The occupancy rate at the Lalitpur-based Alka Hospital, which has a capacity of 100 beds, has declined to between 50 percent and 60 percent of late. The number of patients has also declined in the hospital’s outpatient department.

Kumar Thapa, proprietor of the hospital, said the bed occupancy rate at the institution used to be more than 90 percent in the past. “The decline has reduced the hospital’s income by 50 percent,” Thapa said.

Like Alka, many private hospitals across the country have been reporting a massive decline in patient inflows amid the ongoing slump in economic activities.

“Hospitals that were making profits in the past have been struggling to even generate running costs and pay bank instalments,” said Hari Rijal, senior vice-president of the Association of Private Health Institutions of Nepal (APHIN). “Hospitals that were already running at a loss are on the verge of closure.”

The ongoing economic crisis and the hike in doctor’s fees are being blamed for the decline in patient flows at the private hospitals.

In May, Nepal Medical Association, an umbrella organisation of medical doctors and private health institutions, had hiked doctors’ fees, citing the spiralling inflation. Patients seeking private care now have to pay around Rs1,200 to consult doctors with a DM/MCh degree (Doctor of Medicine/Master of Surgery) and more than five years of experience.

Doctors with an DM/MCh degree and five years of experience charge Rs880 and those with MD/MS/MCh degree and up to five years of experience charge between Rs750 to Rs800. Hospitals additionally charge up to 20 percent of the doctor’s fee. Some doctors have been charging up to Rs1,500 for patients seeking consultation at private clinics.

“The fee hike has been implemented across all private hospitals and clinics in the Kathmandu Valley,” said Rijal, who is also the proprietor of the 100-bed Rapti Life Care Hospital in Dang. “Doctors’ fee hike could be one of the reasons but the major problem might be the decline in economic activities. We have not yet implemented doctors’ consultation fees but our hospital has witnessed a decline in patient flow by up to 40 percent.”

Rising living costs and a drop in income have forced many people to compromise on their health, experts say. They say people have stopped seeking hospital care unless there’s an emergency case.

Several reasons, including economic recession and the government's health insurance scheme could be responsible for the decline, said Dr Anil Bikram Karki, president of the Nepal Medical Association.

Routine surgeries have been postponed and many prefer to be cared for at state-run health facilities, which are comparatively more economical than private ones, doctors say.

Dr Santosh Paudel, director at Bir Hospital, said they have started outpatient department care from 8 O’clock in the morning to address the growing inflow of patients. Nearly 3,000 patients have been visiting the hospital’s outpatient department every day, up from around 2,000 previously, Paudel said.

As many as 530,000 received outpatient care in the fiscal year 2022-23, up from 364,323 in the previous fiscal, hospital data show. The number of patients seeking emergency care in 2022-2023 was 44,000, up from 37,000 in 2021-2022.

While private hospitals suffer, some experts see an opportunity for public ones.

“This is the right time to strengthen and improve services at the state-run health facilities,” said Sri Krishna Bhatta, a public healthcare expert. “The authorities concerned should also make their regulatory mechanisms effective.”