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A
PROJECT ON
HEALTH PROBLEMS AND SERVICES
UNDER SUPERVISION OF:

QUICK LINKS
Home
About us
Our Videos

SUBMITTED BY
NAME:
ENROLLMENT NO:

FAQs
Contact Us

CONTACT US

Submitted in partial fulfillment of the requirements for Address: A1/17, Top Floor,
qualifying
Opposite Metro Pillar No: 636,
Main Najafgarh Road, Uttam
MBA
Nagar
New Delhi - 110058
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HEALTH PROBLEMS AND SERVICES


Under Supervision of :

Contact No: 011-41668088,


9015596280, 9313565406

Submitted By:

CONNECT WITH US

Name :
Programme :
Enrolment No. :
Study Center Code :

OTHER PROJECTS

BONAFIDE CERTIFICATE
This is to certify that the project titled Health Problems and
Services is an original work of the Student and is being
submitted in partial fulfillment for the award of the Masters
Degree in Business Administration of Sikkim Manipal University.
This report has not been submitted earlier either to this
University or to any other University/Institution for the
fulfillment of the requirement of a course of study.

CATEGORIES
.NET (9)
A LEVEL (11)

Signature of Student Signature of Supervisor

AIMA PGDBM (17)

. .

AMITY (44)
ACKNOWLEDGEMENT

ANDROID (9)

With Candor and Pleasure I take opportunity to express my


sincere

thanks

and

obligation

to

my

esteemed

B LEVEL (14)
BBA PROJECT SYNOPSIS (3)

guide. It is because of his able and mature

bba synopsis (4)

guidance and co-operation without which it would not have been

bba synopsis and project (4)

possible for me to complete my project.

BCA (17)

It is my pleasant duty to thank all the staff member of the


computer center who never hesitated me from time during the
project.

bca (2)
bca project (5)
BCA PROJECT SYNOPSIS (3)
bca synopsis (6)

Finally, I gratefully acknowledge the support, encouragement &


patience of my family, and as always, nothing in my life would be
possible without God, Thank You!
(STUDENT NAME)

BTECH (15)
btech project (1)
BTECH PROJECT SYNOPSIS
(2)
btech synopsis (1)

DECLARATION
I hereby declare that this project work titled Health Problems
http://projecthelpline.in/myblog/?p=819

btech synopsis project (1)


C LEVEL (17)
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and Services is my original work and no part of it has been

COMPUTER SCIENCE (31)

submitted for any other degree purpose or published in any

DOEACC (19)

other from till date.

DOEACC Project (2)


DOEACC Project Synopsis (2)

(STUDENT NAME)

ELECTRICAL (11)
TOPIC PAGE NO

ELECTRONICS AND
COMMUNICATION (12)

1.

Introduction

8
2.

Review

of

literature57

FINANCE (32)
finance project (1)
Free Sample Download (2)
GUIDELINE FREE SAMPLE (2)

3.

Objective.73 GUIDELINE FREE SAMPLE


DOWNLOAD (2)
4.
Research
Methology75
5.

Result

and

Healthcare Management
Project WITH GUIDELINE (2)

and

HUMAN RESOURCE
MANAGEMENT (34)

discussion..78
6.

Data

Analysis

Findings111

IEEE (17)

7.

IGNOU (57)

Conclusion...

..122
8.

References

..125
9.

Questionnaire

..

IGNOU B.TECH project (2)


IGNOU B.TECH SYNOPSIS (3)
ignou bca (2)
ignou bca free format (3)

...129

ignou bca free project (3)


HEALTH PROBLEMS AND SERVICES

ignou bca free project report


(3)

1. INTRODUCTION
Healthcare in India features a universal health care system run

ignou bca free synopsis


report (2)

by the constituent states and territories of India. The

ignou bca project (5)

Constitution charges every state with raising of the level of

IGNOU BCA Project &


Synopsis (2)

nutrition and the standard of living of its people and the


improvement of public health as among its primary duties. The
National Health Policy was endorsed by the Parliament of India

ignou bca project and


synopsis (2)

in 1983 and updated in 2002.[1] However, the government sector

ignou bca projects (2)

is understaffed and underfinanced; poor services at state-run

ignou bca report (2)

hospitals

force

many

people

to

visit

private

medical

practitioners.
Government hospitals, some of which are among the best
hospitals in India, provide treatment at taxpayer expense. Most
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ignou bca report guidelines


(2)
ignou bca synopsis (7)
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Government hospitals provide treatment either free or at

ignou bca synopsis and


project (3)

minimal charges. For example, an outpatient card at AIIMS (one

IGNOU M.TECH Projects (3)

of the best hospitals in India) costs a one time fee of rupees 10


(around 20 cents US) and thereafter outpatient medical advice is

IGNOU M.TECH SYNOPSIS


(3)

free. In-hospital treatment costs depend on financial condition of

IGNOU MBA PROJECT (3)

essential drugs are offered free of charge in these hospitals.

the patient and facilities utilized by him but are usually much
less than the private sector. For instance, a patient is waived
treatment costs if he is below poverty line. Another patient may
seek for an air-conditioned room if he is willing to pay extra for
it. The charges for basic in-hospital treatment and investigations

IGNOU MBA PROJECT and


SYNOPSIS (3)
IGNOU MBA SYNOPSIS (3)
ignou mca free format (1)

are much less compared to the private sector. The cost for these

ignou mca free project (3)

subsidies comes from annual allocations from the central and

ignou mca free project


report (3)

state governments.
Primary health care is provided by city and district hospitals and
rural primary health centres (PHCs). These hospitals provide

ignou mca free synopsis


report (3)

treatment free of cost. Primary care is focused on immunization,

ignou mca project (4)

prevention of malnutrition, pregnancy, child birth, postnatal


care, and treatment of common illness Patients who receive

ignou mca project and


synopsis (3)

specialized care or have complicated illnesses are referred to

ignou mca report (2)

secondary (often located in district and taluk headquarters) and


tertiary care hospitals (located in district and state headquarters
or those that are teaching hospitals).
In recent times, India has eradicated mass famines, however the
country still suffers from high levels of malnutrition and disease

ignou mca report guidelines


(3)
ignou mca synopsis (4)
IMT CDL (38)

especially in rural areas. Water supply and sanitation in India is

IMT MBA Finance (6)

also a major issue in the country and many Indians in rural areas

IMT MBA Finance Project (6)

lack access to proper sanitation facilities and safe drinking water.

IMT MBA Finance Synopsis


(6)

However, at the same time, Indias health care system also


includes entities that meet or exceed international quality
standards. The medical tourism business in India has been

IMT MBA Finance Synopsis


WITH GUIDELINE (6)

growing in recent years and as such India is a popular

IMT MBA HR (7)

destination for medical tourists who receive effective medical


treatment at lower costs than in developed countries.
The Indian healthcare industry is seen to be growing at a rapid
pace and is expected to become a US$280 billion industry by
2020.[2] The Indian healthcare market was estimated at US$35

IMT MBA HR Project (6)


IMT MBA HR Project WITH
GUIDELINE (6)
IMT MBA HR Synopsis (6)

2012 and US$145 billion by 2017.[3] According to the Investment

IMT MBA HR Synopsis WITH


GUIDELINE (6)

Commission of India the healthcare sector has experienced

IMT MBA IB (7)

phenomenal growth of 12 percent per annum in the last 4 years.

IMT MBA IB Project (6)

[4] Rising income levels and a growing elderly population are all

IMT MBA IB Project WITH

billion in 2007 and is expected to reach over US$70 billion by

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factors that are driving this growth. In addition, changing

GUIDELINE (6)

demographics, disease profiles and the shift from chronic to

IMT MBA IB Synopsis (5)

lifestyle diseases in the country has led to increased spending on

IMT MBA IB Synopsis WITH


GUIDELINE (5)

healthcare delivery.[5]
Even so, the vast majority of the country suffers from a poor
standard of healthcare infrastructure which has not kept up with
the growing economy. Despite having centers of excellence in
healthcare delivery, these facilities are limited and are
inadequate in meeting the current healthcare demands. Nearly
one million Indians die every year due to inadequate healthcare
facilities and 700 million people have no access to specialist care

IMT MBA IT (7)


IMT MBA IT Project WITH
GUIDELINE (6)
IMT MBA IT Synopsis (6)
IMT MBA IT Synopsis WITH
GUIDELINE (6)

and 80% of specialists live in urban areas.[6]

IMT MBA Marketing (7)

In order to meet manpower shortages and reach world

IMT MBA Marketing Project


WITH GUIDELINE (5)

standards India would require investments of up to $20 billion


over the next 5 years.[7] Forty percent of the primary health
centers in India are understaffed. According to WHO statistics
there are over 250 medical colleges in the modern system of
medicine and over 400 in the Indian system of medicine and
homeopathy (ISM&H). India produces over 25,000 doctors
annually in the modern system of medicine and a similar
number of ISM&H practitioners, nurses and para professionals.
[8] Better policy regulations and the establishment of public
private partnerships are possible solutions to the problem of
manpower shortage.

IMT MBA Marketing


Synopsis (6)
IMT MBA Marketing
Synopsis WITH GUIDELINE
(6)
IMT MBA Project
Management (7)
IMT MBA Project
Management Project (6)

hospital beds per 1000 population. With a world average of 3.96

IMT MBA Project


Management Project Report
(6)

hospital beds per 1000 population India stands just a little over

IMT PROJECT (10)

0.7 hospital beds per 1000 population.[9] Moreover, India faces a

IMT PROJECT SYNOPSIS (9)

shortage of doctors, nurses and paramedics that are needed to

imt synopis (6)

India faces a huge need gap in terms of availability of number of

propel the growing healthcare industry. India is now looking at


establishing academic medical centers (AMCs) for the delivery of
higher quality care with leading examples of The Manipal Group
& All India Institute of Medical Sciences (AIIMS) already in place.
As incomes rise and the number of available financing options in
terms of health insurance policies increase, consumers become

IMT SYNOPSIS (9)


imt synopsis and project (6)
INDERPRASTHA UNIVERSITY
GURU GOBIND SING
(GGSIPU) (7)

more and more engaged in making informed decisions about

INGOU BCA (2)

their health and are well aware of the costs associated with those

INGOU BCA Project (1)

decisions. In order to remain competitive, healthcare providers

INGOU BCA Project Synopsis


(1)

are now not only looking at improving operational efficiency but


are also looking at ways of enhancing patient experience overall.
[10]

INGOU BCA Project Synopsis


2016 (1)

India has approximately 600,000 allopathic doctors registered to

INGOU MCA (1)

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practice medicine. This number however, is higher than the

IPHONE (9)

actual number practicing because it includes doctors who have


emigrated to other countries as well as doctors who have died.

IT Project WITH GUIDELINE


(2)

India licenses 18,000 new doctors a year.[11]

J2EE (9)

Critics say that the national policy lacks specific measures to


achieve broad stated goals. Particular problems include the
failure to integrate health services with wider economic and
social development, the lack of nutritional support and

JOURNALISM (2)
LIBRARY SCIENCE (6)
MANAGEMENT (50)

sanitation, and the poor participatory involvement at the local

MARKETING (31)

level.

Marketing Project WITH


GUIDELINE (2)

Central government efforts at influencing public health have


focused on the five-year plans, on coordinated planning with the
states, and on sponsoring major health programs. Government
expenditures are jointly shared by the central and state

MARKETING Synopsis WITH


GUIDELINE (2)

governments. Goals and strategies are set through central-state

MARKETING Synopsis WITH


GUIDELINE FREE SAMPLE (4)

government consultations of the Central Council of Health and

MBA (33)

Family Welfare. Central government efforts are administered by


the Ministry of Health and Family Welfare, which provides both
administrative and technical services and manages medical
education. States provide public services and health education.
The 1983 National Health Policy is committed to providing health

MBA (40)
MBA Finance (2)
MBA Finance Project WITH
GUIDELINE (3)

services to all by 2000. In 1983 health care expenditures varied

MBA Finance Synopsis (3)

greatly among the states and union territories, from Rs 13 per

MBA IB (2)

capita in Bihar to Rs 60 per capita in Himachal Pradesh, and

MBA IB Synopsis WITH


GUIDELINE (3)

Indian per capita expenditure was low when compared with


other

Asian

countries

outside

of

South

Asia.

Although

government health care spending progressively grew throughout

MBA International Business


(1)

the 1980s, such spending as a percentage of the gross national

mba it (1)

product (GNP) remained fairly constant. In the meantime, health


care spending as a share of total government spending
decreased. During the same period, private-sector spending on
health care was about 1.5 times as much as government
spending.
In the mid-1990s, health spending amounted to 6% of GDP, one
of the highest levels among developing nations. The established
per capita spending is around Rs 320 per year with the major
input from private households (75%). State governments
contribute 15.2%, the central government 5.2%, third-party
insurance and employers 3.3%, and municipal government and

MBA Marketing (1)


MBA Marketing synopsis (1)
MBA MS-100 (4)
MBA OPERATIONS PROJECT
(1)
MBA OPERATIONS PROJECT
SYNOPSIS (1)
MBA OPERATIONS SYNOPSIS
(1)

foreign donors about 1.3, according to a 1995 World Bank study.

