Introduction to Health Care

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RESEARCH DESIGN

STATEMENT OF PROBLEM

Shampoo industry which is a part and parcel of FMCG industry has

high market potential .There is high competition in this industry. To

overcome the competition, different marketing strategies have to be

implemented to increase market share.

Statement of the problem is Comparative Analysis with respect to

Sunsilk and Chik Shampoo.

It is to compare Sunsilk shampoo of HUL with Chik shampoo of Cavin

kare in all the aspects like sales, market coverage, brand image, brand loyalty,

and characteristics of shampoo like quality, quantity, price, fragrance, colour,

availability, dandruff control etc.,

SCOPE OF THE STUDY:

The study covers Comparative Analysis with respect to Sunsilk and

Chik Shampoo carried at some of the specific retail outlets. The study helps

dealers, wholesalers, retailers and petty shops to know the position of a

particular brand of shampoo in the market.

OBJECTIVE OF THE STUDY:

The primary objective of the study is to compare the Sunsilk Shampoo

with Chik Shampoo among retailers and consumers.


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The other secondary objectives are:

Among retailers:

To know the opinion of the retailers about fluctuation in the sales of Sunsilk

Shampoo, Chik Shampoo and other brands of shampoo.

To know the brand image of Sunsilk shampoo.

To study the profitability of various brands of shampoo.

Among consumers:

To know the tastes and preferences of the consumers while

purchasing

shampoo.

Factors considered in purchasing shampoo.

Shampoo consumption among consumers.

To find out brand image and loyalty for shampoos.

DESIGN OF THE STUDY:

The design of the study used is descriptive in nature.

Descriptive research is focused on the accurate description of

the variables in the problem model. Consumer profile studies,

market potential studies, product usage studies, attitude

surveys, sales analysis, media research, and price surveys are

the examples of descriptive research. Any source of


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information can be used in a descriptive study, although most

studies of this nature rely heavily on secondary data source

and survey research.

As a part of descriptive study, survey is conducted using structured

scientific questionnaire.

SOURCES OF DATA COLLECTION:

Data Collected from 2 sources. They are Primary data and secondary data:

1. Primary Data: Primary data are the data that are

collected to help solve problem or take advantage of anopportunity on which a decision is pending. It can be collected

through telephone, personal interview and structured

questionnaire.

2. Secondary Data: Secondary data are data that were

developed for some purpose other than helping to solve the

problem at hand. Secondary data can be collected through

following methods. The researcher has used structured

scientific questionnaire and personal interview for collection

of primary data from retailers and consumers.


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LIMITATIONS OF THE STUDY:

It is hard fact that each study suffer from some

limitations. So is the case with this study. One of the

limitations of the study is, as the information is

collected from the retailers, the monthly sales figure

given by them is based entirely on their own judgment.

So a few of them might have given the wrong figure

related to their monthly sales. Another limitation was

that some of the retailers were busy and could not give

appropriate information. And also very few retailers didnot want to share any information.

Another limitation of the study was the customers who

were personally interviewed did not want to share the

actual data as few of them were giving fake data.


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Time constraints put boundaries to sample area and

hence limited the extent of the study.

Taking convenience sampling might have led to some

bias as people with different age groups have different

perceptions.

Cost

As the sample size is 50(retailers) and 110(Customers)

in numbers, the findings may or may not be

appropriate.

OBJECTIVE OF STUDY

The major objectives of the study have been outlined here:

1) To know the major services provided by the Private hospitals.

2) To know about the Patients opinion towards the best hospital

3) To know the opportunities of healthcare sector

4) To know the major players of the Hospital industry.


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INTRODUCTION TO HEALTH CARE

Before the term health care became popular, English-speakers referred to medicineor to

the health sectorand spoke of the treatment and prevention of illness and disease. The

social and political issue of access to healthcare in the US has led to public debate and

confusing use of terms such as "health care" (medical management of illness or disease),

health insurance (reimbursement of health care costs), and thepublic health (the collective

state and range of health in a population).
http://en.wikipedia.org/wiki/Medicinehttp://en.wikipedia.org/wiki/Medicinehttp://en.wikipedia.org/wiki/Illnesshttp://en.wikipedia.org/wiki/Diseasehttp://en.wikipedia.org/wiki/US_healthcare_reformhttp://en.wikipedia.org/wiki/Health_insurancehttp://en.wikipedia.org/wiki/Public_healthhttp://en.wikipedia.org/wiki/Medicinehttp://en.wikipedia.org/wiki/Illnesshttp://en.wikipedia.org/wiki/Diseasehttp://en.wikipedia.org/wiki/US_healthcare_reformhttp://en.wikipedia.org/wiki/Health_insurancehttp://en.wikipedia.org/wiki/Public_health


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The delivery of modern health care depends on an expanding group of trained

professionals coming together as an interdisciplinary team.

