Over View Of Health Care

Management

Course Code :19MB61D0

Dr. Manav Sahu

Syllabus :

A Conceptual Approach to Understanding the Healthcare Systems – Evolution – Institutional Settings.

Overview of Healthcare Sector in India – Understanding the Hospital Management – Health Policy – levels
of healthcare; primary, secondary and tertiary – systems of medicine – Ayurveda, Siddha, Unani,
Homeopathy, Yoga, Naturopathy, etc. – Preventive and Curative medical care – General and specialty
Hospitals-Pharmacopia

Functional Hospital Organization: Medical specialties: Overview of the functions and sphere of each
specialty: oncology, general medicine, cardiothoracic, gastroenterology, urology, nephrology, radiology,
psychiatry, endocrinology, neurology, ophthalmology, medical services, surgical services, operation theatre,
maternity services, dental services. Hospital code of ethics, medical ethics, standards for hospitals
accreditation, accreditation standards for extended care facilities.

Clinical & Diagnostic Services: Outpatient Services – Accident and Emergency Services – Inpatient Services –
Operation Theatre Services – Intensive Care Unit Services – Nursing Services. Diagnostic and Therapeutic
Services: Laboratory Services – Radio Diagnosis and Imaging Services – Radiation Hazards – Blood
Transfusion Services – infection control, mortuary services, Pharmacy Services: Role of pharmacy manager,
analyzer for pharmacy, drugs management.

Hospital operations management: productive systems in a hospital, Facility Location and Layout,
importance of location, factors, Productivity measures, value addition, capacity utilization, productivity –
capital operations, front office, billing, staffing, housekeeping, transportation, dietary services, emergency
services. Medical Records – Admission – Billing – Nursing Records – Diagnostic Records – Infection Control
Records – Maintenance of Operation Theatres Records – Maintenance of Intensive Care Units Records;
Clinical Records – Housekeeping Records – Food Records – Engineering Records – Maintenance Records –
Security Records – Fatal Documents – Mortuary Maintenance Records – Transportation – Medico Legal
Records,
A Conceptual Approach to Understanding the Healthcare
Systems – Evolution – Institutional Settings.

Overview of Healthcare Sector in India – Understanding

the Hospital Management – Health Policy – levels of
healthcare; primary, secondary and tertiary – systems of
medicine – Ayurveda, Siddha, Unani, Homeopathy, Yoga,
Naturopathy, etc. – Preventive and Curative medical care
– General and specialty Hospitals-Pharmacopia
 A Conceptual Approach to Understanding the Healthcare Systems

Medical care is a programme of services that should make available

to the individual, and thereby to the community, all facilities of
medical and allied services necessary to promote and maintain health
of mind and body.

This programme should take into account the physical, social and
family environment, with a view to the prevention of disease, the
restoration of health and the alleviation of disability
A Conceptual Approach to Understanding the Healthcare Systems
A Conceptual Approach to Understanding the Healthcare Systems
 Health Care Services

Environmental Health Services

Environmental health services are considered as a component of
public health, with overlaps. It covers the following:

1. Water supply
2. Pollution control
3. Sewage disposal
4. Food hygiene
5. Ecology and environmental pollution.
 Health Care Services

Public Health Services

Public health services are concerned with the following.
1. Control of communicable diseases
2. Sanitation
3. Maternal and child health
4. Public health education
5. Vital statistics
6. Health planning
7. Occupational health and reduction of health hazards.
 Health Care Services
Early Diagnosis and Treatment
Primary, Secondary and Tertiary care:

Treatment services are categorised as primary, secondary and tertiary care.

Primary care
Primary care is the entry point into the health system and usually obtained
through family physicians and through the hospital-based ambulatory
outpatients services—besides the community health workers and
multipurpose workers at the grass-roots level.

WHO defined primary health care as “essential health care based on practical,
scientifically sound and socially acceptable methods and technology made
universally accessible to individuals and families.

It is the first level of contact of individuals, the family and the community....and
constitutes the first element of a continuing
 Health Care Services
Early Diagnosis and Treatment
Primary, Secondary and Tertiary care:

Secondary care
Secondary care services are at an intermediate level in the chain of
hospitals.

The services of smaller peripheral hospitals and general hospitals would

fit in this category.

Tertiary care
Tertiary care refers to highly specialised care in specialist hospitals and
speciality services provided in superspeciality centres and research
centres.
 Health Care Services

Personal Health Services

Personal health services are the services provided by hospitals,

health centres and nursing homes, apart from privately practising
physicians.

The care provided has been traditionally classified into:

i. promotion of health,
ii. prevention of disease,
iii. early diagnosis and treatment, and
iv. rehabilitation.
 Health Care Services

Rehabilitation

WHO defines rehabilitation as “the combined and coordinated use

of medical, social, educational and vocational measures for training
or retraining the individual to the highest possible level of
functional ability”.

