Government Hospitals Ss

8/11/2019 Government Hospitals Ss

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SUBMITTED BY-

SANJEET SINGH & YASHMIN SHEIKH

ORGANISATIONAL BEHAVIOUR


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REPORT ON

INDIAN GOVERNMENT HOSPITALS &

MEDICAL CONDITIONS


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STATICS OF INDIAN MEDICAL CONDITIONS


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BRIEF INTRODUCTION

These are the hospitals which were made by the government for

public welfare. Health sector in India is the responsibility of the

state, local and also the central government. Healthcare in India

features a universal health care system run by the constituent

states and territories of India.

It's not hard to find people caught in the gap between India's

dreams of greatness and the awful reality of its broken healthsystem.


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Standing in the crowded entrance hall in the outpatients department of New

Delhi's All India Institute of Medical Sciences (AIIMS), one of India's best

public hospitals

Hospitals form an important arm of the healthcare delivery system. Though

the focus of various National programmes may be on primary health butsecondary and tertiary public hospitals form one of the largest expenditure

category in the national health budget. Over the past decade, inspite of the

complexity of hospitals having increased many fold, not many changes have

been made in the management structure of public hospitals.


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ORGANISATIONAL BEHAVIOUR CONCEPTS INCLUDED FOR

ANALYSING THE EVENT

Poor planning and management

Lack of co-ordination

No team work

Lack of motivation

Organisational structure

Behaviour

Time management

Insufficiency

Drawbacks


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POOR PLANNING &MANAGEMENT

No learning

No use of advance technology

The equipments are outdated

Lack of governments commitment towards quality assurance

Low management capacities at health facilities

Lack of policies and guidelines from the State

Structural problems of the centralized health system

Deficiencies in the quality of services provided

Dismal sanitary conditions

Long waiting times

Rude behaviour of staff

Clinics are badly maintained and equipped.


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3 REASONS WHY GOVERNMENT HOSPITALS IN INDIA SHOULD PROVIDE

GOOD QUALITY HEALTH CARE

1. PUBLIC HOSPITALS IMPOSE SIGNIFICANT OPPORTUNITY COSTS TO

THE SOCIETY

The care as such has a limited impact on the population health. Inspite of

this known fact a major chunk of healthcare budget is spent on secondary

and tertiary care which can be upto 40-50% of state healthcare budgets.Thus infrastructure and administrative costs of hospitals carry a big

opportunity costs with them.


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2. DECREASING UTILIZATION OF PUBLIC HOSPITALS FOR

INPATIENT AND OUTPATIENT CARE

80percent of households prefer to use private sector treatment in India for minor illnesses, and

75percent of households prefer to go to the private sector for major illnesses . Numerous other

studies have confirmed the dominance of the private sector and the reasons for this dominance:

government health services entailed longer waiting periods, arrogant behaviour of doctors and

non-availability of medicines .Even though the treatment in public hospitals is free, the patients

have to pay for tests, and bear the incidental costs of boarding and lodging .


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3. HEALTH EXPENDITURE INCURRED BY PATIENTS IN

PUBLIC HOSPITALS VS PRIVATE HOSPITALS

The services provided in public hospitals amount to a considerable fraction of the

costs in private hospital. Even after spending a comparable amount, all patient gets

is dismal sanitary conditions, long waiting times, rude behaviour of staff, high

infection rates and substandard clinical care. This is one of the prominent reasons

why the patients prefer private healthcare providers more than public hospitals.


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POOR ORGANISATIONAL STRATEGIES

The same could be said of india's health system. Sixty years after independence,

India remains one of the unhealthiest places on earth. Millions of people still suffer

from diseases and ailments that simply no longer exist almost anywhere else on the

planet. Four out of five children are anemic. Almost one in four women who give birth

receives no antenatal care. What makes the picture even bleaker is the fact that

India's economic boom has had, so far at least, little impact on health standards. There are other reasons for India's ill health. Over the past decade or so, funding for

public-health initiatives such as immunization drives and programs to control the

spread of communicable diseases has been cut; some critics blame shifting

government priorities.


