Emerging Trends in Healthcare Management

Transcription

1 Emerging Trends in Healthcare Management Khushboo Sabharwal Gupta PhD Scholar, Department of Management Studies, MANIT, Bhopal Dr. Varsha Rokade Assistant Professor, Department of Management Studies, MANIT, Bhopal Abstract- India is second largest country in term of population. As population increases need for basic needs of people increases at individual level. Around three-fourth of population live below subsistence level and their % of the income is spent on basic needs. Social safety need i.e. health is also prime need for all class people but most of people are unable to afford for good health. Demand for good healthcare has increased and will further continue which has led for changes in system of healthcare and further changes in future would also be needed. New trends are also emerging in the field of healthcare to satisfy the consumers (patients) of all age, classes (lower, middle and upper). In the present paper, recent trends in the field of health care management which have emerged with time have been discussed. Keywords Healthcare, Medical tourism, Healthcare expenditure, Introduction - Healthcare is the diagnosis, treatment, and prevention of disease, illness, injury, and other physical and mental impairments in human beings [1]. India healthcare system delivers the services through public and private healthcare system. Public healthcare are controlled by the government of state or central. All Indian Institutes of Medical Science (AIIMS) are governed by central government, Government Medical Colleges, District Hospitals or General Hospitals are governed by respective state government. Private healthcare are non-government funded healthcare facilities which are governed by societies or individual. Comparison of countries on the basis of major indicators among The world comprises of 248 countries. Comparison of different countries in the world can be done on the basis of major indicators. Study including all the countries of the world is very difficult so only five countries: Brazil, China, United Kingdom, India and United States have been considered in present study. The major indicators considered are: 1. Healthcare expenditure (Total percentage of GDP) 2. Public healthcare expenditure 3. Private healthcare expenditure 4. Trends in Population Healthcare expenditure Health Expenditure is the sum of both public and private spending on health. Healthcare expenditure covers preventive and curative health services, family planning, emergency care, nutritional care and water sanitation. 499

2 Fig.1: Healthcare expenditure as percentage of GDP of different countries Source : Data World Bank, 2012 Fig.1 shows total percentage expenditure on healthcare of GDP by Brazil, China, United Kingdom, India and United States since last five years i.e., from 2007 to United States spends highest percentage of total GDP among five countries on healthcare whereas lowest expenditure of GDP on healthcare is done by India. In United States, the expenditure on healthcare is having increasing trend along with whereas in India the graph declined till 2010 and after that shows negligible improvement. Expenditure on healthcare by other countries in non uniform. Public healthcare expenditure Public expenditure is spending of capital by the government budgets on health of its people. United Kingdom has the highest percentage of healthcare expenditure in terms of public and is constant since the last two years. India among the five countries has least expenditure on public healthcare but increasing trend is seen with time as seen in Fig Fig.2: Public healthcare expenditure as percentage of total healthcare expenditure Source : Data World Bank, 2012

3 Private healthcare expenditure Private healthcare are non-government funded healthcare facilities which are governed by societies or an individual. As seen in Fig.3, in India private sector is more active than public sector in the field of healthcare. There is decreasing trend of private sector in healthcare in all the countries except United States. Fig.3: Private healthcare expenditure as percentage of total healthcare expenditure Source : Data World Bank, 2012 Trend in population Number of people varies with variation in time. All the five countries show increase in population in the last 10 years which can be seen in Fig.4. At present China has the highest population but it is expected that India will overtake China by The studying Fig.1, Fig.2 and Fig.3 with respect to Fig.4, it indicates that Indian government has started working for making public healthcare more successful than private sector. Indian government will have to take large steps and increase healthcare expenditure to cope up with increasing population year wise. 501

4 Fig.4: Year wise variation in population in millions Source : Data World Bank, 2015 Healthcare in India India is a developing country and it will have highest population by 2030 (Source: UN Report). In India, there are five major segments in healthcare which contribute market size. They are: 1. Hospitals both public and private healthcare centres. 2. Pharmaceutical- relating to production and sale of drugs and medicine. 3. Medical Equipments are the vital components of healthcare used for diagnosis, monitoring or treatment of medical conditions. 4. Diagnostic includes the laboratories or methods used to identify the problems or diseases. 5. Insurance Medical insurance covers the expenses of hospitals and reimbursement of amount. Fig.5 shows the expenditure on healthcare in India. Hospitals contribute about 3/4th of health care expenditure and least expenditure is observed for diagnostic. India used to spend 1.4% of GDP on healthcare in In 2012, 4% of GDP on health was spent. 502