Apart from restoration of function (medical), rehabilitation

medicine involves disciplines such as physical medicine,
occupational therapy, speech therapy, education, vocational
guidance.

Rehabilitation is thus not an end-activity of the hospital, but must

start early in the process of medical treatment.
 Health Care Services

Health Team
No single agency can deliver the entire range of medical and health care.

The functional classification of the teams concerned with group health and
personal health is as follows.
The health care team
which consists of all those who are involved in improving health in a community
setting,
without necessarily being in active contact with patients.

The medical care team

which consists of those professionals and paraprofessionals who provide service for
the patient generally in a hospital setting, but without any direct or personal
contact with the patient.

The patient care team

which comprises any group of professionals and semiprofessionals in a hospital
setting who
jointly provide service that brings them into direct contact with the patient.
Classification of health care
 Evolution
History of Hospitals
Medieval Period
The word “hospital” originates from the Latin ‘hospice.’ In fact the word hospital,
hostel and hotel all derive from the common Latin root hospice.

The place or establishment where a guest is received was called the hospitium or
hospitale.

The term hospital has at different times been used to refer to an institution for the
aged and infirm, a place of rest, a hostel where people lived as a small community, and
an institution for the care of the sick and wounded.

Lodging for the pilgrim and the wayfarer was also one of the primary functions of the
early hospital. In its earliest form, the hospital was aimed at the care of the poor and
the destitute,
giving the aura of a “almshouse”
 Evolution
History of Hospitals
Medieval Period

In the early Greek and Roman civilisations, the temples of the gods were used as
hospitals.
These hospitals were not separate entities but formed an integral part of the
temples.
Little distinction was made between the disease and the supernatural powers that
caused diseases, where mysticism and superstition saddled medical practice, and
where more soul healing than physical healing was practised.

The Greeks and Romans considered the temples of gods and their priests responsible
for providing shelter and sustenance to the sick.
Charity was the principal source for defraying illness costs of the poor.
It was in Greece thatHippocrates—universally acknowledged as the father of western
medicine—was born, in 460 BC.
 Evolution
With the birth and spread of Christianity there was an impetus to hospitals which
became an integral part of the Church and its monasteries.

Medicine was reverted to religion, the nuns and monks practising it. Gradually,
these Christian hospitals replaced those of Greece and Rome.

During the crusades. (Christian expeditions to recover the Holy land from
Mohammedans, 1100-1300 AD) over 19,000 hospitals were founded in Europe to
cater for those suffering from war injuries and diseases.

The order of St. John was one such sect, responsible for creating chains of
hospitals.

This order has survived all these centuries and still functions as St. John
Ambulance Corps in England with its branches all over the world, including India
 Evolution
Subsequently, certain decrees issued by the Church for divesting religion from
medical succour had the effect of lowering the status of the entire medical
profession and stopping the monks from practising medicine.

In 1163 AD, the Church formally restricted the clergy from working as
physicians, and this restriction heralded the beginning of the end of hospitals
towards the end of the Crusades (around 1300 AD).

During early nineteenth century, nurses of religious orders were replaced by lay
people who treated patients badly. Patiens were crowded together in common
bed, and infection and gangrene were commonplace all over the hospitals.
 Evolution
Some of the notable hospitals established in the Western world date
back to the ancient times. In 542 AD the earliest hospital was founded at
Hotel Dieu in Paris. St.

Bartholomew’s hospital in London dates from the year 1123 AD. In

keeping with the hospital philosophy then prevalent, there was a
general tendency to lump togther the sick, the
physically handicapped, the socially unwanted and the pauper all
together.

The Spanish built the first hospital in Mexico city in 1524 and the French
in Canada. In North America, the first general hospital, Pennsylvania
Hospital, opened in 1751, Bellevue hospital in New York in 1736 and
Massachusetts hospital in 1811 AD. This was followed by establishment
of hospitals in quick succession in many other places in USA.
 Evolution
Nineteenth Century
The middle of the nineteenth century saw the arrival of Florence Nightingale on the
hospital scene. It fell upon Florence Nightingale to revolutionise nursing by
supplementing
good intentions and humane concern with scientific approach to nursing through
training.
The working of hospitals underwent a sea change as a result of her efforts when she
was sent to attend to the sick and wounded at the Crimean War (1853-1856 between
the joint forces of Britain and France with Russia.
Total casualties: Allies—2,52,000, Russian—2,56,00) in 1854. This was the turning
point in the history of hospitals in the Western World.
Various developments in medical sciences gave impetus to further progress in the
hospital field. Discovery of anaesthesia and the principles of antisepsis were two most
important influences in the development of hospitals.
Discovery of steam sterilisation in 1886, X-ray in 1895 and rubber gloves in 1890
revolutionised surgical treatment and gave further philip to hospital development.
Great progress was being made in cellular pathology, clinical microscopy, bacteriology
and so
on during the period from 1850 to 1900, and each one of these had a definite impact
on hospital progress.
 Evolution
Nineteenth Century

Besides the scientific advances during this period, rapid industrialisation during the
last quarter of 19th century generated enormous funds in the Western World.

