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Hospital management must improve for better service delivery

Staff Correspondent
INEFFICIENT management has taken health care far beyond the reach of poor people despite the fact that infrastructure for delivering health service is better in Bangladesh than many others countries in Europe, Africa and Asia, speakers said at a colloquium yesterday.
The problem which can be solved only through strong government policy is forcing people to move to big countries or cities for better treatment, making healthcare more expensive everyday, they observed.
"Due to lack of management the system is not functioning and the infrastructures are getting destroyed beyond anyone's notice," said Rubaiul Morshed, as he presented keynote speech in one of the three technical sessions held on the concluding day of the two-day Leadership Colloquium on ICT in Healthcare at The Daily Star Centre.
The management system cannot be improved unless there are adequate information and data on patients at the hospital, said Morshed. He observed that the current system of storing data and information in hospitals is outdated and needs to be developed immediately.
"Managing hospital can be defined as an optimal blend of techniques learned through experience and theoretical studies," said Rubaiul Morshed, a health management specialist.
But another problem arises with the rising number of hospitals in private sector, where anyone is allowed to introduce hospital business no matter he or she has any idea or previous experience about health care or not, leading to a rapid fall in the treatment quality.
"As a result many have lost their confidence in allied healthcare, involving the service of nurse and technologists," said Morshed in the session titled "Hospital management system: Possibilities and Challenges."
Morshed's keynote paper studied why people go abroad for treatment, its advantages and disadvantages.
According to his estimate, several lakhs of people go abroad for treatment every year, 98 percent of them to India, Thailand and Singapore. Only 2 percent of them visit hospitals in Europe and America depending on their affordability.
And inside Bangladesh, 7,000 people move to bigger cities everyday for better treatment though there have been infrastructure in their areas for providing healthcare.
For each of those going abroad the cost of treatment, on an average, stands Tk 1,45,000, excluding surgery and medicine cost, data presented at the session
showed. Though total money spent in getting treatment from abroad has never been accounted newspapers have estimated the cost of documented cases as ranging between US$ 145 million and US$ 350 million a year.
"This is just one forth of the picture (people going abroad for treatment) as most people go abroad for treatment on tourist visa and all of them are not documented accordingly," said Morshed mentioning that 81 percent go abroad through tourist visa.
The study has also revealed that 65 percent of the patients going abroad think doctors in the country had not been friendly to them.
But interestingly it is the local doctors who influence more than half of the patients over going abroad for treatment as agents of foreign hospitals. Only 17 percent of patients visit hospitals abroad on their own decision.
Only 35 percent of them consider the point of higher technological facilities before going abroad for treatment.
"We have latest machinery and the best medical equipment in many of our private hospitals. What is questionable is the man operating the machine from behind," said Morshed.
The statement can be substantiated by the experience of those went abroad for treatment. The experience is that in 90 percent cases foreign hospitals did not accept medical investigation done in Bangladesh and in 73 percent cases medical opinion from Bangladesh was not accepted by the foreign hospitals.
Dr Alain B. Labrique from USA discussed several points after Morshed completed his presentation.
"Breakdown of trust and confidence has occurred over the last 30 years in medical sector in the country. Hospitals have failed to deliver. It is about rebuilding the trust and confidence and we have to close the gap," said Labrique.
Labrique suggested for building a hospital management system based on data and information and fixing a goal and vision where the country want to see itself in the upcoming years.
Citing outbreak of diseases like diabetes and cancer Labrique said that healthcare facilities in the rural areas are not prepared at all to face tsunami of these two chronic diseases.
He also emphasized on communication and sharing of knowledge across border and nation, and on online distance learning to develop medical education to provide the best healthcare.
"There are solutions based on ICT and solutions not based on ICT. It is our decision which way we want to go," said Labrique.
"E-health can have negative impact on people if it is used poorly without having any research into the necessity of our society. At first we need to identify and define our problem," he added.
With regards to use of ICT in healthcare Morshed said, "We are still in infancy in terms of using ICT in healthcare. Several hospitals introduced it but they had to cancel it midway following demands from the patient."
He, however, saw the scope of great prospect for medical business in the country and said, "Dhaka can be wonderful destination for medical tourism. And it can be done by 2015 if the decision is taken now."
Concluding the session Dr Ishtiaq Mannan, who chaired the session, said, "We can extend our opportunities by using ICT in healthcare. We can use it in a very creative and innovative way."