Update on Clinical Management of COVID-19
National Policy for Admission of Covid Patients in Hospitals Revised to be more Patient-Centric
India
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New Delhi, May 08, 2021 :
In a significant directive to the States, 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 prompt, effective and comprehensive treatment of patients suffering from COVID19.
As per the Union Government directive to all States and UTs, hospitals under the Central government, State Governments and Union Territory administration including private hospitals (in States and Union Territories) managing COVID Patients shall ensure the following:
- Requirement of a positive test 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 CCC, DCHC or DHC as the case may be.
- No patient will be refused services on any count. This includes medications such as oxygen or essential drugs even if the patient belongs to a different city.
- 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 hospital must be based on need. It should be ensured that beds are not occupied by persons who do not need hospitalization. Further, the discharge should be strictly in accordance with the revised discharge policy available at https://www.mohfw.gov.in/pdf/ReviseddischargePolicyforCOVID19.pdf
Union Health Ministry has advised the Chief Secretaries of States/Union territories to issue necessary orders and circulars, incorporating the above directions within three days, which shall be enforced till replaced by an appropriate uniform policy.
The Health Ministry has earlier enunciated a policy of setting up 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:
- COVID Care Center (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 COVID Care Centres as a last resort.
- Dedicated COVID Health Centre (DCHC) that 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 Dedicated Health Centres. These hospitals would have beds with assured Oxygen support.
- Dedicated COVID Hospital (DCH) that 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 COVID Dedicated Hospitals. 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.
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