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INDEX
TOPICS Pg. Nos.
1. Introduction To Hospitals 3.
2. Health Care Sector - Analysis 5.
3. Medical & Health Care Service 6.
4. Pest Analysis
Political 7.
Economical 8.
Social 9.
Technological 10.
Global 12.
5. Accreditation of Hospitals 14.
6. Models of Accreditation 16.
7. SWOT Analysis
Strength 18.
Weakness 19.
Opportunities 21.
Upcoming Trends 22.
Threats 25.
8. Types Of Hospitals 26.9. Segmentation 29.
Marketing Mix
10. Product
31.
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Product Mix 33.
Flower of Service 35.
TOPICS Pg. Nos.
Quality Dimensions 41.
11. Place
44.
12. Price
46.
13. Promotion
55.
14. People
67.
15. Physical Evidence
70.
16. Process
72.
Blue Printing 74.
Service Encounter 78.
Fish Bone 80.
Service Recovery 83.
17. Future Prediction & Analysis
85.
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18. Wellness Industry
89.
INTRODUCTION TO HOSPITALS
Until the early 1980s, Government-run hospitals and those operated by
charitable organizations were the main providers of subsidized healthcare.
However, the last two decades have seen the mushrooming of corporate
and privately run hospitals.
The corporate hospital sector is most evolved in the south while
charitable/trust hospitals proliferate in the west. However, the north and east
are also showing a growing trend in private hospital expansion.
Previously hospitals were set up as charitable institutions to take care of the
sick and the poor. Today its a place of diagnosis and treatment of human ills,
for the training research, promoting health care activities and to some extenta center helping biosocial research.
World Health Organization (WHO) states that hospitals are socio-medical
organization whose functions are:
Curative,
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Preventive,
Patient services and
Training of health workers in biosocial research.
Indias healthcare sector has made impressive strides in recent years. With
time the classes and quality of hospitals have changed a lot today. Most
hospitals today are trying to provide all ultra facilities and are in the
process of making state of the art hospitals . Hospitals provide the
infrastructure facility to healthcare. Earlier hospitals were thinking inline of
prolonging the duration of patients stay. Nowadays they are going for a
higher patient turnover ratio.
A hospital offers considerable advantages to both patient and society. A
number of health problems require intensive medical treatment and personal
care, which normally cant be available in a patients home or in the clinic of
the doctor. This is possible only in a hospital where a large number of
professionally and technically skilled people apply their knowledge and skill
with the help of world-class expertise, advanced sophisticated equipment and
appliances.
The excellence of hospital services depends on how well the human and
material resources are utilized to promote patient care. The hospital is not an
entity in itself. Today, the hospital is a place for the diagnosis and treatment of
human ills and restoration of health and well being of temporarily deprived
patients. The first and the foremost function of a hospital is to give proper care
to the sick and injured without having social, economic and racial
discrimination.
However, the hospitals must perform many more things in addition to the
patient care. The education and training of doctors and nurses, support tomedical research and assistance to all activities carried out by public health
and voluntary agencies to prevent diseases and further to promote health
attitude are some of the important services of modern hospitals.
The essential function of the hospital in the Indian context is to cater to very
large masses of people by providing comfortable conditions for various users.
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This necessitates creation of a system which encompasses patients, doctors
and nurses in a synergetic totality. The applications of marketing strategies
insist on the development of product or services of the hospitals against the
background of changing environmental conditions. Hospital planning in theIndian condition reflects requirements and comforts of Indian masses. The
marketing management of hospitals diverts ones attention on the planning
and development of the product in the Indian environment.
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THE HEALTHCARE SECTOR: AN ANALYSIS
Healthcare is one of the most essential services in any growing society.Propelled by an affluent and health conscious growing middle-class, the
healthcare industry in India grew by more than 13 per cent per annum in the
last decade. Indias healthcare industry is estimated at Rs 1,500 billion or
US$ 34 billion. This works out to US$ 34 per capita which is 6 per cent of
GDP.
Healthcare statistics state that India has:
5,03,900 doctors
7,37,000 nurses
162 medical colleges
143 pharmacy colleges
3,50,000 chemists
15,097 hospitals accounting for 8,70,161 hospital beds
There is an extensive three-tiered government healthcare infrastructurecomprising of:
23,000 Primary Health Centres(PHC)
1,37,000 sub-centres (serving the semi-urban and rural areas)
3000 Community Health Centres(CHC)
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MEDICAL & HEALTHCARE SERVICE
There are four types of health-care facilities: primary health centers and ruralhospitals, government hospitals, private hospitals, and teaching institutions.
The central and the state governments are major players in this sector,
running hospitals, nursing homes, medical/nursing/paramedical colleges and
medical insurance. A large majority of the population, particularly in rural and
semi urban areas, receives free or highly subsidized treatment in such
hospitals and health care centres.
Private sector investment in the sector was opened up in 1983, to bridge the
huge gap between demand and government-owned healthcare services. Since
then, the private sector has grown significantly and presently accounts for Rs
690 billion, nearly 80% of healthcare expenditure. There are almost 9500
private hospitals and nursing homes in India, majority of them located in
major cities, some of them equipped for providing the most modern state-of-
the-art technology and equipment. However, more than 30% of the national
bed strength is concentrated in 150-odd corporate hospitals. Important names
in the private sector are Escorts, Apollo Hospitals, Max Health Centre, Fortis,
and Wockhardt; several foreign healthcare chains have technical/financial tie-
ups with Indian private healthcare chains.
The health care services (excluding pharmaceuticals) market is estimated to
be growing at the rate of around 16 percent annually.
There are certain industries that directly affect and are directly affected the
status of healthcare in the region.
They may include:
1. Technology and Equipment2. Drugs and Pharmaceuticals
3. Diagnostic laboratories
Medical Insurance
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PEST ANALYSIS
POLITICAL FACTORS
The Government of India places top priority to healthcare in the
national agenda. It is very serious about encouraging indigenous
R&D and creation of human capital. The imminent changes in
Indian laws and procedures relating to recognition of
intellectual property and foreign investments will allow global
pharmaceutical and biotechnology companies to set up partnerships
with Indian counterparts.
With the second largest population in the world and a high
incidence of disease , healthcare is being accorded priority by the
Government of India and individual state governments.
A study of Government Public Health expenditure (Government,
both Central & State - spending on healthcare is 1.7% of GDP)
reveals that only 16% is allocated to primary care and 84% is
allocated to secondary & tertiary care.
Last year, the finance minister announced a list of incentives for
private hospitals to create and upgrade infrastructure, as well as
reduce their operational costs:
1. Tax sops to financial institutions lending to private groups
setting up hospitals with 100 or more beds.
2. Increase in the rate of depreciation from 25 percent to 40
percent for life-saving medical equipment.
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ECONOMIC FACTORS
The FDI policy of India is not up to mark. The 100% FDI route is not
opened in India. If the foreign hospital wants to open its hospital in
India, then the only way it can do so is via joint venture . Because of this
not many foreign players are interested to invest in India.
The Indian healthcare market is expected to grow by around 13 per cent
per annum for the next six years.
It is projected as the next boom in the country after the IT euphoria.
The amount of hospitals in India is very less when compared to the other
developed countries. Even the urban areas do not have enough medical
facilities. It is better not to talk about our rural consumers, where one
village at an average has one doctor only and the doctor is not very well
qualified.
The country lags behind international standards on basic healthcare
infrastructure and facilities. India has 94 beds per 100,000 population
as compared to the WHO norm of 333 beds per 100,000 .
India's healthcare industry is estimated at Rs 1000 billion ( 14 billion). Of
this, pharmaceutical accounts for Rs 200 billion (2.8 billion). As per some
estimates, Rs 185 billion (2.6 billion) is spent on healthcare annually.