The health-care industry incorporates several sectors that are dedicated to providing

services and products dedicated to improving the health of individuals. According to

market classifications of industry such as the Global Industry Classification Standard and

the Industry Classification Benchmark the health-care industry includes health care

equipment & services and pharmaceuticals, biotechnology & life sciences. The particular

sectors associated with these groups are: biotechnology, diagnostic substances, drug

delivery, drug manufacturers, hospitals, medical equipment and instruments, diagnostic

laboratories, nursing homes, providers of health care plans and home health care.

According to government classifications of Industry, which are mostly based on the United

Nations system, the International Standard Industrial Classification, health care generally

consists of hospital activities, medical and dental practice activities, and other human

health activities. The last class consists of all activities for human health not performed by

hospitals or by medical doctors or dentists. This involves activities of, or under the

supervision of, nurses, midwives, physiotherapists, scientific or diagnostic laboratiories,

pathology clinics, ambulance, nursing home, or other para-medical practitioners in the field

of optometry, hydrotherapy, medical massage, music therapy, occupational therapy, speech

therapy, chiropody, homeopathy, chiropractice, acupuncture, etc

The World Health Organization (WHO) is a specialized United Nations agency which acts

as a coordinator and researcher forpublic health around the world. Established on 7 April

1948, and headquartered in Geneva, Switzerland, the agency inherited the mandate and
http://en.wikipedia.org/wiki/Professionalhttp://en.wikipedia.org/wiki/Interdisciplinary_teamhttp://en.wikipedia.org/wiki/Industryhttp://en.wikipedia.org/wiki/Global_Industry_Classification_Standardhttp://en.wikipedia.org/wiki/Industry_Classification_Benchmarkhttp://en.wikipedia.org/wiki/Biotechnologyhttp://en.wikipedia.org/wiki/International_Standard_Industrial_Classificationhttp://en.wikipedia.org/wiki/World_Health_Organizationhttp://en.wikipedia.org/wiki/United_Nationshttp://en.wikipedia.org/wiki/Public_healthhttp://en.wikipedia.org/wiki/Genevahttp://en.wikipedia.org/wiki/Professionalhttp://en.wikipedia.org/wiki/Interdisciplinary_teamhttp://en.wikipedia.org/wiki/Industryhttp://en.wikipedia.org/wiki/Global_Industry_Classification_Standardhttp://en.wikipedia.org/wiki/Industry_Classification_Benchmarkhttp://en.wikipedia.org/wiki/Biotechnologyhttp://en.wikipedia.org/wiki/International_Standard_Industrial_Classificationhttp://en.wikipedia.org/wiki/World_Health_Organizationhttp://en.wikipedia.org/wiki/United_Nationshttp://en.wikipedia.org/wiki/Public_healthhttp://en.wikipedia.org/wiki/Geneva


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resources of its predecessor, the Health Organization, which had been an agency of the

League of Nations. The WHO's constitution states that its mission "is the attainment by all

peoples of the highest possible level of health." Its major task is to combat disease,

especially key infectious diseases, and to promote the general health of the peoples of the

world. Examples of its work include years of fighting smallpox. In 1979 the WHO

declared that the disease had been eradicated - the first disease in history to be completely

eliminated by deliberate human design. The WHO is nearing success in developing

vaccines against malaria and schistosomiasis and aims to eradicate polio within the next

few years. The organization has already endorsed the world's first official HIV/AIDS

Toolkit forZimbabwe from October 3, 2006, making it an international standard.

The WHO is financed by contributions from member states and from donors. In recent

years the WHO's work has involved more collaboration, currently around 80 such

partnerships, withNGOs and thepharmaceutical industry, as well as with foundations such

as the Bill and Melinda Gates Foundation and the Rockefeller Foundation. Voluntary

contributions to the WHO from national and local governments, foundations and NGOs,

other UN organizations, and the private sector (including pharmaceutical companies), now

exceed that of assessed contributions (dues) from its 193 member nations.
http://en.wikipedia.org/wiki/League_of_Nationshttp://en.wikipedia.org/wiki/Smallpoxhttp://en.wikipedia.org/wiki/Malariahttp://en.wikipedia.org/wiki/Schistosomiasishttp://en.wikipedia.org/wiki/Poliohttp://en.wikipedia.org/wiki/Zimbabwehttp://en.wikipedia.org/wiki/Non-governmental_organizationhttp://en.wikipedia.org/wiki/Pharmaceutical_industryhttp://en.wikipedia.org/wiki/Bill_and_Melinda_Gates_Foundationhttp://en.wikipedia.org/wiki/Rockefeller_Foundationhttp://en.wikipedia.org/wiki/League_of_Nationshttp://en.wikipedia.org/wiki/Smallpoxhttp://en.wikipedia.org/wiki/Malariahttp://en.wikipedia.org/wiki/Schistosomiasishttp://en.wikipedia.org/wiki/Poliohttp://en.wikipedia.org/wiki/Zimbabwehttp://en.wikipedia.org/wiki/Non-governmental_organizationhttp://en.wikipedia.org/wiki/Pharmaceutical_industryhttp://en.wikipedia.org/wiki/Bill_and_Melinda_Gates_Foundationhttp://en.wikipedia.org/wiki/Rockefeller_Foundation


