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Branding of Hospitals Through Tangible Factors by Selected Hospitals
Branding of Hospitals Through Tangible Factors by Selected Hospitals
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*RESEARCH SCHOLAR,
KL UNIVERSITY, VADDESWARAM,
GUNTUR (DIST), ANDHRA PRADESH.
**ASSOCIATE PROFESSOR,
KL UNIVERSITY, VADDESWARAM,
GUNTUR (DIST), ANDHRAPRADESH.
ABSTRACT
The Indian Healthcare Sector is expect to reach US$100 billion by 2015 from the current US$ 65
billion, growing at around 20% a year, according to rating agency Fitch. Some of the major
factors driving the growth in the sector include increasing population, growing lifestyle related
health issues, cheaper cost of treatment, thrust in medical tourism, improved health insurance
penetration, increasing disposable income, government initiatives and focus on Public Private
Partnership (PPP) models. Branding is winning people (i.e. patient) confidence by providing best
treatment. Branding of service sector especially Healthcare & Hospitals is different; it is mainly
dependent on word of mouth and patient experience. However, mushrooming of new hospitals in
India made Indian healthcare service providers to go for Branding building of hospitals and
healthcare sector. Healthcare is a consumer driven process, so branding of hospital goes parallel
with service delivery process. In healthcare sector, consumers were known as the brand
ambassadors for the hospitals. A healthy brand identity of a hospital gives high priority in
decision-making. Misbranding of a hospital affects its financial health (i.e. market share loss and
revenue loss). Branding should be based on code of conduct, ethics and social responsibility. The
consumers trust consumer brands and the healthcare consumers trust healthcare brands. This
paper focus on importance of branding of hospitals through tangible benefits, importance of
branding to hospitals.
INTRODUCTION:
In the competitive world of healthcare sector, success depends on providing a great quality
service to patients. The facilities that are available in the hospital play a decisive role in
improving the quality of services. In the developing countries, the hospital services need both
qualitative and quantitative improvements 1 (Dr.R.Kavitha 2012). In India increasing number of
1
Dr.R.Kavitha, Factors Influencing the Service Quality Gap between Expected Service and Perceived Service- A
Study of Sri Gokulam Hospitals, Salem, Volume 1 Issue 1 ‖‖ December. 2012 ‖‖ PP.30-36, International Journal of
Business and Management Invention.
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hospitals, face extremely competitive environments and that created an importance to banding.
Hospital brand image increases patient loyalty directly and improves patient satisfaction through
enhancing service quality, which in turn increases the re-visit intention of patients2. Hospital
brand image indeed serves as a lead factor in enhancing service quality, patient loyalty and
satisfaction (Chao-Chan Wu, June, 2011)
Hospitals should create good will for themselves by providing better service to patients, and the
hospital staff also has to understand, communicate and trust the brand values of hospitals
because their attitude and behavior with patients will influence the success of the hospital brand
over a period of time.
Hospitals have valuable tangible and intangible assets that need to be maintaining with care as
they offer benefits to patients, employees and owners. The key importance of branding hospital
is that, consumers (patients) perceive differences between services provided by different
hospitals. The brand is not just for the customers; good branding can take a small company or a
hospital to the next level3 (GREEN communications 2006, 2). Once a hospital achieves a
superlative position it should be consistent in delivering healthcare to patients as consistency in
delivering service or care to patients will lead to consistency in image of hospital which the
patient carries in his/her mind.
Figure: 1
We can observe that in olden days people use to go to the same doctor for years, may be their
entire life and doctors were trusted without any criticism. Now-a-days situation has changed as
the internet is offering plenty of information about diseases and treatments, the competition is
getting more intense as more and more hospitals that are private were entering in to the market,
and people were travelling far away to get the best treatment they want. Therefore, successful
healthcare organizations are looking beyond the tradition; they are establishing a different way of
thinking about the organization as a whole and increasing the role of marketing4. (DeVries &
McKeever 2008, 15-16.)