Public and private health expenditure is 13% and 87% respectively. Health
insurance is extremely marginal as indicated by "Out of Pocket"
expenditure percentage of 84.6%.
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SOCIAL FACTORS
Certain percentages of beds have to be kept for poor people. E.g. in
Bombay 20% of beds has to be kept reserved for poor people whether itsa private or public hospital.
Look after the needs of local poor people.
Open counseling and relief centres.
Teach hygiene, sanitation among the poor masses.
Safe disposal of hospitals wastes like used injection needles, waste blood
etc. and taking due care of environment.
Spreading awareness about various diseases through campaigns and free
medical check ups.
In brief the social aspect of hospitals industry is to see that latesttreatment and medicines are available to people at large at concessional
rates or free of cost and that its activities are not only restricted to rich
people.
The people in India do not avail of the hospital facilities very soon. This
is because of the high cost related to it. However this may all change
because of the increasing deployment of third party payment either in the
form of Medical and Allied Insurance, or in the form of reimbursements
from the State. The people are now taking more to the hospital facilities.
This in turn will increase the employment opportunities to many people. A
study by NOSU hospital consultants revealed that the hospital industry
shall employ a large proportion of the skilled work force. In fact the
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Healthcare Industry is poised to become the biggest Employer in all
Countries.
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TECHNOLOGICAL FACTORS
The hospital is on the threshold of a major Growth Spiral which shall
assimilate all new technologies to provide cost effective Healthcare. It shall
also be the biggest consumer of all new technologies.
Innovations such as computer based hospital information systems, medical
records; decision support systems, health information networks,
telemedicine, real time image transfers and newer ways of distributing
health information to consumers are beginning to affect the cost, quality,
and accessibility of health care.
The technologies today can support vast databases, network
communications, quick distribution and reliable image transfers. The easy
availability of Healthcare related information is changing the traditional
relationship between the Doctor and the patient.
Employment of Microprocessor Technology to develop implantable devices,which can be monitored with the remote sensors. Healthcare providers in
supporting various physiological defects shall use these devices.
A greater degree of employment of CPU driven Technology, supported with
artificial intelligence, in treating or managing various physiological defect.
A greater degree of employment of Robotics Technology in Operating
Rooms to provide precise and less traumatic as well as less destructive
Surgery (Robotics Micro-surgery).
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A greater degree of employment of Robotics Technology in Laboratory
along with traditional technologies to provide automated and precise
diagnostic studies.
A greater degree of employment of LASER Technology, in and outside of,Operating Rooms to provide precise and less traumatic as well as less
destructive Surgery.
Development and deployment of instrumentation in Medical & Surgical
Practice which shall be based on capturing data on real time basis and
providing necessary electro-physiological interventions or Bio-chemical
interventions. This shall affect both - normal physiology and pathological
physiology.
Development and deployment of cultured tissues for control of vital
Biological processes.
Employment of Information Technology tools for networking of Examination
Rooms, Treatment Rooms, Operating Rooms and Diagnostic Reporting
Rooms.
Employment of Information Technology tools along with Microprocessor
Technologies and modules of (Artificial) Intelligence for remote
maintenance of Equipment and other instruments thereby enabling
development of remote controlled instrumentation for control of
Physiological & Pathological Processes.
Deployment of Information Technology tools for generation of specificdisease related Databases, classified by a number of variables.
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GLOBAL FACTORS
The healthcare sector is among the most rapidly growing services in the
world economy, estimated at $4 trillion yearly in the OECD countriesalone.
The sector has seen new and rapidly evolving forms of cross-border
transactions , spurred by factors as wide-ranging as technology,
demographics, costs, skills, growing private sector participation, natural
endowments, culture and geography.
Globalisation of healthcare is also evident from the growing foreign
equity participation in this sector and establishment of joint
ventures, alliances and management tie-ups among care
establishments, resulting in the transfer of technology, skills and
practices.
Finally, there is the global movement of doctors, nurses and
technicians, and the resulting networks of healthcare professionalsthat are sources of investment and know how.
Investment flows into developing countries and the setting up of state-
of-the-art healthcare establishments there will attract overseas patients
for quality care at low cost. Which may, in turn, be supported by
telehealth services and cross-border movement of health
personnel.
India also has potential to export telehealth services within the
region and is emerging as a base for outsourcing of clinical trials, ethical
and regulatory issues aside.
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Indias importance as a global supplier of medical personnel to
developing and developed countries is long standing.
India is also emerging as a source of foreign direct investment (FDI)in health services, as shown by the regional expansion plans of major
players, such as the Apollo group.
However, India has barely tapped its true potential in the global
healthcare market. Only 5% of all patients treated at reputed hospitals
like Escorts are foreign, compared to 25% at equivalent Thai hospitals.
Inadequacies in supporting infrastructure, equipment, supplies and
domestic regulation, lack of recognition of Indian medical qualifications
and disparity in standards of training and quality remain major
constraints.
Globalisation of our healthcare system can yield many benefits,
including improved quality and standards and more money for
investment in the sector.
Cross-border exchange of practices, knowhow, and
technologies, resulting from the flow of capital, consumers, health
personnel and information, can help in raising standards and the quality
of domestic healthcare.
Concerns have been voiced about the possible two-tiering and
cream-skimming effects of medical tourism and FDI on the
domestic healthcare system. And possible adverse effects on costs,resource allocation and equity within the system. One has to assess
their true cause.
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This growth of Healthcare Industry shall be supported by Political Will and
Social Understanding at all levels of any Society. It must, therefore, meet
the new challenges, by providing cost effective
Healthcare in a manner that improves the Quality of Humane Life.
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ACCREDITATION OF HOSPITALS
AN OVERVIEW
Health services in many developed countries have come under severe
scrutiny in recent years. Positioned against the backdrop of
globalization, there is an intense move towards accreditation of health
services.
Accreditation of hospitals is a voluntary process by which an
authorized agency or organization evaluates and recognizeshealth services according to a set of standards describing the
structures and processes that contribute to desirable patient
outcomes.
Accreditation can be understood as an indicator of professional
achievement and quality of care. Accreditation is opposed to licensing or
regulation of healthcare facilities, which is usually mandatory and state-
imposed.
Accreditation is not new to the health system. The first initiative
towards accreditation was taken in the United States of America as
early as 1910. Over a period of time after several experiments, the Joint
Commission on Accreditation of Healthcare Organisation (JCAHO), a
national accreditation programme, established itself as an esteemed
accreditation body by 1987. JCAHO has high standards of quality
assurance and rigorous process of evaluation, which makes it a much-
esteemed agency for accreditation. Health services certified by JCAHO
are given deemed status.
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THE ONSET OF ACCREDITATION IN INDIA
In India, accreditation of the health services has never been a
serious issue though some feeble attempts have been made to
evolve a voluntary accreditation system in the late eighties andearly nineties interestingly coinciding with the LPG (Liberalisation,
Privatisation, and Globalisation) reforms.
The attempts made by the Indian Hospital Association (IHA) at
both Mumbai and Delhi is worth mentioning. Their efforts were
not well received as the initiative did not involve the various
stakeholders and had moved with predetermined standards of
evaluation, membership fees and assessment mechanisms.
In India, the initial premises of introducing accreditation were
based on the overall objective to ensure the quality of care. The
Bureau of Indian Standards (BIS) had laid down standards for
hospitals having 30, 100 and 250 beds. The National Institute of
Health and Family Welfare (NIFHFW) had such rules laid for more
than 50-bed hospitals and only for equipment. Most of the
standards laid down by both BIS and NIFHFW were criticized for
having an urban bias.There have been attempts in some states to institutionalize
uniform standards for hospitals. In Maharashtra, the government
hospitals follow the Hospital Administration Manual. The Andhra
Pradesh Vaidya Vidhana Parisad has laid down standards for
secondary-level hospitals in the government sector, which comes
under it.
