Dr.

RAM MANOHAR LOHIYA NATIONAL

LAW UNIVERSITY

ECONOMICS-III

BUSINESS CASE ON A PRIVATE HOSPITAL

POST COVID

SUBMITTED TO – SUBMITTED BY –
Dr. Mitali Tiwari Shashwat Singh
Associate Professor Enrollment No.- 210101136
(Economics) B.A. LL.B. (hons.)
Dr. Ram Manohar Lohiya National Law University 3rd Semester, Section ‘B’
 TABLE OF CONTENT

Contents
TABLE OF CONTENT ................................................................................................... 2
ACKNOWLEDGEMENT ............................................................................................... 3
1.OPENING PARAGRAPH ............................................................................................ 4
2.HISTORICAL BACKGROUND.................................................................................. 5
MISSION ...................................................................................................................................................5
VISION ......................................................................................................................................................5
OUR CORE VALUES & COMMITMENTS: ..........................................................................................6
3.RESEARCH ABOUT THE INDUSTRY ..................................................................... 6
4. KEY COMPETITORS ............................................................................................... 8
5. KEY ACTIVITIES OF THE COMPANY ................................................................. 9
6. ORGANISATIONAL STRUCTURE : HIERARCHY ANDMANAGEMENT ..... 10
7. KEY STRATEGIES: MARKETING AND HR ...................................................... 11
8. OPERATION AND IMPLEMENTATION ............................................................. 12
9. SUSTAINABILITY FACTORS .............................................................................. 12
The Present Post Covid Era & Strategies .....................................................................................................14
12. Discussion of the Issues mentioned in the beginning .............................................. 14
Reported Consolidated quarterly numbers for AYUSH HOSPITAL are: ...............................................15
CONCLUSION .............................................................................................................. 17

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 ACKNOWLEDGEMENT

I take this opportunity to express my profound gratitude and deep regards to my guide Dr.
Mitali Tiwari, Professor of Economics for her exemplary guidance, monitoring and constant
encouragement throughout the course of this project. The support, help and guidance given
by her from time to time shall take me a long way in the journey of life.

I would like to thank and express a deep sense of gratitude to my Professor for allocating
this project to me and valuable information and guidance, which helped me in completing
this task through various stages.

I would also like to thank my colleagues and friends for their constant encouragement
without which this assignment would not have been possible.

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 1.OPENING PARAGRAPH

This is the business case of a private hospital in Ballia by the name Ayush Hospital.

Protagonist: Dr Archana Singh

The Chairman and the Secretary and Head of Department Dr. Archana singh along with the other
head of departments and senior doctors were sitting together in the Joint Meeting Room on the
2nd floor around the long square table stressed about the post pandemic situation. There was a
long discussion
Some of the issues that came up in the discussion and something everybody was worried about
are as follows-

● There was an obvious sense of fear amongst the employees, patients which
kept worsening
● Patient input has drastically decreased i.e the there has been a serious decrease in the
number of patients that are being admitted in the hospital
● OPD Patients have decreased by 95% i.e we are getting only 4-5 patients
● Few wards had to be closed off because of very low IPD (indoor patients)
● Elective Surgeries have decreased by more than 90% almost to zero
● Expenses of hospital have increased due to rise in expenditure in sanitizers, PPE kits,
cleaning and sanitisation of the building etc
● Segregation of wards; all these factors have led to a huge decrease in revenue generation
and massive increase in expenditure
● Management had to take tough decision to cut salaries of the employees in the pandemic
by almost 50%
● Employees above the age of 60 were given sabbatical leave

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 2.HISTORICAL BACKGROUND

HOW DID THE HOSPITAL START? HOW DID THE IDEA OF SETTING UP THIS
HOSPITAL TAKEROOT?

Dr Archana singh is a Swimmer. During his career of 45 years, she has madecontributions in
the fields of adventure, sports, environment, disability and social work.
While she was preparing for a competition, while training she was injured, she suffered a spinal
injury because of which many of her activities were affected. So. She felt and understood the
problems with the people suffering from this kind of injury have to go through. She has received
ample help from government to get healthy again. She then established a Hospital center for studies
on spinal injury
Presently, she is the chairman of Ayush Hospital.

