What is fair to expect from private hospitals, and what are the costs for which hospitals must be paid by the government? We analyze this question along the following cost heads:
| Type of cost | Who should bear expense | Rationale |
| RoI / Loan payments on medical equipment | Hospital | Banks to defer EMIs |
| Doctor and nurse salaries | Gov / Insurer | Staff needed for COVID19 care |
| Personal protective equipment and masks | Gov / Insurer | Additional cost needed to provide COVID19 care |
| Diagnostic tests | Gov / Insurer | Additional cost needed to provide COVID19 care |
| Drugs / medicines used for treatment | Gov / Insurer | Additional cost needed to provide COVID19 care |
| Amortized / rental costs for land & buildings | Hospital | Banks to defer EMIs |
| Electricity costs | Gov / Insurer | Additional cost needed to provide COVID19 care |
| Patient personal needs (food, soap, etc.) | Gov / Insurer | Additional cost needed to provide COVID19 care |
| Cleaning and housekeeping | Gov / Insurer | Additional cost needed to provide COVID19 care |
In the following sections, we outline the reasonable costs of COVID19 care. These are costs that would be borne by government institutions too. Therefore, it is only reasonable that these costs be paid to private hospitals.
Crafting this cost sharing mechanism together with private hospitals would not only help the government manage costs well, it would also leverage the current organizational hierarchies and systems to deliver care speedily and efficiently.
1. Daily cost breakup of providing COVID19 ICU facilities (INR)
2. Daily cost breakup of providing COVID19 ICU facilities equipped with Ventilators (INR)
*Drugs and medicines only include anti retroviral drugs and chloroquine. Additional drugs and medicines needed to treat other conditions may be needed
**Testing costs include only COVID19 test. Other tests may be needed particularly in ICUs, depending on the condition of the patient. Examples, x-rays, ultrasounds etc.
3. Daily cost breakup of providing COVID19 Isolation ward (INR)
4. Daily cost breakup of providing COVID19 quarantine facilities (INR)
*Drugs and medicines only include anti retroviral drugs and chloroquine. Additional drugs and medicines needed to treat other conditions may be needed
**Testing costs include only COVID19 test. Other tests may be needed particularly in ICUs, depending on the condition of the patient. Examples, x-rays, ultrasounds etc.
Key Assumptions
- Assumptions for testing costs
- No. of tests for ICU, ICU with Ventilators, Isolation ward: 1 test every 2 days
- No. of tests for quarantine: 2 tests over a 15 day period
- Cost of test: Rs. 4,500 / test.
- Assumptions for medicine costs
- Chloroquine: 3 tablets / day, @ Rs. 8 per tablet
- Anti retroviral drugs: 1 bottle @ Rs. 1500 per bottle
- Cost of mask: Rs. 300 per unit
- Cost of PPE: Rs. 1,500 per unit
- Cost of nurses, doctors, specialists standardized for Tier 1, 2, 3 cities
- Nurses per bed per shift
- ICU: 1
- ICU w ventilator: 1
- Isolation: 0.33
- Quarantine: 0.2
- Doctors per bed per shift: 0.3
- Resident doctors: 0.25 per bed per shift
- Senior / specialist doctors: 0.05 per bed per shift