Medical aids need to do more to prevent patients with chronic diseases landing up in hospital - an expensive exercise that could be reduced with better patient care. The Health Quality Assessment report that analyses claims data from 18 medical schemes representing 77% of all medical aid members, found that the high level of hospital admissions of people with chronic conditions was of "particular concern".It found that almost one in every two people with Ischaemic heart disease, meaning a heart with blocked arteries, will land up in hospital once a year for any reason not necessarily related to their heart.Last year, 10 % of all diabetics were hospitalized for a condition related to diabetes up from only 7% in 2010. Between 10 – 18% of patients with a mental disorder will be hospitalized for it in a year, but 30 – 40% of them will be hospitalised for another reason.Yesterday, PPO Serve Ceo Brian Ruff told the Board of Healthcare Funders conferences that over-hospitalisation in the private sector lead to higher costs and higher medical aid premiums, which also kept young people unable to afford medical aids.While hospitalisation rates concerned researchers and hike prices for all members, the HQA report also found that management of chronic disease by patients and their medical aids was “sub optimal”.For example only half of diabetics have their HbA1C test needed at least twice a year to show how well the disease is being managed.Yet medical aids cannot force people to be healthy by using higher premiums as a penalty for bad health behaviour such as smoking, as the law requires everyone in the same option to pay the same fee regardless of their state of health.Both Bonitas and Discovery Health Medical Schemes have programmes in place to monitor high risk patients’ health and ensure they get adequate treatment to prevent landing up in hospital.Bonitas’ Principal officer Bobby Ramasia said: “With hospitalizations accounting for upwards of 35% of total claims, it is of paramount importance that medical schemes have a range strategies in place to manage the situation proactively”.In Discovery Health Medical scheme chronic disease programmes, doctors can sign up to participate and get paid at a higher rate for doing so. Chronic disease members are incentivised to participate in personalised programmes. For example a consultation with a GP to help them monitor their health and chronic condition would be paid for without dipping into the member’s savings accountDiscovery Health CEO Dr Jonathan Broomberg said: “There is clear evidence that Vitality and these personal health programmes are making people healthier, but there is still a way to go in improving the management of chronic disease patients. Yet without these programmes, even more patients would get sicker or require hospitalisation”. ..