BioMediCal Waste Disposal

HERE IS THE NOTIFICATION FROM MINISTRY OF ENVIRONMENT & FORESTS



New Delhi, 20th July, 1998
S.O. 630 (E).-Whereas a notification in exercise of the powers conferred by Sections 6, 8 and 25 of the Environment (Protection) Act, 1986 (29 of 1986) was published in the Gazette vide S.O. 746 (E) dated 16 October, 1997 inviting objections from the public within 60 days from the date of the publication of the said notification on the Bio-Medical Waste (Management and Handling) Rules, 1998 and whereas all objections received were duly considered..

Now, therefore, in exercise of the powers conferred by section 6, 8 and 25 of the Environment (Protection) Act, 1986 the Central Government hereby notifies the rules for the management and handling of bio-medical waste.

1. SHORT TITLE AND COMMENCEMENT:

(1) These rules may be called the Bio-Medical Waste (Management and Handling) Rules, 1998.

(2) They shall come into force on the date of their publication in the official Gazette.

APPLICATION:

These rules apply to all persons who generate, collect, receive, store, transport, treat, dispose, or handle bio medical waste in any form.

3. DEFINITIONS: In these rules unless the context otherwise requires

(1) "Act" means the Environment (Protection) Act, 1986 (29 of 1986);

(2) "Animal House" means a place where animals are reared/kept for experiments or testing purposes;

(3) "Authorisation" means permission granted by the prescribed authority for the generation, collection, reception, storage, transportation, treatment, disposal and/or any other form of handling of bio-medical waste in accordance with these rules and any guidelines issued by the Central Government.

(4) "Authorised person" means an occupier or operator authorised by the prescribed authority to generate, collect, receive, store, transport, treat, dispose and/or handle bio-medical waste in accordance with these rules and any guidelines issued by the Central Government;

(5) "Bio-medical waste" means any waste, which is generated during the diagnosis, treatment or immunisation of human beings or animals or in research activities pertaining thereto or in the production or testing of biologicals, and including categories mentioned in Schedule I;

(6) "Biologicals" means any preparation made from organisms or micro-organisms or product of metabolism and biochemical reactions intended for use in the diagnosis, immunisation or the treatment of human beings or animals or in research activities pertaining thereto;

(7) "Bio-medical waste treatment facility" means any facility wherein treatment. disposal of bio-medical waste or processes incidental to such treatment or disposal is carried out;

(8) "Occupier" in relation to any institution generating bio-medical waste, which includes a hospital, nursing home, clinic dispensary, veterinary institution, animal house, pathological laboratory, blood bank by whatever name called, means a person who has control over that institution and/or its premises;

(9) "Operator of a bio-medical waste facility" means a person who owns or controls or operates a facility for the collection, reception, storage, transport, treatment, disposal or any other form of handling of bio-medical waste;

(10) "Schedule" means schedule appended to these rules;

4. DUTY OF OCCUPIER:

It shall be the duty of every occupier of an institution generating bio-medical waste which includes a hospital, nursing home, clinic, dispensary, veterinary institution, animal house, pathological laboratory, blood bank by whatever name called to take all steps to ensure that such waste is handled without any adverse effect to human health and the environment.

5. TREATMENT AND DISPOSAL

(1) Bio-medical waste shall be treated and disposed of in accordance with Schedule I, and in compliance with the standards prescribed in Schedule V.

(2) Every occupier, where required, shall set up in accordance with the time-schedule in Schedule VI, requisite bio-medical waste treatment facilities like incinerator, autoclave, microwave system for the treatment of waste, or, ensure requisite treatment of waste at a common waste treatment facility or any other waste treatment facility.

6. SEGREGATION, PACKAGING, TRANSPORTATION AND STORAGE

(1) Bio-medical waste shall not be mixed with other wastes.

(2) Bio-medical waste shall be segregated into containers/bags at the point of generation in accordance with Schedule II prior to its storage, transportation, treatment and disposal. The containers shall be labeled according to Schedule III.