MBA Project Management


Synopsis (2)

Of these proportions, 58.7% goes toward primary health care

MBA PROJECT SYNOPSIS (3)

(curative, preventive, and promotive) and 38.8% is spent on

MCA (15)

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secondary and tertiary inpatient care. The rest goes for

MCA PROJECT TRAINING (3)

nonservice costs.
The Fifth (197478) and Sixth Five-Year Plans and (198084)

MCA Synopsis WITH


GUIDELINE (2)

included programs to assist delivery of preventive medicine and

MLIS (7)

improve the health status of the rural population. Supplemental


nutrition programs and increasing the supply of safe drinking
water were high priorities. The sixth plan aimed at training more
community health workers and increasing efforts to control
communicable diseases. There were also efforts to improve
regional imbalances in the distribution of health care resources.
The Seventh Five-Year Plan (198589) budgeted Rs 33.9 billion for

msc.it FREE SAMPLE


DOWNLOAD (2)
MTECH (15)
MTECH PROJECT SYNOPSIS
(2)
mtech projects (2)

health, an amount roughly double the outlay of the sixth plan.

mtech synopsis (2)

Health spending as a portion of total plan outlays, however, had

mtm project (1)

declined over the years since the first plan in 1951, from a high
of 3.3% of the total plan spending in FY 1951-55 to 1.9% of the

mtm synopsis and project


(1)

total for the seventh plan. Mid-way through the Eighth Five-Year

mtm synopsis\ (1)

Plan (199296), however, health and family welfare was


budgeted at Rs 20 billion, or 4.3% of the total plan spending for
FY 1994, with an additional Rs 3.6 billion in the nonplan budget.
Health care facilities and personnel increased substantially

OPERATIONS (30)
PGDLAN (8)
PHP (9)

between the early 1950s and early 1980s, but because of fast

SCDL (7)

population growth, the number of licensed medical practitioners

scdl project (3)

per 10,000 individuals had fallen by the late 1980s to three per

scdl project report (3)

10,000 from the 1981 level of four per 10,000. In 1991 there
were approximately ten hospital beds per 10,000 individuals. For
comparison, in China there are 1.4 doctors per 1000 people. nn
Primary health centers are the cornerstone of the rural health
care system. By 1991, India had about 22,400 primary health
centers, 11,200 hospitals, and 27,400 clinics. These facilities are
part of a tiered health care system that funnels more difficult

SMU (31)
SMU BCA Project (3)
SMU BCA PROJECT
SYNOPSIS (4)
SMU BCA Project WITH
GUIDELINE (3)

cases into urban hospitals while attempting to provide routine

SMU BCA SYNOPSIS (3)

medical care to the vast majority in the countryside. Primary


health centers and subcenters rely on trained paramedics to

SMU BCA SYNOPSIS WITH


GUIDELINE (3)

meet most of their needs. The main problems affecting the

SMU BSC (IT) (3)

success of primary health centers are the predominance of

SMU BSC (IT) Project WITH


GUIDELINE (2)

clinical and curative concerns over the intended emphasis on


preventive work and the reluctance of staff to work in rural
planning programs often causes the local population to perceive

SMU BSC (IT) Project WITH


GUIDELINE FREE SAMPLE
DOWNLOAD (3)

the primary health centers as hostile to their traditional

SMU BSC (IT) Synopsis (3)

areas. In addition, the integration of health services with family

preference for large families. Therefore, primary health centers


often play an adversarial role in local efforts to implement
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SMU BSC (IT) Synopsis WITH


GUIDELINE (3)
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According to data provided in 1989 by the Ministry of Health and

smu health care


management (2)

Family Welfare, the total number of civilian hospitals for all

SMU Marketing (2)

states and union territories combined was 10,157. In 1991 there

SMU Marketing Project (2)

national health policies.

was a total of 811,000 hospital and health care facilities beds.


The geographical distribution of hospitals varied according to
local socio-economic conditions. In Indias most populous state,
Uttar Pradesh, with a 1991 population of more than 139 million,
there were 735 hospitals as of 1990. In Kerala, with a 1991
population of 29 million occupying an area only one-seventh the
size of Uttar Pradesh, there were 2,053 hospitals.
Although central government has set a goal of health care for all
by 2000, hospitals are distributed unevenly. Private studies of

SMU MARKETING Synopsis


(3)
SMU MBA (7)
SMU MBA FINANCE (4)
SMU MBA FINANCE Project
(3)
SMU MBA FINANCE Project
WITH GUIDELINE (3)

conservative than official Indian data, estimating that in 1992

SMU MBA FINANCE Synopsis


WITH GUIDELINE (2)

there were 7,300 hospitals. Of this total, nearly 4,000 were

SMU MBA Healthcare (3)

owned and managed by central, state, or local governments.

SMU MBA Healthcare


Management (3)

Indias total number of hospitals in the early 1990s were more

Another 2,000, owned and managed by charitable trusts,


received partial support from the government, and the
remaining 1,300 hospitals, many of which were relatively small
facilities, were owned and managed by the private sector. The

SMU MBA Healthcare


Management Project (2)

to urban centers in the early 1990s. A network of regional cancer

SMU MBA Healthcare


Management Synopsis WITH
GUIDELINE (2)

diagnostic and treatment facilities was being established in the

SMU MBA HR (3)

early 1990s in major hospitals that were part of government

SMU MBA HR Project (2)

use of state-of-the-art medical equipment was primarily limited

medical colleges. By 1992 twenty-two such centers were in


operation.

Most

of

the

1,300

private

hospitals

lacked

sophisticated medical facilities, although in 1992 approximately


12% possessed state-of-the-art equipment for diagnosis and
treatment of all major diseases, including cancer. The fast pace
of development of the private medical sector and the burgeoning
middle class in the 1990s have led to the emergence of the new

SMU MBA HR Project WITH


GUIDELINE (2)
SMU MBA HR Synopsis (2)
SMU MBA HR Synopsis WITH
GUIDELINE (2)
SMU MBA IB (3)

concept in India of establishing hospitals and health care

SMU MBA IB Project (2)

facilities on a for-profit basis.

SMU MBA IB Project WITH


GUIDELINE (2)

By the late 1980s, there were approximately 128 medical


colleges roughly three times more than in 1950. These medical
colleges in 1987 accepted a combined annual class of 14,166

SMU MBA IB Project WITH


GUIDELINE FREE SAMPLE (2)

students. Data for 1987 show that there were 320,000 registered

SMU MBA IB Synopsis (2)

medical practitioners and 219,300 registered nurses. Various

SMU MBA IT (2)

studies have shown that in both urban and rural areas people
preferred to pay and seek the more sophisticated services
provided by private physicians rather than use free treatment at
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SMU MBA IT Project (2)


SMU MBA IT Project WITH
GUIDELINE (2)
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public health centers.

SMU MBA IT Synopsis (2)

Indigenous or traditional medical practitioners continue to


practice throughout the country. The two main forms of

SMU MBA IT Synopsis WITH


GUIDELINE (2)

traditional medicine practised are the ayurvedic system, which

SMU MBA PROJECT (4)

deals with mental and spiritual as well as physical well-being,


and the unani (or Galenic) herbal medical practice. A vaidya is a
practitioner of the ayurvedic tradition, and a hakim is a
practitioner of the unani or Greek tradition. These professions
are frequently hereditary. A variety of institutions offer training
in indigenous medical practice. Only in the late 1970s did official
health policy refer to any form of integration between Europeantrained medical personnel and indigenous medical practitioners.
In the early 1990s, there were ninety-eight ayurvedic colleges
and

seventeen

unani

colleges

operating

in

both

the

governmental and non-governmental sectors.


The health problems of India are developing with the country,

SMU MBA Project


Management (3)
SMU MBA Project
Management free sample
download (2)
SMU MBA PROJECT
MANAGEMENT synopsis (2)
SMU MBA PROJECT
SYNOPSIS (3)
smu mba synopsis (1)
smu mba synopsis and
project (1)

many diseases are coming to India from the west, and we are

SMU MBA Tourism (2)

taking them as a better lifestyle. The health problems of India


are:

SMU MBA Tourism Synopsis


(2)

Communicable disease problems

SMU MBA Tourism Synopsis


Diwnload (2)

Nutritional problems

SMU MCA Project (2)

Environmental sanitation problems


Medical care problems
Population problems
Malaria: with the implementation of modified plan of operation
in 1977, the upsurge of malaria cases dropped down from 6.75

SMU MCA PROJECT


SYNOPSIS (3)
SMU MCA Project WITH
GUIDELINE (2)
SMU MCA Synopsis (2)

million cases in 1976 to 2.1 million cases in 1984 since then

SMU MCA/BCA (4)

situation has not shown any improvement.

SMU MSC (IT) (2)

Europe today has a high prevalence of non-communicable


diseases such as cancer, diabetes, cardiovascular diseases,

SMU MSC (IT) PROJECT


Report (2)

obesity disorders, musculoskeletal disorders which can be

SMU MSC (IT) Synopsis (2)

attributable to the interaction of various genetic, environmental

Symbiosis (9)

and especially lifestyle factors, including smoking, alcohol abuse,


unhealthy diets and physical inactivity.
Within the 2008-2013 Health Programme, the European Union

SYSTEM IT (35)
TOURISM (6)

recommends addressing avoidable diseases by developing

Uncategorized (26)

strategies and mechanisms for prevention as well as exchanging

UPTECH UTTAR PRADESH


TECHNICAL UNIVERSITY (3)

information on and responding to non-communicable disease


threats, including gender-specific health threats and rare
diseases. Since most of them are avoidable, the main activities
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identified should focus on raising public awareness, improving


knowledge, and reinforcing preventive measures. The EU aims to
support these actions by setting up networks and information
systems across the Member States to generate a flow of
information, analysis and exchange of best practice in the public
health field
Influenza
Influenza is a highly contagious viral disease, which typically
occurs as an epidemic during the cold months. Serious human
influenza epidemics are rare, but recurrently they are more
severe than the normal seasonal outbreaks, in which case they
are also called pandemics. A pandemic occurs when a new
influenza virus emerges and starts spreading all around the
world as easily as normal influenza.
All Member States are working together to coordinate
preparedness for any influenza pandemic. In the event of an
increased risk of an influenza pandemic, the measures envisaged
in the national and preparedness and response plans would be
put into action. The European Centre for Disease Prevention and
Control plays a key role in coordinating surveillance. Further
action includes medical and non-medical countermeasures and
close coordination between the national authorities, the
European Union and the WHO.
The EU will continue to work to improve sharing of relevant
information and to coordinate risk management measures. This
will include cooperation on stockpiling antiviral drugs, capacity to
produce better influenza vaccines faster, improving national
plans and producing better risk management tools
Leprosy: is another major public health problem in India. During
the year 2003 2004, total of 2.20 lakh new cases were detected,
out of which child cases were 14.91% and deformity grade II and
above was 1.8%. 35% of these cases are estimated to be multibacillary.
Filaria: the problem is increasing in magnitude every year, having
risen from 25 million at risk in 1953 to 553 million presently. Of
these 109 million are living in urban areas and the rest in rural
areas. There are estimated to be at least 6 million attack of acute
filarial disease per year.
Lymphatic filariasis is infection with the filarial worms,
Wuchereria bancrofti, Brugia malayi or B. timori. These parasites
are transmitted to humans through the bite of an infected
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mosquito and develop into adult worms in the lymphatic vessels,


causing

severe

damage

and

swelling

(lymphoedema).

Elephantiasis painful, disfiguring swelling of the legs and


genital organs is a classic sign of late-stage disease.
The infection can be treated with drugs. However, chronic
conditions may not be curable by anti-filarial drugs and require
other measures, eg. surgery for hydrocele, care of the skin and
exercise to increase lymphatic drainage in lymphoedema.
Annual treatment of all individuals at risk (individuals living in
endemic

areas)

with

recommended

anti-filarial

drugs

combination of either diethyl-carbamazine citrate (DEC) and


albendazole, or ivermectin and albendazole; or the regular use of
DEC fortified salt can prevent occurrence of new infection and
disease.
AIDS: the problem of AIDS is increasing in magnitude every year.
Since AIDS was first detected in the year 1986, the cumulative
number of AIDS cases has risen to 124995 by the end of august
2006. It is estimated that by the end of year 2010 12 million HIV
positive cases in the country.
Since the late 1980s the HIV/AIDS epidemic has been a major
health concern and a high priority for the EU. The EU focuses its
action on:
The promotion of prevention and increased awareness-raising
An improvement of surveillance
establishing networks linking major partners involved in the
response to HIV/AIDS
facilitating the dissemination of good practice
The Health Specialist has established major bodies for the
exchange of information and the coordination of activities,
addressing Member States and neighbouring countries. He is
also active in developing countries and at global level and
provides considerable support to the Global Fund and other
institutions.
As the number of newly diagnosed HIV infections has increased
in many EU Member States and in their eastern European
neighbours over the last years, the measures and action already
being taken have to be reinforced and should deliver a
sustainable contribution towards curbing down the HIV/AIDS
epidemic in the future.
Nutritional problems: from the nutrition point of view, the Indian
society is a dual society, consisting of a small group of well fed,
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and a very large group of undernourished. The high groups are


showing diseases of affluence which one finds in developed
countries. Nutrition is the intake of food, considered in relation
to the bodys dietary needs. Good nutrition an adequate, well
balanced diet combined with regular physical activity is a
cornerstone of good health. Poor nutrition can lead to reduced
immunity, increased susceptibility to disease, impaired physical
and mental development, and reduced productivity
Nutrition Problems and Their Solutions
A variety of medical problems can affect your appetite. Your
illness, medicines, or surgery can cause these problems. Many
patients become frustrated when they know they need to eat to
get well but they arent hungry, or when they gain weight
because they are fatigued and unable to exercise.
Each of the following sections describes a nutritional problem
and suggests some possible solutions. Not all solutions will work
for everyone. Choose the remedies that fit your situation.
Decreased appetite:
Lack of appetite, or decreased hunger, is one of the most
troublesome nutrition problems you can experience. Although it
is a common problem, its cause is unknown. There are some
medicines that might stimulate your appetite. Ask your doctor if
such medicines would help you.
Solutions:
Eat smaller meals and snacks more frequently. Eating six or
even or eight times a day might be more easily tolerated than
eating the same amount of food in three meals.
Talk to your doctor. Sometimes, poor appetite is due to
depression, which can be treated. Your appetite is likely to
improve after depression is treated.
Avoid non-nutritious beverages such as black coffee and tea.
Try to eat more protein and fat, and less simple sugars.
Walk or participate in light activity to stimulate your appetite.
Meal guidelines
Drink beverages after a meal instead of before or during a meal
so you do not feel as full.
Plan meals to include your favorite foods.
Try eating the high-calorie foods in your meal first.
Use your imagination to increase the variety of food youre
eating.
Snack guidelines
Dont waste your energy eating foods that provide little or no
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nutritional value (such as potato chips, candy bars, colas, and


other snack foods).
Choose high-protein and high-calorie snacks.
Dining guidelines
Make food preparation an easy task. Choose foods that are
easy to prepare and eat.
Make eating a pleasurable experience, not a chore.
o Liven up your meals by using colorful place settings.
o Play background music during meals.
Eat with others. Invite a guest to share your meal or go out to
dinner.
Use colorful garnishes such as parsley and red or yellow
peppers to make food look more appealing and appetizing.
Weight loss
If your doctor tells you that you have lost too much weight, or if
you are having difficulty maintaining a healthy weight, here are
some tips:
Drink milk or try one of the high-calorie recipes listed below
instead of drinking low-calorie beverages.
Ask your doctor or dietitian about nutritional supplements.
Sometimes, supplements in the form of snacks, drinks (such as
Ensure or Boost), or vitamins might be prescribed to eat between
meals. These supplements help you increase your calories and
get the right amount of nutrients every day. Note: Do not use
supplements in place of your meals.
Avoid low-fat or low-calorie products unless you have been
given other dietary guidelines. Use whole milk, whole milk
cheese, and yogurt.
Use the Calorie Boosters listed below to add calories to your
favorite foods.
High-calorie snacks
Ice cream
Cookies
Pudding
Cheese
Granola bars
Custard
Sandwiches
Nachos with cheese
Eggs
Crackers with peanut butter
Bagels with peanut butter or cream cheese
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Cereal with half and half


Fruit or vegetables with dips
Yogurt with granola
Popcorn with margarine and parmesan cheese
Bread sticks with cheese sauce
Other Infectious Diseases:
Communicable diseases such as tuberculosis, measles and
influenza,

represent

serious

risk

to

human

health.

