The Community of Madrid chaired by Isabel Díaz Ayuso has re-launched the "single health command" so that all the resources of the public and private hospitals in the region function as a single network under the orders of the Ministry in view of the increase in income that They have Madrid health care on the verge of collapse.
It is a mechanism similar to that used by the regional government during the first wave. The main difference is that now there is an order, to which elDiario.es has had access, signed by the counselor Enrique Ruiz Escudero that establishes which private centers will be made available to the administration and sets the rates they will receive for each patient based on if you are admitted to the ward or to an intensive care unit (ICU). The Community of Madrid will pay for each patient who is treated for coronavirus 734 euros per day for those who enter the ward and 2,084 per day for those who do so in the ICU.
The order, which affects 40 private centers, was signed this same January 27. The measure had been announced on Friday by the Minister of Health and has materialized this Wednesday with the signing of the document by the Minister of Health in which he shields himself from the epidemiological evolution in the Community of Madrid that has caused "a significant increase of positive cases and of the accumulated incidence rate of SARS-CoV-2 with a high and continuous increase in hospitalizations of patients in the different hospital centers of the public health system, both in the ward and in the ICU ".
The Madrid administration determines "the need to reinforce the national health system within the Community of Madrid for public health reasons", to ensure "adequate health care for the population", the letter states. The Ministry also recalls the "urgency" to implement this system in order to care for those patients, both with COVID pathology and others, who, due to strict clinical criteria, are referred from the health centers of the public network to the private companies and thus curb healthcare pressure.
The Community of Madrid already has 5,009 patients with coronavirus admitted to Madrid hospitals and 703 in ICUs. Only in the last 24 hours 589 people have entered, according to the data provided this Wednesday by the Ministry of Health. Critical units are already at 129% of their capacity before the Covid and something similar happens in the plants and in the emergency room.
Rates for Covid and Non-Covid patients
The letter in the power of this wording specifies that hospitals and private clinics must establish whether they are patients with a main diagnosis of COVID-19 or another pathology, and will also indicate the number of days of hospital stay of each of them, distinguishing between days of admission to the ward and days of admission to the ICU. The regional government considers that since it is an "expropriation" given "the urgency of the situation" they establish criteria to determine their assessment based on whether they are patients with Covid or are patients who are treated for other pathologies.
For patients who are treated for coronavirus, the Ministry of Health has set fees of 734 euros per patient and day for those who are admitted to the ward and 2,084 euros per day for the most serious patients who require an intensive care unit.
In the case of patients who are referred to private health and who are treated for other pathologies, the regional government has established that it will take into account the public prices set by Order 727/2017 of the Ministry of Health and will add an increase on the cost [de esta larga lista de precios] 7.35%.
In the same order, it is specified that these evaluations take as a reference "the average cost of stay in the ward or ICU of a patient with a main COVID-19 diagnosis, as well as the assessment of costs for a patient with a non-COVID-19 main diagnosis" . The Ministry assures in writing that said assessment "has been previously determined by an independent expert as a result of making it available to the private health centers of the Community of Madrid during the months of March to June 2020."
Prices can be compared to those the Generalitat de Catalunya paid during the first wave of the pandemic. Then, the Catalan Government entered 43,400 euros for each patient who had been in the ICU and had been discharged (a coronavirus patient is usually hospitalized an average of two weeks), in addition to 5,000 euros for each patient who had not gone through the ICU and he would have been admitted for more than 72 hours or he would have died and 2,500 for each patient who had stayed in the center for less than three days.
The Community of Madrid is not the only one that has resorted to private health in the face of the collapse of its hospitals. Other regions are also referring patients to the private sector during this third wave, such as Andalusia, Extremadura, Navarra, Castilla y León and the Valencian Community.
The duration of the implementation of this order comes into force this Wednesday and will run until February 28, 2021 and can be extended, "if necessary, while the end of the health crisis situation is not declared." Clinics have the possibility of submitting an appeal for reconsideration to the Health Minister within a month.