Hospital development in the 20th century has, therefore, been explosive, especially
in the USA and Europe.

A hospital was no longer a place where people went to die.

The advances in medical science brought about by antibiotics, radiation, blood

transfusion, improvement in anaesthetic techniques and the spectacular advances in
surgical techniques and medical electronics have all brought about tremendous
growth and improvement in hospital services.
 Evolution
Hospitals in India

Early indian rulers considered the provision of institutional care to the sick as their
spiritual and temporal responsibility.
The forerunners of the present hospitals can be traced to the times of Buddha,
followed by Ashoka. India could boast of a very well-organised hospital and medical
care system
even in the ancient times. The writings of Sushruta (6th century BC) and Charaka (200
AD) the famous surgeon and physician respectively were considered standard works or
many centuries with instructions (in Charaka Samhita) for creation of hospitals, for
provisions of lying-in and
children rooms, maintenance and sterilisation of bed linen with steam and fumigation,
and use of syringes and other medical appliances. Medicine based on the Indian
system was taught in the ancient university of Taxila. Charaka Samhita, a treatise on
medicine based on the teaching of Charaka was written around 600 AD and Sushruta
Samhita, a treatise of surgical knowledge, was compiled during 400 AD.
The most notable of the early hospitals were those built by King Ashok (273-232 BC).
There were rituals laid down for the attendants and physicians who were enjoined to
wear white clothes and promise to keep the confidence of the patients.
 Evolution
Hospitals in India
However, the age of Indian medicine started its decline from the Mohammedan
invasions in the tenth century. The Mohammedans brought with them their Hakims
who followed the Greek system of medicine which came to be known as “Yunani”. This
system and its physicians started
to prosper at the expense of Ayurveda and its Vaidyas.
However, the influence of Ayurveda continued in the South.
The Modern system of medicine in India was introduced in the 17th century with the
arrival of European Christian missionaries in South India. In the 17th century, the East
India Company—the forerunner of the British empire in India—established its first
hospital in 1664 at Chennai for
its soldiers and in 1668 for civilian population.
European doctors started getting popular and during the later part of 18th and early
19th century, there was a steady growth of modern system of medical practice and
hospitals, pushing
the indigenous system to the background. Organised medical training was started with
the first medical college opening in Calcutta in 1835, two in Delhi in 1835 and 1836,
followed by Mumbai in 1845 and Chennai in 1850.
As the British spread their political control
Institutional Settings.
Understanding the Hospital Management
 Understanding the Hospital Management

A hospital can be variously described as a factory, an office building, a

hotel, an eating establishment, a medical care agency, a social service
institution and a business organisation.

In fact, it is all of these in one, and more.

Sometimes it is run by business means but not necessarily for business
ends. This complex character of the hospital has fascinated social
scientists as well as lay people.

Management science defines a system as “a collection of component

subsystem which, operating together, perform a set of operations in
accomplishment of defined objectives.” A system is viewed as anything
formed of parts placed together or adjusted into a cohesive whole.
Every system is therefore a part of a large system and has its own
subsystem.
 Understanding the Hospital Management
A system is construed as having inputs which undergo certain processing and get
transformed into output, the output itself in turn sending feeback to the input
and the
process, which can be altered to achieve still better output.
A system is therefore a continuous and dynamic phenomenon

Transformation of matter, energy or information produce the output by two

processes, viz. decision process, i.e. the process of deciding what to do, how best to
do it, when to do it and so on, and action process, i.e. the process of putting the
above decisions in action.
 Understanding the Hospital Management

Peculiarities of a Hospital System

In spite of the simple definition of a system, a hospital system is more than the sum
of its parts. The peculiarities of a hospital system are as follows.

1. A hospital is a open system which interacts with its environment.

2. Although a system generally has boundary, the boundaries separating the hospital
system from other social systems are not clear but rather fuzzy.
3. A system must produce enough outputs through use of inputs. But the output of
a hospital system is not clearly measurable.
4. A hospital system has to be in a dynamic equilibrium with the wider social system.
5. A hospital system is not an end in itself. It must function, as a part of the larger
health care system.
6. A hospital system like other open social systems tends towards elaboration and
differentiation, i.e. as it grows, the hospital system tends to become more
specialised in its elements and elaborate in structure, manifesting in the creation of
more and more specialised departments, acquisition of new technology, expansion
of the “product lines” and scope of services.
 Understanding the Hospital Management
from four different perspectives which are as follows

different perspectives which are as follows.