OUR MISSION, VISION & VALUES

MISSION

At Ayush Hospital, our aim is to restore hope and joy in the heart of every patient with unrelenting
attention to clinical excellence, patient safety and an unparalleled dedication to assure exemplary
physical, emotional and spiritual care.

VISION

● To strive to become the first choice as a spinal and orthopedic healthcare provider in Ballia.
● To foster a culture of education in all of our activities and supporting exemplary health
sciences research and development in an environment which is both ethical and respectful
of others

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 ● Utmost dedication to providing quality, value driven health care to all we serve through
education, outreach, and other innovative services in spine and other spinal ailments.
● To strengthen our relationships through affiliation with renowned institutions of higher
learning, offering technological advances and modern facilities.
● To reach the lives of thousands of newly spinal injured every year by providing medical
excellence through both scientific expertise and compassionate therapy.

OUR CORE VALUES & COMMITMENTS:

● To strive to bring awareness in the field of disability and lobby with policy makers to
introduce suitable legislation for prevention of disability and enforcement of the equal
opportunity bill.
● We will continue to put strong emphasis on man power development through education
programs with a focus on graduate and post-graduate courses in Rehabilitation Sciences.

KEY PERSONS INVOLVED IN THE BUILDING OF THIS HOSPITAL SINCE THE

BEGINNING

● Dr Archana singh
● Dr. H.S Chhabra
● Mr. Uman Bedi

3.RESEARCH ABOUT THE INDUSTRY

Healthcare has become one of India’s largest sector, both in terms of revenue and employment.
Healthcare comprises hospitals, medical devices, clinical trials, outsourcing, telemedicine,
medical tourism, health insurance and medical equipment. The Indian healthcare sector is growing
at a brisk pace due to its strengthening coverage, services and increasing expenditure by public as
well private players.

Indian healthcare delivery system is categorised into two major components - public and private.
The Government, i.e. public healthcare system, comprises limited secondary and tertiary care
institutions in key cities and focuses on providing basic healthcare facilities in the form of primary
healthcare centres (PHCs) in rural areas. The private sector provides majority of
secondary, tertiary, and quaternary care institutions with major concentration in metros and tier I
and tier II cities.

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India's competitive advantage lies in its large pool of well-trained medical professionals. India is also
cost competitive compared to its peers in Asia and Western countries. The cost of surgery in India is
about one-tenth of that in the US or Western Europe. India ranks 145 among 195
countries in terms of quality and accessibility of healthcare.

SOURCE: https://www.ibef.org/industry/healthcare-india.aspx

Factors driving the healthcare market in India Include:

• Growing incidence of lifestyle diseases

• Rising demand for affordable healthcare delivery systems due to the increasing healthcare
costs
• Technological advancements
• Emergence of telemedicine
• Rapid health insurance penetration and government initiatives like e-health
• Tax benefits and incentives

There are also strong growth indicators in Indian healthcare expenditure over the coming years.
Between 2008 and 2022, the market is expected to record a Compound Annual Growth Rate (CAGR)
of 16.28% and the total industry size is estimated to touch $372 billion by 2022.
Similarly, the hospital industry in India stood at $61.79 billion in 2017 and is expected toincrease at
a CAGR of 16-17% to reach $132.84 billion by 2022.

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According to KPMG, the healthcare sector in India offers a potent mix of opportunities and
challenges. The significant gap between ‘required’ and ‘actual’ healthcare infrastructure has
driven considerable investment into assets like hospitals and other facilities over the years. In turn,
the growing availability and affordability of healthcare is spurring demand for other
services like diagnostics, pharmacies, equipment etc.

The growth story of the healthcare industry is also contributed to by many non-healthcare
corporates and private equity firms infusing (capital and non-capital) resources. Due to the lowercost
of procedures, India has become an attractive destination for medical tourism and a base forclinical
trials.

KPMG highlights the challenges that the Indian healthcare sector faces on its way up as the optimal
utilisation of resources, minimising operational costs, maximising performance and efficiency,
scaling of business, rapidly evolving technology and globalisation of healthcare delivery quality and
standards1.