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HEALTHCARE IN INDIA

Healthcare is one of Indias largest sectors, in terms of revenue and employment, and

the sector is expanding rapidly. During the 1990s, Indian healthcare grew at a

compound annual rate of 16%. Today the total value of the sector is more than $34

billion. This translates to $34 per capita, or roughly 6% of GDP. By 2012, Indias

healthcare sector is projected to grow to nearly $40 billion.

The private sector accounts for more than 80% of total healthcare spending in India.

Unless there is a decline in the combined federal and state government deficit, which


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currently stands at roughly 9%, the opportunity for significantly higher public health

spending will be limited.

GROWING POPULATION AND ECONOMY

One driver of growth in the healthcare sector is Indias booming population, currently

1.1 billion and increasing at a 2% annual rate. By 2030, India is expected to surpass

China as the worlds most populous nation. By 2050, the population is projected to

reach 1.6 billion.

This population increase is due in part to a decline in infant mortality, the result of

better healthcare facilities and the governments emphasis on eradicating diseases such

as hepatitis and polio among infants. In addition, life expectancy is rapidly approaching


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the levels of the western world. By 2025, an estimated 189 million Indians will be at

least 60 years of agetriple the number in 2004, thanks to greater affluence and better

hygiene. The growing elderly population will place an enormous burden on Indias

healthcare infrastructure.

The Indian economy, estimated at roughly $1 trillion, is growing in tandem with the

population. Goldman Sachs predicts that the Indian economy will expand by at least 5%

annually for the next 45 years (see chart), and that it will be the only emerging economy

to maintain such a robust pace of growth.


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INNOVATIONS IN HOSPITAL INDUSTRY

Auto check-in and check out

Specialty hospitals

Aromatherapy at Apollo.

Biventricular pacing.

Bone bank at AIIMS.

Hospital administration.

Medical records management.

Oxygen under pressure treatment at Apollo.

Waste management.

Telemedicine.

Virtual Hospitals


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TECHNOLOGIES IN HOSPITAL INDUSTRY

Same day OPD

Online reports

Imaging/ MRI Scan

Key Hole Surgery

Medical transcription

Biotechnology

Nanotechnology

SST: Self checking Machines/ equipments

MARKET SEGMENTATION FOR HOSPITALS

A market is composed of different users having different responses to market offerings.

This makes it essential that hospital organizations, especially for making a microscopic


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study of users needs and requirement, make possible grouping of markets. The

marketing strategy formulated on the basis for segmenting the market is income. To some

extent regional considerations may also be adopted as a base for segmenting the market.

The below is the segmentation on the basis of regional consideration:

The aforesaid segmentation makes it clear that doctors would find a variation in the living

habits of both the segments.

Another important base for segmenting hospital services may be income group. This

helps hospital organisations in identifying the status of the users of services. It is essential

as the marketing principles recommend different pricing strategies on the basis of level of

income.

This would help hospital organisations in charging more from high and middle income

groups, charging equal to cost from the low income group and making available free

services to the no income group. Another important advantage of this segmentation is

concerned with implementation of modernization and expansion plan for the hospitals.


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CLASSIFICATION OF HOSPITALS

The classification of Hospitals on the basis of objective, ownership, path and size.


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ON THE BASIS OF THE OBJECTIVE THERE ARE THREE TYPES:

Teaching cum research for developing medicines and promoting research to

improve the quality of medical aid.

General hospital for treating general ailments.

Special hospitals for specialized services in one or few selected areas.

ON THE BASIS OF THE OWNERSHIP, THERE ARE FOUR TYPES:

Government hospital, which is owned, managed and controlled by

government

Semi-government hospital, which is partially shared by the government.

Voluntary organisations also run hospitals.

Charitable trusts also run hospitals.

ON THE BASIS OF PATH OF TREATMENT, THERE ARE:

Allopath which is the system promoted under the English system.

Ayurved, which is based on the Indian system where herbals are used for

preparing medicines.

Unani

Homeopath


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Others

ON THE BASIS OF THE SIZE, THERE ARE:

Teaching hospitals generally have 500 beds, which can be adjusted in tune

with number of students.

