Gap between patient care and target outcomes in public hospitals of UP: CAG report

The Comptroller and Auditor General (CAG) of India has detected gaps between the patient care received and the target outcomes in public hospitals at the primary

The Comptroller and Auditor General (CAG) of India has detected gaps between the patient care received and the target outcomes in public hospitals at the primary and secondary care level in the state.

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The CAG report on ‘Performance Audit of Hospital Management in Uttar Pradesh’ -- covering the period 2013-18 --was tabled by the Parliamentary Affairs minister Suresh Khanna in the legislative assembly on Tuesday.

In the report, the CAG had stated that the report was an attempt to assess the quality of medical services and patient care being provided by the district and block level hospitals of the state.

UP, as the most populous state in the country with poor health indicators as compared to the national average, has a significant weight in the unmet needs of public health in the country, mentioned the report.

According to the report, the policy framework for hospital management in the state had a gap that needed to be addressed. “We noted that the department neither prepared its own norms nor did it adopt those prescribed by the central government in respect of the out-patient and in-patient services, pathology, investigation and human resources. The methodical gap analysis cannot be carried out. This impacted the availability of resources and services in the hospitals,” the CAG said.

The revised drug procurement 2012 and revised equipment procurement policy 2012 also had significant gaps.

The report also highlighted that the patient load in the out-patient department in the test checked hospitals and CHC was spiked by one third during 2013-18. The patients had less than five minutes consultation time, signifying inadequate diagnosis, investigation and treatment in OPD.

The CAG detected that diagnostic services -- both radiological and pathological -- were deficient in terms of availability of functional equipment, consumables and human resources in the test checked hospitals. There were also serious gaps in the availability of essential pathological investigation in almost all the hospitals.

There were considerable gaps in the availability of in-patient services with more than half of the district hospitals lacking burn wards, trauma wards and facilities for dialysis, physiotherapy and psychiatry, observed the report.

The CAG also found significant deficiencies in the three major components of maternity services, including antenatal care, intra-partum care / delivery care and postnatal care. The infection control practices were not sufficiently embedded in the functioning of a large number of hospitals, stated the report.

Block and district hospitals of 19 districts of the state were test checked for preparing this report.