SINT MAARTEN (PHILIPSBURG) – As per April 2nd, 2019 Social & Health Insurances SZV will no longer be sending patients to the Dominican Republic for general medical referrals. Referrals to the Dominican Republic will only continue for specific specialties, emergency and trauma cases to the contracted hospitals in the Dominican Republic.
These specialties and emergency cases include Cornea transplant, Retina detachment, Emergency trauma, Emergency Neonatology, Emergency Obstetrics, Emergency Neurosurgery, Emergency Cardiology and Major trauma cases.
The decision is a cost saving measure. SZV estimates a reduction of 80-85% in referrals to the Dominican Republic. About 1000 patients are referred to the Dominican Republic per year, at least once. The average referral to this destination is about NAF 16.000,- per patient, per trip.
SZV has identified that the quality and type of medical services needed are also available in other destinations where SZV has care contracts, such as Colombia. The care contracts with the hospitals in the Dominican Republic will remain for the specific specialties and emergency/trauma cases.
The decision to reduce referrals to the Dominican Republic may change in the future as the medical referrals abroad procedure is currently being reviewed for re-structuring. Part of the restructuring includes a tender process to contract health care providers in the region based on updated indicators such as costs, logistics, service and quality.
The medical referrals process on a whole, from beginning to end is being reviewed by the Tripartite committee of SZV, SMMC (St. Maarten Medical Center) and VSA (Government) and SZV consultant Grant Thornton.
For the patients who have a follow-up plan for medical care in the Dominican Republic, these cases will be reviewed individually. The premise remains that patients are able to receive the medical care that they require, when it is not available on Sint Maarten.
Patients will gradually be referred to a new destination to continue their follow-up treatment plans. Together with the hospitals in the Dominican Republic, the specialists and house doctors on St. Maarten, it will be ensured that the relevant medical history is available to support the transition of patients.
The general procedure of requesting a medical referral abroad will not change. In emergency and trauma cases, the SMMC and its specialist handle the referral request procedure. The SZV referrals procedure includes a mandatory intake procedure that all patients and companions travelling abroad must undergo.
During the intake process at SZV, patients are explained about the referral process, the destination and the services of the international office who will be the direct contact when abroad. SZV patients who deny a referral abroad must do so in writing and will be responsible for the medical costs on their own.
The right remains to submit a reimbursement request; however, this is subject to approval, with limitations. Information about the referrals abroad procedure is available on the website <a target="_blank" href="http://www.szv.sx/www.szv.sx> Medical > Medical Referrals.