While medical staff do everything they can for patients, they are often limited by the funds made available for the patient’s treatment
Severe trauma or illness often translates into some sort of rehabilitation needed to recover. Amputation and paraplegia fall into these categories. But, let me explain the title of this article with a recent case study. A patient lost his limb below the knee. His trauma recovery, hospital stay, theatre costs and the fees for all the other medical practitioners who contributed came to a total of R2,6 million. This was the combined bill for a one-month treatment period.
Now, depending on the medical scheme, you will only get R20 000 to R110 000 for your prosthetic recovery. This is usually for treatment that stretches over a six-month period. So, in essence, one to five percent of the total funds is spent on life reintegration, which is, in my opinion, the most important part of the entire treatment regime. The lack of funds for proper age and activity-level- related equipment at the rehab stage of the fight is penny wise and pound foolish.
Let me explain. If a prosthetic socket is not refitted in time, or if worn-out silicone stump liners are not replaced timeously, then skin breakdown occurs. The chances of the skin then getting infected and the patient ending up in theatre for a surgical procedure are very good. With theatre costs running at R400 a minute (not including the surgeon, the anaesthetist or hospital stay), it will quickly surpass the cost of the original treatment or product that was needed. The same applies to worn wheelchair cushions resulting in severe pressure sores.
How do we fix this? If the overall treatment focus is placed on favourable treatment outcomes instead of cost cutting wherever possible, then the best treatment protocols must surface. If medical professionals are forced to make treatment decisions based on cost limitations, the best outcome for the patient most certainly takes second place. And may I emphasise that this is usually not the practitioner at fault. They simply must make do with the funds available.
Maintenance of well rehabilitated patients are usually a very cost-effective exercise. We see this every single day. So, let’s hope a proactive funder’s risk assessor reads this article and decides to investigate!