Apart from this some efforts have been made by consumer
bodies, groups of health professionals, hospital organisations and
non-governmental organisations to evolve standards for
accreditation.
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MODELS OF ACCREDITATION
Accreditation across the globe followed three models.
The first model of assessment gives priority to standards related toavailable facility norms, equipment requirements, human resources and
space specifications. Here, the criterion of accreditation is based on the
availability of basic health facilities.
The second gives importance to quality assurance and sets standards
for those institutions striving to arrive or improve quality of care, hence
accreditation is based on satisfying some basic indicators of quality and
involves ranking based on levels of quality.
The third model is based on the ground that health systems should be
accessible and acceptable to health-seekers. It gives importance to the
health-seeker with an emphasis on evaluating health systems from
indicators such as user-friendliness, providing information to users
about the services available, setting up procedures for redressing
grievances, etc. In the third model, the criterion of assessment is
explicitly geared towards people-centric indicators and brings
accountability of the health system to the health-seekers to the table.With each model, the criteria of accreditation changes.
At the threshold of globalization and increasingly opening-up of the Indian
health sector, attempts are being made at various quarters to draft systems of
accreditation. There are certain points, which cannot be missed. What does
accreditation mean for India? The answer to this question would help us to
know which model can be adopted for accreditation of hospitals in India.
If it follows the ranking-model based on quality of services provided,
accreditation will have very little to contribute to the improvement of the
overall health system in India.
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In contrast, the facility-survey model can be partially pertinent in putting in
place the basic facilities required for providing care.
The most relevant model of accreditation for the Indian health system is thepeople-centric model, which would ensure the presence of Acceptability,
Accessibility, and Accountability.
The accreditation process should begin with minimum or moderate level
standards and, over a period of time expand to higher, ideal level standards
and should be achievable by local public health agencies regardless of size
provided that they conduct the essential services of public health.
State and local accreditation programs should coordinate with and conform in
essential ways to a national accreditation program to eliminate possible
duplication and conflict. To succeed in bringing about a perceptible change in
the delivery services of the health system and to go beyond mere an on-site
survey and awarding certificates, any accreditation programme should address
all the dimensions of healthcare.
RATINGS
India's independent credit rating agency CRISIL has assigned a
grade A rating to super specialty hospitals like Escorts and multi
specialty hospitals like Apollo.
NHS of the UK has indicated that India is a favoured destination for
surgeries.
The British Standards Institute has now accredited the Delhi-based
Escorts Hospital.
Apollo Group - India's largest private hospital chain and Escorts
Hospital are now seeking certification from the US-based Joint
Commission on Accreditation of Healthcare Organizations.
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SWOT ANALYSIS
STRENGTHS
Indias healthcare sector has made impressive strides in recent years. It
has transformed to a US$ 17 billion industry and is surging ahead with an
annual growth rate of 13% a year.
In the last five years, the number of patients visiting India for medical
treatment has risen from 10,000 to about 100,000.
With an annual growth rate of 30 percent, India is already inching closer to
Singapore, an established Medicare hub that attracts 150,000 medical
tourists a year.
Hospitals in India boast of conducting the latest surgeries at a very low
cost.
The healthcare industry employs over four million people , which makes
it one of the largest service sectors in the economy.
Indian specialists have performed over 500,000 major surgeries and over
a million other surgical procedures including cardio-thoracic, neurological
and cancer surgeries, with success rates at par with international
standards .
The quality of healthcare has improved considerably with the
availability of world class high-tech medical equipment and information
technology.
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WEAKNESSES
India has poor social sector indices, given the high population of the
poor, acute lack of medical facilities in the lesser-developed parts of the
country, and a lack of public funds to provide adequate medical care and
attention to the entire population.
Indias health expenditure is 5.6 per cent of GDP, whereas most
established market economies spend 7-10 per cent of GDP on health.
USA spends over 14 per cent.
Low doctor-patient ratio : US has 2,340 doctors as compared to Indias
143 doctors for very 10,000 people.
Life Expectancy in India is amongst the lowest at 55.5 years
compared to US at 75.5 years and 66.5 years for Thailand. On an average,
80 out of every 1,000 children die. This figure is just 9 in the US and 30 for
every 1,000 in Thailand.
High deposit fees and high costs of medical services limits itself to high
income level group or is out of reach for common man.
The I dont care attitude by the government hospital. For e.g. Cooper
Hospital.
Medicine and drugs fraud by the menials. Even organ selling by
doctors to make more money.
Complex and long admission procedure for admission, which can
sometimes be fatal.
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The common men and poor men are completely at the mercy of the
overcrowded government hospitals and dispensaries .
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OPPORTUNITIES
At the current pace of growth, healthcare tourism alone can rake in over
$2 billion as additional revenue by 2012. From less than 10,000 patientsvisiting India for medical treatment five years ago, the medical tourism
market in India is worth US$ 333 million, with about 100,000 foreign
patients coming in every year.
Voluntary health insurance market is estimated at Rs 4 billion ($86.3
million) currently but is growing fast. Industry estimates put the figure at
Rs 130 billion ($2.8 billion) by 2005. Joint ventures for offering medical
insurance and other insurance services is one of the Investment & Business
Opportunities.
Trade in medical equipment and products , including warehousing,
selling and servicing the latest medical electronics equipment, diagnostic
kits, reagents and consumables.
Telemedicine systems , for treating patients in remote areas through asatellite connection.
Corporate health care clinics for providing high quality basic services in
consultation, diagnostics, minor surgeries etc .
Business Process Outsourcing of medical transcriptions and other
hospital management administration tasks.
R&D base for new molecule development, clinical trials, etc., utilizing the
high quality scientific manpower and low costs.
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UPCOMING TRENDS
MEDICAL TOURISMIt is the next big success story out of India. From less than 10,000 patients
visiting India for medical treatment five years ago, the medical tourism market
in India is worth US$ 333 million, with about 100,000 foreign patients coming
in every year.
Procedure costs
Procedure Cost (US$)
Surgery Thailand US ($) India ($)
Bone Marrow Transplant 62,500 400,000 30,000
Liver Transplant 75,000 500,000 40,000
Open Heart Surgery (CABG) 14,250 50,000 5,000 - 7,000
Neuro surgery 29,000 8000
Orthopaedic Surgery 20,000 6,000
Cosmetic Surgery 20,000 2,000
Hip Replacement 6,900 4,500
Hysterectomy 2,012 511
Gall Bladder Removal 1,755 555
Knee Surgery 7,000 16,000 4,500
* All figures in US$. The Indian costs are based on the average rates offered
by top Indian hospitals like Escorts Heart Institute, Apollo and Batra Hospital.
The Thailand rates are based on rates provided by Burnrungard Hospital,
Bangkok, which is Thailands largest private hospital.
Source: IBEF Syndication Studies
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PREVENTIVE HEALTHCARE
Growing health consciousness among middle and high-income families inIndia is heralding a new business opportunity - preventive healthcare.
The addressable population for preventive healthcare check-ups in India is
about 160 million. At current estimates, not more than a million people
may have been covered.
For hospitals, the preventive healthcare business is attractive. It allows
them to build long-term relationships, as patients who come for health
check-ups generally come back to the same hospital if they require any
treatment.
HEALTHCARE BPO
Healthcare BPO could potentially be a US$ 4.5 billion opportunity for
India by 2008, offering employment to about 200,000 people.
It includes offshoring of processes such as medical billing, disease
coding, forms processing and claims adjudication.
As healthcare BPO players mature, other businesses like claims
repricing, medical diagnosis and actuarial work are expected to gain
momentum.
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TELEMEDICINE
Telemedicine is a method by which patients can be examined, monitored and
treated, while the patient and doctor are geographically distant.Potentially, the next big success story in the healthcare sector, several
examples already offer an insight into this emergent opportunity that is
changing the lives of over 600 million people in rural India.
