The healthcare market in India
India's secondary and tertiary care, especially in terms of the private sector, is primarily concentrated in urban areas. While no accurate up-to-date statistics are available, as of 2005 the nation had over 15,900 hospitals containing 875,000 beds. More than 70% of secondary care facilities derive from private hospitals, which contain 40% of the country's hospital beds. Half of all the nation's hospital admissions are the responsibility of private hospitals.
Between 2000 and 2006, public hospitals rose by more than two thirds from less than 4,600 to over 7,660. During that period, bed capacity in government-run facilities rose by a modest 14%, reaching just over 430,000 in 2006. According to IMS, the disparity between the two figures can be attributed to efforts to broaden the country's hospital sector, particular through establishing more small community and district inpatient facilities.
Similar to the situation in Brazil and China, India's primary care sector suffers from shortages of staff, equipment and supplies. Overcrowding and poor facilities means many middle income patients seek an initial diagnosis in public hospitals before opting for treatment in private facilities in spite of the obvious financial implications. Efforts are, however, being made to address some of these issues and in particular quality standards were introduced to help drive improvements. IMS has identified that mechanisms which penalise poor performers and reward those providing good quality are badly needed.
Public private partnerships (PPP) are being targeted as a means of improving India's public hospital management. According to IMS, government hospitals are increasingly contracting private operators to manage their facilities, and this is a trend which looks set to continue. Critics, however, claim patients face more substantial payments in PPP-managed facilities while the involvement of private players is also likely to have an impact on hospital procurement strategies, which will begin to affect manufacturers supplying the public hospital sector.
"Similar to the situation in Brazil and China, India's primary care sector suffers from shortages of staff, equipment and supplies."A scheme supported by the World Health Organization aims to bridge the gap between primary health centres and large city-based public hospitals in India by developing a network of 100-bed facilities in smaller towns. Yet again, recruiting and retaining qualified staff has proved a major problem to the progress of the scheme and IMS expects a shortage of fully trained health professionals will continue to prevent improvements to healthcare outside major cities.
Aware of the public hospital sector's shortcomings, successive Indian governments have actively promoted the expansion of the private hospital sector, which has also been strongly driven by the nation's growing middle class. IMS predicts this growth will continue in the long term.
A range of tax exemptions from central and state governments has allowed private providers to purchase land at preferential rates in return for commitments to meet quotas for free treatment of poor outpatients and inpatients. Private hospitals also provide treatment to central state government employees and their families, which is substantially reimbursed under government-backed health insurance programmes for public sector workers.
Leading hospital chains have already invested heavily in expansion programmes in India, particularly by establishing speciality and tertiary care facilities in major metros and tier I cities and constructing new facilities in tier II cities. Some of the most prominent private hospital chains operating in India include Apollo, Fortis, the Global Hospitals Group and Manipal Health Systems. While such leading hospital chains operate to world-class standards, the standards of practice in private facilities elsewhere in India vary widely.
According to IMS, tighter regulations on private providers could trigger a restructuring of the private hospital market and force the closure of smaller poor quality facilities. At state levels, initiatives are currently being pursued that are designed to regulate private providers but draft legislation aimed at imposing minimum standards at national level is still on its way through parliament
Government is pushig hard for medical health insurance to the population. Differnet type of healthcare cards are now initiatted to provide health insurance to poor economic sections