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India last place on earth to find health care

Basic medical needs for the citizens are still not met.
Though huge number of doctors and nurses present its
comparatively far lesser than the countries like US and
Most medical facilities are outdated, cramped and
often unhygienic.
Though the per capita income is less, Indians still
believe that good medical treatment is a necessity.
Despite the pressing demand and constrained supply,
Indian hospitals have devised ways of providing world
class health care affordably.

They maintain the global quality standards.

Though they target a higher income patients,

they cater to low income as well.

Low costs attract large volumes and hence
enterprise is profitable.
These are generally single or multi speciality
institutions and are many times academic
centres as well.
Their charges are typically 95% lower than
those of U.S hospitals without compromising
on quality.


cost of labour seems to be an

obvious answer but it is just a small part of
the story.
Even considering the U.S wages the cost
in India is just 4%-18% in comparison with
US hospitals.
Then how such ultra low costs are
managed still remains unanswered.


deliver the dual commitment of high

quality and ultra low cost, Indian hospitals
developed 3 powerful organisational
(a.) Hub and Spoke configuration of
(b.) Shifting of tasks.
(c.) Cost Effectiveness.

It is basically a pyramid type of a structure where

specialists and highly skilled surgeons are generally at
the top of the pyramid and skilled workers at the
Hubs are generally the metro cities and spokes are
arrayed around them.
This model attracts and retains doctors seeking to
improve the skills rapidly.
It develops continually updating treatment protocols
reducing errors.
It emphasises on creating specialists in relatively rare
sub specialities of medicine.
It promotes innovation which suites local condition.

Rethinking who does what becomes critical when you have to deliver
high quality at ultra low price.
Indian exemplars hospitals match the skill levels of people with the
basic requirement of tasks.
They focus on creating fresh categories of low cost health care
workers at one end of the spectrum and highly efficient specialists at
the other.
They maximize the efficiency by increasing the number of staffs
supporting the most skilled surgeons extending their reach.
Another way of increasing surgeons productivity is to reduce the time
in moving of patients.
An extreme form of task shifting is self service where patients and
family members take over tasks traditionally performed by hospital
Allowing family members to provide those services reduces costs,
allows personal care and ensures continuity of care at home
reducing post surgical complications.


exemplars have the goal of

maximising the number of patients treated
rather than the number of procedures
To achieve the goal, these hospitals follow
the mind set of old fashioned frugality
applied in both ways as innovative and
remarkably mundane.
Cost cutting is the priority even among the


hospitals or doctors have traditionally

looked to the West for advances in medical
knowledge but its about time West looked to
India for innovations in Health Care delivery.
Changes in U.S Health Care will not come
easily and quickly, however U.S health care
system will operate in a very different way if
exposed to the kind of low cost innovation
driving the best Indian hospitals.



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