District hospital generally have 200 beds, which can be raised to 300 in

contingencies.

Taluka hospital generally have 50 beds that can be raised to 100 depending

on the requirement.

Primary health centers generally have 6 beds, which can be raised to 10.


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ISM/ 8 P`s WITH REFERENCE TO HOSPITAL

PRODUCT

The main product in a hospital maybe any of the following:

Medical Services

Medical Training

Medical Education

Medical Research

The main products of hospitals are medical services. The services rendered by hospitals or

public health centers occupy a place of significance, especially while designing the product

mix. In addition to medical care, some hospitals also impart education; training and

research facilities and some hospitals also educate and train paramedical officers, nurses

and other technical staff. It is thus clear that the nature of the hospital governs the

designing of product mix

Medical services can further be classified as follows:Emergency

Out-Patient

In-Patient


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Intensive Care

Operation

SUPPORTIVE SERVICES

To enrich the hospital services certain supportive services are found to be important e.g.

sterilization, supply and maintenance of instruments, materials and garments etc. The

catering departmentcomprises the kitchen, bulk food stores and dining rooms and supplies

meals in the hospital. Heated trolleys have to be used to transport meals to patients.

Pharmaceutical services also occupy a significant place as they influence the treatment

programme of a hospital. An official laundry is essential to provide bacteria free garments

and clothes. The patients need to be provided with disinfected and clean linen. The

laboratories need to be properly manned and proper diagnosis needs to be given by them

to enable right medical prescription. The establishment of laboratories should be between

the OPD and indoors so that both areas are covered without delay or disruption. Clinical

pathology, blood bank and pathological anatomy are important areas to streamline

functional management of hospital laboratories. The radiology departmentshould have hi-

tech facilities keeping in mind patient load of the hospital. Currently ultrasound scanning

and CAT scanning have been found significant in improving services of the radiology

department. The nursing services are also important among supporting services. Nursing

services are managed by a matron who is assisted by a sister-in charge. The norms

accepted by the Indian Nursing Council should be followed. An ideal nurse-patient ratio is

1:5 which is hardly found in Indian hospitals.


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GENERAL FACILITIES

Central Enquiry

For all public information related to Hospital Inpatients.

Cash & Billing

Multiple service counters handle all Cash & Credit transactions relating to patient services,

apart from Pharmacy.

In House Pharmacy with Resident Pharmacists

For all prescribed medications required at any time, by the patients. Pharmacy related

financial transactions are processed here.

Ambulance Services

The Hospital owns a fleet of Ambulances, which transport OPD/ Inpatients within the

Hospital, from one block to another, as well as to & from the Hospital. In addition to these,

the Hospital also uses cars for the transport of its Consultants, Visiting Doctors, Guests &

Dignitaries whenever required.

Common Canteen


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For the staff & the visitors, serving a satisfying variety of regional cuisine.

Patient Canteen

To serve food for Inpatients as per their Dietary recommendation monitored by our

Dieticians.. They also serve standard regional cuisine, in keeping with the hygiene

standards of Hospital food handling & processing. This is not accessible for the common

public.

Bank

The Hospital Counter of the United Bank of India, Thakurpukur Branch, handles all types

of Financial Transactions including Foreign Exchange matters.

Public Toilets

A pay & use facility provided by Sulabh International ensures the users with complete

hygiene & safety. Apart from these, all patient service areas have multiple public Toilets,

for the use of the relatives & families of patients. These are completely segregated from the

toilets for patients.

Guest House

Comfortable accommodation, in single or double occupancy, for the scholars & delegates

who collaborate with the Hospital, on its various research projects & seminars and


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therefore are required to spend a few days, at the Hospital, in close proximity to the

Research Institute.

AUXILIARY SERVICES

Auxiliary services consist of registration and indoors case records, stores management,

transportation management, mortuary arrangement, dietary services, engineering and

maintenance service etc. It is important that these services are maintained properly which

would govern the successful operation of a particular department. The security

arrangements, supplies, transport facilities etc cannot be ignored. For a hospital registration

is a must as it helps in collecting statistics for a hospital e.g. admission, discharge and

average stay of patients in the hospital. The central store issues bulk items. There are

different types of stores like pharmacy stores, chemical stores, linen stores, glassware

stores, surgical stores etc. For carriage of supplies and patients trolleys, wheelchairs and

stretchers are used. The hospital also needs a cold storage or mortuary for preservation of

dead bodies till they are claimed by relatives or for post-mortem. The dietics department

plays a vital role as it provides the hospital menu to meet the needs of patients. The

services of well-qualified and trained dieticians help in providing nutritious diets. The

engineering and maintenance services are concerned with hospital building, furniture and

other equipment. A security force is essential to provide protection to the hospital property.

