Private diagnostic centres and clinics set charges for pathological tests at their whim as the government has no control over the matter.
Against the backdrop, diagnostic centres and clinics in the capital charge varying prices, even by a degree of six times in some cases, for similar medical tests, reports NewAge.
The patients, however, have a little scope to choose the laboratories for the tests as in most of the cases physicians refer them to particular diagnostic centres or clinics.
Former Bangladesh Medical Association president Rashid-e-Mahbub said, ‘The government has no control over the fees for pathological tests set by different diagnostic centres. As a result, they charge according to their will.’
In 1982, the government had set the rate of pathological tests which has not been updated yet, he said, adding that no initiatives was taken by the health ministry or the directorate general of health services to update and fix the charges.
Rashid-e-Mahbub said the main reason that the diagnostic centres show over price variation is cost of reagents. ‘The diagnostic centres claim that they import and use better quality reagents and so their charges are higher,’ he said.
He said the government should fix a standard of reagents and its price to make pathological tests affordable to all patients.
The producers of the drugs have to register maximum retail price for their products with the drug administration, but the owners of the diagnostic centres are not accountable to any regulator who would fix the rates for pathological tests, he said.
Shasthya Andolon co-convener Farida Akhter alleged that the doctors were prescribing the patients on the basis of laboratory diagnosis instead of clinical diagnosis. ‘It is a syndicate of physicians and the owners of the diagnostic centres,’ she complained.
‘We are shouting for fixing a standard cost for medical services in the health policy, but still there is no indication for ensuring that,’ Farida said.
On the other hand, the government is encouraging commission distribution in the name of ‘users fee’ among the doctors of the government sector, she said, adding that it would leave an adverse impact on the total healthcare system.
Allegations have it that that most of the physicians refer the patients to particular diagnostic centres, who provide the physicians with a commission of 40 per cent or more of the total charges for the tests.
A professor in Bangabandhu Sheikh Mujib Medical University told New Age the diagnostic centres set the charges calculating the commissions of the physicians causing such variations in charges.
Health and family welfare secretary Sheikh Altaf Ali on Sunday said the government would form a regulatory body to control the quality of the services at the diagnostic centres. It would also set up a referral pathological laboratory of international standard.
‘Sometimes we observe that same tests conducted by different laboratories show different results. In those cases the referral pathological laboratory will test and that result will be the standard result,’ he said.
The secretary said that the health policy is yet to be finalised. So there remains the scope to insert the issue of fixing charges of diagnostic centres.
The United Hospital charges Tk 205 for urine routine and microscopy examination (urine RME) test, Popular Diagnostic Centre Limited charges Tk 123, Padma Diagnostic Centre Limited Tk 81, Medinova Medical Services Limited Tk 120, Dhaka Community Hospital Tk 61, Ganashastha Nagar Hospital Tk 50 and Aitam Welfare Organisation Tk 30.
Likewise, the United Hospital charges Tk 286 for serum bilirubin test, Padma Diagnostic Centre charges Tk 204, Medinova Medical Services Tk 200, Popular Diagnostic Center Tk 153, Dhaka Community Hospital Tk 123, Ganashastha Nagar Hospital Tk 150 and Aitam Welfare Organisation Tk 80.
It was also found that an ultra-sonogram test of whole abdomen would cost between Tk 460 and Tk 1,534, depending on where patient goes for the test.
United Hospital charges Tk 1,534 for ultra-sonogram of the whole abdomen. For the same test, Padma Diagnostic Centre charges Tk 818, Medinova Medical Services Tk 900, Popular Diagnostic Centre Tk 920, Dhaka Community Hospital Tk 460 and Aitam Welfare Organisation Tk 550.
The variation in charges is also found for all other medical tests such as tests of blood group, stool culture, SGOT and CT scan of brain and head.