Communicable diseases do not respect national frontiers and


can spread rapidly if actions are not taken to control them. New
diseases such as HIV-AIDS and SARS (Severe Acute Respiratory
Syndrome) have emerged and others are developing new
dangerous

characteristics

such

as

multi-drug

resistant

tuberculosis, and methicillin resistant Staphylococcus aureus. In


addition, new scientific developments on the role of infectious
agents in chronic conditions such as cancer, heart diseases or
allergies are under investigation.
Europe is challenged in order to respond in the most efficient
way to these threats. Close collaboration among Member States,
European bodies like the European Centre for Disease
Prevention and Control and International agencies such as the
World Health Organisation is of pivotal importance to minimize
the risks we are facing. The place appropriate and efficient
surveillance systems, early warning and response mechanisms
and prevention and preparedness strategies in order to be ready
to respond to these threats. Detecting emerging communicable
diseases and outbreaks quickly, and sharing information on their
potential for international spread, is crucial for an appropriate
response.
Since 1999 a Network on communicable disease has been in
place and its main role is to monitor and identify quickly
potential threats for the People in order to put in place response
mechanisms in a coordinated way. The Network is composed by
the public health authorities responsible for surveillance and
response in Member States. The European Centre for Disease
Prevention and Control has been operational since May 2005.
This agency fosters a structured and systematic approach to the
control of communicable diseases in the helping to reinforce
synergies between existing capacities at National level
Alcohol
Alcohol is a key public health and social concern across the
Community. Europe has the highest proportion of drinkers in the
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world, the highest levels of alcohol consumption per capita and a


high level of alcohol-related harm. Harmful and hazardous
alcohol consumption is a net cause of 7.4% of all ill-health and
early death.
Environmental sanitation: the most difficult problem to tackle in
this country is perhaps the environmental sanitation problem,
which is multifaceted and multi-factorial. The great sanitary
awakening which took place in England in 1840s is yet to be
born. Air pollution is contamination of the indoor or outdoor
environment by any chemical, physical or biological agent that
modifies

the

natural

characteristics

of

the

atmosphere.

Household combustion devices, motor vehicles, industrial


facilities and forest fires are common sources of air pollution.
Pollutants of major public health concern include particulate
matter, carbon monoxide, ozone, nitrogen dioxide and sulfur
dioxide. Outdoor and indoor air pollution cause respiratory and
other diseases, which can be fatal.
Medical care: India has national health policy. It does not have a
national health service. The financial resources are considered
inadequate to furnish the costs of running such a service.
Population: the population problem is one of the biggest
problem facing the country, with its inevitable consequences on
all aspects of development, especially employment, education
housing, health, health care, sanitation and environment.
Cardiovascular and cerebrovascular diseases, diabetes, and
cancer are emerging as major public health problems in India.
Apart from a rising proportion of older adults, population
exposure to risks associated with certain chronic conditions is
increasing. Obesity is increasing, physical activity is declining,
and tobacco use is a substantial problem in the country.
Although it is commonly believed that non-communicable
diseases (NCDs) are more prevalent in higher income groups,
data from Indias 1995-1996 national survey showed that
tobacco intake and alcohol misuse are higher in the poorest 20%
of the income quintile. As a result, the government of India is
anticipating that the prevalence of tobacco-related conditions
will increase in lower socio-economic groups in the coming
years.
RESOURCES NEEDS TO MEET SERVICES
Resources are needed to meet the vast health needs of a
community. No nation, however rich, has enough resources to
meet all the needs for all health care. Therefore an assenssment
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of the available resources, their proper allocation and efficient


utilization are important considerations for providing efficient
health care services.
Health manpower
Money and material
Time
The term health manpower includes both professional and
auxiliary health personnel who are needed to provide health
care. An auxiliary is defined by WHO as a technical worker in a
certain field with less than full professional training.
The country is producing annually, on an average 26.449
allopathic doctors: 9,865 ayurvedic graduate: 1525 unani
graduates: 320 siddha graduates and 12785 homoeopathic
graduates. Studies in India have shown that there is a
concentration of doctors (up to 73.6%) in urban areas, where
only 26.4% percent of population live.
Money and material:
Money is an important resource for providing health services.
Scarcity of money affects all parts of the health delivery system.
In most developed countries, government expenditure for health
lies between 6 to 12 percent of GNP. In underdeveloped
countries it is less than 1 percent of the GNP and it seldom
exceeds 2 percent of the GNP.
To achieve health for all, WHO has set as a goal the expenditure
of % percent of each countrys GNP o health care. At present
India is spending about 3 percent of GNP on health and family
welfare development.
Time:
Time is money, someone said. It is an important dimension of
health care services. Administrative delays in sanctioning health
projects imply loss of time, proper use of man-hours is also an
important time factor. For example a survey by WHO has shown
that an auxiliary burse mid wife spends 45 percent of her time in
giving medical care: 40 percent in traveling: 5 percent on paper
work: and only 10 percent in performing duties for which she has
been trained. Such studies may be extended to other categories
of health personnel with a view to promote better utilization of
the time resource.

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INTRODUCTION TO DIABETES:
Diabetes is a Greek word meaning a passer through; a siphon.
Mellitus comes from the Greek word sweet. Apparently, the
Greeks named it thus because the excessive amounts of urine
diabetics produce (when blood glucose is too high) attracted flies
and bees because of the glucose content. Diabetes is the
common term for several metabolic disorders in which the body
no longer produces insulin or uses the insulin it produces
effectively.
In 2004, according to the World Health Organization, more than
150 million people worldwide suffer from diabetes. Its incidence
is increasing rapidly, and it is estimated that by the year 2025
this number will double. Diabetes is in the top 5, of the most
significant diseases in the developed world, and is gaining in
significance. Its almost hit the world like an epidemic.
What is diabetes?
It is a common condition and is characterized by abnormally
high blood sugar levels. Diabetes is a number of diseases that
involve problems with the hormone insulin. Normally, the
pancreas (an organ behind the stomach) releases insulin to help
the body store and use the sugar and fat from the food we eat.
Diabetes occurs:
When the pancreas does not produce any insulin, or
When the pancreas produces very little insulin, or
When the body does not respond appropriately to insulin, a
condition called insulin resistance.
Diabetes is a lifelong disease. As yet, there is no cure. People
with diabetes need to manage their disease to stay healthy. India
has currently the worlds largest population of diabetics, with an
estimated 30 million people suffering from the disease.
According to the World Health Organization (WHO), India is
expected to encompass 57 million people, ailing from diabetes
by 2025 and this would become 80 million in by 2030.
Diabetes is characterized by a partial or complete lack of insulin
production by the body. the classification of diabetes mellitus
include five clinical classes. Type 1, type2, other specific types of
diabetes, gestational diabetes, and pre-diabetes. Type1 diabetes
is characterized by absolute insulin deficiency. Type2 diabetes
which has relative insulin deficiency combined with defects in
insulin action account for 95-97% of adult population suffering
from the disease. One specific to our country is malnutrition
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related diabetes mellitus and fibro calcus pancreatic diabetes.


Gestational diabetes is described as diabetes related to
pregnancy. Pre-diabetes is a tern coined for people who have
only fasting high blood sugar and have no other sign and/or
symptomsofdiabetes.
The persistent rise of blood glucose levels in diabetes can lead to
long term complications (if not treated properly) involving
important organs like: eyes, kidneys, nerves, heart, blood vessels.
Who is at risk?
People who are:
In children with unexplained weight loss, fever, nausea and
vomiting.
Obese
Aged 40 years above
Having family history of diabetes (any body in the family affected
by diabetes),
who have sedentary lifestyle (not exercising) and
Unhealthy dietary habits are at risk of developing diabetes.
Women who have suffered from Gestational diabetes (diabetes
you have during your pregnancy) or have given birth to a baby
who weighs more than 9 pounds may also have increased risk of
developing diabetes.
Consequences of Uncontrolled Diabetes:
When diabetes isnt well controlled, a number of serious or lifethreatening problems may develop, including:
Retinopathy. This eye problem occurs in 75% to 95% of adults
who have had diabetes for more than 15 years. Diabetic
retinopathy diabetes is extremely rare before puberty no matter
how long they have had the disease. Medical conditions such as
good control of sugars, management of hypertension and
regulation of blood lipids are important to prevent retinopathy.
Fortunately, the vision loss isnt significant in most people with
the condition.
Kidney damage. About 35% to 45% of people with diabetes
develop kidney damage, a condition called nephropathy. The risk
for kidney disease increases over time and becomes evident 15
to 25 years after the onset of the disease. This complication
carries significant risk of serious illness such as kidney failure
and heart disease.
Poor blood circulation. Damage to nerves and hardening of the
arteries leads to decreased sensation and poor blood circulation
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in the feet. This can lead to increased risk of injury and


decreased ability to heal open sores and wounds, which in turn
significantly raises the risk of amputation. Damage to nerves may
also lead to digestive problems such as nausea, vomiting and
diarrhea.
HEALTHCARE
Healthcare industry is a wide and intensive form of services
which are related to well being of human beings. Health care is
the social sector and it is provided at State level with the help of
Central Government. Health care industry covers hospitals,
health insurances, medical software, health equipments and
pharmacy in it.
Right from the time of Ramayana and Mahabharata, health care
was there but with time, Health care sector has changed
substantially. With improvement in Medical Science and
technology it has gone through considerable change and
improved a lot.
The major inputs of health care industries are as listed below:
I. Hospitals
II Medical insurance
III. Medical software
IV. Health equipments
Health care service is the combination of tangible and intangible
aspect with the intangible aspect dominating the intangible
aspect. In fact it can be said to be completely intangible, in that,
the services (consultancy) offered by the doctor are completely
intangible. The tangible things could include the bed, the dcor,
etc. Efforts made by hospitals to tangiblize the service offering
would be discussed in details in the unique characteristics part
of the report.
Different types of health care services available in India
Hospitals
Pathology Clinics
Blood Banks
Meditation Centers
Emergency services like Ambulances, etc.
Online Medical Services
Telemedicine
Naturopathy
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Yoga Centers
Fitness Centres
Laughter Clubs
Health Spas
In the Constitution of India, health is a state subject. Central govt
intervention to assist the state govt is needed in the areas of
control and eradication of major communicable & noncommunicable diseases, policy formulation, international health,
medical & para-medical education along with regulatory
measures, drug control and prevention of food adulteration,
besides activities concerning the containment of population
growth

including

safe

motherhood,

child

survival

and

immunization Program. The plan outlay for central sector health


programmed in the Annual Plans 1997-98 is Rs.920.20 crore
including a foreign aid component of Rs.400 Crore. A major
portion of outlay is for the control and eradication of diseases
like malaria, blindness being implemented under centrally
sponsored schemes.
Another major component of the central sector health
programmed is purely Central schemes through which financial
assistance is given to institutions engaged in various health
related

activities.

These

institutions

are

responsible

for

contribution in the field of control of communicable & noncommunicable diseases, medical education, training, research
and parent -care.
In our project our focus has been the hospital sector which is the
major component of the healthcare industry.
THE HOSPITAL INDUSTRY
Some Facts
Indias healthcare industry is currently worth Rs 73,000 crore
which is roughly 4 percent of the GDP. The industry is expected
to grow at the rate of 13 percent for the next six years which
amounts to an addition of Rs 9,000 millions each year.
The national average of proportion of households in the middle
and higher middle income group has increased from 14% in
1990 to 20 % in 1999.
The population to bed ratio in India is 1 bed per 1000, in
relation to the WHO norm of 1 bed per 300.
In India, there exists space for 75000 to 100000 hospital beds.

Private

insurance

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will

drive

the

healthcare

revenues.
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Considering the rising middle and higher middle income group


we get a conservative estimate of 200 million insurable lives
Over the last five years, there has been an attitudinal change
amongst a section of Indians who are spending more on
healthcare.
Corporate hospitals mushroomed in the late eighties. The boom
remained short-lived and out of the 22 listed hospitals scrips,
most are being trading below par. An increasingly fragmented
market, lack of statistics, capital intensive operations and a long
gestation period are all wise reasons to shy away from investing
in the healthcare industry. Government and trust hospitals
dominate the scene. Many of the trust hospitals suffer from poor
management. Good corporate hospitals are still too few to
amount to a critical mass.
Corporate hospitals failed a decade ago because they emerged in
isolation and werent part of a larger phenomenon. However,
now, there are the insurance companies, the hospital hardware
and the software companies that have come together to create
the boom.
Factors Attracting Corporatism In the Healthcare Sector
Recognition as an industry: In the mid 80s, the healthcare sector
was recognized as an industry. Hence it became possible to get
long

term

government

funding
also

from

the

Financial

reduced

the

import

Institutions.
duty

on

The

medical

equipments and technology, thus opening up the sector.