Personnel related with defense or police should be given preference while appointing the


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security force. Thus the line services, supportive services and auxiliary services are mainly

concerned with Medicare facilities available in a hospital. The designing of product mix is

meant to make suitable arrangements for improving the level of services in all concerned

areas and in this context the medical education, training and research services play a

significant part.

OTHER AUXILIARY SERVICES PROVIDED BY SOME HOSPITALS INCLUDE

Rehabilitation center

Physio therapy

Occupational Therapy: Occupational therapy trains individuals on activities of daily

living which will allow them to return home after getting cured from long drawn

diseases

Speech Therapy:

De-addiction & mental health:

Volunteer services: A few examples of areas volunteers can work include:

Community Education

Emergency Department

Environmental Services

Information Desks

Marketing and Community Relations

Medical Records

Nutritional Services


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Patient Care

MEDICAL EDUCATION: TRAINING AND RESEARCH

The teaching hospitals are mainly engaged in offering medical education facilities.

Research and training facilities are also made available in these hospitals where patients

are used as inputs for teaching and research both by the teachers and by those who are

taught. Medical institutes and medical colleges both offer education, training and research

activities with one difference being that the institutes are specialized in a particular field

and colleges are generalized

LEVELS OF SERVICE:

CORE PRODUCT

Treatment of human ills

EXPECTED PRODUCT

Infrastructure to support reasonable number of beds

Operation theatres

Equipments like Cardio-respiratory supportive equipment


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AUGMENTED PRODUCT

Ambience:

Central Air-conditioning

Automation equipments (X-Ray Scanners, Printers, Photo Scanners, etc

POTENTIAL PRODUCT

TeleMedicines & Preventive Care

SERVICE FLOWER

Price is one of the most prominent elements in the marketing mix. Price charged must

be acceptable to the target customer and it should co-ordinate with other elements of

the marketing mix. Price charged by the hospitals usually depends on treatment

prescribed by the respective consultants and the facilities offered to the patients. As the

service is intangible it is very hard for determining the price of the particular service

rendered on admission, an initial deposit will be collected at the impatient billing

counter. The amount depends on the category of room and the treatment/surgical


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planned. Various category of rooms, ranging from the general ward, which attends to

the need of the lower classes to the deluxe suite, which attends to the need of the

middle and the upper classes. The prices vary from Rs. 250 for the general ward to Rs

20,000 for the deluxe suite. A hospital does not believe in profit maximization, it aims

at providing quality for its customer at a reasonable price.

PRICING METHODS IN PRIVATE HOSPITALS

1. Cost based pricing

2. Competition based pricing

3. 3. Demand based pricing

DIFFERENTIAL PRICING ALSO TAKES PLACE:

EXTERNALLY (BETWEEN TWO HOSPITALS) &

INTERNALLY (WITHIN A HOSPITAL)

Externally: - Between 2 hospitals even to provide the same treatment, the prices differ.

Even though the operation to be might be the same, pricing differs due to the kind of the

service provided pre-post operation cost is associated with the kind of service you provide

& so the hospital is bound to charge the patient for it. Lilavati believes that it is not only a

service organization but also a business organization but Nanavati believes that providing

health care service is a charity it provides 250 free beds thus differentiating it. Lilavatis

location, the training provider hygiene/ ambience all is other contributing factors.


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Internally: -There is a price differentiation even between the 2 wards of the same

hospitals. There is a difference between general ward and special ward where the rooms

are air-conditioned and extra services are provided. Thus the pricing would be different

even the doctors visiting/consultation charges are different. Sometime if the patient is very

poor then the doctor may wave his fees.

PLACE

In hospitals, distribution of Medicare services plays a crucial role. This focuses on the

instrumentality of almost all who are found involved in making services available to the

ultimate users. In case of hospitals the location of hospital plays a very important role. The

kind of services a hospital is rendering is also very important for determining the location

of the hospital.


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Eg. Tata memorial hospital specializes in cancer treatment and is located at a centre place

unlike other normal hospitals, which you can find all over other places.

It can be unambiguously accepted that the medical personnel need a fair blending of two

important properties i.e. they should be professionally sound and should have in-depth

knowledge at psychology. A particular doctor might be famous for his case handling

records but he may not be made available for all the patients because of the place factor.

Now in this case the service provided, that is the doctor may be a visiting doctor for

different hospitals at different locations to beat the place factors.

Unlike other service industries, under hospital marketing all efforts should be for making

available to the society the best possible medical aid. In a country like India, which is

geographically vast and where majority of the population lives in the rural areas, place

factor for the hospitals play a very crucial role. A typical small village / town may be

having small dispensaries but they will not have super specialty hospitals. For that they

will have to be dependent on the hospitals in the urban areas.

