It’s Day 4 of my study abroad journey in Buenos Aires, and it was an extremely packed day! We started bright and early with a lecture from Dr. Josefina Medrano, a pediatrician and the former Minister of Health of the province Salta during covid, During this presentation we learned about the differences between overseeing a well funded province like the City of Buenos Aires and a more rural one like Salta. Salta is located in the northern part of Argentina, where its main industries and sources of income are agriculture and mining. This region has less hospitals and primary care centers, and they are hard to get to due to rugged terrain. Instead, they have small centers that physicians will periodically travel to in order to give care. One unique thing about this region is they have around the same amount of nurses as they do doctors. This is unusual, as normally there are many more nurses than doctors. Also, this region deals with more infectious diseases, rather than Buenos Aires, which deals with more chronic diseases. During covid, there were not as many resources, but there was a high vaccination rate.

 After this presentation, we had two hospital visits. The first one was to the most funded and well known public hospital in Buenos Aires, Juan Fernandez Hospital. Here we heard from the former head of the hospital, who just recently retired, Dr. Ignacio Previgliano. The second hospital we visited was Los Arcos Private Hospital, part of the Swiss Medical Group, the company Dr. Gabriel Novick works for. While touring this hospital we spoke with its director, Dr. Jorge Lantos. There were many differences between the two hospitals we visited. Fernandez Hospital is a public hospital run by the Ministry of Health of Buenos Aires. This means that the hospital gets its funds from the government, and it is the directors job to negotiate funding based on needs and hospital services and outcomes. This particular hospital also gets money from a donation fund as well. -This hospital services a large region of Buenos Aires and all social classes. It has 200 beds, 831 healthcare workers, and on average 200k patients per year. It has a large number of specialties, including an ER, surgery, maternal, and ICU units. Most of the budget goes towards human resources and salaries. They also have a fixed budget due to it coming from the government. Some of the most popular and funded specialties are orthopedics, surgery, and emergency. Its positives are its specialties, adaptability, and human resources. Its weaknesses are staffing concerns, architecture, lack of space, and technology support.

Los Arcos Hospital is private, meaning patients must either have insurance or pay out of pocket. They get their funds through reimbursements with insurance companies and out of pocket payments. These insurance companies negotiate prices for services. The Swiss Medical Group that owns the hospital also has their own insurance. This hospital has 250 beds and is usually at around 98% capacity. It sees around 144,000 patients per year. It has 1,400 healthcare workers, with around 70% of them being doctors and nurses. While there are around the same number of staff and specialties in both hospitals, we see large differences in the challenges they face. This private hospital has to have a balance between financial incentives and risk. There are consumption issues in this industry due to healthcare inflation being higher than most other areas. This is due to insurance premiums recently being un-fixed and then re-fixed by President Milei, causing companies to boost prices by extremely large amounts, and then having to reimburse members of their company. The main goal for this hospital is to minimize waste in order to increase the value of the hospital. They want to do this by lowering wait times, failure of care delivery, overtreatment, and coordination and administration issues. 

Another large difference between the public and private hospitals were the interior architecture and medical supplies. While the Fernandez hospital had all of the resources needed for a high functioning hospital, some of the supplies looked run down and the interior infrastructure outdated. Some sections, like the ICU and nephrology unit had been updated, but most of the hospital had walls with chipping paint and old furniture, hospital beds, and other items. On the other hand, the Los Arcos Hospital looked newly renovated, as it was only 17 years old. Patient rooms were suites, complete with a living area, bathroom, and bedroom with a hospital bed and pullout couch. They also have an extensive food menu for patients and guests. They have modern technology, for example, they have a pharmacy and lab transport system that allows you to send items through tubes connected throughout the hospital. Overall, while the public hospital had everything needed to have a successful hospital, its interior looked very rundown. The private hospital looked extremely nice and welcoming, and Dr. Lantos joked that many patients say they don’t want to go home. 

After the tours were over, I got to do some exciting culture activities. Me and some of the girls in our group went and got ice cream at Freddo, a popular chain in Argentina. I got dark chocolate and it was so delicious. Afterwards, a group of us went to the Museo Nacional de Bellas Artes, which is the fine arts museum in Buenos Aires. I absolutely love art, and going to art museums is one of my favorite things to do in a new city. There were so many beautiful paintings, with a few from my favorite artist, Claude Monet. 

Tomorrow should be interesting, as the major unions in Argentina plan to strike. Although it will unfortunately alter plans, it will bring a new and authentic perspective to our experience. See you tomorrow!