Since the National Health Policy (the policys main objective was
Health For All by the Year 2000) was approved in 1983, little has
been done to update or amend the policy even as the country
changes and the new health problems arise from ecological
degradation. The focus has been on epidemiological profile of
the medical care and not on comprehensive healthcare.
Socio-Economic Changes: The rise of literacy rate, higher levels of
income and increasing awareness through deep penetration of
media channels, contributed to greater attention being paid to
health. With the rise in the system of nuclear families, it became
necessary for regular health check-ups and increase in health
expenses for the bread-earner of the family.
Brand Development: Many family run business houses have setup charity hospitals. By lending their name to the hospital, they
develop a good image in the markets which further improves the
brand image of products from their other businesses.
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Extension to Related Business: Some pharmaceutical companies


like Wockhardt and Max India, have ventured into this sector as
it is a direct extension to their line of business.
Opening Of The Insurance Sector: In India, approx. 60% of the
total health expenditure comes from self paid category as
against governments contribution of 25-30 %. A majority of
private hospitals are expensive for a normal middle class family.
The opening up of the insurance sector to private players is
expected to give a shot in the arms of the healthcare industry.
Health Insurance will make healthcare affordable to a large
number of people. Currently, in India only 2 million people ( 0.2
% of total population of 1 billion), are covered under Mediclaim,
whereas in developed nations like USA about 75 % of the total
population are covered under some insurance scheme. General
Insurance Company, has never aggressively marketed health
insurance. Moreover, GIC takes up to 6 months to process a
claim and reimburses customers after they have paid for
treatment out of their own pockets. This will give a great
advantage to private players like Cigna which is planning to
launch Smart Cards that can be used in hospitals, patient
guidance facilities, travel insurance, etc.
The Consultants, Financiers and Insurance Agencies are to
benefit from this boom. The insurers will use PPOs that will grow
into HMOs, to assume insurance risks on clients behalf. Medical
Equipments, Medical Software and Hospitals will see the biggest
boom.
THE SERVICE MARKETING TRIANGLE:
Company: Here, the hospital is the company that dreams up
an idea of service offering (treatment), which will satisfy the
customers (patients) expectations (of getting cured).
Customer: The patient who seeks to get cured is the customer
for the hospital as he is the one who avails the service and pays
for it.
Provider: Doctor, the inseparable part of the hospital is the
provider, as he is the one who comes in direct contact with the
patient. The reputation of the hospital is directly in the hands of
the doctor. A satisfied patient is a very important source of word
of mouth promotion for the organization.
-Unique Characteristics:
The service industry has the following characteristics.
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1) Intangibility:
Intangibility means that a customer would have to visualize the
service offering. Since the offering cannot be seen or felt there
would be no stock and hence one would not be able to jeep a
track of the sales etc. This characteristic also makes it different to
measure the benefits and utilities of the product. An individual
would only be able to experience the same.
In the product service continuum, hospitals fall in the bracket of
highly intangible where the service has credence qualities.
i) The services of a doctor i.e. the consulatation provided by the
doctor , his diagnosis etc cannot be touched felt or seen. One can
only visulalise the same.
ii) They can also not measure the benefits. These can only be
experienced by the customer. There is no ownership over the
doctor or the services provided by him.
The remedial measures to overcome intangibility are:a) The marketer should visualize the product/service for the
patient.In case of hospitals any visual of the hospital displaying
the well maintained interiors, the hi-tech equipments used for
treatment would help to tangibilise the product.
b) Association:
The association of a hospital with any well known personality
would help as a good image building exercise. It would also give
the customer a certain level of confidence regarding the services
provided in the hospital.
For (eg 1)- Hospitals like the Tata Memorial Hospital or the
Hinduja hospital are associated with Corporate Houses. They are
owned by these corporate families.
Hence a customer is sure about the services provided in these
hospitals. (eg 2)The Dinanath Mangeshkar Hospital. Since it is
owned by Lata Mangeshkar the customer is sure to receive
quality services.
c)Physical Representation :Intangibility could also be overcome in case of hospital through
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1)Color- The Red Cross signifies the Hospital.


2)Uniforms- The white uniforms of the Doctors And Nurses in
enemy hospitals.
3)Symbols The Red Cross is the common logo with which
people

indentify

hospitals.

Also

logos

of

hospitals

like

Wockhardt.
4)Buildings In case of hospitals the external appearance of the
building or the maintenance i.e how well maintained it is
d)Documentation There are a numbers of hospitals which have
received ISO 9000 certificates. ( Eg) Apollo Hospital.
2) Perishability
A services cannot be stored . So if the service is not consumed
immediately then it loses its value. For Eg If a doctor does not
reach his dispensary on time or has his clinic locked for that
particular day. He loses all his patients for that day. A situation
may also arise when the doctor may be unable to attend to some
of his patients due to a huge rush. In such a case again the
doctor could lose out on all his patients.Same would be the
situation faced by the hospitals. In such a case the hospital too
may lose all its patients for that day.
Solution to the problem of perishability
a) In such a situation the doctor can appoint an assistant who
could cater to the excess patients or he could have students
training under him who during their course of training could also
help him with the excess patients.
(Eg)- Rajgovind Hospital in CBD appoints interns of Medical
College for night duty on a stipend
b) Peak time Essential Services
In a rush hour situation when there are too many customers to
attend to only essential services should be catered to. For (eg 1)
In hospitals during the late night when accident reporting are
high all hands are required at the trauma centers (eg 2) Part time
volunteers for national Emergencies.
3) Variability
It means that the quality of service provided to different people
may not be the same. (ie) Irrespective of the fact that the job
carried out by them is the same the service quality may differ
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because they may be from different backgrounds have different


aptitude, skills, attitude etc.
For Eg :- 2 Doctors, one from a municipal hospital and another
from a reputed hospital may treat a person for the same
problem. But their quality might differ. In such a case
doctors/hospitals are the internal customers and the patients are
the external customers.
Since a transaction is always two way communication, a
customers willingness, background, attitude etc may also effect
the transaction
For ( Eg) A patient may want to avail of a doctors services but
may not be able to afford the services.
(Eg) A patient suffering from Arthritis may be required to lose
weight for further treatment. But the patient may not have the
drive/willingness to lose weight .
Solutions
1)The internal customers or the fresh recruiters could be given
training. They could be given a chance to perform the small parts
of an operation in order to gain experience.
1)The doctors could be given training and could be updated with
all the latest happenings in the medical field in regular intervals.
For (Eg ) AMA prescribes for its member doctors 6 weeks training
every year and 6 months training every 6 years.
1)Training of External customers
( Eg) Diabetic patients are trained to inject insulin on their own
( Eg ) In Case of health care services, a gym instructor may teach
his members to use the gym equipments on their own.
( Eg ) Auto Diagnostic equipments are used in hospital.
These kind of training programmes provided to the external
customer helps to increase the quality of transaction.
4)Inseparability
For any service to take place it is necessary that both the service
provider and the customer be present in the location at the same
time
( eg) An operation cannot be conducted without the doctors
presence. As a result a number of patients due to geographical
distances lose out on the opportunity to get themselves treated
from the very best surgeons and doctors.
Solutions
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1)Training of internal customerHere one experienced person can provide training to the
amateurs. For Eg A surgeon during an operation is surrounded
by interns watching the operation. They could also carry out
some small parts of the operation.
2) Innovational ServicePsychiatrists have innovated group therapy where they call in
10+ patients together to an oval conference table and encourage
them to talk about themselves and their ailments.
4) Video Conferencing
Business Conferences, Consultancy and the Medical world .Only
recently

have

instructions

for

operation

through

video

conferencing been initated but mostly video conferencing has


been used in the medical world as a pedagogical tool. (eg) A
unique and rare brain tumour operation can be broadcast live all
over the world to subscribed medical colleges.
7 Ps of marketing for hospitals
Product:
The service product is an offering of commercial intent having
features of both intangible and tangible, seeking to satisfy the
new wants and demands of the consumer. Hospital industry is
action oriented and there is a lot of interaction with the
customers (patients). The service product of the hospitals
normally have the following features:
o Quality Level: When we talk about marketing hospitals, it is
natural that we are very particular about managing our services
in the right fashion. Supportive services play an important role in
improving the quality of medicare. These services which include
laboratory, blood-banks, catering, radiology and laundry, in a
true sense determine the quality of services made available by
medical and para-medical personnel. They get a strong base for
treatment since the diagnostic aspect determines a direction. To
get the best result from OT, it is natural that equipments are
properly sterlised. In addition, the dresses and clothes are also
required to be made bacteria free. The patients are required to
wear disinfected linen which should be made available. The
radiology department should have hi-tech facilities keeping in
view the pressure of work. Of late, we find sophisticated
equipments and unless hospitals make the same services
available the same, the quality of services cannot be improved.
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o Accessories: This is a very good way of segmenting customers.


Many hospitals provide additional services such as catering,
laundry, yoga sessions, cafeterias, etc. for the customers
(patients)who are willing to pay extra. Hospitals have different
wards General and Special. Certain hospitals provide services
for the family members of the patients (when they are not from
the same city) accommodation and catering.
o Packaging: It is the bundling of many services into the core
service. Eg: Apollo hospital offers a full health check-up to the
patients. Similarly other hospitals also offer package deals for
health check-ups. For example if a person has to undergo a
bypass surgery, he can pay a lump sum amount during
admission, say rupees 1 lakh for all procedures, tests, stay, etc, at
once.
o Product line: hospitals through their services offer many
choices to the patients and cover a wide range of customer
needs. For example: Apollo hospital has dental department,
cardiology department, etc. and within the dental department it
has dental surgery, root canal, etc.
o Brand name: The hospitals, to differentiate themselves, and
their services from others use a brand name. The intangibility
factor of the service makes it all the more important for the
hospitals to do so.
Place
Under hospital marketing, distribution of Medicare services plays
a crucial role. This focuses on the instrumentality of almost all
who are found involved in making services available to the
ultimate users. In case of hospitals the location of hospital plays
a very important role. The kind of services a hospital is rendering
is also very important for determining the location of the
hospital.
Eg. Tata memorial hospital specializes in cancer treatment and is
located at a centre place unlike other normal hospitals, which
you can find all over other places.
It can be unambiguously accepted that the medical personnel
need a fair blending of two important properties i.e. they
should be professionally sound and should have in-depth
knowledge at psychology. A particular doctor might be famous
for his case handling records but he may not be made available
for all the patients because of the place factor. Now in this case
the service provided, that is the doctor may be a visiting doctor
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for different hospitals at different locations to beat the place


factors.
Unlike other service industries, under hospital marketing all
efforts should be for making available to the society the best
possible medical aid.
In a country like India, which is geographically vast and where
majority of the population lives in the rural areas, place factor
for the hospitals play a very crucial role. A typical small village /
town may be having small dispensaries but they will not have
super speciality hospitals. For that they will have to be
dependent on the hospitals in the urban areas.
People
Under hospital marketing the marketing mix variable people
includes all the different people involved in the service providing
process (internal customers of the hospitals) which includes
doctors, nurses, supporting staff etc. The earliest and the best
way of having control on the quality of people will be by
approving professionally sound doctors and other staff.
Hospital is a place where small activity undertaken can be a
matter of life and death, so the people factor is very important.
One of the major classifications of hospitals is private and
government. In the government hospital the people factor has to
be specially taken care of. In Indian government hospitals except
a few almost all the hospitals and their personnel hardly find the
behavioural dimensions significant. It is against this background
that even if the users get the quality medical aid they are found
dissatisfied with the rough and indecent behaviour of the
doctors.
Under hospital marketing a right person for the right job has to
be appointed and they should be adaptable and possess
versatility. The patients in the hospitals are already suffering
from trauma, which has to be understood by the doctors and
other staff. The people of the hospital should be constantly
motivated to give the best of their effort.
Process
Process generally forms the different tasks that are performed
by the hospital. The process factor is mainly dependent on the
size of the hospital and kind of service it is offering. A typical
process involved in a medium sized hospital can be as follows.
Apart from this flow there are other allied activities like record
keeping administration at services etc which fall under the
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process factor. These stages do not exist separately but are


interlinked.

The

most

important

elements

are

lines

of

communication within the setup. The experience of the patient


depends on the final interplay of all these factors.
Physical evidence
It does play an important role in health care services, as the core
benefit a customer seeks is proper diagnosis and cure of the
problem. For a local small time dispensary or hospital physical
evidence may not be of much help. In recent days some major
super speciality hospitals are using physical evidence for
distinguishing itself as something unique.
Physical evidence can be in the form of smart buildings, logos,
mascots etc. a smart building infrastructure indicates that the
hospital can take care of all the needs of the patient.
Examples
1. Lilavati hospital has got a smart building, which helps, in
developing in the minds of the people, the impression that it is
the safest option among the different hospitals available to the
people.
2. Fortis and Apollo hospitals have a unique logo, which can be
easily identified.
Physical evidence also helps in beating the intangibility factor.
Promotion:
Hospitals for promotion use either advertisement or PR or both
after taking into consideration the target customers, media type,
budget and the sales promotion.
Since a few years the prime times in T.V. are reserved for
advertising social issues like family planning, use of different
types of contraceptives, care for the girl child and so on. These
commercials use the common man approach for reference
group appeal. In case of health care products and services use
for common man appeal is widely prevalent. The use of
celebrities is not as effective as that of a common man. An
ordinary person thinks that if it works well for people like him, it
will also work equally well for him. The identification with the
common man is easy and quick.
Besides TV, other media of promotion are to be used
innovatively. Unlike the urban area, in rural areas newspapers
and magazines do not have the same impact in conveying
messages. In villages, hoardings and wall writings near the
markets and recreation centers attract the attention of villagers.
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This market consists of 180 million strong middle income group


and a small income group. This group has a large discretionary
income. These discerning consumers are very careful in choosing
health care services. The last decade has witnessed a health,
appearance and nutrition conscious population.
The health care field has become very competitive. Although
around one-fourth of our population stays in urban India, three
fourths of the total doctors have engaged themselves in this part.
Many of these doctors visit the contiguous rural areas, but they
may operate from the urban area. The patients of upper middle
and upper income group have a wide choice to make from a
number of clinics and hospitals. Therefore, many hospitals have
abandoned traditions and adopted marketing strategies to woo
more and more patients to their clinics.
Word-of-mouth plays a very important role in promotion of
hospitals. A person in need of a health care service does not
know for sure where to search for relevant information. He
consults his family members, relations and friends first. The
patients who come to a hospital generally have the old patients
of that hospital as referrals. Word-of-mouth plays an important
role during information acquisition stage of the customers as
there are no objective performance measures to judge the
various alternatives available to them. Therefore, satisfied past
patients of a hospital can bring more number of patients to that
hospital than a number of advertisements.
In a competitive market place, the images of the firms swill affect
their competitive standing. One factor that is likely to have a
significant impact on the health care scene is the growth of
hospital chains such as Apollo Hospitals, Birla Health Centres,
etc. Artificial heart transplants and other complex operations
although are few in number and generate a small portion of the
total revenue, they help in generating word-of-mouth which
health care providers are actually interested. Many of these
companies are spending a lot in corporate advertising for Image
building.
Rational use of medicines
Rational use of medicines requires that patients receive
medications appropriate to their clinical needs, in doses that
meet their own individual requirements, for an adequate period
of time, and at the lowest cost to them and their community.
A major global problem
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Irrational use of medicines is a major problem worldwide. WHO


estimates that more than half of all medicines are prescribed,
dispensed or sold inappropriately, and that half of all patients
fail to take them correctly. The overuse, underuse or misuse of
medicines results in wastage of scarce resources and widespread
health hazards. Examples of irrational use of medicines include:
use of too many medicines per patient (poly-pharmacy);
inappropriate use of antimicrobials, often in inadequate dosage,
for non-bacterial infections; over-use of injections when oral
formulations would be more appropriate; failure to prescribe in
accordance

with

clinical

guidelines;

inappropriate

self-

medication, often of prescription-only medicines; non-adherence


to dosing regimes.
2. REVIEW OF LITERATURE
The purpose of this literature review is to provide information
that clearly discusses in a scientific, experimental, qualitative,
and quantitative way the relationship between the hours a
person works, drives, and the structure of the work schedule.
The following findings were drawn from the available literature
reviewed as part of this synthesis.