1. Client-oriented perspective which is that of access to service, use of service, quality
of care, maintenance of client autonomy and dignity, responsiveness to client needs,
wishes and freedom of choice.
2. Provider-oriented perspective that of the physician, nurses and other professionals
working for the hospital, and include freedom of professional judgement and
activities, maintenance of proficiency and quality of care, adequate compensation,
control over traditions and terms
of practice and maintenance of professional norms.
3. Organisation-oriented perspective which covers cost control, control of quality,
efficiency, ability to attract clients, ability to attract employee and staff, and
mobilisation of community support.
4. Collective orientation perspective which includes proper allocation of resources
among competing needs, political representation, representation of interests affected
by the organisation, and coordination with other agencies.
Understanding the Hospital Management
Understanding the Hospital Management
 Understanding the Hospital Management
Functions
Intramural Functions of a Hospital
1. Restorative
a. Diagnostic : These comprise the inpatient
service involving medical, surgical
and other specialities, and special
diagnostic procedures.
b. Curative : Treatment of all ailments
c. Rehabilitative : Physical, mental and social rehabilitation
d. Care of emergencies : Accidents as well as diseases

2. Preventive
a. Supervision of normal pregnancies and childbirth
b. Supervision of normal growth and development of children
c. Control of communicable diseases
d. Prevention of prolonged illness
e. Health education
f. Occupational health
 Understanding the Hospital Management
Functions

3. Education
a. Medical undergraduates
b. Specialists and postgraduates
c. Nurses and midwives
d. Medical social workers
e. Paramedical staff
f. Community (health education)

4. Research
a. Physical, psychological and social aspects of health and
disease
b. Clinical medicine
c. Hospital practices and administration
 Understanding the Hospital Management
Functions

Extramural Functions of a Hospital

1. Outpatient services
2. Home care services
3. Outreach services
4. Mobile clinics
5. Day care centre
6. Night hospital
7. Medical care camps
 Understanding the Hospital Management
levels of healthcare
The health care system or models in India can be categorised under the following sectors or
programmes:
Public health sector
Primary health care
• Village-level accredited social health activist
• Village-level Auxiliary Nurse Midwife (ANM), a village-level health worker,
who is the first contact person between the community and health services
• Sub-centres
• Primary Health Centre

Hospitals or health centres

• Community Health Centres
• Rural hospitals
• District hospitals or health centres
• Specialty hospitals
• Teaching hospitals
Private sector

• Private hospitals, polyclinics, nursing homes and dispensaries

• General practitioners and clinics
 Understanding the Hospital Management
levels of healthcare
Levels of medical care Health care services are, generally, categorised at four levels, viz.,
primary, secondary, tertiary and quaternary.
These levels represent different types of care, involving varied degrees of complexity.

Primary care level

Primary care providers may be doctors, nurses or physician assistants.
It is the first level of contact with individuals, family and community, where
primary health care (essential health care) is provided.

Most of the health problems of people can be addressed at this level.

It is at this level that health care will be the most effective.

In the Indian context, primary health care is provided by Primary Health Centres
(PHCs) and their sub-centres through multipurpose health workers, village health
guides and trained health care workers.

Besides providing primary health care, village health care centres bridge cultural
and communication gaps between rural people and the organised health sector.
 Understanding the Hospital Management
levels of healthcare

Secondary care level

The next level is secondary (intermediate) health care.

At this level, more complex problems are dealt with.

In India, this kind of care is, generally, provided by district hospitals and
community health care centres, which also serve as the first referral point.

Secondary care means a patient will be taken care of by specialists.

These specialists focus either on a specific body system/ part or a specific disease
or condition.

For example, if someone has a heart problem, the person needs to consult a
cardiologist. If someone is suffering from problems related to hormones and
diseases, like diabetes or thyroid, then s/he must consult an endocrinologist.
 Understanding the Hospital Management
levels of healthcare
Tertiary care level
Think, learn and discuss... The tertiary level is more specialised
than secondary care level.

It requires specific facilities and attention of highly specialised

health workers.
It is provided by regional or central level institutions.

For example, highly specialised equipment and expertise is

required to treat coronary artery bypass surgery.