(3) If a container is transported from the premises where bio-medical waste is generated to any waste treatment facility outside the premises, the container shall, apart from the label prescribed in Schedule III, also carry information prescribed in Schedule IV.

(4) Notwithstanding anything contained in the Motor Vehicles Act, 1988, or rules thereunder, untreated biomedical waste shall be transported only in such vehicle as may be authorised for the purpose by the competent authority as specified by the government.

(5) No untreated bio-medical waste shall be kept stored beyond a period of 48 hours

Provided that if for any reason it becomes necessary to store the waste beyond such period, the authorised person must take permission of the prescribed authority and take measures to ensure that the waste does not adversely affect human health and the environment.

7. PRESCRIBED AUTHORITY

(1) The Government of every State and Union Territory shall establish a prescribed authority with such members as may be specified for granting authorisation and implementing these rules. If the prescribed authority comprises of more than one member, a chairperson for the authority shall be designated.

(2) The prescribed authority for the State or Union Territory shall be appointed within one month of the coming into force of these rules.

(3) The prescribed authority shall function under the supervision and control of the respective Government of the State or Union Territory.

(4) The prescribed authority shall on receipt of Form 1 make such enquiry as it deems fit and if it is satisfied that the applicant possesses the necessary capacity to handle bio-medical waste in accordance with these rules, grant or renew an authorisation as the case may be.

(5) An authorisation shall be granted for a period of three years, including an initial trial period of one year from the date of issue. Thereafter, an application shall be made by the occupier/operator for renewal. All such subsequent authorisation shall be for a period of three years. A provisional authorisation will be granted for the trial period, to enable the occupier/operator to demonstrate the capacity of the facility.

(6) The prescribed authority may after giving reasonable opportunity of being heard to the applicant and for reasons thereof to be recorded in writing, refuse to grant or renew authorisation.

(7) Every application for authorisation shall be disposed of by the prescribed authority within ninety days from the date of receipt of the application.

(8) The prescribed authority may cancel or suspend an authorisation, if for reasons, to be recorded in writing, the occupier/operator has failed to comply with any provision of the Act or these rules :

Provided that no authorisation shall be cancelled or suspended without giving a reasonable opportunity to the occupier/operator of being heard.

8. AUTHORISATION

(1) Every occupier of an institution generating, collecting, receiving, storing, transporting, treating, disposing and/or handling bio-medical waste in any other manner, except such occupier of clinics, dispensaries, pathological laboratories, blood banks providing treatment/service to less than 1000 (one thousand) patients per month, shall make an application in Form 1 to the prescribed authority for grant of authorisation.

(2) Every operator of a bio-medical waste facility shall make an application in Form 1 to the prescribed authority for grant of authorisation.

(3) Every application in Form 1 for grant of authorisation shall be accompanied by a fee as may be prescribed by the Government of the State or Union Territory.

9. ADVISORY COMMITTEE

The Government of every State/Union Territory shall constitute an advisory committee. The committee will include experts in the field of medical and health, animal husbandry and veterinary sciences, environmental management, municipal administration, and any other related department or organisation including non-governmental organisations. The State Pollution Control Board/Pollution Control Committee shall be represented. As and when required, the committee shall advise the Government of the State/Union Territory and the prescribed authority about matters related to the implementation of these rules.

10. ANNUAL REPORT

Every occupier/operator shall submit an annual report to the prescribed authority in Form 11 by 31 January every year, to include information about the categories and quantities of bio-medical wastes handled during the preceding year. The prescribed authority shall send this information in a compiled form to the Central Pollution Control Board by 31 March every year.

11. MAINTENANCE OF RECORDS

(1) Every authorised person shall maintain records related to the generation, collect ' ion, reception, storage, transporation, treatment, disposal and/or any form of handling of bio-medical waste in accordance with these rules and any guidelines issued.