4. KEY COMPETITORS

In the vast spectrum of healthcare Industry, there are individual markets for primary care service,
hospital care, medical devices, pharmaceuticals, human resource as well as medical and nursing
education. Therefore, the healthcare industry is one of the most important industries. The
competition in the healthcare market is highly profitable to consumers as it helps in the reduction
of cost, improvement in quality, and further encourages innovation. The competition also benefits
customers as it provides incentives for constant product advancements and encourages a higher
level of service performance. To create a competitive environment, the customer must have
multiple procuring options and choices with reasonable pricing. Similarly, competition, regulation,
and financial incentives can be significant ways to improve quality in healthcare. This also
improves clinical outcomes and assists the system to function more efficiently.

https://www.indiahealth-exhibition.com/en/overview/industry-insights/healthcare-market-insight
s-for-India.html

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 5. KEY ACTIVITIES OF THE COMPANY

FACILITIES AVAILABLE AT AYUSH HOSPITAL

● Spinal Disorders & Surgery

● Orthopedics
● Alternative Medicine
● Anaesthesia
● Cardiology
● Chest & Respiratory Medicine
● Dental
● Dermatology
● Emergency (24*7)
● ENT (Ear/Nose/Throat)
● Executive Health Checkup
● Foot Care Clinic (Podiatry)
● Gastroenterology
● Gynaecology
● Internal Medicine
● Speech Therapy
● Urology

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6. ORGANISATIONAL STRUCTURE : HIERARCHY AND
MANAGEMENT

SOURCE: http://hcp1.com/the-hcp-difference/total-hospital-marketing/

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 7. KEY STRATEGIES: MARKETING AND HR

Our marketing strategy includes -

● Displaying of our key services across the city on hoardings and even in our hospital
premises so that people know about the variety of services provided by the hospital
● To promote Medical Tourism
● Collaboration with other hospitals in different services
● Advertisement across written media
● Collaboration with different health insurance companies
● Conduction camps in different all over India and abroad

Human Resource
Human Resource Management is Vital in Health Care
Effective human resources management plays a crucial role in the success of health care systems.
Proper management of human resources is vital in the recruitment and retention of clinical and
non-clinical staff, maintaining staff morale, providing opportunities for professional development,
and in the ability of a healthcare organization to deliver quality health care services and improve
patient health outcomes.

We have a General Manager, Human Resources in our institute. Ten subordinates are working
under the HR Manager. These are the functions of HR
Hiring
– Physician and Nurse Recruitment
– Employee Orientation
– Personnel Management
– Benefits & Compensation Management
– Counseling
– Claims Handling
– Training and Performance Monitoring
– Professional Development Programs
– State and Federal Regulations Education
– Workplace Safety and Sanitation
– Labor Mediation
– Administration – Employee Meetings
– Staff Morale & Retention

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 8. OPERATION AND IMPLEMENTATION

AYUSH HOSPITAL is a NABH Accredited Hospital. These are the following standards which
are implementedin our hospital to provide best services to our patients

1. Access Assessment and Continuity of Care (AAC)

2. Care of Patients (COP)
3. Human Resource Management (HRM)
4. Facility Management and Safety (FMS)
5. Hospital Infection Control (HIC)
6. Information Management System (IMS)
7. Responsibilities of Management (ROM)
8. Patient Rights and Education (PRE)
9. Management of Medication (MOM)
10. Patient Safety and Quality Improvement (PSQ)

9. SUSTAINABILITY FACTORS

The following points show what all factors help this hospital to accumulate funds and help
sustain it.

{I}PATIENTS

● Firstly, its important to note that we see a considerable size from neighboring
towns
● We are not dependant on seasonal patients. Our services are such that ensures the input of
perineal patients who come all year round
● Here patients mainly come for elective and emergency orthopedics and spine surgeries all
over the year
● Most of the patients are of paraplegic and quadriplegic (neurological deficit) so they need
prolonged hospitalisation

{II} SERVICES

● AYUSH HOSPITAL is also Ballia’s biggest rehabilitation centre (physiotherapy)

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 ● Many patients from all over the towns surrounding Ballia come to
AYUSH HOSPITAL only for rehabilitation(physiotherapy)

{III} Employees-

All employees are on salary basis. As AYUSH HOSPITAL is nonprofit org, the turnover
of employees is very low, the profit of organisation is distributed among the salaried
employees which is evident by salary increment every January. So, the employee turnover
is very low here.

