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Medical Aid News South Africa

Affordable surgical excellence: why it’s important to question hospital options

As the new year unfolds, it is crucial for consumers to approach their health expenditure with foresight, particularly regarding scheduled surgeries. In the current economic landscape where costs across the board are increasing and where medical-aid benefits decrease year-on-year, savvy financial thinking and cost-savings are paramount.
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"Patients can avoid depleting their medical-scheme funds and the potential inability to afford out-of-benefit medical interventions by being more informed and knowledgeable about healthcare expenses and the options available to them when it comes to hospitalisation. It is always in the patient’s interest to shop around to save costs where possible, without sacrificing quality of care,” says Bibi Goss-Ross, managing director of Advanced Healthcare South Africa.

Day hospitals, being inherently focused on same-day surgical procedures, exclusively provide facilities for operating theatres and ward accommodations and are cheaper than acute hospitals. They are streamlined and cost-efficient and many procedures can be safely performed in a day hospital including colonoscopies, orthopaedic scopes, cataract surgeries, fracture repairs, grommets, biopsies, tonsil removals, and other day-case surgeries.

“Information empowers and by asking the right questions about surgeries, consumers can be empowered to obtain superior surgical and medical care at a competitive cost,” Goss-Ross said.

Internationally, in countries such as Australia and the US, 70 to 80% of all surgical procedures are performed in day hospitals, which translates to an average saving of approximately 20% compared to having the same procedures in acute hospitals, according to Ambulatory Surgery Centre Association (ASCA) in America.

In South Africa, the use of day hospitals is increasing with medical-aid schemes seeing the benefits. Discovery Health Medical Scheme (DHMS) for example provides an incentive to doctors to perform a planned procedure that allows for same-day discharge, in a day clinic. According to DHMS, by 2022, 33% of its members' procedures were performed in a day clinic, up 9% from 2019.

“Thinking that the medical aid pays in any case is certainly not a responsible attitude; all increases in medical expenses are most certainly passed on to the consumer in the form of increased premiums and decreased benefits. We need to think smart about hospitalisation and affordable healthcare,” adds Goss-Ross.

Several factors influence the cost model of day hospitals so making informed decisions about surgical procedures’ location allows individuals to actively contribute to saving on their health costs.

Goss-Ross further elaborates on the benefits of day hospitals:

  • Cost-effective: Day hospitals transform the surgical landscape by providing high-quality care at a fraction of the cost compared to traditional acute hospitals. Streamlined processes and focused services enable efficient space and resource use, resulting in substantial cost savings.

    The absence of large kitchen facilities, intensive care units, specialised theatres, overnight beds, after-hours staff, and emergency units lower the costs. Theatre fees per minute compared to an acute facility are better priced as are ward rates compared to larger healthcare facilities. Goss-Ross says private patients benefit from this as witnessed by an increase in cash-paying patients supporting day hospitals.

  • Faster admission and recovery: Day hospitals provide a distinct advantage in terms of expedited admissions and enhanced recovery, primarily due to their thoughtfully designed and user-friendly atmosphere. In stark contrast to traditional patient-recovery environments, day hospitals prioritise creating spaces that don't evoke the stereotypical aspects of a trauma setting.

    This subtle yet significant departure from the conventional look and feel ensures that individuals entering these facilities are met with an ambiance that is both comforting and non-intrusive. By consciously steering away from the typical associations with medical distress, day hospitals aim to foster an environment that contributes positively to the healing process, emphasising the importance of a welcoming and rejuvenating space in expediting recovery.

    Patients check in early morning and are home by nightfall, and benefit from a more comfortable and rapid recuperation process in the familiarity of their own homes.

  • Designed for efficiency: The small facility set-up with the wards next to the theatre complex, eliminate the long passage walks of patients to the theatre complex. Waiting time is limited as no emergency cases are performed in-between booked cases. Theatre teams remain consistent as they are not subject to shifts per day or emergencies, which from a doctor’s perspective, contribute to theatre-staff uniformity and greater productivity.

    Day hospitals are designed with efficiency in mind, featuring compact facilities catering to a wide range of procedures. Surgeons benefit from a focused environment, enabling them to perform more procedures in less time, ultimately reducing costs for both the facility and the patient.

  • Technological advancements ensure quality outcomes: Rapid advances in surgery and anaesthetic technologies contribute to high-quality outcomes for patients undergoing procedures in day hospitals. State-of-the-art technology ensures that quality and safety are never compromised.
  • Wide range of procedures: The versatility of services makes day hospitals a comprehensive option for various medical needs. They offer a broad spectrum of surgeries, including plastic surgery, ophthalmic, dermatological, ENT, general surgery, gynaecological, maxillofacial and dentistry, orthopaedic and urology procedures, all performed in a sterile environment on a same-day-in-and-out basis.
  • Convenience and accessibility: The family-type atmosphere at most day hospital facilities creates a positive environment for both surgeons and patients. Globally, day hospitals offer an option for safe, convenient care in cost-effective settings for a growing number of relevant procedures.
  • "Medical cost drivers push up medical-aid tariffs. Doctors charge more, hospitals charge more, and medical aid premiums increase every year. Yet we seldom stop to think where these increases come from and how they can be prevented or managed.”

    “Just as people shop around for value, whether it is for everyday household items or big-ticket items such as cars, so should consumers start actively looking for the best value when it comes to short-procedure surgery. Day hospitals offer cost-effective surgeries while maintaining the highest quality and safety standards. Anyone eligible for day surgery should strongly request this option as the smart alternative in hospitalisation,” concludes Goss-Ross.

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