2
Chao-Chan Wu, The impact of hospital brand image on service quality, patient satisfaction and loyalty African
Journal of Business Management Vol. 5(12), pp. 4873-4882, 18 June, 2011.
3
GREEN communications. 2006. Guide to creating a brand. http://www.greenblog.co.uk/files/quide-to-creating-a-
brand.pdf Accessed: 19.10.2011
4
DeVries K, McKeever J. 2008. Constructing a Better Brand. Marketing Health Services Vol 28 Issue 4, p15-19.
EBSCOhost Business Source Elite database.
228
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HISTORY OF HOSPITALS:
The words Hospital, Hotel, Spital and Hospice are derived from the Latin word Hospitium
meaning “a place of entertainment for strangers, lodging, an inn, a guest-chamber” (Lewis &
Short 1958:8675). During the Golden Age of Islam (9th-13th centuries), the Persian word
bimaristan denoted a hospital, while maristan referred to an institution for the insane (Major
1954:2296; Porter 1997:1057). In earlier days, priests act as physicians or medicine men,
Priests/doctors were also a part of the ruling class enjoying great political influences and the
temple/hospital was set as meeting place. In India by 600 BC, hospitals were constructed and
during the time of King Ashoka, Indian hospitals began to look like modern hospitals following
sanitation and cesarean sections in order to save both child and mother. One Physician was
appointed for every ten villages to serve health care needs of people.
Middle age: During the middle age, Religion continued to be the dominant influence in the
establishment of hospitals. Religious community took responsibility to care for poor.
Characterized Greek medicine was lost and separation of patients was eliminated, sanitation was
ignored and three to five patients were allotted same bed. Surgeries are avoided in order not to
“disturb the body” and to avoid the shedding of blood. First, Pope Innocent III in 1198 urged
wealthy Christians to build hospitals in every town. The oldest hospital still in existence are the
“Hotel –Dieu” in Lyons and Paris, France. The term “Hotel-Dieu” indicates that it is a public
hospital. During the crusades (i.e.at the end of the 11 th century) The growth of hospitals
accelerated,. Military hospitals came into being along the traveled routes: the knights Hospitalist
of the Order of St John in 1099 established in the Holy Land, a hospital take care for 2000 8
patients. (johnpunnoose.com/yahoo.../HISTORY_OF_HOSPITALS.11155632.doc).
Renaissance Age: The renaissance period is from the fourteenth to the sixteenth centuries. This
period has seen the beginning of support for hospitals by secular authorities and by end of
fifteenth century, many cities and towns supported institutional health care. The gradual transfer
of responsibility for institutional healthcare from the church to civil authorities continued in
Europe after the dissolution of the monasteries in 1540 9 by Henry VIII. This period was well
known as the period of the great school of medicine.
In Germany, in central and in Eastern Europe Schools of medicine were flourishing. The
scientific study of human anatomy as a science was facilitated by dissections of animals. In
1506, in 1528 the Royal College of Surgeons followed by organization of the Royal College of
Physicians was established in England. In Italy and in France Clinical surgery took great strides
during this period, especially under Ambrose Pare. By the mid fifteenth century, all major courts
and cities of Europe sent physicians to Italy for advanced training.
5
LEWIS C T & SHORT C 1958. A Latin dictionary. Oxford: Clarendon Press.
6
MAJOR R H 1954. A history of medicine. Springfield Ill.: Charles C. Thomas.
7
PORTER R 1997. The greatest benefit to mankind. London: Harper Collins.
8
johnpunnoose.com/yahoo_site_admin/assets/docs/HISTORY_OF_HOSPITALS.11155632.doc.
