Many Covid patients are being admitted to the intensive care unit or kept there for a prolonged period even if they do not need critical care support, state government officials involved in tackling the pandemic and insurance companies have alleged.

Most private hospitals have increased the number of ICU beds for Covid19 patients and many have realised that the demand might not be as much as they had anticipated.

Some of the insurance companies said they were regularly seeking justifications for decisions to keep stable Covid patients in ICUs. Insurance firms said they often refrained from deducting from reimbursements because doctors said they felt the patient needed ICU care.

At least one private hospital denied the allegation. “We often have to refuse critical patients because of lack of beds. There is no question of keeping a patient in the critical care unit for a longer duration than required,” said Rupak Barua, the Group CEO of AMRI Hospitals and president of the Association of Hospitals of Eastern India.

Some of the parameters for sending a Covid patient to the ICU are severe respiratory dis¬tress and requirement of highflow oxygen, and abnormal blood pressure and pulse rate, said doctors.

“The reports don’t come to insurance agencies real time. So, we don’t know whether the data related to oxygen saturation, blood pressure and pulse are true or not. One has to be¬lieve what hospitals say,” said an official of an insurance agency.

The tariff for an ICU bed in private hospitals varies between Rs 6,500 and Rs 11,000 a day, said officials of these healthcare units. The tariff for a bed in a general ward, on the other hand, varies between Rs 2,500 and Rs 4,000.

“Unnecessary and prolonged ICU stay is mostly reported from middle level hospitals and nursing homes. We seek justifications. If the healthcare unit is unable to provide any, we take steps,” said Prabir Mukherjee, the regional head of medical officers, east, Star Health and Allied Insurance Co.

State government officials said they had come across many such cases.

“The monitoring teams set up by the health department for Covid patients are regularly coming across patients kept in ICUs despite not needing critical care. The hospitals are being asked to shift these patients. In many such cases we have observed that the private healthcare units are not following government advisories,” said Gopal Dhali, the state government’s officer on special duty for Covid19 and head of the School of Digestive and Liver Diseases, SSKM Hospital.

A health department official said they had found such cases in government hospitals, too, but the reason was not monitory. “If a stable patient is kept in the ICU, the pressure on doctors and nurses is much less,” the official said.

Some insurance officials alleged that a section of private hospitals were taking advantage of the protocol that blocked access of family members and others to Covid patients for health reasons.

“Recently we sent two investigators to a private hospital in Calcutta to check on one such case. But they were not allowed to meet the patient. The investigators could not do much other than go through the data provided by the hospital,” said an official of a private insurance company.

Chandramouli Bhattacharya, a doctor who is part of the Covid treatment team at Peerless Hospital, said they assess the clinical condition of a Covid patient such as the oxygen saturation level before deciding whether she or he needs to be shifted to the ICU.

“Once the parameters improve, the patient is shifted to a stepdown unit,” he said.