Can you afford a ventilator in South Africa?

Prior to the arrival of Covid-19, ventilators were off the radar for most people outside of hospitals and other emergency settings. This changed rapidly as the pandemic progressed, and an increasing number of patients had to rely on them for survival.

With hospitals stretched to capacity, and the public health system already under strain, this kind of intensive care is largely out of reach for uninsured South Africans.

We have a look at how ventilators work, how the care is delivered, and how this determines the cost.   

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How do ventilators work?

Besides using ventilators to assist severe Covid-19 cases - which includes approximately 6% of affected patients - they’re also used when patients have pneumonia, suffer a stroke, or fall into a coma.

Sean Chetty, who’s an associate professor and executive head at the Department of Anaesthesiology and Critical Care at Stellenbosch University, points out that ventilators work by forcing air into a patient’s lungs.

“This allows oxygen to be delivered through the airways to the alveoli, which are the tiny air bubbles that make up the lung. Once it arrives there, gas exchange can take place with the blood,” says Chetty.

He explains that the delivery of the gas from the ventilator can either be “internal” or “external”:   

• Internal means that practitioners put a tube down the patient’s throat, and from there it delivers the gas directly into the lungs. The patient does nothing. The ventilator takes over full control of the patient’s breathing function.
• External means that practitioners put a mask on the patient’s face and the ventilator assists them to breathe.

READ MORE: Can you afford an ambulance in South Africa?

What’s the cost of a ventilator?

Chetty says that ventilatory support is almost always done in the Intensive Care Unit (ICU) of a hospital.

“This is because the nursing of these patients is very specialised and requires highly skilled nurses who need to take care of patients in a 1:1 or 1:1.5 ratio,” says Chetty.

He explains that during the pandemic, hospitals have been forced to do some external ventilatory support in wards. But he adds that this is not ideal. 

“Therefore, the cost of access to the ventilator is calculated by hospitals in terms of the complete package of ICU care, not just for access to the ventilator itself,” says Chetty.

According to statistics released by Discovery Health Medical Scheme, in the course of the pandemic, the average cost per ventilated patient admitted to the ICU has been R340,737.

This is a hefty fee, and the majority of South Africans would not be able to afford this without going into long-term debt. It is, therefore, of utmost importance to have a medical aid plan or hospital plan.

Chetty says that most medical aids will cover in-hospital care for a patient. But the degree to which this is applicable will depend on your chosen plan and provider.

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