Late referrals of the critically ill put govt. hospitals in a fix

Late referrals of the critically ill put govt. hospitals in a fix

This also causes mental agony to families of the victims

10/06/2021

A majority of such patients are brought in ambulances in the evening. B. Jothi RamalingamJOTHI RAMALINGAM B

Serena Josephine M. CHENNAI

A critically-ill patient diagnosed with COVID-19, who was undergoing treatment at a private hospital, was shifted to a government hospital at about 11 p.m. He died three hours later. Similarly, an octogenarian, referred from a private facility to a government hospital, was declared dead on arrival.

Such incidents have become common in Chennai’s government hospitals. Last-minute referrals of critically-ill COVID-19 patients from private hospitals are not only putting government hospitals in a fix but are also causing mental agony to families of the victims, say senior doctors.

Every day, the major government hospitals in Chennai receive a number of critically-ill COVID-19 patients, even in intubated states, from private hospitals. Most of them are late referrals.

“A majority of such patients are flown in ambulances late in the evening. Most emergency calls that we get after 7 p.m. or 8 p.m. are of such patients. We receive at least 10-15 such cases a day. Almost all of them are last-minute referrals and about 90% of them die in six to eight hours or a maximum of a day. They are shifted in very critical conditions, including in intubated states. They are shifted to government hospitals after seven to eight days of treatment in private facilities,” a doctor at the Rajiv Gandhi Government General Hospital said on the condition of anonymity.

Recently, the hospital received eight very critically-ill patients, all late referrals, from private hospitals on a single day, he noted.

A doctor at the Government Stanley Medical College Hospital said they received a patient who was referred from a private hospital. He died five minutes after arrival. When the hospital added about 50 beds to its ICU during the peak, 40 of them were occupied by the evening as there were many such referrals, he said.

While the deaths of patients referred in the eleventh hour are accounted for by the respective government hospitals, doctors say it causes a lot of distress to families of the deceased.

“From top hospitals to nursing homes, many institutions resort to last-minute referrals. Private hospitals should avoid such referrals of critically-ill patients to at least save the families from mental agony. The families are traumatised and such practices can be avoided in the best interest of the patients,” he said.

A Health Department official said, “Patients should be referred with complete treatment history, at a mutually convenient time. Private hospitals should also make sure that the patient’s condition will not worsen during the transit.”