Low Cost Health Care Delivery Models In India

 Sonymol K, Chief Nursing Officer, Aster Medcity, CochinSonymol brings 20 years of experience in Nursing Administration, Training, Quality, and Strategy. Presently, she is designated at Aster Medcity as Chief Nursing Officer.

India is a developing country; the need of meeting health care demands is a challenge that India is currently facing. Healthcare is a social responsibility, that every country must take consideration in their political agenda, give economical priority during budget allocation. Current trends in India are changing due to the enormous awareness of the citizens, impact of universal healthcare insurance, healthcare became the top priority in political agenda as well as in the budget.

Objective: To analyze the present low-cost healthcare delivery models and its impact on healthcare delivery in India.

There are many innovative models in which India operates its low-cost health care delivery.
Many corporate and private sector hospitals have adopted these models successfully and able to meet the healthcare needs of citizens of India. In India 70 percent of the population belongs to rural sector where the accessibility, availability and afford-ability of the health care become a challenge often. Research studies suggests that below 20 percent of the Indian population is covered by healthcare insurance, simultaneously remaining 80 percent of the population bears the cost of healthcare out of their pocket. These innovative healthcare delivery models, helping the rural population to avail healthcare facility at an affordable cost.

Some of the innovative models are:
PPP model: Public private partnership is one of the health care delivery models in which we can offer health care to the rural public. There are three categories of partner-ship in this model. Firstly, Infrastructure model in which private hospitals can have tie up with providing infra-structure facilities to the public sector. Secondly Clinical model, in which private sector can aid in terms of providing clinical care such as doctors, nurses and other para medical staffs. The third version is integrated model, in which both infrastructure and clinical care can be taken care by private hospitals.

Hub and Spoke design: In this model,
one hub can have several spoke centers that caters the needs of the rural population. This also acts as a referral and business center for this hub. Through this model, the tertiary private hospitals can provide service to the rural areas, where accessibility, availability and affordability becomes a challenge. Most of the preventive and primary healthcare needs of the rural public can be addressed by this model. If they require secondary and tertiary care, that can be made available by the structured process of hub hospitals like referrals, transportation facilities, insurance guidance and health education.

Task shifting: This is a model in which the business strategy becomes volume based than margin based. In other words, shifting and fixing the tasks after assessing the specific competencies of the workers. For e.g.: A doc-tor who performs surgery can devote his time and plan his tasks only on the clinical aspects(surgery) without wasting his/her time and energy for non-clinical tasks.

Simultaneously, the non-clinical works are performed by skilled workers who are trained to do so. This can yield, increased utilization of the facility, optimum utilization of the manpower and ultimately scalability of the services. The hospitals like NH, Arvind eye hospitals has proven these strategies for low-cost health care delivery.

With revolutionized use of technology, Telemedicine & Telenursing is growing at a rapid pace

Out sourcing models: Non-clinical services like security, housekeeping, Food and Beverage, Drivers are outsourced/contracted. This in turn helps in increasing the focus on clinical service staff and reduction of capital budget expenditure. The continuous supply of the manpower is ensured by the vendor as per terms and conditions which reduces the day to day panic situations of the short supply of manpower resources. This model is also a proven strategy in delivering low-cost healthcare delivery.

Telemedicine & Telenursing: With revolutionized use of technology, Telemedicine & Telenursing is growing at a rapid pace. This has increased the accessibility of healthcare to the customers at the finger tips by saving the energy and time in visiting the doctors at their office. Also, this is a strategy in delivering accessible healthcare to rural public.

Renting-out of medical equipment: Few hospitals whose capital investment is less, are adopting the strategy of renting the costly equipment like X-ray machine, CT machine, MRI machine etc. This can reduce the financial burden and ensuring low-cost healthcare delivery to public.

Adoption of public hospitals by Private hospitals: In this model, tertiary private hospitals are adopting local public hospitals in which they are providing healthcare services to the rural public with minimal cost. In India, this is one of the strategic plan of delivering Corporate Social responsibility (CSR).

The penetration of healthcare insurance is very minimal in India. There is a drastic need of providing low-cost health care delivery to the public, considering the socio-economic status, geographical landmark, skilled man-power. In this article, the author discussed about various models currently available in India to deliver healthcare at an affordable cost. After the implementation of the governmental policy (Ayushmaan Bharath) the healthcare be-comes more accessible and affordable to the rural public and this enhances the technological leverage in healthcare as well. Thus, healthcare becomes on the prime priorities in Indian political agenda.