(2) All records shall be subject to inspection and verification by the prescribed authority at any time.

12. ACCIDENT REPORTING

When any accident occurs at any institution or facility or any other site where bio-medical waste is handled or during transportation of such waste, the authorised person shall report the accident in Form Ill to the prescribed authority forthwith.

13. APPEAL

Any person aggrieved by an order made by the prescribed authority under these rules may, within thirty days from the date on which the order is communicated to him, prefer an appeal to such authority as the Government of State/Union Territory may think fit to constitute :

Provided that the authority may entertain the appeal after the expiry of the said period of thirty days if it is satisfied that the appellant was prevented by sufficient cause from filing the appeal in time.


SCHEDULE I
(See Rule 5)
CATEGORIES OF BIO-MEDICAL WASTE

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Option Waste Category Treatment & Disposal
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Category No. I Human Anatomical Waste
(human tissues, organs, body parts) incineration@/deep burial*

Category No. 2 Animal Waste
(animal tissues, organs, body parts carcasses, bleeding parts, fluid, incineration@/deep burial*
blood and experimental animals used in research, waste generated
by veterinary hospitals colleges, discharge from hospitals, animal
houses)

Category No 3 Microbiology & Biotechnology Waste
(wastes from laboratory cultures, stocks or specimens of micro- local autoclaving/micro-
organisms live or attenuated vaccines, human and animal cell waving/incineration@
culture used in research and infectious agents from research
and industrial laboratories, wastes from production of biologicals,
toxins, dishes and devices used for transfer of cultures)

Category No 4 Waste sharps
(needles, syringes, scalpels, blades, glass, etc. that may cause disinfection (chemical treat-
puncture and cuts. This includes both used and unused sharps) ment@01/auto claving/micro-
waving and mutilation/
shredding"

Category No 5 Discarded Medicines and Cytotoxic drugs
(wastes comprising of outdated, contaminated and discarded inc ineratio n@/destruct ion and
medicines) drugs disposal in secured
landfills

Category No 6 Solid Waste
(Items contaminated with blood, and body fluids including cotton,
dressings, soiled plaster casts, lines, beddings, other material incineration@
contaminated with blood) autoclaving/microwaving

Category No. 7 Solid Waste
(wastes generated from disposable items other than the waste shaprs disinfection by chemical
such as tubings, catheters, intravenous sets etc). treatment@@ autoclaving/
microwaving and mutilation/
shredding##

Category No. 8 Liquid Waste
(waste generated from laboratory and washing, cleaning, house- disinfection by chemical
keeping and disinfecting activities) treatment@@ and discharge
into drains.

Category No. 9 Incineration Ash
(ash from incineration of any bio-medical waste) disposal in municipal landfill

Category No. 10 Chemical Waste
(chemicals used in production of biologicals, chemicals used in chemical treatment@@ and
disinfection, as insecticides, etc.) discharge into drains for
liquids and secured landfill
for solids
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@@ Chemicals treatment using at least 1% hypochlorite solution or any other equivalent chemical reagent. It must be ensured that chemical treatment ensures disinfection.

## Multilation/shredding must be such so as to prevent unauthorised reuse.

@ There will be no chemical pretreatment before incineration. Chlorinated plastics shall not be incinerated.

* Deep burial shall be an option available only in towns with population less than five lakhs and in rural areas.


SCHEDULE II
(see Rule 6)
COLOUR CODING AND TYPE OF CONTAINER FOR DISPOSAL OF BIO-MEDICAL WASTES
Colour Conding
Type of Container -I Waste Category
Treatment options as per

Schedule I

Yellow
Plastic bag Cat. 1, Cat. 2, and Cat. 3,

Cat. 6.
Incineration/deep burial


Red
Disinfected container/plastic bag Cat. 3, Cat. 6, Cat.7.
Autoclaving/Microwaving/

Chemical Treatment

Blue/White

translucent
Plastic bag/puncture proof Cat. 4, Cat. 7.