During Corona Times

- Home Quarantine Assistance
- Covid Lab
- Online Consultation

10. COVID/lockdown related impact on the company and the strategies to be

adopted in Post COVID/lockdown

● There is an obvious sense of fear amongst the employees, patients which keeps
worsening
● Patient input has drastically decreased i.e the there has been a serious decrease in the
number of patients that are being admitted in the hospital
● OPD Patients have decreased by 95% i.e we are getting only 4-5 patients
● Few wards had to be closed off because of very low IPD (indoor patients)
● Elective Surgeries have decreased by more than 90% almost to zero
● Expenses of hospital have increased due to rise in expenditure in sanitizers, PPE kits,
cleaning and sanitisation of the building etc
● Segregation of wards; all these factors have led to a huge decrease in revenue generation
and massive increase in expenditure
● Management had to take tough decision to cut salaries of the employees in the pandemic
by almost 50%
● Employees above the age of 60 were given sabbatical leave.

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The Present Post Covid Era & Strategies

Our post Covid strategy includes increasing the number of beds, ensuring better facilities for the
segregation of patients, treating every patient as a potential case of Covid and proper hygiene.

12. Discussion of the Issues mentioned in the beginning

• The salaries of the employees had to be slashed by 50% or less.

• Employees earning upto 50,000 had 7% cut in their salaries
• Employees earning upto I,00,000 had 15% cut in their salaries.
• Employees earning upto 1-1,50,000 had 20% cut in their
salaries
• Employees earning upto 1.5 - 2,10,000 had 30% cut
• Employees earning 2-4lakh had 40%
cut
• Employees earning 4+lakh had 50%
cut

Rosters were made regarding the schedule for doctors and other staff members such that no one
was exposed for a long time and gets 2 weeks to quarantine. Orders were placed for all the PPE
kits, testing equipment, sanitizer etc. The hospital priority was to keep its employees safe hence
it first refused to admit any patients of corona but later on due to rapid rise in cases and huge dip
in revenue it had to budge and also start admitting corona patients.

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Reported Consolidated quarterly numbers for AYUSH HOSPITAL are:
Net Sales at Rs 605.95 lakh in June 2022 down 46.77% from Rs. 1,138.31 inJune 2020.
Quarterly Net Loss at Rs. 178.92 lakh in June 2021 down 363.85% from Rs. 67.81
lakhs in June 2020.

Jun'22 Mar'21 Jun'20

Net Sales/Income from operations 605.95 1,112.92 1,138.31
Consumption of Raw Materials 147.88 233.68 242.11
Employees Cost 206.22 218.70 235.91
Depreciation 71.65 80.08 70.95
Other Expenses 355.14 534.76 518.01
P/L Before Other Inc., Int., Excpt. -170.49 64.11 90.89
Items & Tax

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 Other Income 4.45 18.41 19.56
Interest 41.08 56.95 50.92
P/L Before Tax -211.12 7.16 49.47
Net Profit/(Loss) For the Period -190.74 -43.26 75.19

Awards and Recognition

1. Pharmacie de Quality - 2017

2. Quality Excellence Award - 2017
3. NABH - Accreditation Certificate 2018 - 2021
4. AYUSH HOSPITAL nominated as “Best Patient Friendly Hospital”

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 CONCLUSION

It is envisaged that COVID-19 infections will not persist in the population into 2023, because of
the rapid development of effective therapy or vaccination. Accordingly, doctors and hospitals
will be treating patients while infections are still present in the community. The healthcare
facilities and doctors will need to treat patients with resource constraints including, but not
limited to, lack of virus or antibody testing capabilities, lack of contact tracing support,
unavailability of nurses, doctors, admin staff, personal protective equipment (PPE), and shortage
of hospital or ICU beds.

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