Lung cancer is likely caused by exposure to diesel exhaust

and the longer that exposure lasts the more likely it is that a
cancer will develop. Though the evidence linking this exposure to
bladder cancer is less robust than that to lung cancer, it remains
likely that there is such a relationship and that it is governed by a
positive dose response curve[8].
There is some evidence that cardiovascular disease is caused in
part by truck driving and its risk increases with the duration of
this activity and the disruption of the sleep cycle[6]
Based on exposure assessments, noise-induced hearing loss
could well be a result of a working lifetime as a driver. This effect
would be mitigated by the improvement in cab design reported
to be occurring with consequent reduction in the intensity of
noise reaching the driver[9].

The evidence concerning a relationship between wholebody

vibration (WBV) and musculoskeletal effects, such as low back


pain (LBP) syndrome, relies primarily on self-reporting and
application of risks derived from other environments. There are
several studies available though that contain objective evidence
of vertebral pathology related to an occupation as a professional
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driver. In conclusion, the available data support the hypothesis


that there is likely a causative relationship between professional
driving and a variety of vertebral disorders as well as LBP
syndrome. While the literature suggests a role for WBV in the
genesis of these disorders, it cannot be established based on
current published materials[7].
The literature related to commercial driving and other
musculoskeletal disorders has the same limitations as the
previous item, and while a causative relationship is logical, it can
only be viewed as suggestive within this context.
Gastrointestinal (GI) disorders would be expected to be
impacted by varying shift assignments and disruption to normal
circadian rhythm. While the information currently available
documents an increase in symptoms in drivers, it is inadequate
to implicate the specific risk factors that impact on these
symptoms.
The literature suggests, but does not establish, that disruption
of circadian rhythm may have negative impacts on the general
health of workers. The stabilization of shift especially when
stabilized to a day schedule appears to have a beneficial effect
on subjective health complaints\ though stabilizing to an evening
or night schedule may not provide the same benefit.
Finally, the literature contains no definitive information
concerning (a) the relationship between reproductive health and
duration of driving, (b) the effects of prolonged work hours, or (c)
increasing driving from 10 to 11 hr while decreasing overall work
time from 15 to 14 hr on the general health of workers. No data
are available concerning the effects of allowing for increased
sleep time from 6 to 8 hr in an adult working population.
The Department of Child and Adolescent Health and
Developments (CAH) work is similarly guided by international
goals, in particular the Millennium Development Goals (MDGs) as
well as those articulated in the United Nations General Assembly
Special Session on HIV/AIDS (2001) and on children (2002, see
links below). The MDGs set clear goals and targets for eradicating
extreme poverty and hunger, reducing child mortality, maternal
mortality and the spread of HIV/AIDS.
CAH has committed to working towards these goals as a matter
of human rights, development and security. The Department
galvanizes efforts at country and regional level to help
governments develop national child health policies; raises
awareness at global level through conferences and work shops;
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and assists countries in the different WHO regions in devising


child survival strategies.
2002WHO reference number: WHO/FCH/CAH/02.14
This document is intended for policy makers and progamme
managers in both developed and developing countries, as well as
decision makers in international organizations supporting public
health initiatives in developing countries.
It makes a compelling case for concerted action to improve the
quality and especially the friendliness of health services to
adolescents. Drawing upon case studies from around the world,
it reiterates that this can be and has been done by non
governmental organisations and government bodies working
with limited financial resources. It highlights the critical role that
adolescents themselves can play, in conjunction with committed
adults, to contribute to their own health and well being.
New York, NY, US: Springer-Verlag Publishing. (1989).
Our objective in this book is to present national baseline
epidemiological and etiological data on the joint occurrence of
delinquent behavior and alcohol, drug, and mental health (ADM)
problems. Specifically, we propose to address each of the
following questions. 1. What patterns of joint delinquent-ADM
problems are found within the adolescent population? 2. What
proportion of youth exhibit each multiple pattern, and how are
youth exhibiting these patterns distributed in the general
population by age, sex, race, class, and place of residence? 3.
How do these patterns differ with regard to the frequency of
each type of behavior? 4. Is there a particular temporal order or
developmental sequence in the onset of these behaviors or
disorders that is more likely than others? 5. Can we identify a
common set of causes for these problems? 6. What is the
predictive effect of joint involvement in these behaviors on
subsequent long-range career or chronic involvement in crime
or ADM disorders? (For example, does the presence of heavy
drug use with crime during adolescence increase the risk of a
long-range criminal career and, if so, is the effect additive or
interactive.
According to Neil D. Weinstein in 2002
A mailed questionnaire was used to obtain comparative risk
judgments for 32 different hazards from a random sample of 296
individuals living in central New Jersey. The results demonstrate
that an optimistic bias about susceptibility to harm-a tendency to
claim that one is less at risk than ones peersis not limited to
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any particular age, sex, educational, or occupational group. It


was found that an optimistic bias is often introduced when
people extrapolate from their past experience to estimate their
future vulnerability. Thus, the hazards most likely to elicit
unrealistic optimism are those associated with the belief (often
incorrect) that if the problem has not yet appeared, it is unlikely
to occur in the future. Optimistic biases also increase with the
perceived preventability of a hazard and decrease with perceived
frequency and personal experience. Other data presented
illustrate the inconsistent relationships between personal risk
judgments and objective risk factors.
According to Lonnie R. Snowden in 15 APR 1999
The present study examined racial differences in use of mental
health services in the specialty mental health and general
medical sectors of care. Data came from household and
institutional surveys and permitted estimation of services use
both in the general population alone and when supplemented
with samples of persons confined in jails, prisons, and mental
hospitals. In uncontrolled analysis, African Americans in the
community presented a mixed pattern of under-, equal-, and
overrepresentation in services. Weighting the sample and
controlling for sociodemographic differences and diagnoses
yielded results indicating that African Americans in the
community were consistently less likely than Whites to have
sought help. Adding to the analysis persons who were confined
eliminated the disparity in the general medical-sector services
and reduced the disparity in specialty mental health sector
services. Conclusions as to parity and underutilization of mental
health services vary with methodological factors linked to
adverse social circumstances of African American life
According to Katie Buston in 17TH June 2002
This study explored the health-related views and experiences of
adolescent users of mental health services through semistructured interviews with 32 1420-year olds who had been
diagnosed with a mental illness. The majority of respondents had
both negative and positive things to say about their contact with
health services. These relate to: the doctorpatient relationship,
treatment received, the health-care system, and the environs of
the hospital or clinic. The views and experiences of young people
with regard to their health care must be taken into account in
efforts to boost help-seeking, attendance and compliance rates
and, generally, to improve child and adolescent mental health
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services. In particular, further attention needs to be given to the


development of empathic communication skills by health
professionals working with adolescents with mental health
problems. Work on the health-related views and experiences of
representative samples of young people with mental health
problems should be prioritized.
According to Sam Shapiro; Elizabeth A. Skinner in 2002
Utilization

of

health

and

mental

health

services

by

noninstitutionalized persons aged 18 years and older is


examined based on interviews with probability samples of 3,000
to 3,500 persons In each of three sites of the National Institute of
Mental Health Epidemiologic Catchment Area (ECA) program:
New Haven, Conn, Baltimore, and St Louis. In all three ECAs, 6%
to 7% of the adults made a visit during the prior six months for
mental health reasons; proportions were considerably higher
among persons with recent DSM-III disorders covered by the
Diagnostic

Interview

Schedule

(DIS)

or

severe

cognitive

impairment. Between 24% and 38% of all ambulatory visits by


persons with DIS disorders were to mental health specialists. In
seeking mental health services, men were more likely to turn to
the specialty sector than to the generalist; women used both
sectors about equally. The aged infrequently received care from
mental health specialists. Visits for mental health reasons varied
considerably depending on specific types of DIS disorder.
According to M.Goddard in 2004:
The pursuit of equity of access to health care is a central
objective of many health care systems. This paper first sets out a
general theoretical framework within which equity of access can
be examined. It then applies the framework by examining the
extent to which research evidence has been able to detect
systematic inequities of access in UK, where equity of access has
been a central focus in the National Health Service since its
inception in 1948. Inequity between socio-economic groups is
used as an illustrative example, and the extent of inequity of
access experienced is explored in each of five service areas:
general practitioner consultations; acute hospital care; mental
health services; preventative medicine and health promotion;
and long-term health care. The paper concludes that there
appear to be important inequities in access to some types of
health care in the UK, but that the evidence is often
methodologically inadequate, making it difficult to draw firm
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conclusions. In particular, it is difficult to establish the causes of


inequities which in turn limits the scope for recommending
appropriate policy to reduce inequities of access. The theoretical
framework and the lessons learned from the UK are of direct
relevance to researchers from other countries seeking to
examine equity of access in a wide variety of institutional
settings.
According to Padgett, in 2001:
This study describes use of medical, mental health, alcohol, and
drug services by 832 adult residents of the New York City
homeless shelter system and examines associations between
service use during the past three months and an array of
predisposing, enabling, and need factors. Utilization rates were
23% for medical services, 13% for mental health services, and 10
and 7.5% for alcohol and drug treatment services, respectively.
Service contacts were more often hospitals than ambulatory care
clinics. Logistic regression analyses revealed that need factors
were stronger predictors of all four types of service use.
Predisposing factors other than education and black ethnic
status were not significant, and the enabling factor of enrollment
in Medicaid and/or Medicare was significant only for use of
medical and drug services. Among the need factors, measures of
mental health status were analyzed as indices of distress to test
a stress-utilization model of prediction for all four types of
service use. While these measures did not predict use of
nonmental health services, physical health problems were
associated with use of all four types of services. Implications for
future health services research and for service delivery to the
homeless

are

discussed,

including

the

need

for

more

information on availability of services and on psychosocial and


cultural characteristics of homeless persons that may affect their
help-seeking behavior.
According to S.Fanshal and J.W.Bush in 1992:
In order to develop an operational definition of health, we found
it necessary first to develop the concept of function/dysfunction
as a continuum, based on ones ability to carry on the usual daily
activities appropriate to social roles. Then, to those operating the
health system, each member of the population can be seen as
belonging to one and only one state from a class of functional
states that can be defined on an ordinal scale. Next, we found it
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necessary to assign to each state a weight defined on a cardinal


scale, the set of weights for these states being called the Health
Status Index (HSI). The HSI rests on value judgments, of a
societal nature, expressed by the administrators responsible for
policy decisions. Prognosis is then defined as the transitional
probability of a change in functional state with time. Thus, the
concepts state of health and severity of illness are decomposed
into the parameters function/dysfunction and prognosis. Finally,
together with an operational definition of time and target
population, it becomes possible to give a quantitative definition
of the output of a health program (or health system) as the
changes in the functional history of the target population
resulting from the intervention of the health program (or
system). Other concepts that are given quantitative definitions
are program effectiveness and population health status. This
study next explores the relation between health program output
and modern decision theory for program planning, and shows
how these analytical tools are useful for fitting the results of the
study into larger conceptual frameworks. Finally, the method
developed is illustrated, first with a simplified simulated program
for computer use, and then with an analysis of a small section of
a tuberculosis-control program.
According to N Engl J Med in 2003
To determine whether groups other than the elderly and the
uninsured have difficulty obtaining access to medical care, we
studied 7633 adults nationwide. As we expected, the insured had
much greater access than the uninsured, but among the insured
there were substantial disparities in access to care.
Insured adults of working age were 3.5 times as likely (95
percent confidence interval, 2.7 to 4.4) as the elderly to have
needed supportive medical services (including medications and
supplies) but not to have received them, and 3.4 times (2.3 to
4.4) as likely to have had major financial difficulties because of
illness. Among insured, working-age adults, the poor were 4.4
times (3.5 to 5.3) as likely as those who were not poor to have
needed supportive services but not to have received them, and
5.2 times (3.6 to 6.8) as likely to have had major financial
problems because of illness. Apart from insurance status and
income, blacks were 1.7 times (1.1 to 2.2) as likely as whites to
have needed supportive services but not to have received them.
Hispanics with a medical illness were 2.2 times (1.3 to 3.2) as
likely as whites not to have seen a physician within the past year.
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We conclude that insured, working-age adults have less access to


medical care than the elderly, and that poor, black, or Hispanic
persons in this group are at risk for even greater problems with
access to care. Current policy strategies are unlikely to improve
the ability of these groups to obtain care
According to Buckingham in 2002:
This new edition of Ann Bowlings well-known and highly
respected text has been thoroughly revised and updated to
reflect key methodological developments in health research. It is
a comprehensive, easy to read, guide to the range of methods
used to study and evaluate health and health services. It
describes the concepts and methods used by the main
disciplines involved in health research, including: demography,
epidemiology, health economics, psychology and sociology.The
research methods described cover the assessment of health
needs, morbidity and mortality trends and rates, costing health
services, sampling for survey research, cross-sectional and
longitudinal
techniques

survey
of

design,

group

experimental

assignment,

methods

questionnaire

and

design,

interviewing techniques, coding and analysis of quantitative data,


methods and analysis of qualitative observational studies, and
types of unstructured interviewing. With new material on topics
such as cluster randomization, utility analyses, patients
preferences, and perception of risk, the text is aimed at students
and researchers of health and health services. It has also been
designed for health professionals and policy makers who have
responsibility for applying research findings in practice, and who
need to know how to judge the value of that research.
According to ANDERSEN, R. in 1999:
In this monograph the author uses data from his study with
ANDERSON [A decade of health services. Social survey trends in
use and expenditure, Chicago 1967, Abstr. Hyg., 1969, v. 44,
abstr. 3151] to develop a three-stage model in which
predisposing, enabling, and need components are used in an
attempt to explain families widely differing use of medical care
services.
It postulates that use takes place (1) where a family is
predisposed to receive medical care, (2) where conditions make
health services available to the family and (3) where the family
perceives a need for these services and responds to it. Use is
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then the fourth and resultant component. Degrees of discretion


exercised in using hospital, physician and dental services, the
three major categories of care, are differentiated. Finally
hypotheses derived from the model are summarized. A common
unit of use is developed, the aim being to allow comparisons and
summations of use across services. The model is then applied,
and by an empirical analysis an examination is made of the
interrelationships between its components and families varying
use of health services, and their differential importance for the
three major care categories. Each component includes subcomponents, all of which are measured empirically by selected
variables. The final chapter then returns to consider the
implications of this analysis for modifying the model and for
social policies on distribution of services.
This model is a valuable contribution towards a theoretical
framework for analysing patterns of use. Particularly useful is the
development beyond simple one-to-one variables provided by
the Sonquist and Morgan computer programme-Automatic
Interaction Detector (AID) (The detection o f interaction effects.
1964. Ann Arbor: Univ. of Michigan, Survey Research centre for
Social Research, Monograph 35). This indicates the single
predictor which will most
improve ability to predict values of the dependent variables at
any stage of the analysis. Interpretation, however, demands
strict and explicit consideration of the assumed causal priorities
which determine the stages at which different variables are
introduced, and hence the final results
According to A. S Levey, R Atkins, J Coresh, in 2007:
Chronic kidney disease (CKD) is increasingly recognized as a
global public health problem. There is now convincing evidence
that CKD can be detected using simple laboratory tests, and that
treatment can prevent or delay complications of decreased
kidney function, slow the progression of kidney disease, and
reduce the risk of cardiovascular disease (CVD). Translating these
advances to simple and applicable public health measures must
be adopted as a goal worldwide. Understanding the relationship
between CKD and other chronic diseases is important to
developing a public health policy to improve outcomes. The 2004
Kidney