5 Fig.5: Healthcare expenditure in India Source : IDFC Securities Hospital Sector November 2010 Driving Factors for growth of Healthcare The major driving factors for growth of healthcare can be seen in Fig.6. Each of the factor affects healthcare growth directly or indirectly. Fig.6:Drivers for growth of healthcare 503

6 1. Demographic factor - In demographic factors major contribution is of increasing population, increasing life expectancy,increasing education/ awareness, increase in life -style diseases. a) Increasing Population - Increasing population is major factor for growth of healthcare. By 2030 it is estimated that India will surpass china in term of most populous nation. this increase in population is due to decrease in infant mortality as a result of increased healthcare facilities and Government initiatives is decreasing risk of Hepatises, Polio etc in infants. b) Increasing life expectancy - People are aware about the sanitation and government health plans so age an individual has increased to an average life span of around 65 years. c) Increasing Education /Literacy rate- Government initiatives play important role in term of education at district,village levels providing free books, education etc. d) Increases in life -style disease - Day by day consumption of junk food increase among all age group of people which lead to emergence of diseases like heart attack, diabetes,blood pressure etc. 2. Economic factor- Government encourages growth of healthcare by providing tax benefits, subsidies, reduced custom duty on imports of equipments and higher depreciation on medical instruments etc. 3. Increase in middle -income class - India traditionally have culture for working men individually now as awareness / education increase among population,which lead to the entry of women in workforce. Now many women are highly educated which lead to increase income of family. 4. Increasing diseases risk - WHO estimated that in coming years many people will die due to major killers of diseases which include cardiovascular, injuries, diabetes, cancer, tuberculosis, AIDS etc. These diseases are increasing as the life style of individuals changing. 5. Absence of appropriate Infrastructure - as medical tourism is increasing in India lead to the growing demand for quality of healthcare. Quality of care can be provided with appropriate infrastructure, as government and private healthcare providers are lacking. 6. Lack of insurance cover- In India many people are not covered under insurance, as middle - class peoples are struggling enough to sustain their basic need. Peoples below poverty line die in debt of treatment of their loving one in case of serious illness. Major Emerging Trends In Indian Healthcare New trend in Indian Healthcare are as follows :- 1. Dual-burden of diseases 2. Medical Tourism 3. Telemedicine 4. Quality of care 5. Technological 6. Health Insurance 504

7 Dual-burden of diseases Now days India is facing the dual burden of disease of both communicable diseases and chronic noncommunicable diseases (NCDs) which includes cardiovascular disease (CVD), cancer, chronic obstructive pulmonary disease (COPD) and diabetes. Communicable diseases are controlled to some extent by initiative of government and many non-government organizations. NCDs has being occurred due to changing life -styles of people's. As life -style of individual is changing they are focussing on income generation, increasing competition among individual for job, education, prestige etc. This lead to the consumption of high caloric food (junks food ) and low physical work. Fig.7: Main causes of death in India by 2030 (projected) Source : 1& 2 Fig.7 shows that major causes of death in India in 2030 would be from chronic and noncommunicable diseases which is 79% of total deaths and only 20% of deaths would be due to communicable diseases. Medical Tourism Tourists that travel to other countries for sack of treatment are called Medical tourism. India has become a main medical tourism hub. People's travel aboard because treatment at their home country is expensive, they don't have medical insurance or due to long waiting lists for treatment and for better or more advanced medical technology. In India, private healthcare sectors provide advance 505