Quaternary care
It is an extension of tertiary care, and is more specialised and highly
unusual.
All hospitals or medical centres cannot provide quaternary care.
It includes experimental medicines and procedures.
Understanding the Hospital Management
levels of healthcare
 Understanding the Hospital Management
Factors Influencing Hospital Utilisation

1. Hospital bed availability:

2. Population coverage and bed distribution
3. Age profile of population:
4. Availability of medical services other than hospitals:
5. Customs and attitudes of medical profession:
6. Method of payment for hospital services:
7. Availability of qualified medical manpower
8. Housing:
9. Morbidity pattern:
10. Hospital bottlenecks:
11. Internal organisation
12. Public attitudes
Understanding the Hospital Management
Factors Influencing Hospital Utilisation
 Indigenous Systems of Medicines:
Ayurveda, Siddha, Unani, Yoga, Homeopathy and Naturopathy

(i) Ayurveda:
The word ‘Ayurveda’ has derived out of fusion of two separate words- Áyu’ i.e. life
and ‘veda’ i.e. knowledge.
Thus in literal meaning Ayurveda is the science of life.
Ayurveda is a classical system of preventive, promotive and curative healthcare
originating from the Vedas documented around 5000 years ago and currently
recognized and practiced in India and many countries in the world.
It is one of the most ancient healthcare systems having equal scientific relevance in
the modern world, that take a holistic view of the physical, mental, spiritual and
social aspects of human life, health and disease.
It is believed that Ayurveda is originated out of Vedas (particularly Rigveda and
Atharvaveda). Numerous references of health, diseases, their treatment as well as
use of nonmaterialistic things such as sun rays, fasting, mantra etc; are available in
these Vedas. The knowledge of Ayurveda was first comprehensively documented in
the compendia like ‘Brahma Samhita’, Ágnivesha tantra’, ‘Bhela Samhita’ etc. Out of
these, only some part of Bhela Samhita is available today. The Agnivesha Tantra was
edited by Charak around 5000 years back called Charak Samhita and thereafter re-
edited by Dridhbala, which is one of the main text of Ayurveda available in complete
form today.
 Indigenous Systems of Medicines:
Ayurveda, Siddha, Unani, Yoga, Homeopathy and Naturopathy

According to Ayurveda, health is considered as a basic pre-requisite for achieving the

goals of life - Dharma (duties), Arth (finance), Kama (materialistic desires) and Moksha
(salvation).
Ayurveda, all objects and living bodies are composed of five basic elements, called the
Pancha Mahabhootas, namely: Prithvi (earth), Jal (water), Agni (fire), Vayu (air) and
Akash (ether).
The philosophy of Ayurveda is based on the fundamental correlation between the
universe and the man.
Hence Ayurveda has also stressed on environmental aspects and has advised various
measures for conservation of nature as well as to avoid the pollution of Air, water and
Soil. Ayurveda imbibes the humoral theory of Tridosha- the Vata (ether + air), Pitta
(fire) and Kapha (earth + water), which are considered as the three physiological
entities in living beings responsible for all metabolic functions.

The treatment approach in the Ayurveda system is holistic and individualized having
preventive, curative, mitigative, recuperative and rehabilitative aspects.
 Indigenous Systems of Medicines:
Ayurveda, Siddha, Unani, Yoga, Homeopathy and Naturopathy

The preventive aspect of Ayurveda is called Svasth-Vritta and includes personal

hygiene, daily and seasonal regimens, appropriate social behavior and use of
materials & practices for healthy aging and prevention of premature loss of health
attribute.

The curative treatment consists of Aushadhi (drugs), Ahara (diet) and Vihara (life
style).

Ayurveda largely uses plants as raw materials for the manufacture of drugs, though
materials of animal and marine origin, metals and minerals are also used. Ayurvedic
medicines are generally safe and have little or no known adverse side-effects,

Initially, clinical medicine of Ayurveda was developed into eight distinct specialties,
i.e. Kayachikitsa (Internal Medicine), Shalya Tantra (Surgery), Shalakya (Eye and
ENT), Kaumar Bhritya (Pediatrics), Graha Chikitsa (Psychiatry), Agad Tantra
(Toxicology), Rasayana (Gerontology) and Vajikarana (Science of virility), on the basis
of which it is called ‘Ashtang Ayurveda’. During the last 60 years of its development
after India became independent, Ayurveda has come up to provide 22 specialized
courses of study at post-graduation level.
 Indigenous Systems of Medicines:
Unani
Unani system of medicine is a comprehensive medical system, which provides
preventive, promotive, curative and rehabilitative health care.
The system is holistic in nature and takes into account the whole personality of an
individual rather than taking a reductionist approach towards disease.
The fundamentals, diagnosis and treatment modalities of the system are based on
scientific principles.
The basic framework of this system is based on the Hippocratic theory of four
Humours, according to which any disturbance in the equilibrium of humours causes
disease and therefore the treatment aims at restoring the humoral equilibrium.
The system also believes that Medicatrix Naturae (Tabiat Mudabbira-i Badan) is the
supreme power, which controls all the physiological functions of the body, provides
resistance against diseases and helps in healing naturally.
Temperament (Mizaj) of a patient is given great importance both in diagnosis and
treatment of diseases.
It is also taken into consideration for identifying the most suitable diet and lifestyle for
promoting the health of a particular individual.
 Indigenous Systems of Medicines:
Unani
Unani system of medicine described four mode of treatment viz.,
Ilaj-bil-Tadbir (Regimenal Therapy), Ilaj-bil-Ghidha (Dietotherapy), Ilaj-bilDawa
(Pharmacotherapy) and Ilaj-bil-Yad (Surgery).
The thrust areas of Unani medicine include; skin diseases, liver disorders,
noncommunicable diseases including life style diseases, metabolic & geriatric diseases
and menstrual / gynaecological disorders etc.

