National policy for admission of COVID patients in hospitals revised to be more patient-centric

This patient-centric measure aims to ensure a prompt, effective and comprehensive treatment of patients suffering from COVID-19

In a significant directive to the states and Union Territories (UT)s, the Union Ministry of Health and Family Welfare has revised the national policy for admission of COVID patients to various categories of COVID facilities. This patient-centric measure aims to ensure a prompt, effective and comprehensive treatment of patients suffering from COVID-19.

As per the Union Government directive to all states and UTs, hospitals under the Central Government, state governments and UT administration, including private hospitals (in states and UTs) managing COVID patients shall ensure that a positive test report for COVID-19 virus is not mandatory for admission to a COVID health facility. A suspect case shall be admitted to the suspect ward of Covid Care Centre (CCC), Dedicated COVID Health Centre (DCHC) or Dedicated COVID Hospital (DHC), as the case may be.

In addition, no patient will be refused services on any account. This includes medications such as oxygen or essential drugs even if the patient belongs to a different city and no patient shall be refused admission on the ground that he/she is not able to produce a valid identity card that does not belong to the city where the hospital is located.

Admissions to the hospital must be based on need. It should be ensured that beds are not occupied by persons who do not need hospitalisation. Further, the discharge should be strictly in accordance with the revised discharge policy available at https://www.mohfw.gov.in/pdf/ReviseddischargePolicyforCOVID19.pdf.

The Union Health Ministry has advised the chief secretaries of states and UTs to issue necessary orders and circulars, incorporating the above directions within three days, which shall be enforced till replaced by an appropriate uniform policy.

Commenting on the new guidelines, Dr Ravi Wankhedkar, Chairman, IMA Covid Registry said, “Though late, but much-needed welcome guidelines; will benefit patients who have all the signs of COVID, but a negative test, and also prevent him/her from becoming a super spreader. Moreover, problems of inter-city/inter-state patients will be solved.”

The ministry has earlier enunciated a policy of setting up a three-tier health infrastructure for appropriate management of suspect/confirmed COVID-19 cases. The guidance document issued in this regard on 7th April, 2020 envisages setting up of CCC that shall offer care for mild cases. These have been set up in hostels, hotels, schools, stadiums, lodges etc., both public and private. Functional hospitals like CHCs, etc., which may be handling regular, non-COVID cases, may also be designated as CCCs as a last resort.

DCHC shall offer care for all cases that have been clinically assigned as moderate. These should either be a full hospital or a separate block in a hospital with preferably separate entry/exit/zoning. Private hospitals may also be designated as COVID DCHCs. These hospitals would have beds with assured oxygen support.

DCH shall offer comprehensive care primarily for those who have been clinically assigned as severe. These hospitals should either be a full hospital or a separate block in a hospital with preferably separate entry/exit. Private hospitals may also be designated as DCHs. These hospitals would have fully equipped ICUs, ventilators and beds with assured oxygen support.

The above-mentioned COVID health infrastructure has been aligned with clinical management protocol for admission of mild cases to CCC, moderate cases to DCHC and severe cases to DCH.