Gujarat : The Online Telemedicine Research Institute (OTRI)
provided telemedicine links for teleconsultation, thereby
establishing 750 sessions in a period of 30 days in Bhuj after the
earthquake in January 2001.
Karnataka : Asia Heart Foundation, Bangalore has successfully
been practising Telecardiology between Bangalore and cities in
eastern India. Paramedics are guided to save patients suffering
from Acute Myocardial Infarction by performing life-saving
procedures as per doctors directions over video conferencing.
Tamil Nadu : Apollo Hospital, Chennai is providing expert opinion
from its tertiary level hospitals in bigger cities to those in far-
flung towns of India. Over a period of 27 months, over 4,000
patients benefited from teleconsultations and over 75 per cent of
those teleconsulted were treated in their respective cities.
Haryana: Jiva International, a healthcare venture on the
outskirts of Delhi, is implementing a novel plan that takes
medical care right inside rural India by using a GPRS enabled
Java application available with Nokias 6800 model. The
Teledoc project won the World Summit Award for eHealth, at
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the World Summit on Information Society (WSIS) held in
Geneva, Switzerland.
THREATS
The government is reducing the grants given to hospitals, thus making it
impossible to cater to the poor people.
The unions of the menials and even doctors : they can go on a strike,
disrupting the functioning of the entire health care unit.
Competition from other international hospital chains , which are more,advanced in technology and better financial support.
The public spending on health in India is a mere 0.9% of GDP and the
private spending on health is 4.2%. India ranks 171st out of 175 countries
in terms of public spending on health.
Government pays more attention on age-old programmes like
tuberculosis, leprosy etc. and less attention on killer diseases cardio
vascular, diabetes, obesity and hypertension.
Unplanned urbanization and neglect of the public health system as
whole has led to the resurgence of water-borne diseases like hepatitis and
cholera every year. More virulent forms of tuberculosis are being seen in
those infected with HIV, which appears to have spread widely in India.
The number of people in India infected with the HIV/AIDS virus has risen
sharply. According to India's National AIDS Control Organisation (NACO),
more than 4.5 million Indians are infected. HIV/AIDS in India is not only
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confined to high-risk groups and in cities, but is gradually spreading into
rural areas and the general population.
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TYPES OF HOSPITALS
CLASSIFICATION ON THE BASIS OF OBJECTIVES
Hospital
Teaching-cum-Research Hospitals:
These hospitals are teaching based . They are found engaged in advancing
knowledge , promoting the research activities and training the medics.
As for example , All-India Medical Institute, New Delhi, Post-Graduate
Medical Education and Research Institute, Chandigarh, etc.
General Hospitals :
The general hospitals also offer teaching and research facilities but these
objectives are secondary. The main objective in the general hospitals is to
provide medical care. As for example, different medical colleges and district
and sub divisional hospitals like DY Patil Medical College.
Special Hospitals :
The main objective of special hospital is to provide specialized medical
services . These hospitals concentrate on a particular organ of the body or
a particular disease. For eg. The Asian Heart Hospital, Mumbai.
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Special
Hospital
Teaching cum
Research
General
Hospital
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CLASSIFICATION ON THE BASIS OF OWNERSHIP
Government Hospitals :
These hospitals are fully owned managed and controlled by the
government . They are mainly involved in healing the needy and providing
healthcare to everyone at very affordable rates.
Semi-Government Hospitals:
These hospitals are partly owned by government . Time to time government
assistance is provided to these hospitals may in the form of finance.
Voluntary Agencies:
There are some hospitals which are run and are in control of voluntary
organizations they can be of any form i.e. may be general hospitals or
special hospitals or even teaching institutes.
Private Charitable:
These private charitable hospitals are owned and controlled by the
charitable organizations , which are private.
For e.g. Ramakrishna Mission Hospital, Mumbai.
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GovernmentHospital Semi-Government
Hospital
VoluntaryAgencies PrivateCharitable
Hospital
Hospital
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CLASSIFICATION ON THE BASIS OF MEDICINE
CLASSIFICATION ON THE BASIS OF SIZE
Hospitals can also be classified on the basis of their size. There
are variations in the size of the hospitals.
As such, the teaching hospitals generally have 500 beds, which
can be increased according to the number of students.
The district hospitals generally have 200 beds, which can be
raised to 300 depending on population.
The teshil / taluk / sub-divisional hospitals generally have 50beds that can be raised to 100 depending on population.
The primary health centers generally have 6 beds that can be
raised to 10 beds.
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Hospital
TeachingHospital
DistrictHospital
Tehsil/Taluka/Subdivisional
Hospital
Primary HealthCenters
HOSPITALS AYURVEDIC
HOMEOPATHY UNANI
ALLOPATHY
OTHERS
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SEGMENTATION
EXTERNAL SEGMENTATION1. Income wise:
No income
Low income
Middle income
High income
2. Gender wise:
Maternity hospitals for females.
3. Family life cycle:
Childcare hospitals.
1. Institute of Child Health and Hospital for Children
2. Center For Genetic Health Care
The center is actively involved in Genetic Health Care of
Unborns, Children and Adults for the last 15 years. Facilitiesavailable at the centre are unique and under one roof.
4. Specialized hospitals:
Heart,
1. Asian Heart Institute & Research Centre
Speciality Heart Hospital at Bandra Kurla Complex, Mumbai
Eye,
Dental etc.
5. On basis of disease:
Tuberculosis, Tuberculosis Research Centre
Cancer, Jeevan Jyot Cancer Hospital
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http://ich.tn.nic.in/http://ich.tn.nic.in/http://www.indiaspace.com/pages/genetics.htmhttp://www.ahirc.com/http://www.trc-chennai.org/http://www.trc-chennai.org/http://epages.webindia.com/india/jeevanjyotcancer/http://epages.webindia.com/india/jeevanjyotcancer/http://ich.tn.nic.in/http://www.indiaspace.com/pages/genetics.htmhttp://www.ahirc.com/http://www.trc-chennai.org/http://epages.webindia.com/india/jeevanjyotcancer/8/8/2019 Healthcare Sector Final Copy
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INTERNAL SEGMENTATION
1. Type of care:
Intensive care unit
Normal ward
General ward for check up
2. Facilities/comfort wise:
Ac room
Non-AC room
Deluxe room
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PRODUCT
Kotler says a product is anything that can be offered to a market to
satisfy a want or a need. Products that are marketed include physical goods,
services, experiences, events, persons, places, properties, organisations,
information and ideas.
In the case of hospitals, different types of hospitals offer different services to
their users. Some of the hospitals give priority to medical education, trainingand research while some others concentrate on medical treatment.
The product of a hospital can be any of the following:
PRODUCT
PRODUCT LINE WIDTH, DEPTH & LENGTH
Medical
services
Medical training Medical
education
Medical
researchCardiac Surgery Dentistry Heart diseases
Dental Operation Ophthalmology CancerDermatology Neurology AidsNeuroscience
The following is the product width, depth & length of Lilavati Hospital:
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MEDICALSERVICES
MEDICALTRAINING
MEDICALEDUCATION
MEDICALRESEARCH
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LILAVATI
MEDICALSERVICES
SURGICAL DIAGNOSTIC ALLIED DENTAL
CARDIOLOGY
CLINICAL CARE
DERMATOLOGY
RESPIRATORY
ONCOLOGY
ANDROLOGY
OPTHALMOLOGY
ORTHOPAEDICS
GENERALSURGERY
ENT
NUCLEARMEDICINE
PATHOLOGY
RADIOLOGY &IMAGING
PHYSIOTHERAPY
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PRODUCT MIX
Level 1: Core / generic product:
This is the basic service product.
In hospitals, health or well-being by way of the treatment provided by the
doctor to deal with the ailment of the patients is the core product or service.
