Bakulahar-Ratnanagar Hospital, Chitwan District
Background info
staff cost for 20 out of 60 doctors covered by HIB directly , 15 staff members covered by Ministry of Health, to be able to actually perform and offer sufficient health services the hospital uses re-imbursements they receive for health services from health insurance to employ additional staff – working with overall more than 200 staff (incl. HIB/MoH-financed staff); allows hospital to offer better service than private hospitals close around
serving … patients per day, bed cacacity of …
about 80% of patients (clients) to hospital are health insured
more info: https://rhospitalgovnp.wixsite.com/ratnanagar-hospital
Dr Madan Gyawali, Medical Superintendent, Bakulahar-Ratnanagar Hospital “As a hospital, if you face a lack of resources, you cannot offer medical services; without these services patients will not come; without patients the hospital cannot receive resources (by the government). Re-imbursement (for medical services and pre-scribed drugs) by HIB has been helping us to break that cycle. We can even invest in additional services to offer them to our patients.” |
Concept of 1st service point provider: beneficiaries are bound to visit hospital / medical provider which is the designated as 1st service point for their district (linked to address of insured person); HiB assigns the status to selected empanelled hospitals
Q&A
How do you decide on what additional (medical) services you invest in as a hospital? – can you use data from openIMIS e.g. on what services are in demand?
hospital management can observe on what services patients need to be referred to other medical centres repeatedly and whether there is much demand for a certain service – one possible entry point to decide whether to start offering that service at the hospital, e.g. started services on psychiatry, physiotherapy, intensive care unit ICU, currently plans to offer eye care services
based on experience of staff (service providers) and on data from electronic health record EHR
partly applying for additional funds from ministry for bigger investments in new services e.g. new building to offer maternal and child care services - in March 2023 40 ‘normal’ birth deliveries and 13 caesarean sections could be offered in this new clinic section; demand is even higher
generally, referral rate of 5-8% of insured people (HIB recommends rate of </=5%), i.e. these patients have to be referred to a close by higher level medical service facility (for this district hospital close to Bharatpur airport)
hospital owned pharmacy as important source of ‘income ’to the hospital (30% of overall income for hospital) - contributes to investment streams for hospital to offer additional services
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