A number of factors, while taking necessary medical measures to a patient who arrived at the hospital''s emergency department, may lead to serious complications or even death, including the skill and experience of the emergency doctor, the policies of private hospitals, as well as the delay of insurance companies in approving some medical procedures and examinations, According to a number of specialists who spoke to the newspaper.
Insurance approval
A former member of the Shura Council, Dr. Muhammad al-Qunbait, told “Makkah” that he had seen the case of a patient who arrived at the emergency department in a private hospital, suffering from severe abdominal pain, and the doctor did not decide on a CT scan for him until three hours after his arrival. The procedure was for another number of hours, and he underwent surgery later after it became clear that he suffers from a blockage in the intestine, and after a long delay, it could seriously threaten his life.
He added that with regard to the reasons for the insurance companies delay in granting the patient approval for necessary medical procedures, this is bureaucratic on the part of the company and is not justified, and it may be procrastination on the part of the insurance company to avoid payment if the doctor’s consideration of the medical procedure is dismissed.
Al-Qunabit stated that the Health Insurance Council must be held fully responsible for the occurrence of these cases, some of which may lead to the death of the patient. Consequently, the Council shall have an obligation to constantly monitor private hospitals and conduct questionnaires with patients to ensure that regulations are applied and that they are not exposed to such cases in private hospital emergencies.
Medical Insurance
For his part, a spokesperson for insurance companies, Adel Al-Issa, said, in emergency cases, processing of the beneficiary begins, and then the approval request procedures begin, where the approval must be answered by the insurance company to the service provider''s request to start treatment within 60 minutes from the time the request is received.
In the same context, consultant emergency medicine Dr. Samir Al-Hamed emphasized that the principle in the directives of the Ministry of Health is to speed up dealing with emergency cases without waiting for approval from any party, but the problem that occurs or the delay in taking the appropriate action occurs in private hospitals in ambiguous or not emergency cases. Very clear, compared, for example, to emergency cases resulting from traffic accidents or the like. Here, taking the appropriate medical action that saves the patient from death or complications depends on a number of factors.
6 factors delay patient rescue
1- The emergency doctor’s decision and his exclusion for a specific diagnosis through conducting the appropriate examinations
2- The private hospital’s policy in dealing with ambiguous emergency cases
3- Delay or procrastination by some insurance companies in approving medical procedures, especially if the patient''s medical insurance category is (B)
4- The lack of medical insurance for the Saudi patient
5- The Ministry of Health is late in paying the dues for private hospitals that treat Saudis who have been approved for treatment in the private hospital at its expense
6- The skill, experience and efficiency of the emergency doctor in quickly and correctly diagnosing the condition
