a red or containment zone cannot move out of their zones, nobody may enter the zones as well.

What about my office?

The private offices can operate in non-containment zones. The guidelines for offices to work will be listed by the state governments and the DMs (district magistrates).

Will I be allowed to use my bike/car or any other personal vehicle?

There is a likely chance of you being allowed to take out your bike or car or other vehicles (not helicopters or aeroplanes), if you are not in a containment zone. You need to check the rules listed by your state government or DM. The number of people who can ride at one time will also be decided by the state.

Can my driver, house help or neighbour drive me to my office/destination? Will I be allowed to take them to my workplace?

Yes, provided they are not from a red zone which may be risky for the passenger. This facility is prohibited in a containment zone. Also, check with your workplace regarding the norms to follow within the office. For the details on travelling with others in the car, look into the info provided by your state government, DM and Resident Welfare Association (RWA).

Will be able to fill petrol or diesel for my vehicle?

Definitely, yes. All petrol pumps, LPG and oil agencies will continue to be open.

What if I need to take a cab, auto or book one via Ola/Uber?

The same rules apply to them as well. Unless you are in a containment zone, the restrictions for using cabs and autos will be eased.

What if I need to use public transport like buses?

Some states have allowed buses to run, such as in Tamil Nadu in certain areas. You will have to check with the state government or DM's regulations enlisted for knowing the routes and norms to follow inside a bus.

Can I use my city's Metro line?

Unfortunately, metro lines are not allowed to open and will remain closed until further notification from the Centre.

Can I walk around in my area?

Walking will be permitted under the guidelines issued by the state and DM. Walking in groups will be prohibited and social distancing norms are to be followed in public at all times. Movement is allowed between 7 am to 7 pm in any zone - containment, red, orange or green.

Can I take my grandparents/kids out for a walk?

People older than 65 years of age, or younger than 10, persons with co-morbidities, pregnant women are not allowed to venture out of their residences, as they are highly susceptible to the infection.

Can I go out with my friends?

A group of less than 5 people are allowed to walk together. If you are planning to use vehicles such as bikes, every induvial must have their own as more than one person on atwo-wheeler is not allowed in certain areas. Curfew timings are from 7 am to 7 pm as movent is prohibited beyond these timings. Check the regulations issued by your local DM or state government to know further details.

What if I need to see my friends, relatives or others?

The Resident Welfare Association (RWA) will make a decision about allowing visitors inside a zone, barring containment zones. Nobody is allowed within the containment zone or permitted to leave.

Can we now go to restaurants?

Restaurants are still closed irrespective of the zone. Take-away or delivery services will be available, nevertheless.

Can we go to malls?

Malls and restaurants and shops in the malls will remain closed irrespective of the zone, as these are crowd-pulling zones.

Does that mean multiplexes, theatres and drama/concert halls are closed as well?

Cinema halls, theatres, multiplexes and drama/concert halls will remain closed regardless of which zone they are in, till further instructions are sent by the Centre.

Can I go to the beach or a monument/heritage site?

Since such public places will attract a huge crowd that will be tough to control, beaches, monuments, heritage sites and such public places will be closed.

Can I go to coffee shops?

As coffee shops will fall under the category of restaurants, they will also be closed. Take-away and delivery services can be availed from the shops.

What about essentials?

Grocery shops, milk vendors, newspaper circulation are allowed to stay open. Proper sanitisation must be done from time-to-time to ensure customer and vendors’ safety.

I need to repair my phone. Will stand-alone non-essential services be open?

Such non-essential services are allowed to open in non-containment zones. Refer the state governments and DMs rules for knowing the type of shops and state and districts they are permitted in.

What about in-house repairs or services? Can I call a mechanic to my house?

Yes, provided your RWA has permitted to allow mechanics, workmen and labourers inside in non-containment zones.

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News Network
May 12,2020

Ahmedabad, May 12: The Gujarat High Court on Tuesday declared state BJP minister Bhupendrasinh Chudasama's election in 2017 as void on grounds of malpractice and manipulation.

Justice Paresh Upadhyay cancelled Bhupendrasinh Chudasama's election in an order passed on a petition filed by Congress candidate Ashwin Rathod, challenging the BJP leader's victory from Dholka constituency by a margin of 327 votes in the 2017 Gujarat Assembly polls.

In his election petition, Ashwin Rathod alleged that Bhupendrasinh Chudasama indulged in "corrupt practice and breach of many of the mandatory instructions of the Election Commission, at various stages of the election process, more particularly at the time of counting of votes".

Bhupendrasinh Chudasama currently holds charge of the education, law and justice, legislative and parliamentary affairs, and some other departments in the Vijay Rupani government.

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