9
ibid
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REVIEW OF LITERATURE:
The image of healthcare facilities has evolved ever since the nation's first hospital opened in
Pennsylvania, in 175210 (Matthew DeGeeter December 1, 2009).Emerging of new hospitals and
the demand for health care has created a need for creating a brand to a hospital, as branding is a
valuable intangible asset (Chao-Chan Wu, June 2011)1for any organization. Branding creates an
image to a hospital and reduces customers’ perceived risks in buying services (Kim et al.,
2008a). Building a brand to a hospital can be done by offering a quality service to patients both
in and out. According to G D Kunders, quality is the only measure of a hospital's brands, not the
high number of patients or the amount of money it makes (Building Brand Image for Hospitals,
Express health, September 2009). The service in health care is intangible, brings trust and
goodwill to hospitals. Patients were treated as brand ambassadors’ as in health care sector,
hospital promotion is in hands of patients, depends on patients satisfaction. Successful branding
for a hospital is a function of “Empathy and Sensitivity” and is all about communicating “care”
through hospital staff, facility and collateral. Indian Corporate hospitals have spreading their
wings, setting up branches under one umbrella with two-pronged strategy to attract Indians as
well foreign patients (Hindu 15 March 2005). The Brand positioning of Hospitals revolves
around number of (Chicago’s magazine Top Doctors 2005) emotionally tied factors like
expertise off staff, level of care and intensity of service provided.
The hospital market has today changed from a seller’s market to a buyer’s market, where, the
patient is more important. In order to achieve patient satisfaction, the hospital has to develop its
own technology and has to become more service-oriented. The patient-customer in the hospital is
very different from the regular customer, the difference being that they do not want to be
customers in the first place. The hospital customer is forced to be a customer because of their
illness and unfortunately, he/she has to part with their money 11. (Annamalai Solayappan, Jothi
Jayakrishnan 2010). Good branding can take a small company or a hospital to the next level
(GREEN communications 2006, 2) improving its financial status. Customers engage with
hospitals with the medium of hospitals brand and the brand creates a relationship between the
hospital and the customers.
10
Changing perception: Hospital brand as a design strategy December 1, 2009 by Matthew DeGeeter.
11
Annamalai Solayappan, Jothi Jayakrishnan 2010, Key Determinants of Brand-Customer Relationship in Hospital
Industry: Vol. LXII No. 4/2010, 119-128, Economic Sciences Series.
12
http://wdi.worldbank.org/table/2.15
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organizations. In 2010, the health statistics shows that the birth rate per thousand populations is
22.9 where as the death rate is 8.2 per thousand populations.
Among all the industries in the world healthcare industry is the largest industry contributing an
income of approx US$ 2.8 Trillion. In India, healthcare industries is one of the largest service
sectors offering employment to about 4 million people and contributes an income of around $ 30
billion constituting 5% of GDP. By 2025, India population will be approximately 1.4 billion; in
order to fulfill the health necessities of this population the health care sector should also increase
its size to $ 100 billion contributing 8 to 10% of GDP. In the last 4 years according to the
opportunities provided by the Investment Commission of India, the health care sector has
witnessed a substantial growth of over 12% per annum. Medical Tourism or Medical Value
Travel was well known as the key drivers to Indian health care industry. By 2015, McKinsey-CII
estimates the number of potential insurable lives at 315 million with a potential of US$ 7,700 13
million in health insurance premium by 2015. Health care should adopt the advanced and
innovative technology. Among those, telemedicine is one of the innovative technologies.
Through telemedicine, even the interiors can access high quality health care.
13
http://www.cii.in/Sectors.aspx?enc=prvePUj2bdMtgTmvPwvisYH+5EnGjyGXO9hLECvTuNu2yMtqEr4D408mS
sgiIyM
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Development of private hospitals results in development of health care sector. The private sector
is the dominant sector with part of the people seeking indoor care and the other part of the people
seeking ambulatory care i.e., out patients care (Dr.R.kavitha, 2012). The above-mentioned
hospitals are the centers of excellence in health care sector offering international service to
patients by adopting technological changes. APOLLO hospital was pioneer and has created a
brand image by offering best service to patients in India.
232
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the infrastructure it has. In 2003, it was declared as a super brand by Super brand council
because of its excellence in providing services, goodwill, dominance, loyalty and emotional
bonding with patients. It has about 5,000 doctors across more than 50 specialties:
Proven strength to attract clinical talent across continents14. It has established about 36 hospitals
with 580015 beds to serve the people.