Disease

Improving

Global

Outcomes

(KDIGO)

Controversies Conference on Definition and Classification of


Chronic Kidney Disease represented an important endorsement
of the Kidney Disease Outcome Quality Initiative definition and
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classification of CKD by the international community. The 2006


KDIGO Controversies Conference on CKD was convened to
consider six major topics: (1) CKD classification, (2) CKD
screening and surveillance, (3) public policy for CKD, (4) CVD and
CVD risk factors as risk factors for development and progression
of CKD, (5) association of CKD with chronic infections, and (6)
association of CKD with cancer. This report contains the
recommendations from the meeting. It has been reviewed by the
conference participants and approved as position statement by
the KDIGO Board of Directors. KDIGO will work in collaboration
with international and national public health organizations to
facilitate implementation of these recommendations.
3. OBJECTIVES
1. To find the curable and non curable diseases which are coming
to India. And inform the government or non government
organizations that the way they are fighting with the situation is
not enough to meet the health problems.
2. To find the diseases which are coming from the bad life style
and bad habits to just take care of minor things. The government
should take appropriate step or programs to make people
beware of all communicable or non communicable diseases.
3. To find if the modern India is able to fight the epidemic or the
communicable diseases in the controlled manner.
4. To find if the adequate health facility is available in the metros
as well as the rural areas of India.
3. RESEARCH MEHDOLOGY
The research design is a pattern or an outline of research project
working. It is a statement of only essential elements of study,
those that provide basic guidelines for the details of the project.
The present study is being conducted followed by Descriptive
Research Design.
1) NATURE OF REAEARCH:
Exploratory Research:
2) Research Technique:
Direct Interviews
Survey
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i) Total population: 598


ii) Sample Size: 30
Sampling criteria
Familiar with the medical services & policies related to medical
professional.
3) Tools Used:
Questionnaire
4) Sources of Data
Primary Data:
All Primary data has been collected through personal interviews
with the medical professionals of the company and also personal
observation to get valuable information on the related topic of
the company.
Sample Size
Sampling methods
Secondary Data
Secondary data has been collected as follows:
Paper-based sources books, journals, market reports, annual
reports, internal records of organizations, newspapers and
magazines
Electronic sources Internet, Intranet & Health Department
website.
5. RESULT AND DISCUSSION
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. The
healthcare industry in India expected to grow in size to Rs
270,000 core by 2012. The healthcare industry employs over four
million people, which makes it one of the largest service sectors
in the economy of our country.
Healthcare is dependent on the people served; Indias huge
population of a billion people represents a big opportunity.
People are spending more on healthcare. The rise in literacy rate;
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the higher levels of income; and an increased awareness through


the deep penetration of media, has constituted to greater
attention being paid to health. India has a very low density of
doctors. Infant mortality is amongst the highest in India.
Hospitals in India are running at 80-90% occupancy. Major
corporations

like

the

Tatas,

Apollo

Group,

Fortis,

Max,

Wockhardt, Piramal, Duncan, Ispat, Escorts have made significant


investments in setting up state-ofthe-art private hospitals in
cities like Mumbai, New Delhi, Chennai and Hyderabad.
Good Healthcare in India is in extreme short supply and it is this
gap that Corporate are looking to plug. Most users of healthcare
prefer private services to government ones. The private
Healthcare segment has grown into a formidable industry
estimated to be Rs.8,00,000 crores. Using the latest technical
equipment and the services of highly skilled medical personnel
these hospitals are in a position to provide a variety of general as
well as specialists services.
India is well positioned to tap the top end of the $3 trillion
global healthcare industry because of the facilities and services it
offers, and by leveraging the brand equity of Indian healthcare
professionals across the globe, said Vinod Khanna, Union
Minister of State for External Affairs.
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. This would improve the
quality of life of our people, leading to greater socio-economic
progress of the country.
As medical costs sky rocket in the developed world, countries like
India have immense potential for what is called Medical
Tourism, highlighted Harpal Singh, Conference Chairman, in his
theme address. India, with outstanding human resource talent
and the setting up of world class medical facilities, was now
poised to take leadership in the fast emerging arena of
healthcare management which is witnessing the first signs of
globalization.
MARKET ANALYSIS

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Market Overview
India has a fairly comprehensive healthcare system comprising
of government and private service providers. However, the
system reaches barely fifty percent of the population mainly on
account of general infrastructure bottlenecks. 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. The density of doctors is also low. There are only 43
doctors for a population of 10,000.
Size of Market
Indias healthcare industry is estimated at Rs 1000 billion. Of this,
pharmaceuticals account for Rs 200 billion. As per some
estimates, Rs 185 billion is spent on healthcare annually. On
average, Indian families spend 600 per month on healthcare
which is 11% of the household income, showing that they are
willing to spend provided the service they get is of high standard.
According to The World Health Report 2000, Indias health
expenditure is 5.2% of its GDP. Public and private health
expenditure is 13% and 87% respectively.
CII-McKinsey Study
A joint study Healthcare in India: The Road Ahead done by the
Confederation of Indian Industry and McKinsey & Company in
2002 mentions that India has 1.5 beds per 1000 people while
China, Brazil & Thailand have an average of 4.3 beds. The study
projects that changing demographic and disease profiles and
rising treatment costs will result in healthcare spending more
than doubling over the next 10 years. Private healthcare will be
the largest component of this spending in 2012, rising to Rs 1560
billion from the current level of Rs 690 billion. In addition, public
spending could double from Rs 170 billion if the Government
reaches its target spending level of 2% of the GDP, up from 0.9%
today.
PEST ANALYSIS:
Political factors:
Most of the healthy nations are also wealthy nations. In India
even after 53 years of independence we all have to accept that
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government has failed to provide basic healthcare. Healthcare is


the neglected field, only meant for slogans by our politicians.
To improve healthcare facilities we have to provide special
assistance to private healthcare sector. The reality in private
healthcare sector is that as an industry it has long gestation
period and so most of the bigger projects fail.
Government has to give certain concessions to private health
sector. It can be in the form of free land for small hospitals at
district levels or concession in power tariff. Government later on
gets back revenue in the form of tax when these institutions start
making profits. Concessions can be limited to first five years or
so.
Maharashtra government is playing an important role in the
development of the hospital sector.
Economic factors:
The Indian healthcare is the next boom in the country after the
IT euphoria. Setting up hospitals is not an easy task.
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. In the rural areas one village has only
one doctor, who may not be very well qualified.
The other governments of other states should take up a cue from
the Maharashtra government, in setting up similar Joint ventures
all over the state with the assistance of World Bank. The World
Bank can make available funds of around Rs 700 crore for state
health systems and development projects.
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. This
in turn will increase the employment opportunities to many
people.
Social Factors:
1. 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.
2. Look after the needs of local poor people.
3. Open counseling and relief centers.
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4. Teach hygiene, sanitation among the poor masses.


5. Safe disposal of hospitals wastes like used injection needles,
waste blood etc. and taking due care of environment.
6. Spreading awareness about various diseases through
campaigns and free medical check ups.
7. In brief the social aspect of hospitals industry is to see that
latest treatment 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.
Technological Factors
We are witnessing Information technologies transforming the
way health care shall be delivered. 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.
INTRODUCTION TO HOSPITALS:
Until the early 1980s, Government-run hospitals and those
operated by charitable organizations. The last two decades have
seen the mushrooming of corporate and privately run hospitals.
Most large trust and corporate hospitals have invested in
modern equipment and focus on super-specialties.
The private sector accounts for 70% of primary medical care and
40% of all hospital care in India. They employ 80% of the
countrys medical personnel.
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. Key therapeutic areas are cardiology,
nephrology, oncology, orthopaedics, geriatrics, maternity and
trauma/critical care.
Hospitals are not for profit making, they are social institution to
make available to society the required Medicare services.
However this may not be true for private hospitals. Today
hospitals are a place of diagnosis and treatment of human ills,
for the training research, promoting health care activities and to
some extent a center helping biosocial research. WHO states that
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hospitals are socio-medical organization whose functions are:


Curative, preventive, patient services and training of health
workers in biosocial research.
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.
CLASSIFICATION OF HOSPITALS:
The classification of Hospitals on the basis of objective,
ownership, path and size.
1. On the basis of the OBJECTIVE there are three types:
Teaching cum research for developing medicines and promoting
research to improve the quality of medical aid.
General hospital for treating general ailments.
Special hospitals for specialized services in one or few selected
areas.
2. On the basis of the OWNERSHIP, there are four types:
Government hospital, which is owned, managed and controlled
by government
Semi-government hospital, which is partially shared by the
government.
Voluntary organisations also run hospitals.
Charitable trusts also runs hospitals.
3. On the basis of PATH OF TREATMENT, there are:
Allopath which is the system promoted under the English
system.
Ayurved, which is based on the Indian system where herbals are
used for preparing medicines.
Unani
Homeopath
Others
4. On the basis of the SIZE, there are:
Teaching hospitals generally have 500 beds, which can be
adjusted in tune with number of students.
District hospital generally have 200 beds, which can be raised
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to 300 in contingencies.
Taluka hospital generally have 50 beds that can be raised to
100 depending on the requirement.
Primary health centres generally have 6 beds, which can be
raised to 10.
Classification of Hospitals
LATEST HOSPITAL INDUSTRY FOR PATIENTS:
Intangibility
Intangibility indicates that the service has no physical attributes
and as a result, impossible for customer to taste, hears, feel or
smell before they actually use it. Hospital industry is where the
customers (patients) get treated for physical problems they have.
The customers cant really realize the service provided until they
get well. For this they have to provide good supplementary
services.The only way they can provide tangible clues to make
the service provided a success. For e.g. the hospitals provide
extra facilities like television, or then friendly personnels can
make a difference.
Inconsistency
Its also referred to as heterogeneity or variability. The
inconsistency occurs largely because of
Different service providers perform differently on different
occasions.
Interaction between customer and provider may vary from
customer to customer.
Standardization is hard to maintain. Every doctor is not the same
and may not give the same diagnosis. Also a patient may not
each diagnosis in a different way. Also since the quality of work
done can be determined only after the service is performed the
providers have to be well trained in case of performing the
service process.
Inseparability
Inseparability means that the service can not be separated from
the creator-seller of the service. Infact there are many services
which are created, delivered and consumed simultaneously
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through interaction between customer and service producers.


Here too the customer, i.e. the patient has to come upto the
hospital to get the treatment. The customer has to be present
when the service is performed. Infact in case of hospitals the
service is created and delivered simultaneously. The type of
service to be provided depends on the customer.
Inventory
Services cannot be easily saved, stored or inventoried. This is all
due to the perishable nature of the services. Also theres cost
also associated with the carrying of inventory. Here the costs are
more subjective and are related to capacity utilization for e.g. if a
doctor is available but theres no patient during that period, the
fixed cost of the idle physicians salary is a high inventory carrying
cost.
Also due to demand fluctuations the services cannot be stored.
E.g. theres a lot of rush at the dentists clinic in December and
January as thats the time when there are lots of tourist visiting
India.
OPPORTUNITIES
With global revenues of approximately US$ 2.8 trillion, the
healthcare industry is the worlds largest industry and India is
emerging as a major player in this industry, because of its high
population.
As per the Insurance Regulatory and Development Authority
(IRDA), the Indian healthcare industry has the potential to show
the

same

exponential

growth

that

the

software

and

pharmaceutical industries have shown in the past decade.


Further, as per the IRDA, only 10 percent of the market potential
has been tapped till date and market studies indicate a 35
percent growthin thecomingyears.
A big opportunity for the industry emerges from the privatisation
of the insurance segment, which would extrapolate into a new
delivery system in India. There is a vast insurable population in
India, given that only 2 million people ie 0.2 percent of the total
population are covered under Mediclaim. According to a recent
study, there are 315 million potentially insurable lives in the
country.
A World Health Organisation report states that India needs to
add 80,000 hospital beds each year to meet the demand of its
population. The huge shortage of beds outlines a major
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opportunity for the industry.