PROMOTION

Customers need to be made aware of the existence of the service provided. Promotion

includes advertising, sales promotion, personal selling & publicity.

Hospitals generally do not undertake aggressive promotion; they rely a lot on a favorable

word of mouth. To increase the clientele, a hospital may continuously introduce different

health services. Hospitals conduct camps in rural areas to give medical check ups at a


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reasonable price so that they approach the hospitals in the future. They generally advertise

in the health & fitness magazines.

As hospitals spend millions of rupees in technology and infrastructure, it becomes

necessary, that they attract patients and generate funds. In order, to do the same, the

hospitals follow various marketing and brand building exercises. Some of them are listed

below:

1. Many hospitals have eminent personalities from the industry in their Board of trustees.

This indirectly leads to increase in, inflow of patients, working in the companies of these

Trustees. Besides the presence of eminent personalities creates a sense of confidence in the

minds of people.

2 Private hospitals can attract their shareholders by offering discounts. For example, a

special discount of 20 percent on all preventive health checks is offered to all shareholders

of Apollo Hospitals Limited.

3. Hospitals have a long-term understanding with PPOs (Preferred Provider

Organization), which further have understanding with corporates. Any case of sickness

found in the employees of these corporates refer them to the PPOs which further sends

them to the hospital for check-ups and treatment.

4. The success rate of crucial operations and surgeries, reflect the technological and

knowledge- based edge of the hospital over the competitors. Such successes are discussed

in health magazines and newspapers, which become a natural advantage for the hospital.


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5. Some hospitals by means of their past track record have created a niche market for

themselves. For example, Hinduja is known for its high-quality healthcare at reasonable

rates, whereas Lilavati Hospital is known for its five star services.

6. Hospitals hold seminars and conferences relating to specific diseases, where they

invite the doctors from all round the country, for detailed discussion. This makes the

hospital well known amongst the doctors, who could in future refer complicated cases to

the hospital.

7. Hospitals can also promote medical colleges. This helps them to generate extra

resources in form of fees using the same infrastructure.

PEOPLE

In hospitals, the marketing mix variable people includes all the different people involved in

the service providing process (internal customers of the hospitals) which includes doctors,


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nurses, supporting staff etc. The earliest and the best way of having control on the quality

of people will be by approving professionally sound doctors and other staff.

Hospital is a place where small activity undertaken can be a matter of life and death, so the

people factor is very important. One of the major classifications of hospitals is private

and government. In the government hospital the people factor has to be specially taken

care of. In Indian government hospitals except a few almost all the hospitals and their

personnel hardly find the behavioral dimensions significant. It is against this background

that even if the users get the quality medical aid they are found dissatisfied with the rough

and indecent behavior of the doctors.

PHYSICAL EVIDENCE

It does play an important role in health care services, as the core benefit a customer seeks

is proper diagnosis and cure of the problem. For a local small time dispensary or hospital

physical evidence may not be of much help. In recent days some major super specialty

hospitals are using physical evidence for distinguishing itself as something unique.

Physical evidence can be in the form of smart buildings, logos, mascots etc. a smart

building infrastructure indicates that the hospital can take care of all the needs of the

patient. Examples: -

1. Lilavati hospital has got a smart building, which helps, in developing in the minds of

the people, the impression that it is the safest option among the different hospitals

available to the people.


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2. Fortis and Apollo hospitals have a unique logo, which can be easily identified.

Three Aspects of Physical Evidence are:

Ambient Factors: Smell in the hospital, Effect of Colors used on walls

Design Factors: Design of the rooms, plush interiors, ICU location, etc.

Social Factors: Type of Patients that come to the Hospital

PROCESS

It is the way of undertaking transactions, supplying information and providing services in a

way that is acceptable to the consumers and effective to the organizations. Since service is

inseparable, it is the process through which consumers get into interaction with the service

provider. Process generally forms the different tasks that are performed by the hospital.

The process factor is mainly dependent on the size of the hospital and kind of service it is

offering.

PRODUCTIVITY AND QUALITY

RELIABILITY Ensuring that Doctors are well trained and


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ASSURANCE Trust, the number of successful treatments

TANGIBLES Gate of bldg, surrounding area, Surgery equipments,

EMPATHY Courtesy shown by nurses, ward boys etc

RESPONSIVENESS Emergency responsiveness

PEST ANALYSIS

1) Political Analysis:

The government is reducing its hold on subsidies.

There are particular pressure groups which tend to have an influence on

government hospitals

The cost of medicines also tends to affect hospitals besides affecting the

pharmaceutical industries

Relationships between neighboring countries also affect the hospital sector


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2) Economic Analysis:

Increase in income would lead to an increase in the standard of living. Thus peoples

lifestyles changes and health is better understood. Thus there is a room for specialized

treatment, doctors, and hospitals

Government has made loans easily available and thus people with limited means could

avail better/specialized treatment

3) Social Environment Analysis:

Medical facilities have increased since there is more awareness of healthcare among the

population

Certain percentages of beds have to be kept for poor people. E.g. in Bombay 20% of beds has

to be kept reserved for poor people.

