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Instituto Tecnológico de Santo Domingo

The ARS and Senasa guarantee 100% coverage of tests and treatments for patients with COVID-19

The Executive President of the Abreu Clinic, Jesús Fernandes, during a webinar conducted by INTEC, said that 105 private clinics have 4,350 hospital beds, 452 intensive care unit beds and 252 mechanical ventilators.

SANTO DOMINGO. –The health risk insurers (ARS) and the National Health Insurance (Senasa) guarantee the Coverage of Coronavirus COVID-19 test, hospitalization and intensive care unit (ICU) expenses of the affiliates who contract the disease, assured Jeffrey Lizardo, manager of the National Health Insurance and Eduardo Cruz, executive president of Grupo Humano.

By participating in the webinar "Capacities and Challenges of the Dominican Health System before COVID-19", organized by the Instituto Tecnológico de Santo Domingo (INTEC), Cruz pointed out that, as of March 31, upon request by the Health Superintendency, 100% of Dominicans have coverage of the COVID-19 test.

“All those affiliates who are in the contributory regime will go to their laboratory with their authorization, like any other ambulatory test, and the ARS and SENASA will authorize it. Those patients who are neither in an ARS nor in SENASA, the government guarantees them without co-payment for all Dominicans, ”said Cruz.

Regarding treatment, which includes hospitalization, medications, intensive care and fees, the executive of Grupo Humano said that both the ARS and SENASA have also guaranteed these coverages to their members.

Likewise, Lizardo indicated that citizens who do not have any type of affiliation in the Social Security System, in case they need the test to rule out COVID-19 contagion, must go to the hospitals that have been identified by the National Service of Health (SNS) to serve that population. "There are about 187 hospitals nationwide, which would be the reference centers," he said.

Jeffrey Lizardo, manager of health services Senasa, added that an online process has already been implemented for patients to make their requests directly to laboratories, whether or not they are affiliated with the Dominican social security system.

“Our concern is how to guarantee the continuity of services, because there are many affiliates with other pathologies to whom we must continue to provide services. Likewise, all the services for the treatment of COVID-19 are covered for the population, contributory and subsidized regime, "said Lizardo.

In the Webinar also participated medical advisers to the Executive Power, Jorge Marte, medical director of the Center for Diagnosis of Advanced Medicine and Telemedicine (CEDIMAT) and Beloved Alejandro Báez, president of the Santo Domingo Health Cluster; and Jesús Fernandes, executive president of the Abreu Clinic. The activity was moderated by the coordinator of the Social Security Observatory (OSES), Eladio Pérez.

INTEC announced a series of webinars in order to analyze the impact of COVID-19 in the Dominican Republic from different perspectives, as well as to propose a debate that leads to the search for possible solutions and minimization of risks.

COVID-19 Peak in the DR

On when to wait for the peak in the contagion curve, Jorge Marte said that there is no answer to know when it will occur. "It is important that while we cannot predict when the spike will occur, it is important that we be clear that it has not yet occurred."

As for the number of confirmed cases, Mars said it is unclear how many are positive. "The positives that the Minister of Health reports to us every day, we can infer that they are only one apart from the positives, but in reality, how many are out there waiting for the test result or even more, how many are there that are not even known?" They have taken the test, "he said.

Mars pointed out that this not only hinders a final analysis, but it must also be inferred that the positive cases are much higher, while the reality of the dead is that. In addition, he said that would indicate, on the other hand, that the mortality rate is much lower. "The dead are those, but the positives are not those, how many more, we do not know," he said.

Attention at private level

The president of the Abreu Clinic, Jesús Fernandes established that, with a survey of 105 clinics nationwide, the private system has 4,350 beds equivalent to 40 to 50 beds for hospitalization per clinic, 452 intensive care beds y 252 fans.

Fernandes explained that as the pandemic develops, eventualities of other pathologies and emergencies that need assistance continue to occur. He also indicated that not all hospital beds have been destined for patients with COVID-19, he specified that the Association of Private Clinics and Hospitals (ANDECLIP) estimate an average of 20% of beds to provide assistance to patients, it is that is, between eight and nine beds per clinic, and of the fans, 50%, equivalent to 126 units.

He said that the two great patronages of the capital: the Plaza de la Salud and CEDIMAT, due to their legal nature and social function, are excluded from these figures. In the case of the Plaza de la Salud, it has 273 hospital beds and 18 intensive care beds, while CEDIMAT has 120 beds and 22 intensive care beds.

Fernandes pointed out that a patient with COVID-19 is highly contagious and care cannot be guaranteed putting other patients at risk. In this sense, he stated that the great challenge of the health system at public and private level is the protection of personnel. He also denounced that the costs of biosafety equipment have increased due to speculation.

Public-private synergy

In this regard, the new advisor to the Executive Power in public health and disaster systems, massive emergencies and critical care, Amado Alejandro Báez, said that carrying out the public-private synergy will define success in this process, and that the flattening of the epidemiology curve it will depend on the supply and demand and the capacity of the health system.

“The flattening of the curve speaks of the volume of case prevalence having to be within the range of the system's responsiveness. At the moment that volume reaches a peak and the capacity of the public and private response system exceeds, there is a domino effect that affects COVID-19 and all other patients who need health care, "said Baéz, who chairs the Santo Domingo Health Cluster.

Báez specified that according to the cases observed, 80% of those infected with COVID-19 will not need hospitalization and 20% will require hospitalization.

He said that COVID-19 is a new virus that has no information about it. "The population must understand that we are all learning, nobody knows anything about this virus, we learn day by day. The flattening of the curve will depend on non-mobilization, this is a challenge, because being a new virus there is no vaccine. The genetic sequence of the virus has allowed us to have great advances, the therapeutic interventions that we are carrying out are experimental, ”said the expert.

Eduardo Cruz, from ARS Primera de Humano, stated that everything needs to be looked at strategically, "the most urgent thing is to increase the capacity of tests and the number of laboratories that can carry them out and maintain the flow of funds to service providers."

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