Table:2 List of Apollo Hospitals engaged in Tertiary, Secondary and Primary Health care
Sl. Name of Owned Hospitals – Place Classification
No. Operational
1. Apollo Hospitals Chennai Super Specialty
2. Apollo Hospital Hyderabad Super Specialty
3. Apollo Specialty Hospital Chennai Cancer / Neuro / Ortho
4. Apollo Cancer Hospital Hyderabad Cancer Specialty
5. Apollo Hospitals Madurai Super Specialty
6. Apollo Heart and Kidney Hospital Vizag Cardiac
7. Apollo Hospitals Aragonda Multi Specialty
8. Apollo Hospitals Chennai Multi Specialty
9. Al Khaleej Heart Scan Centre Dubai Diagnostic
10. Apollo Emergency Medical Centre Hyderabad Multi Specialty
11. Apollo Centre Hyderabad Diagnostic
12. Indraprastha Apollo Hospitals New Delhi Super Specialty
13. Apollo (Secondary Care) Hyderabad Secondary Care
14. Apollo (Secondary Care) Hyderabad Secondary Care
Managed Hospitals- Operational
15. Abdur Razzaque Ansari Memorial Ranchi Super Specialty
16. Weavers Hospitals Bihar Tertiary
17. Rajiv Gandhi Cancer Institute New Delhi Cancer Specialty
18. Jahangir Hospital & Medical Centre Pune Multi Specialty
19. Central Travancore Specialists Chengannur Multi Specialty
Hospitals Ltd.,
20. Saumya Apollo Hospitals Vijayawada Super Specialty
21. Lotus Apollo Hospitals Erode Multi Specialty
22. Jodhana Medical and Research Centre Jodhpur Multi Specialty
23. Nirmay Hospital Dabhol Secondary Care
24. Kirms Apollo Hospitals Nagpur Multi Specialty
25. Amar Hospitals Hyderabad Multi Specialty
26. AMRI Apollo Hospitals Calcutta Multi Specialty
27. Venkatasai Hospitals Ananthapur Multi Specialty
28. NDMC Hospital Bacheli Multi Specialty
29. Florence Medical Centre Siliguri Multi Specialty
Source: The Economic Times, Health Care,
14
http://www.slideshare.net/shveta_bhatia/apollo-hospital-presentation.
15
businesstoday.intoday.in › ... › FEATURES › Dec 23, 2012.
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Apollo hospitals were providing quality services to patients through sophisticated equipments
and technologies, providing a wide range of Preventive Health Checkup packages that suits all
ages and requirements.
Its collaboration with Ericsson initiated Telemedicine concept through which rural and remote
area people can access health care. Apollo Specialty Hospitals has signed an MoU with the
Ludwig Boltzmann Institute16 for Applied Radiation Research at Donauspital, Vienna, under
which the two organizations will exchange knowledge and experience. The brand name Apollo
was expanded by starting Apollo medical stores in both urban and rural areas. By this, the rural
people came to know the brand Apollo. In 2003, it has launched a concept of media tourism that
has enhanced the brand mileage. It was providing an ambulance service “1066” to take care in
case of emergency. All these tangible factors increased the flow of patients to the hospital.
Narayana hrudalaya:
During past few decades, an emerging brand in healthcare sector is Narayana Hrudayalaya. It
was founded in the year 2000 in India, head quarter Bengaluru. There are about 23 hospitals
spread across 14 cities having an infrastructure of 6200 beds and was planning to expand the
16
http://www.slideshare.net/shveta_bhatia/apollo-hospital-presentation
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number of beds to 30000 in coming years. The narayan hrudalaya group comprises of 1300 full
time Doctors and 12,500 employees spread across their hospitals. It is well known as low cost
and high quality service provider in India. It was best owed for its service quality, affordabilit y
and scale17. Narayana Health differentiated from others by providing pre-eminent centre for
telemedicine in India, delivering services at free of cost and now it is one among the largest
telemedicine networks in India as well as in the world. Their main intentin is to service rural
people in the country, by doing this the name; Narayan Hrudayalaya was known to most of the
people both in urban and rural.