Look after the needs of local poor people.

Open counseling and relief centers.

Teach hygiene, sanitation among the poor masses.

Safe disposal of hospitals wastes like used injection needles, waste blood etc. and taking due

care of environment.

Spreading awareness about various diseases through campaigns and free medical check ups.

4) Technological Environment Analysis:


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Breakthrough innovation in the field of specialized equipment

Communication has managed to bridge the gap between places located at long distances

Test tube babies

Mobility of medical services

Mobile phones, credit cards (for payment purposes) etc have made doctors and medical

facilities easily available


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MAJOR CORPORATE PLAYERS

The Apollo Group of Hospitals: The Apollo group is India's first corporate hospital, the first to

set-up hospital outside the country and the first to attract foreign investment. With

2600 beds, Apollo is one of Asia's largest healthcare players. The recent merger between its 3

group companies, Indian Hospitals Corporation Ltd., Deccan Hospitals Corporation Limited and

Om Sindoori Hospitals Limited, will help the group raise money at a better rate and by

consolidating inventory; it will save around 10% of the material cost. The group is planning to

invest Rs.2000 crore, to build around 15 new hospitals in India, Sri Lanka, Nepal and Malaysia.

Fortis Healthcare: Fortis is the late Ranbaxy's Parvinder Singh's privately owned company. The

company is a 250 crore, 200 bed cardiac hospital, located in the town of Mohali. The company

also has 12 cardiac and information centers in and around the town, to arrange travel and stay for

patients and family. The company has plans of increasing the capacity to around 375 beds and

also plans to tie up with an overseas partner.

Max India: After selling of his stake in Hutchison Max Telecom, Analjit Singh has decided to

invest around 200 crores, for setting up world class healthcare services in India. Max India plans

a three tier structure of medical services - Max Consultation and Diagnostic Clinics, MaxMed, a

150 bed multi-specialty hospital and Max General, a 400 bed hospital. The company has already

tied up with Harvard Medical International, to undertake clinical trials for drugs, under research

abroad and setting up of Max University, for education and research.


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Escorts: EHIRC located in New Delhi has more than 220 beds. The hospital has a total 77

Critical Care beds to provide intensive care to patients after surgery or angioplasty, emergency

admissions or other patients needing highly specialized management including Telecardiology

(ECG transmission through telephone). The EHIRC is unique in the field of Preventive

Cardiology with a fully developed programme of Monitored Exercise, Yoga and Meditation for

Life style management.

Wockhardt & Duncans Gleneagles International: They are South Asia's first Journal of

Clinical Investigation accredited super specialty hospitals. Have associations with Harvard

Medical International, which gives them access to the best hospitals in the US for knowledge and

research. Leader in medical tourism in India


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MEDICAL TOURISM

Medical tourism (also called medical travel, health tourism or global healthcare) is a term

initially coined by travel agencies and the mass media to describe the rapidly-growing practice of

traveling across international borders to obtain health care. Such services typically include

elective procedures as well as complex specialized surgeries such as joint replacement

(knee/hip), cardiac surgery, dental surgery, and cosmetic surgeries. As a practical matter,

providers and customers commonly use informal channels of communication-connection-

contract, and in such cases this tends to mean less regulatory or legal oversight to assure quality

and less formal recourse to reimbursement or redress, if needed.

Leisure aspects typically associated with travel and tourism may be included on such medical

travel trips. Prospective medical tourism patients need to keep in mind the extra cost of travel

and accommodations when deciding on treatment locations.

Factors that have led to the increasing popularity of medical travel include the high cost of health

care, long wait times for certain procedures, the ease and affordability of international travel, and

improvements in both technology and standards of care in many countries.


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OPPORTUNITIES WITHIN INDIAS HEALTHCARE SECTOR

Given the current state of Indias healthcare system, its challenges and its growth prospects,

PricewaterhouseCoopers has identified a number of market opportunities for foreign

companies that want to participate in the sector.

MEDICAL TOURISM ON THE RISE

Medical tourism is one of the major external drivers of growth of the Indian healthcare

sector. A Google search of India medical tourism turns up more than two million results.

The emergence of India as a destination for medical tourism leverages the countrys well

educated, English-speaking medical staff, state-of-the-art private hospitals and diagnostic

facilities, and relatively low cost to address the spiralling healthcare costs of the western

world. India provides best-in-class treatment, in some cases at less than one-tenth the cost

incurred in the US (see chart). Indias private hospitals excel in fields such as cardiology,

joint replacement, orthopaedic surgery, gastroenterology, ophthalmology, transplants and

urology.