The healthcare industry is a fast growing industry and coupled
with strength of Indian innovative and scientific manpower and
also low costs, it is slowly achieving key industry status in India.
Some Suggestions for improving the position of the hospitals
1. The general perception that large hospitals, with high bedoccupancy rate, are profitable, is misleading. Global experience
shows that hospital with more than 250 beds dont do well. Many
Indian hospitals are following the US healthcare industry, by
decreasing the average length of stay of patients and increasing
patient turnover. US research shows that 80% of the revenues
form a patient comes in the first 72 hours post- admission.
Hospitals generate a lot of revenues from General Inspection,
because the patient turnover is very high.
A large percent of revenues come from specialized services like
operations and surgeries. It is because of these reasons that
many corporates are planning for a small 100 beds specialized
hospitals, which caters to specific diseases like cardiac, cosmetic
surgery, neurology etc. Research shows that there exist a lot of
space for super-specialized hospitals with 100-150 beds, which
generate revenues equivalent to large 500 bed general hospital.
Typically large hospitals with approximately 500 bed capacity
takes about 9-10 years to break even whereas super-specialty
hospitals with about 100 beds take about 6-7 years to break
even. Therefore, going in for super-speciality hospitals seems to
be a more viable option today.
2. Hospitals could also generate revenues from medicines if they
are supplying them in-house. Some hospitals make it mandatory
for the patients to buy medicines from the hospitals chemist
shop. A margin of 15-20 % can be charged for such medicinal
supplies. Though many hospitals run by Trusts do not earn this
way, but new entrants or corporates for whom private
healthcare sector is a direct extension of their line of business (
eg. Pharma companies), can generate good returns from
medicine supply.
3. Health Plan packages can be provided by hospitals to family
and corporate. For example Family Health Plan Services (FHP), a
subsidiary of Apollo Hospitals does health management of
employees of its clients.With a wide net work of Hospitals and
Healthcare providers countrywide, and a tie -up with General
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Insurance Corporation of India, FHP offers a range of services to


employees and dependants, such as Preventive Healthcare,
Corporate

Counselling,

welfare

Programmes,

Claims

Administration, Patient-care Coordination and so on. So FHPs


healthcare packages, optimize the benefits while keeping the
cost under control.
4. Apart from preventive healthcare, stress management
programs could be provided. For example Effective Stress
Management Programme offered by Wockhardt Hospital.This
programme provides a medical perspective of stress and is
conducted by a medical professional. The programme includes a
series of one-to-one sessions, with a clinical Psychologist
highlighting the factors responsible for inducing stress, and the
methodologies, which can be adopted to cope with this
phenomenon practically.
5. Hospitals can become integrated healthcare systems i.e. when
medicines, food services, laundry and linen etc will become
purchased services. These third-party operations will increase
the profit margins.
6. Mergers could be used for synergy of skills i.e. to help the
merged organisations benefit from one anothers individual
strengths by applying them across the board. It also helps them
to make joint investments in branding or information technology
and also to react effectively to the changed market forces.
Alternatively hospitals can go in for Group Purchases, as in USA.
The buying power of large GPOs in USA like Premier, VHA / UHC
and AmeriNet gives them the clout to exert price pressure on
suppliers, particularly for products in lower demand. And as
GPOs have consolidated, manufacturers have offered bigger
discounts to hang on to their contracts. So there exists a lot of
supply management opportunity, which will affect spending
productivity.
The Future
Healthcare industry is booming all over the world. In the US it is
already the largest service sector. And world-wide it is slated to
be a $4 trillion market by 2005. A World Bank Report in
November 1999 points at the emergence of large-scale, investorowned hospitals in the country as a dramatic development. The
Corporate hospitals will play a positive role in the healthcare
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sector by taking the load off government hospitals, whose


performance hasnt been upto the mark.
The Healthcare Industry is on the threshold of a major Growth
Spiral which shall assimilate all new technologies to provide cost
effective Healthcare. It shall not only employ the largest chunk of
all available capital but shall also employ a large proportion of
the skilled work force. The Healthcare Industry is poised to
become the biggest Employer in all Countries. It shall also be the
biggest consumer of all new technologies.
Specifically, in the next decade, it is anticipate that the
Healthcare Industry shall grow at an accelerated pace and will
achieve a Growth Rate of 8 10 % per annum in India and a
Growth Rate of 4 8 % per annum in most of the Countries of
third World. As a result, most of the Countries in the world
(Other than USA) shall add more Hospital Beds.
This accelerated growth will require a large body of skilled
Healthcare Providers. As a result, the Medical Education Sector,
including Medical and all Para-medical staff, shall also witness a
faster growth. It is anticipated that the numbers of skilled
Healthcare Providers shall double in next decade.
The addition of Hospital Beds shall catalyse a Growth in Hospital
Equipment

Industry.

It

shall

also

fuel

the

growth

of

Pharmaceutical Industry. It shall specifically affect the Medical


and Surgical Supply Segment and there too, the Prosthetic
Devices Segment shall witness a very rapid growth.
In the next decade, the Earths Population shall reach a peak
number. This, coupled with availability of better Healthcare shall
lead to a higher Expectancy of Life at Birth. The average age of
Earths Population shall increase. This will require a far superior
understanding

of

Multiple

Organ

Syndromes

and

there

treatments. There shall be a shift in focus of providing


Healthcare. The Hospitals shall tend to be the providers of Acute
& Intensive Healthcare; while new cost effective modalities shall
provide intermediate care or nursing only care.
These new modalities shall not follow the rigid standards as set
for Hospitals & shall employ a smaller number of trained medical
manpower. These modalities shall augment the Home Care, as is
available in the Joint Family Environment to more than half the
population of world today. This will necessitate a greater
interaction between the Healthcare Provider, the Medical Charge
and the other segments of Healthcare Industry.
This growth of Healthcare Industry shall be supported by
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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.
SOME PLAYERS
The Apollo Group of Hospitals
Driven by its line of being the architect of healthcare in India,
the Apollo Hospitals Group, comprising of one of the largest
networks of 26 hospitals, 10 clinics and over 10,000 employees
across the country, represents the changing face of healthcare in
India contemporary and corporatized. It has been the first
private company to administer health insurance in the country
and Indraprastha Apollo Hospital in Delhi is the fourth largest
corporate hospital in the world.
The Apollo group is Indias first corporate hospital, the first to
set-up hospital outside the country and the first to attract foreign
investment. With 2600 beds, Apollo is one of Asias largest
healthcare players. The recent merger between its 3 group
companies, Indian Hospitals Corporation Ltd., Deccan hospitals
Corporation Limited and Om Sindoori Hospitals Limited, will help
the group raise money at a better rate and by consolidating
inventory, it will save around 10% of the material cost. The group
is planning to invest Rs. 2000 crore , to bulid around 15 new
hospitals, in India, Sri Lanka, Nepal and Malaysia.
Apollo claims to maintain the best of medical standards with a
record of over 7.4 million treated patients, 3,15,000 preventive
health checks done, 98.5 percent success rate in 45,000 cardiac
surgeries, etc. And helping the company maintain a balance
between the corporate culture and rigorous medical excellence
is recognition of IT as intrinsic to every process, whether it is dayto-day running of hospitals, education or telemedicine.
The application of IT in the day-to-day working of the largest
hospital of the group, Indraprastha Apollo, throws light on the
extent of the automation drive within the company. The
management realised the fact that in order to have a modern
hospital in place all the work processes had to be related to IT.
Hence, the need for an end-to-end integrated solution. This led
to the implementation of the Hospital Information System (HIS),
which was an integral part of the hospital inception project.
The hospital today boasts of an integrated HIS, which provides
for end-to-end integration of the various processes and
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functional areas within the hospital to make for a seamless


workflow. The work processes of the hospital are primarily
divided into two areas the patient (comprising of in-patient and
out-patient) and the non-patient all the back-end departments
like housekeeping, engineering, finance, materials, purchase and
HRD.
The workflow process starts with the patient seeking an
appointment with the doctor. HIS contains all the information
relating to appointment schedules of the doctors. Depending on
the availability of the doctor, the patient is given the date and
time of appointment. This information is then fed into the
system and the updated information is available to the doctor in
real-time.
On the date of his appointment, the patient registers himself at
the counter by filling up of a form, which contains all the basic
information related to the patient. This data is feeded into the
system with a Unique Hospital Identifier (UHI) number allotted
to the patient so that by the time the patient meets the doctor,
he already has all the required basic information. This is followed
by 15 minutes of consultation with the doctor after which the
doctor gives his prescription, the data is again keyed into the
system as a patient record under his UHI and is accessible for
quick reference.
One of the biggest advantages of HIS is that any medically
relevant information related to the patient is available at the click
of a button, thereby saving precious time, which means a lot
when it comes to saving a life. HIS also acts as a kind of ERP for
the hospital with its automation of various back-end areas like
financial, accounting and inventory, which are integrated with
the patient areas wherever required.
The hospital has also developed a very effective mailing system
for its employees, which is based on Microsoft Exchange. The
companys Intranet is being used to run mailing applications as
well as information relating to company policies, leave
information and basic information relating to the company.
Telemedicine Healthcare for all.
A very significant IT initiative of the Apollo Hospitals Group, and
of great relevance to a developing country like India in taking
healthcare to the masses, is the area of telemedicine.
Incorporated in 1999, Apollo Telemedicine Enterprises (ATEL), the
telemedicine division of the Apollo Hospitals Group, has already
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set up over 10 telemedicine links between the Apollo Institutions


at Delhi, Hyderabad and Chennai and distant locations across the
country. It has developed competence in developing costeffective turnkey telemedicine solutions.
Teleme-dicine ensures that the benefits of hi-tech medicine can
go to everyone, and not just to people who live in big cities. The
group has forged alliances with government organisations like
the Indian Space Research Organisation (ISRO) for VSAT
bandwidth and Wipro for hardware, to provide telemedicine
facilities to far-flung and rural areas. The division is working
towards developing a strong Apollo Telemedicine Network, which
allows the participant sites to collaborate with institutions in the
country and abroad, and provides their clientele access to better
healthcare in areas not adequately served by the medical
community.
A patient and his doctor can interact with specialists based in the
specialty centers and receive second opinion or interpretations
to complex medical cases. The patient reports can be
transmitted from a consulting canter to a specialty canter using
the telemedicine software and the communication link, which
could be ISDN or VSAT connectivity.
Other Services offered by Apollo:
-Apollo Pharmacy
Apollo Pharmacy operates round the clock catering to all your
medicine needs.
-Caf Apollo
Caf Apollo is a sit down dining facility of the hospital. It offers a
wide selection of snacks and a variety of meals.
-Apollo Food Plaza
There is food facility located in the atrium of the hospital serving
a delightful array of delicacies.
Timings : 8.00am 9:00pm
-Fast Food Cafe
For the convenience of ICU attendants there is a 24 hours cafe in
the ICU lobby.
-Gift Shop
The Gift Shop carries a wide range of gifts including
Confectionery, Cards, Books, Newspapers, Magazines and other
novelties.
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-Bank Facilities
-The Oriental Bank of Commerce
The Indraprastha Apollo Branch of the Oriental Bank of
Commerce is located at one of the Gates.
Bank Hours
Monday to Friday : 10:00am 2:00pm
Saturday : 10:00am 12:00pm
The bank remains closed on Sundays and National Holidays.
-The ICICI ATM Counter
The ICICI ATM counter is also located in the hospital.
Fortis Healthcare
Fortis is the late Ranbaxys Parvinder Singhs privately owned
company. The company is a 250 crore, 200 bed cardiac hospital,
located in the town of Mohali. The company also has 12 cardiac
and information centres in and around the town, to arrange
travel and stay for patients and family. The company has plans of
increasing the capacity to around 375 beds and also plans to tie
up with an overseas partner.
Max India
After selling of his stake in Hutchison Max Telecom, Analjit Singh
has decided to invest around 200 crores, for setting up
worldclass healthcare services in India. Max India plans a three
tier structure of medical services Max Consultation and
Diagnostic Clinics, MaxMed, a 150 bed multispeciality hospital
and Max General, a 400 bed hospital. The company has already
tied up with Harvard Medical International, to undertake clinical
trials for drugs, under research abroad and setting up of Max
University, for education and research.
Escorts
EHIRC located in New Delhi has more than 220 beds. The
hospital has a total 77 Critical Care beds to provide intensive
care to patients after surgery or angioplasty, emergency
admissions or other patients needing highly specialized
management including Telecardiology (ECG transmission through
telephone). The EHIRC is unique in the field of Preventive
Cardiology with a fully developed programme of Monitored
Exercise, Yoga and Meditation for Life style management.
WOCKHARDT and DUNCANS GLENEAGLES INTERNATIONAL also
have major expansion plans.
This report is prepared by Mona Pandit and Parin Mehta of
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Sydneham Institute of Management exclusively for India Infoline


as part of their project curriculum.
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. The
healthcare industry in India expected to grow in size to Rs
270,000 core by 2012. The healthcare industry employs over four
million people, which makes it one of the largest service sectors
in the economy of our country.
Healthcare is dependent on the people served; Indias huge
population of a billion people represents a big opportunity.
People are spending more on healthcare. The rise in literacy rate;
the higher levels of income; and an increased awareness through
the deep penetration of media, has constituted to greater
attention being paid to health. India has a very low density of
doctors. Infant mortality is amongst the highest in India.
Global Health Observatory (GHO)
Mortality and Global Burden of Disease (GBD)
Age standardized death rates: Measuring how many people die
each year and why they have died is one of the most important
means along with gauging how various diseases and injuries
are affecting the living of assessing the effectiveness of a
countrys health system. Having those numbers helps health
authorities determine whether they are focussing on the right
kinds of public health actions that will reduce the number of
preventable deaths and disease. Globally, around 60 million
people die each year. Almost 20% of these deaths occur in
children under the age of 5. Most of these preventable deaths in
children occur in low- and middle-income countries.
The GHO issues analytical reports on the current situation and
trends for priority health issues. A key output of the GHO is the
annual publication World Health Statistics, which compiles
statistics for key health indicators on an annual basis. The World
Health Statistics also include a brief report on annual progress
towards the health-related MDGs. In addition, the GHO provides
analytical reports on cross-cutting topics such as the report on
women and health and burden of disease. Lastly, the GHO
provides the link to specific disease or programme reports with a
strong analytical component
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Bringing together all existing WHO Global Nutrition Databases


dynamically, as well as other existing food and nutrition-related
data from partner agencies, NLIS is a web-based tool which
provides nutrition and nutrition-related health and development
data in the form of automated country profiles and user-defined
downloadable data. Data presented in the country profiles are
structured by the UNICEF conceptual framework for causes of
malnutrition and intend to give an overview snapshot of a
countrys nutrition, health, and development at the national
level.
NLIS draws data for the country profiles from available
databases. Sources include the World Health Organization
(WHO), United Nations Childrens Fund (UNICEF), UN Statistics
Division, UN Development Programme (UNDP), Food and
Agriculture Organization of the UN (FAO), Demographic and
Health Surveys (DHS), the World Bank, International Food Policy
Research Institute (IFPRI), and the International Labour
Organization (ILO). More recent data might be available from
other sources, including in-country sources.
The WHO Global Data Bank on Infant and Young Child Feeding
WHO began the Global Data Bank on Breastfeeding in 1991 as
part of its monitoring and surveillance activities. Since then the
Data Bank has undergone several revisions to accommodate new
sets of definitions and indicators and integrate all operational
targets of the Global Strategy for Infant and Young Child Feeding,
changing as a result the name to WHO Global Data Bank on
Infant and Young Child Feeding.
The Data Bank is maintained and managed in keeping with
internationally accepted definitions and indicators. It pools
information mainly from national and regional surveys, and
studies dealing specifically with the prevalence and duration of
breastfeeding and complementary feeding. The Global Data Bank
on Infant and Young Child Feeding is continually updated as new
studies and surveys become available.
Data for inclusion are based on indicators from household
surveys and for some countries from facility based surveys.
The aim is to achieve worldwide coverage in order to permit:
Comparison between countries and regions, and within
countries
Assessment of breastfeeding and complementary feeding
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trends and practices as a basis for future action