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THE PROBLEMS OF HEALTHCARE SYSTEM IN

INDIA

Indian healthcare system is plagued with numerous problems and too many laws. The solution

is to ensure that regulation is streamlined and proper viz. Clinical Establishment Act

It is said that "health is wealth"; but in India, health is getting increasingly unaffordable

STATISTICAL BACKGROUND

The doctor population in India is 1:1,500 when compared to an estimated 1:1,000 in China and

1:350 in the United States . In urban India, the ratio is estimated at around 1:500 while rural

India it is at around 1:2,500

There are about 9.2 lakh allopathic doctors in India and surprisingly about 7.5 lakh doctors

practicing 'alternate' medicine

India has about 12,760 allopathic government hospitals, with a bed capacity of 5.76 lakh

However, India has less than 1 bed per 1,000 population compared to a ratio of 3 for China and

3.1 for USA


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PRIME PROBLEMS FACED BY INDIA'S HEALTHCARE

SYSTEM

'Capitation fees' has made it difficult for genuine students to pursue the medicalprofession and could also be a cause for 'medical inflation'

There is a shortage of teaching staff in government hospitals due to a pay differentialcompared to private institutes

There is no common nationwide entrance exam like JEE or CAT, for admission into MBBS

Referrals or commissions between doctors and pharmaceutical companies or hospitalsneeds to be regulated

Lack of sanitation and proper hygiene is one of the root causes for illnesses to spreadand the healthcare system is unaffordable for many

In April 2010, the President of MCI and his two associates were arrested by the CentralBureau of Investigation (CBI) while accepting a bribe of Rs2 crore to grant license to amedical college in Punjab.


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FUNDING/PAYMENT REFORMS

Reform of the funding and payment arrangements for public hospitals is

another common approach to address problems with productivity, efficiency,

quality, and responsiveness

Problems with productivity and efficiency are commonly addressed by

altering the structure of funding or payments to providers. These paymentsreforms usually tighten the link between resource allocation and delivery of

specific outputs.

Different structural changes are made to funding and payments systems to

address concerns about clinical or consumer quality or responsiveness to

users


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COMPETITIVE ENVIRONMENT/MARKET STRUCTURE

The structure of the market to which the reformed hospitals are exposed is a

critical influence on their behavioras it directly determines what strategies

will make sense to generate more revenue

Unfortunately, market structure is a problem in most segments of the health

sector. There are two related problems. First, little or no competition mayemergereducing pressures on the provider to deliver value for money in

order to maximize profits

Even for services where monopoly power is not an issue, providers may still

capture market share or maximize profits through various forms of

distortionary behavior


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ORGANIZATIONAL BEHAVIOR MANAGEMENT IN

HEALTH CARE

Organizational behavior management (OBM) focuses on what people do,

analyzes why they do it, and then applies an evidence-based intervention

strategy to improve what people do.

First, we need to define medical error. This task is neither simple nor

straightforward because the definition of a medical error varies markedlyacross different hospitals and health care systems.


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MEDICAL ERRORS TO TARGET WITH ORGANISED

MANAGEMENT

ERRORS REMAINING AFTER SYSTEM CHANGE

It is acknowledged that several types of errors are already being addressed by well -informed system-based changes, but a number of categories of errors persist. These include technical errors duringcare procedures, failures in communication among caregivers and between provider and patient,contamination errors due to ineffective employee and patient hygiene, and lapses in patient

monitoring.

Diagnosis errors, such as using the wrong test, delays in diagnosis, and failing to act as indicated ontest results.

Treatment errors, such as ordering a wrong drug or dosage, accidental puncture or laceration, andincorrectly executing a procedure.

Monitoring errors, such as bedsores, failure to rescue, and patient falls.

Infection-control errors, such as failing to wash hands, lack of glove use, and compromising sterile -field maintenance.

Communication errors, such as failing to inform other caregivers of acute risk, changes in care, andcritical hand-off information, as well as ineffective communication with patients.


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CONCLUSION

A significant amount of taxpayers money is spent on Government hospitals which puts

these hospitals in a critical position to be accountable for the quality of services and

deliver quality services within the constraints of available resources. It should be tried by

the public hospitals to prevent diversion of its customer to private setups due bad quality

of services. This warrants an existence of a quality management and control mechanism

for government hospitals.

Quality of service should not be denied just because the direct consumer is not asking for

it; but concrete measures towards quality assurance are necessary because lots of

money is being spent in providing the infrastructure and bearing the administrative costs

in the public hospitals. A few state governments (Gujarat, Kerala) are coming up with

answers to these questions by taking concrete actions towards quality assurance andcommitment for continuous quality improvement.


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SOURCES OF INFORMATION

News channel reports

WHO reports

Wikipedia

Indian Medical association

Medical magzines

Documents

Government Hospitals Ss