Level 2: Expected products:
This is the basic product and minimum purchase conditions that must be met.
In hospitals, in addition to the core product, all other supplementary services
like a bed, waiting area, availability of medicines and drugs, meals, hygiene
etc.
Cooper Hospital Waiting Area, Beds
Lilavati Hospital Waiting Area,
Beds,
Availability of medicines (24
hours),
Availability of Blood Banks, etc.
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Level 3: Augmented Product:
Along with the basic and expected offering, the service provider needs to
differentiate its services from its competitors.
Lilavati Hospital Great Infrastructure,
Cardiac Ambulances,
Centrally AC,
Cafeteria
Product Augmentation is not observed much in case of BMC hospitals because
these hospitals are established to provide free (or at nominal rate) services to
the customers. They dont find the need to differentiate. They are established
as they form a part of the basic infrastructure of the city.
Level 4: Potential product:
The potential product contains potentially feasible features and benefits that
play a significant role in holding and attracting the customer. These features
and benefits are useful or likely to be useful to the buyers.
AHIRC Beds are provided for ICU attendants
free of charge along with other
communication facilities like internet
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FLOWER OF SERVICE
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INFORMATION
+ In a hospital, providing information refers to making the patients or the
general public aware of the services and facilities offered by the hospital.
+ The customer needs to have some basic information about the service
provider so that he/she can make a choice between the different service
providers.
In the hospitals the basic information that a customer would require is as
follows:
+ The different types of services that the hospital offers. Eg:
General, specialized
+ The technologies that are being used.
+ About the in-house doctors and their qualification
+ About the visiting doctors i.e. their qualification, number of
times they visit in a day and at what time, etc.
The tools which hospitals use to provide information are television, internet,
radio, etc.
Dr. Batras Health Care Clinic radio advertisements
Lilavati Hospital has used internet as one of its tool to provide information.
The webpage appears as:
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ORDER TAKING
This refers to the promptness of the service provider in taking the order of the
customers.Promptness should be in the following areas:
+ Formalities: The paper work & the legal formalities prior to the
admission must be minimum.
+ Accommodation: the patient should be given the accommodation as soon
as he\she completes the formalities.
+ Responsiveness: the patient must be attended as soon as he is
accommodated.
At AHIRC, a patient is required to come in with two relatives. This is because,
when the patient enters the hospital, he is either sent to the bed allotted to
him (through prior booking) or to the pathology department if certain tests
need to be carried out. One relative accompanies the patient, while the other
relative remains at the admission counter to complete the admission
formalities. This way, the patient is not kept waiting while the admission is
carried out.
SAFE KEEPING: [SAFETY AND HYGIENE]
When a patient has to undergo a surgery or an operation, he always has a fear
that whether he\she is in safe hands.
Therefore the doctors, nurses, ward boys and all the other employees, who
come in direct contact of the patient, must possess an ability to build trust,win his confidence & make him feel that he is in safe hands.
Eg: Most of the hospitals display the success rate of their doctors.
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HOSPITALITY
This is becoming increasingly important in the healthcare sector, particularly in
hospitals as the expectations of people towards medical care are everincreasing. No longer are they limited to only the clinical outcomes but also
involve the delivery process, margin of safety and behavior of personnel.
The AHIRC provides a host of conveniences to patients and their relatives.
Service to patients:
+ A choice of packages from twin sharing, single room and deluxe suites
are available to patients.
+ A lot of care has been taken to ensure that the patient does not feel
walled in. For example, all rooms have natural and indirect lighting with
huge windows and in some cases, terrace gardens. A number of
facilities are provided to the patient such as a television, in-house meals
etc. So as to make the room aesthetically pleasing and improve patient
mentality (they are usually depressed), all medical sockets, instruments
or attachments are hidden from view, behind a panel beside the bed.
Service to relatives:
The AHIRC is the only hospital in Mumbai that has a separate family waiting
area for relatives of patients in ICU. Each cubicle in the waiting area has
provisions for sleeping such as a bed, pillows, blankets etc. The reason for
such an arrangement is that , in the ICU cases, one person should be present
in the hospital 24 hours so that he is available to sign the consent form.
Patient number is allotted to the relatives bed and in the case of an
emergency, the relative is immediately called by the secretary in charge.Relatives also enjoy facilities like internet connection, a multi-cuisine cafeteria,
prayer rooms, library, public call booths, coffee machines, a gift shop etc.
There is even a travel agency located on the ground floor that caters to the
traveling and sight seeing needs of the visitors (particularly in the case of
patients from abroad).
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EXCEPTION
Exceptional service is not what you are expected to give, its a kind of service
which you provide to your customers to win customer satisfaction so that hewould be loyal to you & spread good word.
This petal is deformed in case of many BMC hospitals. Private hospitals make
use of this petal at its best to differentiate their service.
BILLING
Hospitals should ensure that billing and payment procedures are quick so as to
enable the patient to return home soon after discharge.At AHIRC, two types of
bills are generated i.e. Interim bills and Final bill. The interim bills are
generated to give on a bi-weekly basis. They give the patient an idea about
the charge payable for the specified period. It helps is avoiding any confusion
at the time of generating the final bill.
The final bill is generated at the time of discharge. This considers all the
interim bills and the advance deposit paid.
PAYMENT :
The norms for payment of the bill must be simple.
1. The payment counter should be easily accessible. The
customer must be able to easily locate it.
2. The mode of the payment should be easy and quick. The
customer should be able to easily settle the bill and leave.
If the payment is made by the credit cards, even this must be quick andshould be on the different counter.
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SERVICE QUALITY DIMENSION
RELIABILITY
The ability of the service provider to meet the promises made by them
accurately. The customer must develop a feeling that they can depend on
that particular service provider for their problem.
1. The staff of the hospital has to be very accurate while performing their
job. Only than the customers would rely on them. For e.g. during
surgery the amount of anesthesia to be given to the particular patient
has to be accurate.
2. The service provided should be such that the customers develop a
feeling of loyalty so that the hospitals get the repeat customers as well
as new customers. e.g. if Mr. X goes to Lilavati hospital for the bypass
surgery and the surgery is conducted successfully and he recovers
soon, he would not only become loyal to the hospital but also he will
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narrate the whole incident to many others thereby giving Lilavati more
customers.
ASSURANCE
The service provider and the employees must be capable of winning the
trust and confidence of the customers.
1. The customers can be assured by informing them that the doctors,
nurses, ward boys and the other related staff is competent enough in
providing them their expected level of service.
2. The frontline staffs have to be very polite and friendly to the patient and
the relatives.
3. The patient must develop the feel that he is safe in that particular
hospital. For e.g. when a patient is brought to the hospital in emergency
he and the relatives must be attended with courtesy and also the
doctors and the nurses must politely tell them, that nothing will happen
to the patient, we will try our level best and not react with abrupt and
angry statements. His words should sound empathetic and at the same
time consoling.
TANGIBLES
This includes the ambience, the technologies used, the facilities used to
communicate things etc.
1. The ambience of the hospitals must be gentle and clean. The
technologies used in the hospitals have to be latest or updated
regularly. Because now a days people do not buy the product butbenefits.
2. The environment of the hospital has to be peaceful. The corridors
outside the rooms should not be crowded. Even in the visiting hours too
many people should not be allowed at a time.
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3. The seating arrangements for the patient who have just come for some
tests and the person accompanying him have to be comfortable.
4. The signboards must be the perfect indicators so that there is no
difficulty for the customer to locate the place, he wants to go to. Foreg., in Asian Heart Hospital, the technologies used are latest, the
visitors are given two passes so only two people can go and see the
patient in the visiting hours.
EMPATHY
The attitude of the service provider should be caring and if possible
individual attention to each customer should be given
1. The attitude of the doctors and nurses should be concerned. They
should be approachable as and when required.