Container
Autoclaving/Microwaving/

Chemical Treatment and

destruction/shredding

Black
Plastic bag Cat. 5 and Cat. 9 and

Cat. 10. (solid)
Disposal in secured landfill



Notes:

1. Colour coding of waste categories with multiple treatment options as defined in Schedule I, shall be selected depending on treatment option chosen, which shall be as specified in Schedule I.

2. Waste collection bags for waste types needing incineration shall not be made of chlorinated plastics.

3. Categories 8 and 10 (liquid) do not require containers/bags.

4. Category 3 if disinfected locally need not be put in containers/bags.


SCHEDULE III
(see Rule 6)
LABEL FOR BIO-MEDICAL WASTE CONTAINERS/BAGS



HANDLE WITH CARE

Note : Lable shall be non-washable and prominently visible.


SCHEDULE IV
(see Rule 6)
LABEL FOR TRANSPORT OF BIO-MEDICAL WASTE CONTAINERS/BAGS

Day ............ Month ..............
Year ...........
Date of generation ...................

Waste category No ........
Waste class
Waste description

Sender's Name & Address Receiver's Name & Address
Phone No ........ Phone No ...............
Telex No .... Telex No ...............
Fax No ............... Fax No .................
Contact Person ........ Contact Person .........
In case of emergency please contact
Name & Address :

Phone No.
Note :
Label shall be non-washable and prominently visible.


SCHEDULE V
(see Rule 5 and Schedule 1)
STANDARDS FOR TREATMENT AND DISPOSAL OF BIO-MEDICAL WASTES
STANDARDS FOR INCINERATORS:

All incinerators shall meet the following operating and emission standards

A. Operating Standards

1. Combustion efficiency (CE) shall be at least 99.00%.

2. The Combustion efficiency is computed as follows:


%C02
C.E. = ------------ X 100
%C02 + % CO

3. The temperature of the primary chamber shall be 800 ± 50 deg. C°.

4. The secondary chamber gas residence time shall be at least I (one) second at 1050 ± 50 C°, with minimum 3% Oxygen in the stack gas.

B. Emission Standards


Parameters Concentration mg/Nm3 at (12% CO2 correction)

(1) Particulate matter 150
(2) Nitrogen Oxides 450
(3) HCI 50
(4) Minimum stack height shall be 30 metres above ground
(5) Volatile organic compounds in ash shall not be more than 0.01%

Note :

• Suitably designed pollution control devices should be installed/retrofitted with the incinerator to achieve the above emission limits, if necessary.

• Wastes to be incinerated shall not be chemically treated with any chlorinated disinfectants.

• Chlorinated plastics shall not be incinerated.

• Toxic metals in incineration ash shall be limited within the regulatory quantities as defined under the Hazardous Waste (Management and Handling Rules,) 1989.

• Only low sulphur fuel like L.D.0dLS.H.S.1Diesel shall be used as fuel in the incinerator.

STANDARDS FOR WASTE AUTOCLAVING:

The autoclave should be dedicated for the purposes of disinfecting and treating bio-medical waste,

(I) When operating a gravity flow autoclave, medical waste shall be subjected to :

(i) a temperature of not less than 121 C' and pressure of 15 pounds per square inch (psi) for an autoclave residence time of not less than 60 minutes; or

(ii) a temperature of not less than 135 C° and a pressure of 31 psi for an autoclave residence time of not less than 45 minutes; or

(iii) a temperature of not less than 149 C° and a pressure of 52 psi for an autoclave residence time of not less than 30 minutes.