EMERGING HEALTH INSURANCE MARKET

In recent years, there has been a liberalization of the Indian healthcare sector to allow for a

much-needed private insurance market to emerge. Due to liberalization and a growing


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middle class with increased spending power, there has been an increase in the number of

insurance policies issued in the country. In 2001-02, 7.5 million policies were sold. By

2003-4, the number of policies issued had increased by 37%, to 10.3 million.

The Insurance Regulatory and Development Authority (IRDA) eliminated tariffs on general

insurance as of January 1, 2007, and this move is expected to drive additional growth of

private insurance products. In the wake of liberalization, health insurance is projected to

grow to $5.75 billion by 2010, according to a study by the New Delhi-based PHD Chamber

of Commerce and Industry. The IRDA believes that eliminating tariffs will encourage

scientific rating and adoption of better risk management practices, and lead to independent

pricing for each line of business, so that premiums will be based on actual risks and costs.

The implementation of the new policy also will encourage the development of innovative

practices and customer-friendly options for policyholders, boosting penetration.

Removal of tariffs also will result in wider acceptance of individual health coverage. Health

insurance will make healthcare more affordable to larger segments of the populace,

boosting healthcare expenditures per household and driving the demand for quality care.

Finally, the elimination of insurance tariffs will serve as a litmus test for further legislation,

such as co-payments and hospital accreditations, which the government plans to implement

over the next two to three years.

In the post liberalization era, some companies have been licensed to act as third party

administrators of health services. The objective is to strengthen the health insurance

industry and increase its penetration by bringing more professionalism to claims

management, facilitating cashless services to policyholders, and reducing the claims ratio.


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Currently there are 25 licensed third party administrators in the Indian health insurance

industry

GROWTH OF TELEMEDICINE

Only 25% of Indias specialist physicians reside in semi-urban areas, and a mere 3 % live in

rural areas. As a result, rural areas, with a population approaching 700 million, continue to

be deprived of proper healthcare facilities.

One solution is telemedicinethe remote diagnosis, monitoring and treatment of patients

via videoconferencing or the Internet. Telemedicine is a fast-emerging trend in India,

supported by exponential growth in the countrys information and communications

technology (ICT) sector, and plummeting telecom costs.

Several major private hospitals have adopted telemedicine services, and a number of

hospitals have developed public-private partnerships (PPPs), among them Apollo, AIIMS,

Narayana Hridayalaya, Aravind Hospitals and San kara Nethralaya

MEDICAL EQUIPMENT MARKET

The rebuilding of Indias healthcare infrastructure, combined with the emergence of

medical tourism and telemedicine, will drive strong demand for medical equipment, such

as x-ray machines, CT scanners and electrocardiograph (EKG) machines. Leading

international companies market most high value medical equipment, while only

consumables and disposable equipment are made locally. Many international companies


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have expanded their operations in the Indian market in recent years and established

manufacturing facilities to assemble equipment for the domestic market and export sales.

The competition is expected to intensify with the entry of more global firms into the

medical equipment marketplace.

The government is encouraging the growth of this market, throughpolicies such as a

reduction in import duties on medical equipment, higher depreciation on life-saving medical

equipment (40%, up from 25%), and a number of other tax incentives

PHARMACEUTICAL INDUSTRY OPPORTUNITIES

Despite widespread poverty and inadequate public healthcare provision, India has much to

offer the leading drug makers. An increase in lifestyle diseases resulting from the adoption

of unhealthy western diets, combined with a growing middle class that has more disposable

income to spend on treatment, will provide new opportunities for global pharmaceutical

firms.


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PROBLEMS FACED BY THE INDUSTRY

Low public spending on health

Lack of adequate beds in the hospitals

Lack of emphasis on prevention

Enforcing standards of medical care rendered by hospitals and private health practitioners

Extremely low bed : people ratio

Dominated by Government and Charitable Hospitals

Excessive overlap across primary, secondary and tertiary care

Skewed towards urban populace

Lack of adequate corporatization

Insurance to provide financial protection from catastrophic events

More research, awareness and communication and greater public involvement in

understanding health issues.


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CONCLUSION

The Indian healthcare sector can be viewed as a glass half empty or a glass half full. The

challenges the sector faces are substantial, from the need to improve physical

infrastructure to the necessity of providing health insurance and ensuring the availability

of trained medical personnel. But the opportunities are equally compelling, from developing

new infrastructure and providing medical equipment to delivering telemedicine solutions

and conducting cost-effective clinical trials. For companies that view the Indian healthcare

sector as a glass half full, the potential is enormous.

Documents

Introduction to Health Care