Monitoring and analysis of trends over time
Evaluation of the impact of infant and young child feeding
promotion programmes
Ready access to current data for use by policy- and decisionmakers, scientists, researchers, hospital administrators, health
workers, and other interested parties
Global Database on National Nutrition Policies and Programmes:
The Global Database on National Nutrition Policies and
Programmes was established in 1995 initially to monitor and
evaluate the progress in implementing the World Declaration
and Plan of Action for Nutrition. However, it has been further
developed

to

monitor

country

progress

in

developing,

strengthening and implementing national nutrition plans,


policies and programmes, including multi-sectoral actions,
development of dietary guidelines, undertaking of nutrition
surveys, demographic, and epidemiological data. Included in the
database are:
outcomes of a 1994 evaluation on country progress in
implementing the World Declaration and Plan of Action for
Nutrition;1
status of the development and implementation of national food
and nutrition policies and plans since 1994;
summary of available national food and nutrition policies and
plans, including priority goals and strategies and planned
programme activities, together with estimated budget, where
available;
technical and financial support provided to Member States by
WHO and other agencies;
demographic data relating to health and nutrition for each
country;
information on multisectoral action, development of dietary
guidelines, and nutrition surveys;
trends in WHOs global and regional nutrition budget since
1988; and
information on regional activities, where applicable.
The data and information is derived mainly from government
polices and plans, such as national plans of action for nutrition,
national food and nutrition polices, national health policies, and
other food and nutrition related polices, where applicable. Data
have also been obtained from country reports prepared for the
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International Conference on Nutrition in 1992, the World Food


Summit in 1996 and various regional follow-up meetings and
consultations. Additional data and information are also provided
periodically by each WHO Regional Office. It is envisaged that the
regional review meetings planned for 2000 for the African
Region,

the

Region

of

the

Americas,

and

the

Eastern

Mediterranean Region will generate additional new data and


information for countries in those respective regions.
The Section on Developing and Implementing National Nutrition
Policies and Plans (Section 4.1 in this report) was prepared using
the data and information extracted from this database.
Furthermore, currently a global review and comparative analysis
of national nutrition policies, and plans of action is being
undertaken using the data and information available in this
database to evaluate progress and country experiences. This
review will look at priority nutrition issues identified by
countries, key elements for developing and implementing
effective and sustainable nutrition policies and programmes,
lessons learned, and the way forward, including further actions
and support required.
6. DATA ANALYSIS & FINDINGS
During the research work a questionnaire has been prepared
and the analysis and interpretation is mode on the basis of it
which is as follows:1. When people are asked how many times a year they go for the
medical checkup then the response is collected and summarized
in the Table 1.
TABLE 1
Criteria Frequency Percentage
Once in a week NIL 0
Once in a month NIL 0
Once in three months 7 7
Once in six months 15 15
Once in a year 20 20
Only If Required 58 58
FINDINGS:
58% percentage of the sample population goes for the medical
checkup when they required in emergency, 20% goes once in a
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year 15% people go for medical checkup once in 6 months while


only 7% goes once in a three months.
ANALYSIS:
Health Problems in India are not detected at the primary stage
since the people does not go for the medical checkup the regular
basis. They only goes when a medical emergency comes around
them.
2. When Sample population were asked how often you eat
outside. The responses are collected and summarized in the
Table 2.
TABLE 2
Criteria Frequency Percentage
Once in a week or more 32 32
Once in a month or more 26 26
Once in three months or more 25 25
Once in six months 8 8
Once in a year 9 9
Never
FINDINGS:
From the Population sample most of the people preferred to eat
outside once in a week or a month duration while very few goes
once in a year for the food court outside
ANALYSIS:
If is observed that due to the outside unhealthy eating habits the
Indians are more prone to the infection diseases. Which we can
reduce by eating healthy from the good place/ Restaurants /
Hotels etc.
3. When the respondents we asked If, they workout, then the
response is collected and the summarized in Table 3.
TABLE 3
Criteria Frequency Percentage
Four days a week 20 20
Five days a week 20 20
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Six days a week 7 7


Not at all 53 53
FINDINGS:
20% percentage of the sample population doing the workout in
four days a week, 7% doing the workout in six days a week and
53% people does not work out.
ANALYSIS:
An observed that due to less work out is the main reason for
unhealthy or bad fitness problem.
4. When respondents were asked, If they are involved in the
outdoor sports.
TABLE 4
Criteria Frequency Percentage
Yes 43 43
No 57 7
FINDINGS:
43% percentage of the sample population involved in outdoor
sport and 57% population does not involve any kinds of outdoor
sports.
ANALYSIS:
According to above observation people does not want to show
interest in outdoor sports. Thats why they face many health
problems in future.
5. The answer to the question do you feel tired after working for
a short span of time. The response is
TABLE 5
Criteria Frequency Percentage
Yes 38 38%
No 62 62%
FINDINGS:
38% percentage of the sample population feel tired after working
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for a short span of time and 62% population does not feel tired
after working for a short span of time.
ANALYSIS:
An above Observation showing that people does not working
regularly thats why they feel tired after working for a short span
of time.
6. When Respondents were asked if they feel the adequate
medical facility is available throughout the result then the result
is gathered & Summarized in table 6.
TABLE 6
Criteria Frequency Percentage
Yes 80 80%
No 20 20%
FINDINGS:
80% percentage of the sample population were feel adequate
medical facility is available throughout the country and 20%
sample population does not feel like that.
ANALYSIS:
An above observation showing that adequate medical facility is
an available in India. There is available all require medical
facilities.
7. When Respondents were asked If India is able to Combat the
epidemics situation rise due to Communicable diseases. The
responses are summarized to table 7.
TABLE 7
Criteria Frequency Percentage
Yes 77 77%
No 23 23%
FINDINGS:
77% percentage of the sample population were feel that India is
able to combat epidemics situation rise due to Communicable
diseases and other hand 23% sample population does not feel
like that.
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ANALYSIS:
If is observed that India is able to combat epidemics situation
rise due to Communicable diseases and there is provide all
medical facilities for peoples.
7. CONCLUSION
58% percentage of the sample population goes for the medical
checkup when they required in emergency, 20% goes once in a
year 15% people go for medical checkup once in 6 months while
only 7% goes once in a three months.
Health Problems in India are not detected at the primary stage
since the people does not go for the medical checkup the regular
basis. They only go when a medical emergency comes around
them.
From the Population sample most of the people preferred to eat
outside once in a week or a month duration while very few goes
once in a year for the food court outside, If is observed that due
to the outside unhealthy eating habits the Indians are more
prone to the infection diseases. Which we can reduce by eating
healthy from the good place/ Restaurants / Hotels etc.
20% percentage of the sample population doing the workout in
four days a week, 7% doing the workout in six days a week and
53% people does not work out.
An observed that due to less work out is the main reason for
unhealthy or bad fitness problem.
43% percentage of the sample population involved in outdoor
sport and 57% population does not involve any kinds of outdoor
sports.
According to above observation people does not want to show
interest in outdoor sports. Thats why they face many health
problems in future.
38% percentage of the sample population feel tired after working
for a short span of time and 62% population does not feel tired
after working for a short span of time.
An above Observation showing that people does not working
regularly thats why they feel tired after working for a short span
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of time.
80% percentage of the sample population were feel adequate
medical facility is available throughout the country and 20%
sample population does not feel like that.
An above observation showing that adequate medical facility is
an available in India. There is available all require medical
facilities.
77% percentage of the sample population were feel that India is
able to combat epidemics situation rise due to Communicable
diseases and other hand 23% sample population does not feel
like that.
If is observed that India is able to combat epidemics situation
rise due to Communicable diseases and there is provide all
medical facilities for peoples.
8. REFERENCES
1. NATIONAL HEALTH POLICY 2002
2.

http://www.indianhealthcare.in/index.php?

option=com_content&view=article&catid=131&id=168%3AIndian+Healthcare:+The+Growth+Story
3. http://www.ibef.org/industry/healthcare.aspx
4. http://cii.in/menu_content.php?menu_id=238
5.

http://knowledge.wharton.upenn.edu/india/article.cfm?

articleid=4277
6.

The

Times

Of

India.

http://economictimes.indiatimes.com/Healthcare/Lacking_healthcare_a_million_Indians_die_every_year_Oxfo
7.

http://knowledge.wharton.upenn.edu/india/article.cfm;jsessionid=a830ad0556799af14ed03640274d5d3a1b7
articleid=4277
8. http://searo.who.int/EN/Section313/Section1519_10852.htm
9. http://www.technopak.com/tkc/index.asp?ol=5
10. http://www.technopak.com/tkc/index.asp?ol=6
11.
http://202.131.96.59:8080/dspace/bitstream/123456789/113/1/Medical+TourismPheba+Chacko.pdf
12. http://www.technopak.com/tkc/index.asp?ol=8
13.

Healthcare

in

India.

Boston

Analytics.

http://www.bostonanalytics.com/india_watch/Healthcare%20in%20India%20Executive%20Summary.pdf.
14. http://www.irdaindia.org/
15.
http://projecthelpline.in/myblog/?p=819

http://www.indianhealthcare.in/index.php?
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option=com_content&view=article&catid=121&id=170
16.

http://www.indianhealthcare.in/index.php?

option=com_content&view=article&catid=39:&id=330:MALVINDER,+SHIVINDER+PLAN+TO+ENTER+HEALTH+IN
17.

Status

of

Malaria

in

India.

http://medind.nic.in/jac/t00/i1/jact00i1p19.pdf.
18. 2.5 million people in India living with Aids, according to new
estimates.

New

York

Times.

http://data.unaids.org/pub/PressRelease/2007/070706_indiapressrelease_en.pdf.
Retrieved 2007-06-08.
19. Sharp drop in India Aids levels, BBC
20. 2.5 million people in India living with HIV, according to new
estimates.

World

Heath

Organization.

http://www.who.int/mediacentre/news/releases/2007/pr37/en/index.html.
Retrieved 2007-06-08.
21. Robinson, Simon (2008-05-01). Indias Medical Emergency.
Time.
http://www.time.com/time/nation/article/0,8599,1736516,00.html.
Retrieved 2010-05-04.
22.

http://www.worldbank.org.in/WBSITE/EXTERNAL/COUNTRIES/SOUTHASIAEXT/INDIAEXTN/0,,contentMDK:214
23. India: Undernourished Children: A Call for Reform and
Action.

World

Bank.

http://web.worldbank.org/WBSITE/EXTERNAL/COUNTRIES/SOUTHASIAEXT/0,,contentMDK:20916955~pagePK:
24. Pandey, Geeta (2006-10-13). Hunger critical in South Asia.
BBC.

http://news.bbc.co.uk/2/hi/south_asia/6046718.stm.

Retrieved 2010-01-05.
25. Using shame to change sanitary habits, Los Angeles Times, 6
September 2007
26. The Politics of Toilets, Boloji
27. Mumbai Slum: Dharavi, National Geographic, May 2007
28.

Development

Policy

Review.

World

Bank.

http://web.worldbank.org/WBSITE/EXTERNAL/COUNTRIES/SOUTHASIAEXT/0,,contentMDK:20980493~pagePK:
29.

http://www.indianhealthcare.in/index.php?

option=com_content&view=article&catid=39%3A&id=327%3AINDIA+TURNING+AFFORDABLE,+QUALITY+OPTI
30.

http://www.indianhealthcare.in/index.php?

option=com_content&view=article&catid=131&id=168&start=2
31.

http://www.indianhealthcare.in/index.php?

option=com_content&view=article&catid=122&id=173
National health policy 2002
Health situation in India
World report, making a difference
Health information of India
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Delivery of healthcare services in India published by national


commission on macroeconomics and health
Researches methodology by R. Panneerselvam
Health screen.. Volume 2, No.7, July 2005(diabetes clinical
management cover story pg 10 17)
Health care: www.wipro.in/domains/healthcare/indexhtm
www.ahrg.gov
http:/en.wikipedia.org/wiki/healthcare_in_India
http://en.wikipedia.org.wiki.ministry_of_health_and_family_welfare_India
www.indmedica.com
www.herc.research.va.gov
www.wpro.who.int/health_topics
www.whoind.org
www.who.int
7. QUESTIONNAIRE
Questionnaire:
Name: __________________
Date of birth: _________________
Sex: _______________
Marital status: ___________
No. of children (if any): ______________
Physical address: ______________________
1. How often do you go for a medical checkup?
a) Once a week or more
b) Once a month or more
c) Once in three months or more
d) Once in six months or more
e) Once in a year
f) Only if required
2. How often do you eat outside?
a) Once a week or more
b) Once a month or more
c) Once in three months or more
d) Once in six months or more
e) Once in a year
f) Never
3. Do you workout?
a) Four days a week
b) Five days a week
c) Six days a week
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d)Not at all.
4. Are you involved in any outdoor sports?
a) Yes
b) No
5. Do you feel tired after working for a short span of time?
a) Yes
b) No
6. Do you think there is enough medical facility available to the
population of India right from metro cities to the rural India?
a) Yes
b) No
7. Do you consider India is able to fight the epidemic situations?
a) Yes
b) No
8. Do you consider India is able to Communicable diseases?
a) Yes
b) No

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