(II) When operating a vacuum autoclave, medical waste shall be subjected to a minimum of one pre-vacuum pulse to purge the autoclave of all air. The waste shall be subjected to the following:

(i) a temperature of not less than 121 C° and pressure of 15 psi per an autoclave residence time of not less than 45 minutes; or

(ii) a temperature of not less than 135 C° and a pressure of 31 psi for an autoclave residence time of not less than 30 minutes;

(III) Medical waste shall not be considered properly treated unless the time, temperature and pressure indicators indicate that the required time, temperature and pressure were reached during the autoclave process. If for any reasons, time temperature or pressure indicator indicates that the required temperature, pressure or residence time was not reached, the entire load of medical waste must be autoclaved again until the proper temperature, pressure and residence time were achieved.

(IV) Recording of operational parameters

Each autoclave shall have graphic or computer recording devices which will automatically and continuously monitor and record dates, time of day, load identification number and operating parameters throughout the entire length of the autoclave cycle.

(V) Validation test

Spore testing :

The autoclave should completely and consistently kill the approved biological indicator at the maximum design capacity of each autoclave unit. Biological indicator for autoclave shall be Bacillus stearothermophilus spores using vials or spore Strips; with at least 1X104 spores per millilitre. Under no circumstances will an autoclave have minimum operating parameters less than a residence time of 30 minutes, regardless of temperature and pressure, a temperature less than 121 C° or a pressure less than 15 psi.

(VI) Routine Test

A chemical indicator strip/tape the changes colour when a certain temperature is reached can be used to verify that a specific temperature has been achieved. It may be necessary to use more than one strip over the waste package at different location to ensure that the inner content of the package has been adequately autoclaved

STANDARD FOR LIQUID WASTE:

The effluent generated from the hospital should conform to the following limits

PARAMETERS PERMISSIBLE LIMITS

PH 63-9.0
Susponded solids 100 mg/l
Oil and grease 10 mg/l
BOD 30 mg/l
COD 250 mg/l
Bio-assay test 90% survival of fish after 96 hours in 100% effluent.

these limits are applicable to those, hospitals which are either connected with sewers without terminal sewage treatment plant or not connected to public sewers. For discharge into public sewers with terminal facilities, the general standards as notified under the Environment (Protection) Act, 1986 shall be applicable.

STANDARDS OF MICROWAVING

1 Microwave treatment shall not be used for cytotoxic, hazardous or radioactive wastes, contaminated animal car casses, body parts and large metal items.

2. The microwave system shall comply with the efficacy test/routine tests and a performance guarantee may be provided by the supplier before operation of the limit.

3. The microwave should completely and consistently kill the bacteria and other pathogenic organisms that is ensured by approved biological indicator at the maximum design capacity of each microwave unit. Biological indicators for microwave shall be Bacillus Subtilis spores using vials or spore strips with at least 1 x 101 spores per milliliter.

STANDARDS FOR DEEP BURIAL

1. A pit or trench should he dug about 2 meters deep. It should be half filled with waste, then covered with lime within 50 cm of the surface, before filling the rest of the pit with soil.

2. It must be ensured that animals do not have any access to burial sites. Covers of galvanised iron/wire meshes may be used.

3. On each occasion, when wastes are added to the pit, a layer of 10 em of soil shall be added to cover the wastes.

4. Burial must be performed under close and dedicated supervision.

5. The deep burial site should be relatively impermeable and no shallow well should be close to the site.

6. The pits should be distant from habitation, and sited so as to ensure that no contamination occurs of any surface water or ground water. The area should not be prone to flooding or erosion.

7. The location of the deep burial site will be authorised by the prescribed authority.

8. The institution shall maintain a record of all pits for deep burial.


SCHEDULE VI
(see Rule 5)
SCHEDULE FOR WASTE TREATMENT FACILITIES LIKE INCINERATOR/ AUTOCLAVE/ MICROWAVE SYSTEM

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A Hospitals and nursing homes in towns with population of 30 lakhs by 31st December, 1999 or earlier
and above
B. Hospitals and nursing homes in towns with population of below
30 lakhs,
(a) with 500 beds and above by 31st December, 1999 or earlier
(b) with 200 beds and above but less than 500 beds by 31st December, 2000 or earlier
(c) with 50 beds and above but less than 200 beds by 31st December, 2001 or earlier
(d) with less than 50 beds by 31st December, 2002 or earlier
C. All other institutions generating bio-medical waste not included by 31st December, 2002 or earlier
in A and B above
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FORM I
(see rule 8)
APPLICATION FOR AUTHORISATION
(To be submitted in duplicate.)
To

The Prescribed Authority
(Name of the State Govt/UT Administration)
Address.