The Unani system of medicine includes the Science of Maintaining Health (Hifzän-i
Sihhat). It has the methods of understanding and maintaining health in a positive and
individualized manner with different guidelines for different temperaments, genders,
age groups, geographical regions, seasons, occupations etc.

Some of the more commonly used guidelines are summarized as: Regimens for
Seasons (Tadäbir-i Mavsam), Regimens for Agegroups (Tadäbir-i Asnän), Regimens
for Pregnancy (Tadäbér-i Ùaml), Regimens for Travellers (Tadäbir-i Musäfir) etc
 Indigenous Systems of Medicines:
Unani
Originating in Greece (Yunan), this system travelled to many countries before coming
to India to find here its permanent home.
During its journey wherever it passed, the system enriched its repository by
imbibing which was best of the healthcare systems in vogue in those countries.
The system after getting further developed in the Arab and Persian lands came to
India around the 8th century and took deep roots in the Indian civilization.
 Indigenous Systems of Medicines:
Siddha,
The Siddha System of medicine is one of the ancient systems of medicine in India
having its close bedd with Dravidian culture.
The term Siddha means achievements and Siddhars are those who have achieved
perfection in medicine.
Eighteen Siddhars are said to have contributed towards the systematic development of
this system and recorded their experiences in Tamil language.
The Siddha system of Medicine emphasizes on the patient, environment, age, sex,
race, habits, mental frame work, habitat, diet, appetite, physical condition,
physiological constitution of the diseases for its treatment which is individualistic in
nature
Diagnosis of diseases are done through examination of pulse, urine, eyes, study of
voice, colour of body, tongue and status of the digestion of individual patients. System
has unique treasure for the conversion of metals and minerals as drugs and many
infective diseases are treated with the medicines containing specially processed
mercury, silver, arsenic, lead and sulphur without any side effects.
The strength of the Siddha system lies in providing very effective therapy in the case of
Psoriasis, Rheumatic disorders, Chronic liver disorders, Benign prostate hypertrophy,
bleeding piles, peptic ulcer including various kinds of Dermatological disorders of non
psoriatic nature
 Indigenous Systems of Medicines:
Siddha,
During the last six decades, there has been continuous development in Siddha
medical education and this has led to the establishment of the National Institute of
Siddha at Chennai as apex Institute having six specialties in post-graduate teaching
leading to the award of M.D(S) Degree.

These are Maruthuvam (General Medicine), Sirappu Maruthuvam (Special Medicine),

Kuzhanthai Maruthuvam (Paediatrics), Gunapadam (Pharmacology), Noi Nadal
(Pathology) and Nanju Nool & Maruthuva Neethinool (Toxicology)
 Indigenous Systems of Medicines:
Yoga,
The word "Yoga" comes from the Sanskrit word "yuj" which means "to unite or
integrate." Yoga is about the union of a person's own consciousness and the universal
consciousness.
It is primarily a way of life, first propounded by Maharshi Patanjali in systematic form
Yogsutra.
The discipline of Yoga consists of eight components namely, restraint (Yama),
observance of austerity (Niyama), physical postures (Asana), breathing control
(Pranayam), restraining of sense organs (Pratyahar), contemplation (Dharna),
meditation (Dhyan) and Deep meditation (Samadhi).
These steps in the practice of Yoga have the potential to elevate social and personal
behavior and to promote physical health by better circulation of oxygenated blood in
the body, restraining the sense organs and thereby inducing tranquility and serenity of
mind and spirit.
The practice of Yoga has also been found to be useful in the prevention of certain
psychosomatic diseases and improves individual resistance and ability to endure
stressful situations.
Yoga is a promotive, preventive rehabilitative and curative intervention for overall
enhancement of health status.
 Indigenous Systems of Medicines:
Yoga,
A number of postures are described in Yoga literature to improve health, to prevent
diseases and to cure illness. The physical postures are required to be chosen
judiciously and have to be practiced in the correct way so that the benefits of
prevention of disease, promotion of health and therapeutic use can be derived from
them.

