PESHAWAR: Unnecessary referral of patients from district headquarters hospitals by doctors to provincial capital has been creating shortage of beds at intensive care units at medical teaching institutions (MTIs) in Peshawar.
“Finding a bed for critically ill or injured patient at MTIs is a big issue created by unnecessary referral of patients from district headquarters hospitals. We need to streamline referral system to be able to admit patients requiring intensive care,” director at one of the MTIs in Peshawar told Dawn.
He said that there were 40 beds for serious patients at Khyber Teaching Hospital (KTH) but all of them remained occupied all the time. Those included 10-bed surgical ICU, 12 medical, 10 paeds and eight neonatal but given the number of patients, those beds were not enough, he said.
Lady Reading Hospital (LRH), the largest health facility of the province, has a total of 34 ICU beds but no space is available for critical patient in emergency. In addition, the 2,000-bed hospital has also 10-bed high dependency unit and six other specialised dedicated beds for patients requiring emergency care. It means that there are a total of 50-beds, which can be utilised for serious patients if government puts in place a proper referral system.
Experts say ICUs at district hospitals should be strengthened to treat critically ill people
The 1,250-bed Hayatabad Medical Complex (HMC) has 35 beds in medical, surgical, cardiac surgery and paeds ICUs and cardiac care unit. Intensive care specialists say that given the number of total beds, HMC should have more than 100 ICU beds and same is true for LRH and KTH.
“Even these beds are enough for patients but the situation has been worsened by people being referred from all over the province. There are other MTIs too which have got well-equipped and well-staffed ICUs but patients are still being sent to Peshawar,” he said.
This situation is benefitting private hospitals in Peshawar where people are charged heavily as opposed to free services in MTIs.
Medical director at one of the MTIs told this scribe that patients also developed a feeling that private hospitals were better than public ones and they took their serious patients there. “However, they contact MTIs to shift their patients when they run out of money after a couple of days. They don’t succeed in finding space in MTIs and continue to pay to private hospitals,” he said.
According to him, MTIs also shift serious patients from different wards and operation theatres to ICUs in addition to receiving patients from other districts due to which the issue of availability of beds cannot be resolved.
“The government should strengthen ICUs at district hospitals and allow referral of patients only when they require tertiary care services in emergency,” he said.
Afghan patients are the worst sufferers, who can’t be accommodated in MTIs and directly go to private hospitals. They pay Rs100,000 or more per day to private hospitals. “The government has slashed the entry of Afghan patients and now only 12 patients with serious diseases are allowed at the border to enter Pakistan but mostly they land in private hospitals,” he said.
Health officials said that the province had 2,550 hospitals, which included 10 MTIs and about 28 district headquarters hospitals but patients preferred to visit Peshawar-based hospitals. There is a standard practice worldwide that patients are referred to tertiary care hospitals and physicians write their history with evidence that they don’t have facilities, but in Khyber Pakhtunkhwa patients directly visit MTIs that overburden all services including ICUs.
“People also bring their patients directly to Peshawar from far-off areas such as Buner and Swat even without referral by doctors,” said the director of MTI.
Published in Dawn, July 22nd, 2024