1. Particulars of Applicant

(i) Name of the Applicant
(In block letters & in full)
(ii) Name of the Institution:
Address:
Tele No., Fax No. Telex No.

2. Activity for which authorisation is sought:

(i) Generation
(ii) Collection
(iii) Reception
(iv) Storage
(v) Transportation
(vi) Treatment
(vii) Disposal
(viii) Any other form of handling

3. Please state whether applying for resh authorisation or for renewal:
(In case of renewal previous authorisation-number and date)
4.

(i) Address of the institution handling bio-medical wastes:

(ii) Address of the place of the treatment facility:

(iii) Address of the place of disposal of the waste:

5.

(i) Mode of transportation (in any) of bio-medical waste:

(ii) Mode(s) of treatment:

6. Brief description of method of treatment and disposal (attach details):

7.

(i) Category (see Schedule 1) of waste to be handled

(ii) Quantity of waste (category-wise) to be handled per month

8. Declaration

I do hereby declare that the statements made and information given above are true to the best of my knowledge and belief and that I have not concealed any information.

I do also hereby undertake to provide any further information sought by the prescribed authority in relation to these rules and to fulfill any conditions stipulated by the prescribed authority.

Date : Signature of the Applicant

Place : Designation of the Applicant


FORM II
(see rule 10)
ANNUALREPORT
(To be submitted to the prescribed authority by 31 January every year).

1 . Particulars of the applicant:

(i) Name of the authorised person (occupier/operator):

(ii) Name of the institution:

Address

Tel. No

Telex No.

Fax No.

2. Categories of waste generated and quantity on a monthly average basis:

3. Brief details of the treatment facility:

In case of off-site facility:

(i) Name of the operator

(ii) Name and address of the facility:

Tel. No., Telex No., Fax No.

4. Category-wise quantity of waste treated:

5. Mode of treatment with details:

6. Any other information:

7. Certified that the above report is for the period from


Date ............................... Signature ...........................................

Place.............................. Designation..........................................


FORM III
(see Rule 12)
ACCIDENT REPORTING
1. Date and time of accident:

2. Sequence of events leading to accident

3. The waste involved in accident :

4. Assessment of the effects of the accidents on human health and the environment,.

5. Emergency measures taken

6. Steps taken to alleviate the effects of accidents

7. Steps taken to prevent the recurrence of such an accident


Date ............................... Signature ...........................................

Place.............................. Designation..........................................

Hospital Administrators should see to the SEXUAL intrests of Handicapped/Disabled patients!!

As we know, the human sexual and reproductive functions can be physically and psychologically impaired . It is also obvious that these functions can be indirectly affected by a great number of nonsexual injuries, disorders, disabilities, and diseases, indeed, the damage may well be compounded by ignorance and negative social attitudes. Thus, as a rule, physically or mentally handicapped persons find themselves confronted with special sexual problems of their own.


In our society the handicapped and disabled, such as amputees, paraplegics and quadriplegics, and the victims of cerebral palsy, may receive much valuable medical help, but very little support in developing their sexual interests. On the contrary, under the pretext of "protection", their families, friends, doctors, nurses, and teachers often deny them any opportunity to become sexually active or even explicitly discourage them. Many people simply assume that a serious physical or mental handicap precludes any hope for a rewarding sex life. However, this assumption is false. Except for extremely serious cases, in which the sheer need to survive requires all available energy, some form of sexual pleasure is always possible. The fact that this simple truth is not widely recognized only reflects the sensual poverty of our culture.


