Complain, Not Remain Silent: Scheduled or Emergency — Surgical Care is Free

Complain, Not Remain Silent: Scheduled or Emergency — Surgical Care is Free

Photo: unsplash.com / Jonathan Borba
15 June 2024
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VoxCheck, with the support of the USAID Health Reform Support project, continues to explain to patients how the state Medical Guarantees Program works, which medical services are free for Ukrainians under the program, and what to do if your rights are violated during the provision of this medical assistance. This time, we focus on the service package “Surgical Operations for Adults and Children in Inpatient Settings”. We explain what this package includes and how to assert your right to free medical care, regardless of whether the operation is planned or emergency.

Renewed patient rights

Kharkiv region is one of the leaders in the number of complaints submitted to the National Health Service of Ukraine (NHSU), with 38% of them related to demands for payments for services and medications covered by the Medical Guarantees Program. Within the “Surgical Operations for Adults and Children in Inpatient Settings” package, complaints about demands for money are predominant — 76% of the total number. Over five years, 22 such complaints were received, and only five resulted in the restoration of the patient’s rights.

One complaint was recorded at the City Clinical Multidisciplinary Hospital No. 25. A patient complained that during the treatment of chronic cholecystitis and chronic pancreatitis, she had to purchase medications that should have been provided for free. After reviewing the complaint and the NHSU’s claims work with the hospital, the medical institution refunded the woman for the medications.

VoxCheck contacted the hospital for comments on the reasons for the situation and what the hospital did to resolve it.

The examination and treatment of the patient were carried out according to the protocols for providing medical care for cholecystitis and pancreatitis that were available at the hospital. According to these protocols, medications were prescribed that were not included in the National List of Essential Medicines,” explained Acting Director of the medical institution Maksym Suplichenko.

In response to the complaint, the hospital discussed it with the patient and the doctor responsible for her treatment. As a result, the patient was refunded, and the doctor started to review and revise the local protocols.

The City Clinical Multidisciplinary Hospital of the Kharkiv City Council No. 25 has 88 million UAH in its account, and the City Clinical Hospital for Emergency Care has 49 million UAH, and one issues notes for purchasing medicines for 2000 UAH, the other for 5000 UAH. This is beyond any sense. They refunded this money, but I have questions for the managers,” noted the Head of the National Health Service of Ukraine Natalia Husak in an interview with LB.ua on May 29, 2024.

Natalia also mentioned in the same interview that refunding patients is a lengthy process. “Sometimes the time from the complaint to when we restore the patient’s rights is over a year from the start of correspondence with them. Some medical institutions recognize it immediately, while others do not. Sometimes they claim that the medications or examinations needed for a specific patient are not included in the package. We begin to investigate clinically. This correspondence is lengthy.

How to ensure that the service will be provided free of charge?

The “Surgical Operations for Adults and Children in Inpatient Settings” service package is contracted by 33 institutions in the Kharkiv region: 18 of them are in Kharkiv, and others are in towns such as Barvinkove, Blyzniuky, Bohodukhiv, Valky, Derhachi, Krasnohrad, Lozova, and Merefa. Under this package, the right to free services is granted not only to patients referred by a family doctor or treating physician but also to those brought in by emergency medical services, transferred from another medical institution, or those who themselves arrived in an emergency condition.

You can find the necessary medical institution on the NHSU dashboard (“Service Provision Map by Contracts” with details by service groups). Select the region (“Kharkiv”) and the service group (“Surgical Operations for Adults and Children in Inpatient Settings”). The address and contacts of the nearest medical institutions can also be obtained from the contact center operator by calling 16-77.

More about free medical services can be found in the electronic guide “Guide to the Medical Guarantees Program for Patients 2024.” You can download the guide at the following link.

What the Medical Guarantees Program ensures

In addition to performing surgical operations, the “Surgical Operations for Adults and Children in Inpatient Settings” service package also includes the initial examination of the patient, laboratory and instrumental investigations, preparation for surgical intervention, and a range of postoperative services according to the patient’s medical needs. The service list includes:

  • Timely pain relief, anesthetic support, and procedural sedation if necessary at all stages of diagnosis and treatment, with 24/7 access to non-narcotic and narcotic pain medications. Provision of anesthesia and anesthetic monitoring during surgical operations and examinations.
  • Intensive care for patients in life-threatening conditions.
  • Postoperative monitoring and subsequent medication therapy.
  • Provision of medicines supplied through centralized procurement by the Ministry of Health of Ukraine, other central and local budget programs, as well as medicines defined by the National List of Essential Medicines, necessary medical devices, and consumables according to sectoral health standards and medical-technological documents.
  • Round-the-clock medical supervision and nursing care for patients.
  • Consultations with doctors of other specialties and referral of patients to other healthcare facilities/units for specialized and palliative medical care as indicated.
  • Provision of rehabilitation services in the acute rehabilitation period (in the absence of contraindications) in inpatient settings and referral for rehabilitation care in post-acute and long-term rehabilitation periods.

The package also includes preventive measures, inpatient meals, teleconsultation and telediagnosis, remote monitoring observation, and more.

A complaint today — less corruption tomorrow

Every complaint about extortion or other violations in medical institutions is an important step toward creating a transparent and fair healthcare system. When patients speak up, they help identify and eliminate violations in the operation of medical institutions. Moreover, timely responses to violations contribute to forming a system where medical institutions and doctors are accountable for their actions, and patients are confident in their rights.

How to file a complaint to the NHSU if patient rights are violated:

  • Submit a complaint through the online form available on the official NHSU website in the “For Citizens” section.
  • Send a complaint via email to: [email protected].
  • Mail a complaint to the address: 19 Stepana Bandery Avenue, Kyiv, 04073.
  • Call the NHSU Information and Reference Service at 16-77.

This information piece was produced with the assistance of the United States Agency for International Development (USAID), provided on behalf of the people of the United States of America. This article’s content, which does not necessarily reflect the views of USAID, the United States Government, is the sole responsibility of Deloitte Consulting under contract #72012118C00001.

Attention

The authors do not work for, consult to, own shares in or receive funding from any company or organization that would benefit from this article, and have no relevant affiliations