2. The doctors and nurses must have the ability to understand the problem
of the patient and give the solution accordingly.
3. The doctors must communicate well to the patient and the relatives
about the disease the patient is suffering from.
4. The nurse and the ward boy should be assigned to look after the
patient.
RESPONSIVENESS
The service delivery should be prompt and up to the mark.
1. The patient should be attended as soon as he comes to the hospital and
registers himself. In case of emergency he should be attendedimmediately.
2. The nurse should be able to locate the doctor soon if he is needed.
For e.g. a patient suddenly starts sinking or breathing at a faster rate
the nurse should be able to call the doctor immediately. For this, a good
intercom facility is required.
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PLACE
STATISTICS REVEALS THAT :
PROBLEMS-OF-ACCESS:
Fifty-four per cent delivered their babies without the support of trained
personnel.
Fifty-eight per cent of children have not completed their immunisation
schedule and 14 per cent have not received a single vaccine.
Only one in two women seeks treatment for illness, usually because
the nearest health service is too far away, or it's too expensive.
These examples are only meant to illustrate the fact that people's
access to health care is limited by their ability to pay, as well the
availability of services.
DISTRIBUTION
The most commonly recognized medical facility is probably the hospital. In the
past decade, however, the shift has been away from providing all care in the
most expensive medical environment. As a result, a number of other less
expensive options have developed. There are ambulatory surgery centers,
rehabilitation centers, nursing homes and other residential care facilities,
specialty service centers and home care programs, just to name a few.
1. Medical camps
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They are the most common form of distributing the medical services. These
camps are generally held when there is a calamity. As we recently saw,
these camps being held at various parts of Mumbai, in the aftermath of
the floods of 26th
July. Such camps are organized on an even larger scalewhen the calamity is of a very high magnitude. Eg. The camps that were
set up in Gujarat ( areas of Bhuj & Anjar) were huge enough to have
several Operation Theatres in them & they accommodate upto 100
patients at one point of time. They are equipped with quite a lot of
equipments like X ray machine, the ECG etc. they are manned by nurses,
general practitioners, specialists, & other medical professionals.
2. Air Ambulances
Rooftop heli-pad is available for the emergency airlifting of patients to and
from the hospital for specialized trauma treatment.
These air ambulances have a crew of up to 5 people, which includes one
specialized doctor, a Para-medical staff, 3 member rescue team. Family
members of the patient are generally not allowed to accompany him. Though
not very common in India, its a regular feature in the hospitals of developed
countries. Even in India, these emergency services are developed. Eg. The
Madke Hospital in Mumbai.
3. Ambulances
As we all know, they are the most common mode of transport used in moving
in the patients from the place of illness to the hospitals.
4. Mobile Vans
Mobile Hospital and Research Centre, was flagged off on October 19, 2002 byHis Excellency Dr.APJ Abdul Kalam, President of India.
It has been found to be extremely popular & a practical health care model for
Uttaranchal.
The aim has been to bring advancements in modern medical sciences at the
doorstep of the common man, who otherwise would have been neglected of its
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benefits. The project has been conceived, keeping in mind the specific needs
of remote hilly terrain of Uttaranchal where negligible modern health care is
available to needy and poor people who are staying in far-flung areas of
Uttaranchal
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PRICE
The pricing management of a social institution becomes complicated as the
policy makers are expected to take social factors into considerations. The
lower sections of society look forth to free and cost-free services, as they are
not economically backed to support their familys healthcare expenses.
Naturally this jeopardizes the task of top management. It is close to
impossible for even the government, specially in an over populated country
like ours, to make available world-class services to all without charging any
fee. But then, it is also not rational that we expect free services, though wehave the capacity to pay, which is another problem with the middle-income
class of the country.
The pricing strategy helps us to projecting our image . Not only this, if the
strategies are welfare oriented, the task of satisfying the users is also
simplified. But the satisfaction depends upon sophistication. And sophistication
cant be possible unless we change our pricing strategies. Even the affluent
sections of society expect low cost services from social institutions in general
and hospitals in particular the task of innovating services in line with latest
developments in the field of physical sciences is difficult.
Healthcare services involve the use of expensive and complex machinery,
which involve huge investments. Apart from that, the cost of maintaining them
and cost of running the hospital is in no terms cheap. Doctors salaries along
with the salaries of the nurses and helpers constitute a great part of the cost
too. In a developing country like ours, where the level of income of the
general masses is found low, it is significant that pricing decisions are liberal
to the economically weaker sections of the society.
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There are a number of questions that service marketers need to ask
themselves as they prepare to create and implement a well thought out
pricing strategy.
HOW MUCH TO CHARGE?
PRICING IN GOVT. HOSPITALS
In the Indian setting where a number of persons are below the poverty line it
is challenging task to formulate a pricing strategy, which is successful in
serving the social interests and generating profits. It is due to this that mostgovernment hospitals are in deplorable condition. The ultimate sufferers are
the society and specially the poorer sections. Since the affluent sections have
an option to avail the expensive medical services made available by private
hospitals. The societal marketing principles make an advocacy in favors of
protecting the public interests but it is not meant that the hospitals have a
uniform pricing/free structure for all the users. The fee strategy for
hospitals should be in proportion to the incomes of users, which would
engineer a sound foundation for qualitative or quantitative
improvements.
DISCRIMINATORY PRICING:
For social institutions like govt. hospitals a discriminatory fee structure is
preferred since it provides even the weaker sections of society, an opportunity
to avail the quality medical services. This enables hospitals to innovateservices to keep pace with the latest developments in medical sciences.
1. Free service: Generally speaking, all categories of hospitals should
adopt cost-free services to the weaker sections of the society having no
source of income for paying even the nominal charges. In this
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context, the government hospitals should be given special grants to
avoid an imbalance in their financial management.
2. Subsidised services: The users belonging to the low-income groupshould be made available subsidized services. That is, the public or
hospitals make nominal charges for the services made available to
them. It is more or less clear that subsidized services are a bit lower
than the cost involved on treatment. Both the central and state
governments would give the subsidies.
3. Cost-based Services: This is based on the principle of no-profit, no-
loss. Or say, the cost based strategy in which prices or fees are equal to
the costs involved on treatment. This is basically for the middle
income group.
4. Cost plus Subsidy: This strategy allows charging more than the costs
involved on the services, but only from the better-off sections of
society. The transfer of these surpluses to the account of subsidy for
compensating the losses on account of providing free or subsidized
services to the weaker sections and low-income group users is also
necessary.
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1. 2.
3. 4.
On one hand, it is judicious that no discrimination is found in respect of
making available the medical aids, but on the other hand, we cant adopt
uniform policy while making available to the users and their attendants other
facilities like standard of room, indoor facilities and other non medical
amenities.
This is justified on the ground that all groups are not paying equal fees for
availing their services. Moreover when no income group has been availing the
services without paying any fee, their expectations would not be more than
the proper medical aids.
At Cooper Hospital all the patients are not charged. Only those who can
afford to pay would pay others can pay whatever they can or pay nothing atall.
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Government HospitalsFEE/CHARGE
FREE(For No Income group)
SUBSIDISED(For Low Income group)
COST + LOSSES FROM 2(Middle Income group)
COST + SURPLUS TOMAKE UP THE LOSSESOF 1.(High Income group)
DiscriminatoryPricing
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PRICING IN PRIVATE HOSPITALS
It is difficult to offer free or subsidized services to the masses. On the otherhand, the technological sophistication has raised the cost of services as the
inputs used in making available the medical services are found costly due
to rising inflationary pressure.
Thus private hospitals take the following approaches to pricing:
1. Cost Based Pricing:
Direct price + overhead costs + profit margin.