The United Nations General Assembly had declared June 21st as the International
Yoga Day on December 11, 2014. Accordingly the first International Yoga Day
Celebration was organized at Rajpath in New Delhi on June 21, 2015. Two Guinness
World Records were achieved, viz: the Largest Yoga Lesson involving 35,985
participants and Maximum number of Nationalities (84) participated in a single yoga
lesson. The Second International Day of Yoga celebrations were solemnized at the
Capitol Complex in Chandigarh on the morning of 21st of June, 2016.
 Indigenous Systems of Medicines:
Naturopathy
Naturopathy is rooted in the healing wisdom of many cultures and times based on
principal of natural healing.
The principles and practices of Naturopathy are integrated in the life style, if the
people observe living close to nature.
Naturopathy is a cost effective drugless, non-invasive therapy involving the use of
natural materials for health care and healthy living. It is based on the theories of
vitality, boosting the selfhealing capacity of the body and the principles of healthy
living.
Naturopathy is a system of natural treatment and also a way of life widely practiced,
globally accepted and recognized for health preservation and management of illnesses
without medicines.
Naturopathy advocates living in harmony with constructive principles of Nature on the
physical, mental, social and spiritual planes. It has great promotive, preventive,
curative as well as restorative potentials.
Naturopathy promotes healing by stimulating the body’s inherent power to regain
health with the help of five elements of nature – Earth, Water, Air, Fire and Ether. It is a
call to “Return to Nature” and to resort to a simple way of living in harmony with the
self, society and environment. Naturopathy advocates ‘Better Health without
Medicines’.
Indigenous Systems of Medicines:
Naturopathy
 Indigenous Systems of Medicines:
Homeopathy
"Homoeopathy" was introduced as a scientific system of drug therapeutics by a
German Physician, Dr. Christian Frederick Samuel Hahnemann in 1805.
While translating a medical treatise by Scottish physician and chemist, William Cullen,
from English to German, in 1790, he came across a foot note under Cinchona that
attributed its fever curing property to the astringent (decongestant) qualities of the
drug. Being sceptical of Cullen's remarks concerning the effect of Cinchona for curing
malaria, Hahnemann experimented its effect on himself by taking repeated doses of
cinchona tincture and experienced fever, shivering and joint pains: symptoms similar
to those of malarial fever.
After series of experiments, Hahnemann concluded that a drug that could produce
certain symptoms in healthy individuals could also cure similar disease symptoms, in
accordance with some hidden, natural laws of similars as had been vaguely perceived
by ancient physicians.
This led to the coining of the word "homoeo-pathy" (which comes from the Greek:
ὅμοιος hómoios, "-like" and πάθος páthos, "suffering").
Based on this, Hahnemann postulated the key principle of Homoeopathy, the Law of
Similars, logically evolving it as an experimental science, according to the method of
inductive reasoning after exact observation, correct interpretation, rational
explanation and scientific construction.
Indigenous Systems of Medicines:
Homeopathy
 History and Today
India's Ministry of Health was established with independence from Britain in 1947.

The government has made health a priority in its series of five-year plans, each of which
determines state spending priorities for the coming five years.

The National Health Policy was endorsed by Parliament in 1983. The policy aimed at
universal health care coverage by 2000, and the program was updated in 2002.

The health care system in India is primarily administered by the states. India's
Constitution tasks each state with providing health care for its people.

In order to address lack of medical coverage in rural areas, the national government
launched the National Rural Health Mission in 2005.

This mission focuses resources on rural areas and poor states which have weak health
services in the hope of improving health care in India's poorest regions.
 Preventive and Curative medical care
Chronic diseases are the leading cause of death and disability worldwide and are
linked to increasing health costs. Preventative care is advocated as part of a population
health approach and includes both clinical preventative services and screening tests.
Identifying and preventing potential problems downstream is one strategy for
controlling utilization and improving health outcomes.
Levels of Prevention 
 Preventive and Curative medical care

Curative or therapeutic care is what we usually think of simply as care. 

We have a sore throat, we go to the doctor, they diagnose strep throat and
prescribe an antibiotic, we take it, and the sore throat goes away.
More complicated problems often involve more complicated treatments. The
challenge is that there is often more than one way to treat a given problem and
that each treatment choice has different risks and benefits.

Examples of curative care include:

Antibiotics for bacterial infections
Chemotherapy or radiation therapy for cancer
Cast for a broken bone
Dialysis treatment for kidney failure
Surgery for appendicitis
Acupuncture for certain conditions
Dietary programs for certain conditions
 General and specialty Hospitals-

The term general hospital covers many types of institutions ranging from the rural hospital to
the district hospital to the bigger institution with facilities for teaching and research.
For the provision of comprehensive medical care to the community, the general hospital is the
most appropriate institution.

