Fri, September 24, 2021

in-focus

More clinics join forces with NHSO to expand COVID care for patients at home, in communities


Before joining the National Health Security Office’s (NHSO) Home Isolation and Community Isolation system on July 12, Ramintra Health Sanaclinic in Bangkok’s Khan Na Yao district was already reaching out to Covid-19 patients who lacked access to proper healthcare.

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The clinic has been volunteering with a group of healthcare workers running a Facebook page called Rao Tong Rot (We Will Survive). The group consists of medical doctors, nurses and other healthcare workers doing whatever they can to help Covid-19 patients who are unable to access healthcare.

And when the clinic – which was already a member of NHSO’s primary care network in Bangkok – was asked to become part of NHSO’s Home Isolation and Community Isolation system, it didn’t hesitate to say yes.

Initially, the clinic is capable of caring for only 16 patients at a time, but it expects to quickly expand its capacity until it can handle up to 100 COVID-19 patients in Home or Community Isolation, said Nunthasak Sookhkaew, a dentist who runs the clinic.

“We’re glad to be joining hands with the NHSO to take care of COVID-19 patients at home, which is a very good policy to cope with the outbreak situation,” he said. “I think all other healthcare providers should join this effort to help those affected.”

More clinics join forces with NHSO to expand COVID care for patients at home, in communities

As well as providing patients with a thermometer, fingertip pulse oximeter, medications and three meals a day, the clinic also gives them a follow-up video call twice a day, said Dr Piyapong Suvansanya, medical director of Ramintra Health Sahaclinic.

The regular video calls not only check the patients’ condition but also assure them they are being looked after in a proper healthcare system, he said, adding that the caller can also provide appropriate advice after checking the actual health situation of these patients.

If their symptoms worsen, for example with a lung infection even while on NHSO-supplied favipiravir, the clinic will immediately contact Nopparat Rajathanee Hospital and arrange the transfer of the patients to the private hospital for treatment, he said.

The 1,000-baht budget for three meals per patient per day is sufficient and the clinic has no trouble delivering them as this is also part of its voluntary work, said Nunthasak.

As for the 1,100 baht reimbursement for providing each patient with a thermometer and fingertip pulse oximeter, the clinic actually pays more than the given rate, he said.

But this is not a problem because the clinic is willing to help support the NHSO’s effort to aid COVID-19 patients.

The NHSO’s supplying of favipiravir, in particular, helps the clinic cope better with patients who go into COVID-19 isolation at home with mild symptoms but later develop moderate symptoms, he said.

“Since July 12, we’re very happy to have become a part of the NHSO’s Home Isolation and Community Isolation system that helps improve public access to necessary healthcare,” he said.

The provision of COVID-19 antigen test kits has also been very helpful when it comes to active case finding, he said.

The rapid test kits are used for screening people to see who actually needs to undergo an RT-PCR test to confirm if they are infected with the virus, he said.

The NHSO along with Department of Medical Services has developed a guideline for properly reimbursing primary care providers for services offered to COVID-19 patients while they wait at home or in the community for their turn to be admitted to a hospital or field hospital for treatment, said Dr Athaporn Limpanyalers, deputy secretary-general of the NHSO.

“The NHSO would like to thank Ramintra Health Sahaclinic and all other clinics that are taking part in this at-home COVID-19 care system. We do need cooperation from all sides to reach out to all infected patients during this crisis,” he said.

Dr Pattarapan Sakda, the owner of another medical clinic taking part in the COVID-19 care system, said his clinic joined Home and Community Isolation programme on July 19 and is taking care of about 160 patients.

Every day about 20 new COVID-19 patients contact the clinic and request to receive care under the Home Isolation programme, said the doctor.

The Home and Community Isolation system was designed by the Department of Medical Services as a mechanism to turn houses and communities into virtual hospitals equipped with necessary medical devices, medications, food and doctors, said Dr Jadej Thammatacharee, secretary-general of the NHSO.

Several factors are normally considered when deciding which homes or communities are suitable for this COVID-19 care system, he said.

First, only an infected person with no or mild symptoms should receive care at home.

Second, the condition of the patient’s home should also be suitable for COVID-19 isolation. It should have a separate bedroom for each infected person. A residence where two or three infected people sleep in the same room is not suitable for home isolation.

Third, the COVID-19 patient’s understanding and cooperation are also key factors when assessing if he or she should be included in the Home Isolation and Community Isolation programme.

And the other important factor is the relevant hospital’s readiness to arrange a proper healthcare setting, in which a medical doctor is available to make regular video calls to home isolation patients, who are also supplied with thermometers, fingertip pulse oximeters, and three meals a day.

“Because the COVID-19 situation changes constantly and fast, we have to work faster,” said Dr Jadej.

Published : August 13, 2021

By : The Nation