Immediately after surgery or a major medical incident such as a heart attack or stroke, hospital care is often needed. But, as soon as is possible, patients are sent home, largely due to costs.
Charges can be really high – especially if you needed intensive care. This comes in at about R13 000 to R15 000 per day. But, even an extended stay in a general ward can amount to a large sum of money.
“Depending on the medical aid plan you have in place, your medical aid will cover the bulk of these costs. But they will stop paying once the doctor’s report shows that you no longer need such high levels of care,” explains Elize Porter, Managing Director of Unique Health, an organisation that offers a range of services in the health care industry.
But without being able to care for themselves yet, where do patients go for assistance until they have fully recovered?
The one option is for the patient’s family to take care of them at home or they have to find an alternative way of providing care. Staying with family is often very comforting for the patient, but it may be impractical and could place the family under a lot of pressure. If the patient’s family members work, they may have to take leave, and the home may need to be fitted with specialist care equipment like grab bars and specialised bath seats.
“Another option to consider is a step-down facility. This may be the best solution in many cases,” explains Arthur Case, CEO of the Evergreen Group, which specialises in developing lifestyle village accommodation for retirees. “These facilities provide nursing services for people whose condition requires a lower level of care than a is offered in hospitals. It could be a stand-alone care centre, linked to a hospital, or within a retirement home, such as the one at the new Evergreen Lifestyle Care Centre in Muizenberg, in Cape Town.”
It’s got the support of Porter, who highlights the cost factor with this type of facility, explaining, “While hospital care, at the most basic level, starts at a cost of about R2 500 per day, the costs at a step-down care facility are a lot less – in the region of about R1 000 or less per day. Often, a patient’s medical aid will cover them for a stipulated number of days in a step-down facility because the costs are so much lower than full hospital care.
“During the patient’s stay in a step-down facility, they will receive care by medical practitioners as they require for their particular condition. But once the particular goal for the care is achieved, the medical aid will withdraw the funding, having met its obligation in terms of providing medical care to its client.”
“Because step-down facilities are much more affordable, some patients choose to extend their stay beyond what their medical aids cover and pay for the additional days themselves,” explains Case.
It is also important to distinguish between medical care offered in a step-down facility, and frail care.
According to Porter, “Medical aids will cover medical care but they are not likely to cover frail care costs. Sometimes a patient is given medical care after a health incident, but when it becomes clear that the personl’s health has deteriorated permanently as a result of the health incident, and that the person will no longer be able to look after themselves, then they require the services of a frail care or assisted living. Medical aids don’t cover these costs.”