This approach involves setting prices relative to financial costs. The
hospital sets a price sufficient to recover the full costs (variable, semi
variable & fixed) of providing the service. These ads a sufficient margin
to yield the described level of profit at the predicted sales volume.
Hospitals generally incur high fixed costs due to expensive physicalfacilities.
In hospital services, this method is cumbersome because the tracking &
identification of costs apart from doctors fee, is difficult.
In spite of this, some hospitals in the private sector do follow this
method.
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2. Demand/Value Based Pricing:
This involves settling a price consistent with the customers
perception of service value. That is, prices are based on whatcustomers will pay for the services provided.
Hospitals with a reputation for high quality successful treatments etc.
can & do charge a premium simply based on the sheer perception of
quality health care. Those who can afford are generally willing to spend
high amounts on quality care.
However there was a case during the out break of leptospirosis , when
the was a huge requirement of white blood platelets they were not
easily available in the city. As a result its charges rose from Rs.250- 300
to Rs.1000+ deposit of Rs. 600
3. Relationship Pricing:
Hospitals may undertake relationship pricing with regard to corporate
clients so as to develop & maintain long-term customer relationships.
Here the hospital offers companys o n treatment of its employees over
a period of time.
4. Competition based pricing:
Using other price as an anchor for the hospitals price, heterogeneity of
service across and within providers makes the approach complicated.
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WHAT SHOULD BE THE BASIS OF PRICING?
Pricing in hospitals may be based on the following:
1. Time based: It is based on the time of use. Fr example: In case of
an admission the duration of the patients stay is un predictable, so
rooms may be charged on a daily basis. In AHI, the rate of a suit is
Rs.5500 /- per day.
2. Value based: it is based on the value or the importance of the
service. In case of consultation with a doctor or out patients, doctor's
fee may reflect till expertise or be tied to the complexity of the
diagnosis etc.
3. Flat rate basis: This is charging flat/ standard rates for some
services. Again, there may be flat rates assigned to various
treatments for example: charges for an X- Ray, ECG & so on.
At Breach Candy Hospital on admission, an initial deposit is collectedat the in-patient billing counter. The amount depends on the category of
room and the treatment / surgical procedure planned.
The in-house doctors are paid salaries by the hospital as per the
hospital norms whereas the visiting doctors decide the fees in
consultation with the patients and only 10% of this fee is retained
by the hospital. All the billing transactions are done through the
hospital.
Various categories of rooms ranging from a shared room to the deluxe
suite are available.
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Room Charges and Deposits at Breach Candy Hospital:-
GENERAL:
Room Category Tariff (Rs.) Deposit (Rs.)Deluxe 4,500 40,000New wing 4,200 40,000Single Rooms (West) 3,000 30,000Single Rooms (East) 2,500 25,000Single Rooms (Shared Bath) 1,500 20,000Double Shared Room 1,300 20,000Non A/C Single Room (Shared
Bath)
1,200 20,000
MATERNITY:
Room Category Tariff (Rs.) Deposit (Rs.)Deluxe Maternity 4,500 20,000Single Room (With Attendant Couch) 3,500 20,000Single Room 3,200 20,000Single Rooms (Shared Bath) 2,400 20,000Double Shared Room (Shared Bath) 2,200 20,000Shared Room (Shared Bath) 1,300 20,000Labour Room 1,800
INTENSIVE CARE UNITS:
Room Category Tariff (Rs.) Deposit (Rs.)Surgical 5,000 40,000Medical 5,000 40,000Neonatal 1 3,500 35,000Neonatal 2 2,200 30,000High Dependency Unit 3,200 30,000Day Care 900 20,000
CHARGES AT COOPER HOSPITAL :
Category Amount (Rs.)1. a) Outside patient- for case paper
b) 14 days after for re-checking
Rs.10
Rs.102. a) Light checking
b) E.C.G
Rs.30
Rs.303. a) Ultra sonography
b) If they need the imaging film
Rs.100
Rs.50
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4. E.E.G. - brain Checking for
psychiatric
Rs.250
5. Extra special Surgery Rs.50006. Special Surgery Rs.500
7. Normal Surgery Rs.200
PROMOTION
Buoyed by corporatisation of healthcare, Indias promotion as a sought after
medical tourism destination and threatened by the mushrooming of new
hospitals, it is becoming difficult for hospitals these days to depend on mere
word of mouth promotion to attract patients.
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Hospitals usually resort to personal selling for business-to-business
marketing. Both in the case of corporate tie-ups and approaching doctors for
patient referrals, it is the hospitals marketing executive who personally
approaches the corporate or the doctor so as to pitch and finalize the deal.
Network of doctors:
On the other hand, they also have a network of doctors linked to them.
These doctors are consulting doctors who dont have clinics of their own.
Thus, they treat all their patients in the hospital premises itself. Other visiting
doctors are also linked to the hospital and even they pull their patient-base to
the hospital for surgery, treatment and recovery. Many hospitals also provide
incentives to the doctors so as to ensure that the hospital is the first
preference of the doctors for referral.
Apollo Hospital in Chennai interacts with doctors on one on one basis. They
regularly conduct seminars and continual education programmes to explain to
doctors the advances in the medical sciences and the infrastructure that their
hospital has.
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(b) Customer service and training:
In hospitals, almost all the services are delivered in the customers presence.Front-line personnel are directly involved in the process of offering the
services, due to which they must be efficiently informed, trained and
supported.
For instance, if nurses neglect patients, receptionists misbehave and doctors
do not show a human approach, the hospital will fail in delivering good service
to the society in spite of the availability of most sophisticated equipments and
technologies, efficient doctors and nurses and most comfortable buildings and
infrastructure facilities.
Thus, hospitals invest a lot in internal marketing by way of training so as to
ensure that the employees are at their best of behavior with the patients and
well informed about the various activities of the hospital, including free check-
up camps and talks. Important ways of internal marketing is analyzing
feedback from regular customer satisfaction surveys and improve service
delivery so that the way of service delivery itself is the marketing of the
service.
Example: One way in which AHI ensures good customer service is by holding
training programs for nurses every 15 days, enlightening them about how to
handle various patients etc.
At Fortis Hospital at Noida, theres also a system of taking feedback from
patients and visitor, which enables them to check flow in their service.
(c) Word of mouth:
In Medicare services, word of mouth plays a very important role, as people are
more likely to trust a hospital if they have heard about its success in
treatments or quality care from a patient. Thus, by ensuring good customer
service, hospitals also get a lot of promotion by way of word of mouth.
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CAMPS FOR SOCIAL PURPOSE:
They conduct camps in rural areas to give medical check ups at reasonable
prices, they sponsor visits to old age homes etc. Participating in the countrysbiggest medical conventions and conducting health camps are also other
prominent forms of making their presence felt.
For example: Hinduja Hospital had also sent a team of their medics to Bhuj
when the catastrophic earthquake hit the place some time ago.
ADVERTISING
They are not used frequently in hospital marketing. Hospitals can focus on the
quality of their services, their contribution to the social transformation
process, but they cannot advertise for generating profits.
Mostly, advertising through mass communication media like TV ( special
programmes, interviews of specialists), print media (fitness
magazines, news papers) etc. is only used in social marketing where the
objective is to pass on a social message like family planning, childimmunization, health and family welfare etc.
SALES PROMOTION
In hospitals, sales promotion usually by way of:
- Sign up rebates or discounts, especially in the case of corporate clients
- Gift premiums, for ex. Doctors are offered various gifts and benefits in returnfor patient referrals.
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PUBLICITY AND PUBLIC RELATIONS
Hospitals may sometimes issue press releases regarding the success of rare
and crucial operations and surgeries. This is because its success rate of crucialoperations and surgeries reflects the technological and knowledge- based edge
of the hospitals over the competitors. When many successes are discussed in
health magazines and newspapers, it becomes a natural advantage for the
hospital.