8 medical treatment with quality of care and they are working on quality standards for effective and error free treatment. Cost of treatment of some surgeries in India and other countries (US Dollar) Comparison of Medical Treatments Cost The cost of treatment is much lower in India, because of low infrastructure and lower doctor -patient ratio. As per American Medical Association, a knee replacement surgery will cost $40,000 in US, $10,000 in Thailand and $13,000 in Singapore, but $8500 in India. In US for a bone marrow transplant total expenditure would be around $400,000, in UK $150,000 but in India it will cost just $30,000. No matter what treatment is required, 70-75% of total cost is saved in India but nt at the expense of quality. Medical procedure can be even combined with extra activities such as Ayurveda/Spa services, beach or backwaters holiday, other beauty procedures, Yoga or spiritual vacation and so on. Thailand Procedures US ($) India ($) Korea ($) Malaysia ($) ($) Heart Bypass $144,000 $5,200 $28,900 $15,121 $11,430 Angioplasty $57,000 $3,300 $15,200 $3,788 $5,430 Heart Valve Replacement $170,000 $5,500 $43,500 $21,212 $10,580 Hip Replacement $50,000 $7,000 $14,120 $7,879 $7,500 Hip Resurfacing $50,000 $7,000 $15,600 $15,152 $12,350 Knee Replacement $50,000 $6,200 $19,800 $12,297 $7,000 Spinal Fusion $100,000 $6,500 $15,400 $9,091 $6,000 Dental Implant $2,800 $1,000 $4,200 $3,636 $345 Lap Band $30,000 $3,000 N/A $11,515 N/A Breast Implants $10,000 $3,500 $12,500 $2,727 N/A Rhinoplasty $8,000 $4,000 $5,000 $3,901 $1,293 Face Lift $15,000 $4,000 $15,300 $3,697 $3,440 Hysterectomy $15,000 $2,500 $11,000 $2,727 $5,

9 Gastric Sleeve $28,700 $5,000 N/A $13,636 N/A Gastric Bypass $32,972 $5,000 N/A $16,667 $9,450 Liposuction $9,000 $2,800 N/A $2,303 $2,299 Tummy Tuck $9,750 $3,000 N/A $5,000 N/A Lasik (both eyes) $4,400 $500 $6,000 $1,818 $477 Cornea eyes) (both N/A N/A $7,000 $1,800 N/A Retina N/A $850 $10,200 $4,242 $3,000 IVF Treatment N/A $3,250 $2,180 $9,091 $3,819 Fig.8: Source : 1& 2 Telemedicine Telemedicine is the use of telecommunication and information technologies in order to provide clinical health care at a distance. It helps in eliminating distance barriers and can improve access to medical services that would often not be consistently available in distant communities. It is also used to save lives in critical care and emergency situations. Narayana Hrudayalya (NH) is one of the largest super speciality hospitals for cardiac care in the world which was established by cardiac surgeon Dr. Devi Prasad Shetty. Its telemedicine network is the largest in the world, with over 900 telemedicine centers in 60 countries, 800 of which are scattered across India. through creative partnerships with both government and private entities it has successfully developed a unique model for extending general primary care and tele-cardiology services to poor patients in remote areas. he network currently performs over 3.5 lakh teleconsultations annually (Wharton Knowledge, 2012). Quality of care Medical tourism in India is increasing because of cheap treatment but it is not at the expense of comprise in quality being delivered to patients. Many of the hospitals in India follow rules laid down by Joint Commission of International and are accredited to it. Many hospitals follow rules laid down by National Accreditation Board of Hospitals (NABH) and accredited to it. Technological Many of the new techniques have evolved with time such as operation with the help of robotic arm, laser treatment etc. And now world has become a smaller place to live in and technology is transferred to the whole world within no time. 507

10 Health Insurance - It covers an individual s hospitalization, expenses and medical care bills incurred due to illness. But in India very few people opt for health insurance. Currently around less than 15% of the population has health insurance but it is expected to reach around 45% by Conclusion India is a developing country with increase in population at very fast rate. It would surpass China by Healthcare sector in India has not developed upto the mark till yet in comparison to US and UK. Even expenditure of healthcare is very low as compared to other countries. Private sector has shown development in the past in terms of quality of service. Still new diseases have come up. Number of deaths would increase due to chronic and non-communicable diseases with time. If government of India wants to deliver quality in healthcare to its people, public hospitals, health centres needs to be increased with betterment of quality. References 1. Patel V, Chatterji S, Chisholm D, Ebrahim S, Gopalakrishna G, Mathers C, Mohan V, Prabhakaran D, Ravindran RD, Reddy KS. Chronic diseases and injuries in India. Lancet 2011; 377: Mohan S, Reddy KS, Prabhakaran D. Chronic non-communicable diseases in India. Reversing the tide. Public Health Foundation of India, on 24/02/ Sabharwal K, Sharma V, Base Line Assessment- First Step Toward NABH Accreditation of a Rural Based Tertiary Care 550 Bedded Hospital in Gujarat, MBA (HA) Project report Report byassocham. Emerging trends in healthcare: A journey from Bench to bedside by,