Such a hospital aims to provide treatment with a range of general medical, surgical, obstetric
and gynaecological, paediatric, orthopaedic, eye and ENT services, except for illnesses requiring
highly sophisticated treatment in specialised institutions.
A general hospital pervades the medical care scene and is the dominant medical care facility.
.
 General and specialty Hospitals-
CLASSIFICATION OF HOSPITALS

Hospitals in general can be divided into two categories depending upon the
agencies which finance them.
Government or public hospitals are those that are managed by government
services, either central or state or public, municipal or departmental bodies that
are financed
from the overall budget for public services.
Nongovernment hospitals, on the other hand, are those that are managed by
individuals, charitable organisations, religious groups, philanthropic bodies,
cooperative societies,
industrial undertakings or individuals.
Many are operated on noncommercial, nonprofit (and sometimes no-profit no-
loss) basics. Its modern varient is the private hospital run on commercial basis,
funded and managed as a commercial enterprise by corporate groups or
individuals.
 General and specialty Hospitals-

On the basis of ownership patterns, nongovernment hospitals are classified as

follows.

1. Private (Personal)

2. Partnership

3. Private (family) trust

4. Public charitable trust

5. Cooperative society

6. Private limited company

7. Public limited company.

 General and specialty Hospitals-
Pros and Cons of a General Hospital:
Now here’s looking at the pros and cons of the general hospital to give you a fair
idea of which of them can prove to be the best option for you.

Pros-
You can get all your queries solved under a roof
Treatments in general hospitals may be less expensive than in specialized hospitals
Due to their big size, they usually have more beds than the specialized hospitals

Cons-
Their sheer size itself is a big issue, especially when it comes to hygiene, quality of
services provided and maintenance
There may be less of a personalized care since there are a variety of patients with
a variety of ailments under one roof
 specialty Hospitals-
 While a specialized hospital is one, which specializes in the treatment of a particular or a
group of related ailments only, such as ENT (ear, nose and throat) surgeries.

Pros and cons of a specialized hospital:

Pros-
Critics suggest that specialized hospitals can draw large volumes, thereby reducing costs and
improving the quality of the services provided to you.
Specialized hospitals may increase their standards of quality, thereby encouraging the general
hospitals to improve their quality standards too as a result of competition.
Specialized hospitals are seen to deliver better amenities for its patients and also achieve a
higher percentage of patient satisfaction.
Specialized hospitals also put greater management responsibilities on the doctors that help to
improve quality as well as productivity.
Cons-
Specialized hospitals may tend to prefer well-insured patients while neglecting uninsured
patients.
Some critics contend that the specialized hospitals tend to threaten the capability of the
general hospitals to cross-subsidize services or patients that are less profitable.
Specialized hospitals may not be able to manage critical emergency situations all the time
since the particular physician may not be present on site all the time.
The ownership structure of the specialization hospitals may encourage physicians to self-refer
to over utilize hospital services.
 Pharmacopia
Pharmacopoeia: the word derives from the ancient Greek φαρμακοποιΐα
(pharmakopoiia), from φαρμακο- (pharmako-) ″drug″, followed by the verb-
stem ποι- (poi-) ″make″ and finally the abstract noun ending -ια (-ia).

These three elements together can be rendered as ″drug-mak-ing″ or ″to

make a drug″. A pharmacopoeia, pharmacopeia, or pharmacopoea, in its
modern sense, is a legally binding collection, prepared by a national or
regional authority, of standards and quality specifications for medicines used
in that country or region.

A quality specification is composed of a set of appropriate tests that will

confirm the identity and purity of the product, ascertain the strength (or
amount) of the active substance and, when needed, its performance
characteristics
 Pharmacopia

The role of a modern pharmacopoeia is to furnish quality specifications for active

pharmaceutical ingredients (APIs), FPPs and general requirements, e.g. for
dosage forms.

The existence of such specifications and requirements is necessary for the proper
functioning or regulatory control of medicines. Pharmacopoeial requirements
form a base for establishing quality requirements for individual pharmaceutical
preparations in their final form.

According to the information available to the World Health Organization (WHO),

140 independent countries are at present employing some 30 national as well as
the African, European and International Pharmacopoeias (2). Compared to
national and regional pharmacopoeias,

The International Pharmacopoeia (Ph. Int.) is issued by WHO as a

recommendation with the aim to provide international standards – including less
technically demanding alternatives where needed - for adoption by Member
States and to help achieve a potentially global uniformity of quality specifications
for selected pharmaceutical products, excipients and dosage forms
 Overview of the functions and sphere of each specialty:

oncology,
General medicine,
cardiothoracic,
gastroenterology,
Urology,
nephrology,
radiology,
psychiatry,
endocrinology,
neurology,
ophthalmology,
medical services,
surgical services,
operation theatre,
maternity services,
dental services.
oncology, general medicine, cardiothoracic, gastroenterology, urology, nephrology, radiology,
psychiatry, endocrinology, neurology, ophthalmology, medical services, surgical services,
operation theatre, maternity services, dental services.