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Kundiges in gesondheidsbedryf krap kop oor toename in hospitalisasie | SA-News.com
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Kundiges in gesondheidsbedryf krap kop oor toename in hospitalisasie
Kundiges in die gesondheidsbedryf het op die jaarlikse konferensie van die Hospitaalvereniging van Suid-Afrika (Hasa) in Kaapstad hewig van mekaar verskil oor wat die redes vir ‘n skerp toename in die koste van mediese skemas is.
Matthew Prior, hoof van gesondheidsbeleid van Life Healtcare, sê ’n toename in benutting van gesondheidsdienste word die afgelope jare as die hoofoorsaak beskou vir hoë mediese inflasie. Hy sê die premieverhogings wat mediese skemas van hul lede eis, is die werklike maatstaf van mediese inflasie vir verbruikers.
Prior het die debat gelei oor die redes vir die toename in die benutting.
Navorsing deur Medscheme, die administrateur van mediese skemas, toon daar is ’n verband tussen ’n toename in hospitaalbeddens en die skerp styging in hospitalisasie wat verlede jaar ervaar is, sê dr. Jenni Noble, hoofbestuurder van Medscheme.
Die mededingingsowerhede se paneel wat die markondersoek na die gesondheidsbedryf doen, het in 2016 ’n verslag uitgereik oor die faktore wat die koste van mediese skemas opjaag.
Ander faktore speel ‘n rol
Mariné Erasmus, direkteur van die gesondheidsekonome Econex, sê daar is aan die vraag- en die aanbodkant faktore wat tot die toename in benutting lei.
Navorsing wys egter die grootste dryfvere is faktore aan die vraagkant.
Die vraag wat deur verskaffers veroorsaak word, is boonop ’n “baie klein deel van die faktore wat aan die verskaffingskant” benutting verhoog.
“Wanneer gepraat word oor benutting wat toeneem en die koste wat daarmee geassosieer word, is dit ’n wyer debat as net die getal hospitaalbeddens wat toeneem.”
Sy sê die faktore aan die vraagkant sluit in dat lidmaatskap van mediese skemas nie verpligtend is nie en die impak wat voorgeskrewe minimum voordele (VMV’s) het.
Erasmus sê dit is faktore wat met regulasies aangepak kan word.
Noble sê hiervolgens kan meer as 50% van opnames in hospitale nie verklaar word deur faktore soos ouderdom, geslag, chroniese siektes en lede van mediese skemas wat van een plan na die ander skuif nie.
“Die vraag is dus, wat veroorsaak hierdie ekstra toename?”
Volgens haar het Medscheme navorsing gedoen nadat baie mediese skemas in 2016 ’n skerp toename in hospitaalbesteding ervaar het. Hulle het probeer uitvind watter faktore aan sowel die vraag- as die aanbodkant daartoe lei.
Daar is niks spesifiek aan die vraagkant gevind waaraan die toename in hospitalisasie toegeskryf kon word nie. Faktore soos ouderdom en die siektelas van die bevolking het nie skielik skerp toegeneem nie, hoewel dit voortdurend styg.
Daarom is navorsing gedoen om die verhouding tussen die getal nuwe beddens en hospitalisasie te ontleed om te bepaal of dit ’n rol aan die vraagkant kan speel. Volgens haar het hulle wel ’n verband gevind tussen die toename in beddae en die getal nuwe hospitaalbeddens wat in gebruik geneem is.
Probleem moet beter nagevors word
Roly Buys, ’n konsultant van Mediclinic Suider-Afrika, het gemaan teen ’n oordeel vel oor die hospitaalbedryf op grond van inligting wat nie behoorlik nagevors is nie.
Volgens hom is “verskaffersgedrewe vraag” ’n onderwerp wat moeilik is om na te vors en baie literatuur daaroor is “hoogs verdag”.
Hy beskryf ook die verslag van die markondersoek waarna Noble verwys het, as “hoogs verdag” omdat van die data oor hospitaalopnames gedupliseer is en dit die bevindinge oor verskaffersgedrewe vraag oordrewe laat lyk.
“Ons stem almal saam daar word ’n verskil in benutting gesien, maar die probleem moet presies bepaal word voordat ’n oplossing gesoek word.”
Hy sê in Suid-Afrika word alles wat nie verduidelik kan word nie oor stygende benutting aan verskaffersgedrewe faktore toegeskryf, maar bedrog en vermorsing asook nuwe tegnologie kan ook ’n rol speel.
Hy sê as verskaffersgedrewe faktore bekyk word, moet ook gekyk word na die rol wat dokters speel.
Hy meen die rol wat mediese skemas se voordeelontwerp in ’n toename in hospitalisasie speel, moet ook bekyk word.
Volgens Noble het die getal hospitaalbeddens in die land van 2010 tot 2016 met 22% toegeneem. Terselfdertyd het die lede van mediese skemas net met 6% toegeneem.
Die toename in nuwe beddens was nie om ’n tekort aan te vul nie. Suid-Afrika het in die private sektor sowat vier hospitaalbeddens per 1 000 mense wat verseker is deur mediese skemas. Dit is amper dubbeld die internasionale standaard.
Boonop word verwag in 2017 gaan nog 500 nuwe beddens in nuwe hospitale bygevoeg word.
“Daar is ’n verband wat ons nie kan ignoreer nie, gegewe die voortgesette toename in hospitaalbeddens en die feit dat ons waarskynlik reeds genoeg beddens het. As ons die volhoubaarheid van private gesondheidsorg wil bespreek, kan ons nie ons kop in die sand begrawe en sê die toename in hospitaalbeddens dryf nie die vraag nie.”
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Categories: Health, Hospitals, Medical Aid, Netwerk24, News, Uncategorized, Wellness
Tags: consumers, gesondheidsbedryf, gesondheidsdepartement, gesondheidsdienste, Health, Healthcare, healthcare costs, healthcare system, hospitalisasie, medical scheme, medical schemes, mediese inflasie, premieverhogings, South Africa, Wellness
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