Wednesday, January 19

€ 12,414 per patient and two weeks in ICU: X-ray of COVID shunts in Madrid during the first wave

Over 99 days, the public health system of the Community of Madrid had to use the private network to take on the COVID infections that reached public hospitals during the first wave of the pandemic. After the outbreak of the virus and the approval of the state of alarm, on March 14, 2020, the autonomous government resorted to the ‘single health command’ due to the collapse of the public network. For the assistance to patients infected with coronavirus in that period, the regional Executive has paid 25.5 million euros. The bill amounts to 35 million with patients referred for other pathologies.

Madrid was the community in which the most deaths from Covid were left out of the official statistics

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During the months in which the first state of alarm was in force, 1,950 infected patients passed through the beds of private hospitals, referred by the Ministry of Health, 108 of them were admitted to the ICU. The documentation provided by the regional transparency portal to this wording allows to delve into the operation of these transfers, covered by Order SND / 232/2020 of the Ministry of Health, and for which 34 private network centers were enabled.

The average stay in these facilities was 12 days in the ward and 15 in the ICU. Taking these data into account, the average cost per patient infected with Covid and derived between the months of March and June amounted to 12,414 euros. The Hospital Doce de Octubre and the Infanta Sofía were the centers that referred the largest number of these infected. For their part, HM Montepríncipe and HM Puerta del Sur, those who received the greatest influx of admitted with this profile.

Group HM received the highest volume of referrals

The group that owns these two centers, HM Hospitals, assumed the largest volume of infected patients, its facilities hosted around 30% of referrals of COVID patients that were made in the first wave. These transfers were in effect until June 21, 2020, when the derivations of the first wave ended. The Community used this mechanism again after the rebound in the health emergency that occurred after the Christmas celebrations, between January and May 2021.

Origin and destination of referrals to the private company

Hospital of origin and destination of referrals of Covid-19 cases in the first wave of Covid-19 in the Community of Madrid

Source: Community of Madrid

Taking into account a report from the consulting firm KPMG, made at the request of the Association of Private Hospitalization Centers and Companies of Madrid, the Community of Madrid estimated the daily cost of the stay in the ward at 875.59 euros and at 2.486.22 euros that of ICU care. The total breakdown of the bill paid by the Community for the referrals of COVID patients in the first wave has been divided into 20 million paid for the plant admissions; 3.9 million, for the ICU stay and 1.5 million, for adaptation expenses. This last concept has been used to meet the disbursements made by companies to enable their facilities during the first weeks of the health emergency.

After the service provided, the companies had to draw up an application to receive the relevant compensation from the Community. Some centers did not limit themselves only to exposing how many patients they cared for, they also recorded other costs that they had to bear. In the case of the Hestia Madrid hospital, its manager alleged in that economic repair that the center had to “remain fully open and with its means at full disposal during the toughest phase of the pandemic, despite the lower volume of referrals in the field. of the concerts “.

Returning to the data of the first wave, the residence time is varied. Those hospitals that are specialized in medium stays, such as Hestia Madrid and Fundación Instituto San José, welcomed patients who were admitted for an average of 35 days. The first, which belongs to the Hestia Alliance group, is also the center that has received the highest compensation for the care provided during the first wave of the pandemic: 3.9 million euros for treating 144 patients. One patient, from Hospital La Paz, was admitted for 217 days: he entered on March 20 and was discharged on October 23. Another, after 257 days, was still hospitalized at the time the documentation was sent to the Ministry of Health. Of the 144 patients who were referred, 25 died at the center.

The information provided by Hestia to the Community of Madrid, and accessed by through the transparency portal, helps to understand how the referrals worked in this 341-seat center during the worst weeks of the health emergency. The patients who arrived at their beds came from seven different public hospitals and from a center for the elderly, the Amavir de Colmenar Viejo concerted residence. Despite the fact that the protocol that hindered referrals was already in place –Infolibre published that those instructions that the regional government tried to hide were digitally signed on March 18 and 20– Hestia received ten residents between March 24 and 25: three of them died, six were voluntarily discharged and one of them was transferred to La Paz.

Assistance to residences was billed

The Muprespa Fraternity mutual has also billed the services provided in three dependent residences of the Community of Madrid, a nurse and two nursing assistants were working in nursing homes between April 15 and May 18, 2020 full time. For this work, the company claimed “5,514.38 euros for the costs of health personnel displaced to outside centers in compliance with the instructions” of the Ministry of Health, according to the invoice issued by the mutual. In addition, the hospital they have in the capital treated 21 patients, with an average stay of ten days.

Along with Hestia Madrid, the Fundación Instituto San José has also registered an average stay of more than 30 days. This data does not attract attention if one takes into account that the stay of those hospitalized in 2020 was 47.43 days, according to the report published by the institution. Sources from the center explain that in their facilities those admitted tend to have a “very long stay profile” because they require “functional or neurological rehabilitation.”

Therefore, regarding the profile of patients during the first wave of the pandemic, these same sources highlight that they suffered from “a mild COVID-19”, since they do not have an ICU to care for more serious hospitalized patients. In these cases, if the pathologies are complicated, those hospitalized are usually referred to acute hospitals. 14 patients derived from the public health system passed through this Foundation and the Community of Madrid has paid 452,680 euros for the assistance provided. Both in Hestia and in the Fundación Instituto San José, the average amount paid per patient is one of the highest, above 30,000 euros.

Five hospitals exceeded one hundred patients referred by the Community of Madrid: HM Montepríncipe (170), HM Puerta del Sur (162), Hestia Madrid (114), HM Madrid (106) and Hospital Fuensanta (100). In the three hospitals of the HM group, the average cost per stay has ranged between 7,600 and 8,600 euros. For its part, in Fuensanta the Government has disbursed 12,626 euros on average for each of the patients treated. The choice of referrals was made “by clinical criteria and given the reorganization of care that occurred in all the centers” of the Madrid Health Service (SERMAS), sources from the Ministry state.

The HM group received the highest number of Covid referrals that were made between March and June 2020, 625 of the 1,834 patients who were transferred were treated at one of its centers. Although the origin is very varied, around a third (202) came from the Doce de Octubre hospital and more than a sixth (113) from the Infanta Sofía.

In most cases, private groups receive patients from many hospitals, the distribution is widely distributed. However, there is an exception: the licensed hospitals of Quirón – Fundación Jiménez Díaz, Rey Juan Carlos and Infanta Elena – referred most of their patients to private hospitals of the same group. Neither the Ministry of Health nor the private company have clarified to the operation of these transfers.

The bill for assistance to COVID patients during the first wave of the pandemic amounts to 25.5 million euros, although the amount can be increased since the Ministry still has three requests to process.

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