CONCLUSION:
In the healthcare industry, patients choose brands consulting their friends, colleagues and family
before going to a doctor. The word TRUST rules the health care industry. Branding of service
sector especially Healthcare & Hospitals is different as it is mainly dependent on word of mouth
and patient satisfaction. Investment in Branding gains consumer confidence, leads to an increase
in the market share, enhanced loyalty, and accelerated revenue growth. By establishing strong
brand image, the frequency of the patients to the hospital will be increased. Branding of the
17
Philanthropy Awards 2013". Online webpage of Forbes India. Retrieved 2013-12-6.
18
http://www.fortisescorts.in/AboutUs.aspx
19
Ibid.
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Hospitals is to recall the service provided and service provider through core benefits, tangible
benefits and intangible benefits.
REVIEW OF LITERATURE:
1. Annamalai Solayappan, Jothi Jayakrishnan 2010,Key Determinants of Brand-Customer
Relationship in Hospital Industry: Vol. LXII No. 4/2010 ,119-128, Economic Sciences
Series.
2. Chao-Chan Wu, The impact of hospital brand image on service quality, patient
satisfaction and loyalty, African Journal of Business Management Vol. 5(12), pp. 4873-
4882, 18 June, 2011.
3. Dina Barbis, 2012, Brand model creation for a small healthcare service, submitted to
HAAGA-HELIA University of applied sciences.
4. Dr.R.Kavitha, Factors Influencing the Service Quality Gap between Expected Service
and Perceived Service- A Study of Sri Gokulam Hospitals., Salem Volume 1 Issue 1 ‖‖
December. 2012 ‖‖ PP.30-36, International Journal of Business and Management
Invention.
5. DeVries K, McKeever J. 2008. Constructing a Better Brand. Marketing Health Services
Vol 28 Issue 4, p15-19. EBSCOhost Business Source Elite database.
6. Dr Ingy Mohamed Fikry Farid, Development of a Model for Healthcare Service Quality:
An Application to the Private Healthcare Sector in Egypt, Dissertation, Business,
Administration, Maastricht School of Management.
7. (GREEN communications. 2006. Guide to creating a
brand).http://www.greenblog.co.uk/files/quide-to-creating-a-brand.pdf Accessed:
19.10.2011.
8. Hunt S.D. and Edison. S (1995), “On the marketing of marketing knowledge”, Journal of
marketing management.
9. ICFAI, Health Care Sector, Volume I, 2003, ICFAI University Press, Hyderabad.
10. Kelly J. Devers, Linda R. Brewster, and Lawrence P. Casalino, Changes in Hospital
Competitive Strategy: A New Medical Arms Race?, HSR: Health Services Research
38:1, Part II (February 2003).
11. Kevin Lane Keller (2003), Strategic Brand Management, (2 nd edition), Person Education,
New Delhi.
12. Karl D. Speak, Health Care Branding : Addressing the Branding Challenges in Today’s
Health Care Marketplace, Journal of Health Care Marketing, 1996
13. K. R. Nayar, Universalizing Health Services in India: The Techno-managerial Fix, Indian
Journal of Public Health, Volume 57, Issue 4, October-December, 2013.
14. Kathleen DeVries and John McKeever, Constructing a Better Brand, MHS Winter 2008.
15. Kyung Hoon Kim, Kang Sik Kim, Dong Yul Kim, Jong Ho Kim, Suk Hou Kang, Brand
equity in hospital marketing, Journal of Business Research 61 (2008) 75–82.
16. J de Jager & T du Plooy,Measuring tangibility and assurance as a determinants of service
quality for public healthcare in south Africa, Acta Commercii 2007.
17. Suresh. K (2003), New Age Branding –concepts & cases volume – II ICFAI Books,
ICFAI University, Hyderabad.
18. Suresh. K (2004), HealthCare Sector Vol. II, ICFAI University Press, Hyderabad.
237