Aku dan Statistik

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29 Disember 2010

Aku, MCO dan Private Specialists

Dalam perubatan, 1+1 tak semestinya 2. Itulah nasihat seorang professor masa aku student dulu yang aku pegang sampai sekarang. Setiap pesakit adalah unik dan perawatan serta proses penyembuhan adalah berbeza antara satu sama lain. Aku tak nafikan bahawa ada sesetengah hospital yang buat ujian2 tak perlu kepada seseorang pesakit tetapi kadang2 susah nak menyakinkan pesakit terutamanya yang hypochondriac.

Bila seorang lelaki berumur 30 tahun datang mengadu sakit dada dan takut dia mungkin sakit jantung, apa yang perlu dibuat? Setelah mengambil sejarah dia, anda pasti ianya adalah sakit2 biasa sahaja tetapi kadang2 anda susah nak menghilangkan kerisauan dia. Kalau kita tak buat ECG kat dia, dia takkan rasa senang hati dan pasti akan ke klinik lain untuk buat ECG untuk menyedapkan hatinya. Mungkin ada doktor lain yang lebih berpengalaman merasakan dia perlu buat Stress Test dan complete blood test untuk pengesahan. Manalah kita tahu kan? Adakalanya dia masih tak puashati dan meminta dirujuk ke klinik pakar kerana dia ada Medical Card. Tapi kalau Specialist terus direct buat Angiogram ataupun sengaja nak buat Echocardiogram, itu dah melampau dah...

Susah beb nak buat keputusan...

Watch on errant hospitals

By ISABELLE LAI
isabellelai@thestar.com.my

PETALING JAYA: Private hospitals will be monitored to ensure that they do not put patients through unnecessary procedures just because they have medical insurance, said Health Ministry director-general Tan Sri Dr Ismail Merican.

“The ministry will continuously direct private hospitals, managed care organisations (MCO), insurance companies and other interested parties to ensure that the cost of healthcare is reasonable, detailed and transparent.

“This will help patients make informed decisions on getting treatment as they will be more aware of the charges that will be incurred,” he said in a statement here yesterday.

He said the ministry would also look at ways to address the discrepancies between charges for self-paying patients and those with insurance policies as this problem had also contributed to overall healthcare costs. He said the problem was also compounded by some private hospitals being pressured by their shareholders to charge more to fulfil their key performance index.

His statement came following a meeting last Friday with the Association of Private Hospitals Malaysia, Malaysian Medical Asso­ciation, Malaysian Medical Council, hospital chief executive officers, private hospital and MCO representatives, insurance companies and several healthcare professional groups and independent professionals.

“The purpose of the meeting was to explore ways of curbing increasing private healthcare costs,” said Dr Ismail, adding that several points were agreed upon, including making insurance policy holders aware of the medical coverage they were entitled to. Hospitals, he said, must also inform patients about all professional and potential charges before they were admitted or treated.

He said it was also agreed that MCOs must not interfere with the clinical judgment management of patients by medical practitioners, including by general medical practitioners.


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