The situation is especially difficult for those handicapped or disabled patients who have to live in hospitals or nursing homes, or similar institutions. In such places patients usually have very little privacy and little opportunity to meet other people from the outside. Living areas are segregated according to sex. In addition, the staff is often prudish and intolerant. Many doctors, in fact, do not know that their patients are capable of sexual enjoyment and thus never think of discussing the subject. Thus, the men and women in their care remain without guidance, and many possible sexual alternatives are left unexplored. Furthermore, many hospital administrations feel that they cannot permit any sexual activity on their premises, because this would bring them in conflict with the law, and, unfortunately, this concern may be justified. Conservative employees or relatives of patients who disapprove of non marital sex might bring suit against the institution. Finally, since many patients are incapable of coitus and therefore practice other forms of sexual intercourse, they may well be guilty of "sodomy" or "crimes against nature" as defined in many IPC CODES. This is another reason why doctors may be reluctant to help their patients with necessary sexual experimentation's. Needless to say, all of this applies not only to long-term,

Unfortunately the situation is same for many people who are hospitalized for only a few months or even weeks and, during that time, are needlessly deprived of sexual intercourse. Not every illness demands sexual abstinence, but virtually no hospital offers its patients an opportunity to become intimate with visiting spouses or lovers. On the other hand, in case of a serious illness, lovers may not even be allowed to visit at all, because they are not officially recognized "family members". Such a regulation is especially insensitive to homosexual patients.

Clinical sex research has shown that a great many of even severely handicapped persons can enjoy sex if they are willing to raise their sexual consciousness and to break out of conventional patterns.

Thus depriving them for there sexual options and life inside hospital for long is questionable and needs a second thought in all hospitals and place where we keep such people for treatment for long, in fact, hospital administrators should changed their policies and now allow their patients to find sexual satisfaction.

Unusual problems are faced by the mentally handicapped, especially those who are institutionalized. Still, in principle, everything said above also applies to them. In the past, they were often treated as if they had no sexual interests or sexual rights.. The necessary privacy should be provided by their families or by the institutions to which they are confined. On the other hand, the mentally handicapped also have to be protected against sexual exploitation. This can be done by personal attention, appropriate institutional regulations, and sensible criminal laws.

Where sterilization seems desirable and unavoidable , informed consent should be obtained. Yet, as a matter of policy, the least restrictive alternative should always be preferred. As long as nobody else is harmed, all handicapped and disabled persons are entitled to full sexual fulfillment according to their a

Revenue generation and patient load pattern in a small size hospital

REPORT SUMMARY FOR - REVENUE GENERATION AND PATIENT LOAD OF A 100 BEDED HOSPITAL IN U.P, INDIA

From my analysis and study of data following conclusions regarding the revenue and service usage at can be drawn for ABC Hospital: -

Regarding In- Patient Department: -

1. Patients of General Medicine category comes in maximum number in the IPD of ABC Hospital.

2. The contribution of Doctor’s Fees towards total revenue generated is maximum, while Microbiology services contributes minimum.

3. Consumption of pharmacy (in monetary terms) is maximum in case of Neurosurgery patients and maximum miscellaneous charges are charged to the patients of Nephrology.

4. On and average 392 patients are admitted in a month in the In-Patient Department of Regency.

5. From corporate institutions, with which ABC HOSPITAL has its tie-ups on an average 28 patient’s come for IPD Services, Maximum number of patients comes from GAIL in a month.

6. On an average 84 operative cases are being done in a month from which on an average Rs3,04,092 is generated.

7. Among various categories of rooms available in General Ward maximum number of patients are being admitted and its utilisation is more than any other category of beds.

8. In Deluxe and S.Deluxe rooms more traffic is required, as their utilisation is relatively low.

Regarding diagnostic services: -

1. Among various diagnostic services maximum revenue comes from CT Scan, while minimum from comes TMT.
2. In IPD and OPD both maximum number of tests are done for ECG.