To reach the consumers, Apollo Hospitals rely mostly on public relations.
Whenever their doctors perform pioneering surgeries or winning awards for
their achievements, they talk to the media and when people come to know
about their achievements they get confidence to go for the services.
INSTRUCTIONAL MATERIALS
Use of traditional approaches like printed materials , ranging from brochers
and instruction manuals to step-by-step instructions are used by hospitals
they also follow printing and making readily available various emergency or
appointment numbers .
AHIC:
AHIC has a patient guide in every patients room which gives patient valuable
information regarding booking, cancellations, various facilities available, what
to expect during the stay, discharge procedure, billing and payment
procedures etc..
They also have a patient education service, wherein brochers regarding the
heart, what the various heart ailments are, what the various heart surgeries or
treatments involve, how heart disease can be avoided by way of healthy
eating and exercise etc.
Almost all the private hospitals have web sites with information for patients,
doctors, facilities available, price for the same etc. One of the most effective
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marketing tool of Jaslok Hospital is a web site (www.jaslokhospital.net), which
is constantly updated by their technical staff.
Brochures and printed material are also available at certain other places.
For ex. Printed material at the blood bank helps educate patients or donors onwhy to donate blood, precautions to be taken before donating blood etc.
CORPORATE TIE-UPS
There are 2 ways of doing this:
Direct Tie- Ups:
Hospitals may either tie-up directly with corporate and offer health check-
ups and treatments at discounted rates to the employees of the corporate
Sometimes free conferences or camps are also conducted for the
employees of corporate by the hospital so as to educate them on prevention of
heart diseases etc. Corporate Tie-ups - entitles executives to consultation and
admission without payment formalities.
The bills are settled directly by the company, simplifying the admission and
discharge procedures for selected employees. Regular correspondence is
maintained with their corporate clients, they are sent brochures and flyers
regularly.
For Example, Breach Candy Hospital has tie-ups with 150 corporate
companies and consulates, Also Hinduja hospital has around 170 Corporate
tie-ups.
The marketing strategy of Jaslok Hospital involves tying up with corporates,
some of them being Oil and Natural Gas Commission (ONGC), Mumbai Port
Trust (MBT), Bhabha Atomic Research Centre (BARC) and Air India.
At AHIC they undertake corporate marketing by approaching various
corporate and inviting them to join their panel. Different packages are offered
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to these corporate such as discounts of 5-10% depending on the strength of
employees, health check ups and programs for employees etc. corporate are
also offered credit facilities i.e. the bill of employees is sent to the company
after 15 days for settlement.
PPOs (Preferred Provider Organization):
They can attract corporate business through PPOs (Preferred Provider
Organization). PPOs have an understanding with corporate and in case an
employee falls sick, the corporate refers the employee to the PPO, which in
turn sends them to the hospital for check-ups and treatments. which brings
them a lot of business and also, helps in promoting the high class quality of
service they provide.
FREE HEALTH CHECK-UPS
This can be an important marketing tool as a patient attending a free health
check up camp or talk at the hospital, goes back with a nice and charitable
image of the hospital. Thus, the next time he is sick, he thinks of coming tothat hospital. Most hospitals feel that if more than 50% of the patients who
attend these free camps turn for further check ups, then organizing the camps
are worth the trouble.
For example Breach Candy Hospital conducts conducts free pediatric camps
and eye camps . They also offer free check ups and free treatment to
outpatients from time to time.
Other marketing strategies of Jaslok Hospital involves that the hospital
conducts free health check-ups like diabetes and cardiac check ups for the
general public.
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CONTINUOUS MEDICAL EDUCATION PROGRAMS/
EXHIBITIONS
Under this, hospitals hold seminars and conferences relating to specific
diseases or latest technology, where they involve the doctors from all around
the country, for detailed discussion. This makes the hospital well known
amongst the doctors, who could in future refer complicated cases to the
hospital.
For example Liver Day was celebrated at Apollo Hospital, which was aimed
at educating and creating awareness amongst children and parents, theyorganized a fashion show and health quiz, which generated a lot of interest
Fortis Hospital at Noida was the first hospital to organise an exhibition in
the National Capital Region, wherein the general public could visit all
departments of the hospital and get answers from experts. Secondly, Fortis
launched a dialysis technician programme for women from the weaker section
of society in which they were given free training by the hospital and they will
be assimilated in the hospital itself.
PRESENCE OF EMINENT PERSONALITIES
In board of trustees:
Many hospitals have eminent personalities from the industry in their Board of
trustees so as to create a sense of confidence in the minds of people.
As Patients:
Celebrities, who, when admitted, are spoken about in the newspapers whichgains a lot of indirect promotion for the hospital. Breach Candys clientele
consists of a lot of celebrities treated which includes the Former Prime
Minister Mr. Vajpayee, Late Mr. Dhirubhai Ambani, Shammi Kapoor,
Shahrukh Khan, etc .
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INTERNATIONAL MARKETING
With medical tourism picking up, hospitals are emphasizing on marketing
themselves in the developed special packages for those overseas patientsand have tie ups with various hotels.
At AHIC International marketing is done by organizing cutting edge medical
programs & inviting foreign doctors to participate in them. Besides, many
members of the surgical & cardiology team hold positions in international
bodies pertaining to cardiac care and are on the editorial boards of
international journals. Some of them are also visiting professors to various
universities abroad.
Also tie-ups with foreign consulates help them make their brand name. For
the same reason Jaslok hospita l has recently tied-up with FICCI to utilise the
potential of this upcoming sector. They are also inviting foreign faculty and
holding joint symposiums with the foreign delegates to share their skills,
knowledge and experience. The hospital has a tie up with Stanford University
Medical Centre, US and they hold video conferencing every month with the
doctors of the centre, who interact with the faculty of their hospital.
BRANDING
A small hospital set-up that caters to the needs of the local community may
not feel the need to create a brand. For them, local identity through word of
mouth is sufficient. However, brand plays a vital role in the growth of
ambitious healthcare service providers like corporate hospitals. The healthcare
industry is moving towards corporatisation.
Unlike other industries, healthcare is highly consumer driven. Since branding
goes parallel to any consumer related activities , hospitals are moving
towards satisfying consumer needs. Therefore, the need of getting branded is
originating from the consumer itself.
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Branding is an empowerment of the Indian healthcare consumer.
Experts feel that without a strong branded customer service, a hospitals
marketing budget is wasted.We live in a very different healthcare world today where the consumer is far
more knowledgeable about the diseases and their choices of treatment.
Institutions which will focus their energies in identifying the needs of their
patients and create seamlessness in the experience of their patients will
become the trusted brands of the community
It is formed by keeping tin mind the following factors :
1. Reputation:
Marketing or brand building may not be a conscious attempt . Brand speaks a
level of reputation. If one has developed a good reputation, this will lead to
creating a brand. When one achieves a superlative reputation, it extends into
a great brand. For instance, institutions like CMC Vellore, Lilavati hospital,
Nanavati hospital have created a strong brand for themselves through their
decades of dedicated service.
2. Exclusivity of the Hospital:
A brand should have some exclusivity and must be built around the vision
that the hospital stands for . Brands should convey this upfront, otherwise it
is futile spending on brand building. Brands communicate in a certain
language.A Hospital should ask oneself- Which language does my hospital speak?
Hospital should find its key strengths and then build its brand based on these
key factors. Factors like service delivery, clinical expertise, and medical
technology help to create an image.
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3. Word of mouth:
This being a promotional technique adds to build a brand. Unlike consumerbrands, healthcare is a very sensitive, personal experience. It depends on a in
a hospital. Brands are established in healthcare through and therefore brand-
building in healthcare is a lengthy process.
4. Patients experience:
Healthcare brands emerge not through advertising but through the power of
patient experience. Hospitals should see things from a patients perspective.
Each patient has different needs. The hospital should