Vol. 490 No. 4
10 Mr. J. O'Keeffe asked the Minister for Health and Children his views on whether it is ridiculous to have hospital beds unnecessarily occupied by VHI insured patients who need to undergo certain tests and who are unable to obtain reimbursement of cost unless they stay overnight; and if he will have discussions with the VHI to put in place a more sensible and cost effective arrangement. [10181/98]
I understand the Deputy to be referring to situations where procedures rendered on an outpatient basis are subject to an annual excess amount and may not therefore qualify for full reimbursement, as against inpatient procedures in respect of which excess amounts are not applied.
The VHI has informed me that it is not correct to say that members have to unnecessarily occupy hospital beds to obtain reimbursement of costs. It has pointed out that its members are reimbursed for care provided on an inpatient, day care and side room basis. Neither of the latter two categories require overnight admission to obtain reimbursement. The Deputy may be interested to note that according to published operational statistics for VHI in respect of 1996-97, the number of day care claims assessed was 145,000 approximately as against 181,000 in-patient claims assessed. The corresponding figures for l995-96 were 120,000 and 173,000. These illustrate that day case activity is widely availed of in the provision of care to VHI members.
I am informed that VHI anticipate that further developments will continue to occur to ensure that appropriate levels of care are utilised by its members for medically necessary procedures.