Regarding IPD to OPD Transfer: -

1. In general the rate of admission from OPD TO IPD is low and it needs improvement.

v For all above categories, I found that there wasn’t much fluctuation in the trend of revenue generation and utilisation services in the hospital.

Institutes Offering Hospital Administration Courses

List of Institutions in India

1. Administrative Staff College of India, Bella Vista, Khairatabad, Raj Bhavan Road, Hyderabad-500 082. (In association with the Hinduja Foundation).
2. All India Institute of Local Self Government, Sthanikraj Bhavan, CD Barfiwala Marg, Andheri West, Mumbai-58.
3. All India Institute of Medical Sciences (AIIMS) Ansari Nagar, New Delhi-110 029.
4. Apollo Institute of Hospital Administration, Apollo Hospital Campus, Jubilee Hills, Hyderabad-500 033.
5. ASCI-Hinduja Institute of Healthcare Management, ASCI College Park, Banjara Hills, Road #3, Hyderabad-500 034.
6. Birla Institute of Science and Technology, Pilani-333 031, Rajasthan, (http://www.bits-pilani.ac.in/).
7. Birla Institute of Technology, Mestra, Ranchi-835 125, Bihar, (http://www.bitmesra.ac.in/).
8. Christian Medical College, Vellore-632 002, TN (http://results.southindia.com/Medical-entrance-exam/cmcgroupC-24.html).
9. Department of Management Studies, Madurai Kamaraj University, Palkalai Nagar, Madurai-625 021 (www.mkuniversity.org/docs/MBAPro07.doc)
10. Faculty of Management Studies, University of Delhi, Delhi-110 007 (du.ac.in/course/syllabi/MBA%20Syllabus.pdf).
11. Indian Institute of Health Management Research (IIHMR), Opp.Sanganer Airport, Jaipur-302 011.
12. Institute of Management Studies, Devi Ahilya Viswa vidyalaya, Indore-452 001, Madhya Pradesh.
13. Manipal Academy of Higher Education, University Building, Madhav Nagar, Manipal-576 119, Karnataka.
14. National Institute of Health and Family Welfare, New Mehrauli Road, Munirka, New Delhi-110 067.
15. Tata Institute of Social Sciences, Deonar, Mumbai-88
Courses for Medical students available at:
1. AIIMS, Ansari Nagar, New Delhi-110029. (Non-medical sponsored graduates with 60 per cent marks and seven years work experience in administrative position in a hospital are eligible to apply)
2. Armed Forces Medical College, Sholapur Road, Pune-411040.
3. Kasturba Medical College, Manipal-576119.
4. Nizam’s Institute of Medical Sciences, Panjagutta, Hyderabad-500082
5. The National Institute of Health and Family Welfare, New Mehrauli Road, Munrika, New Delhi-110067. (It offers PG certificate course I Health and Family Welfare Management through Distance Learning).
6. University of Delhi, Faculty of Management Studies, New Delhi-110007. (http://www.fms.edu/).

Courses for non-medical students available at:

1. Tata Institute of Social Science, Sion-Trombay Road, Deonar, Mumbai-400088.
2. Apollo Institute of Hospital Administration, Apollo Hospital Campus, Jubilee Hills, Hyderabad-500033.
3. Indian Institute of Health Management Research (IIHMR), 1, Prabhu Dayal Marg, Sanganer Airport, Jaipur-302011.

4. Sri Ramachandra Medical College & Research Institute (Deemed University), Porur, Chennai-600116. Admission is usually on the basis of a competitive entrance examination.
5. Symbiosis Centre of Health Care, Pune
6. KJ College of Continuing Medical Education, Chennai
7. Indian Institute of social Welfare and Management. Kolkata
8. Padamshree (www.padamshree.org/MHA.html)

9. Institute of Management of Management Studies (IMS) , DAVV, Indore. (http://www.ims.edu/)

Medical Video

MEDICAL VIDEO