Although there has been a significant improvement in healthcare services in India post-independence era, there is still a long way to go before India can provide affordable and timely health services to all its citizens.
Current Status of Healthcare in India
Along with the economic growth in the last few decades, there has also been a surge of diseases affecting the health of the Indian population. Although the percentage of people living in poverty has reduced, there has been a rise in communicable and non-communicable diseases or lifestyle diseases (which accounted for 60% of deaths in 2015 from 40% in 2003).
Along with other industries, healthcare in India has also grown manifold regarding both employment and revenue. According to research by Deloitte, healthcare will be a $280 billion industry by 2020. Despite this growth, there are several challenges that the medical sector has to overcome to serve its huge patient population.
Not Enough Funds Go to Healthcare
According to statistics from 2014, India spends only about 4% of its GDP on healthcare whereas the US allocates about 100 times more. Due to this, 60% of medical expenses of Indians were met through personal savings compared to only 13% in the US.
Inequality in Urban and Rural Facilities
In India, unlike other countries, the urban vs. rural divide is huge. Because the spending power is more by people in cities and towns, all healthcare services are diverted only to this sector leaving the rural areas lacking in medical facilities. Over 60% of hospitals, 70% of dispensaries and 80% of well trained and qualified doctors operate only in the urban areas.
Inadequate Infrastructure
The ratio of the doctors, hospital beds, nurses to the number of patients is alarming. There is one bed for every 2000 patients, one doctor for over 10000 people in a government hospital.
There is one state-run hospital for every 90000 people.
These numbers are disappointing when compared to those of peer countries.
India also has a lower number of specialist doctors, especially in rural areas and community health centers as per statistics.
No Optimal Insurance
In India, healthcare is becoming more expensive and practically unaffordable to some strata of society. Hospitalization and treatment costs have skyrocketed. The only respite patients can get is through insurance.
India’s per capita expenditure on insurance is the lowest in the world, about 30% when compared to over 80% in the west. Over 70% of Indians have to pay out of pocket for medical bills as they do not have insurance.
Less Emphasis on Preventive Care
Another major challenge facing Indian healthcare is the paucity of preventive care mechanisms. The lifestyle choices and hectic schedule of people do not allow them to watch their health. This unhealthy lifestyle and stress give way to diseases like diabetes and hypertension.
It’s a given that the doctor-patient ratio in India is skewed. This makes it even more crucial to focus on preventive healthcare. The healthcare industry shows more focus on reactive than proactive steps. Patients are advised to ask a doctor at Docprime about preventive care.
Preventive healthcare helps to make consumers aware of their health and make smart and consistent choices on their lifestyle, diet and general health.
Preventive care helps tackle big problems at the early stage. Due to lack of preventive healthcare facilities at hospitals, people are adopting home monitoring systems to assess their health.
Delay in Diagnosis of Illnesses
There are many incidents of delayed diagnosis of major illnesses even with top hospitals and doctors. The reasons for this are either lack of infrastructure to run lab tests or lack of accountability of the healthcare staff or the inability to convert the test results into proper treatment decisions. These lapses in the healthcare system cause the patients a lot of wasted time, cost and mental trauma.
Patients have the right to step in and ask a doctor about their current health status, diagnosis, and treatment plan.
No Support for Medical Research
Only research leads to true success in the healthcare of any country. Medicine and vaccine for infectious and chronic diseases need to be made accessible to all. Unfortunately, healthcare is at the mercy of big pharmaceutical companies who only deal with drugs that are profitable and essential drugs are neglected.
The main reason for the lack of research interest is the overburdening of the research staff and lack of resources. Most of the workforce in medical centers work long hours in continuous duty and have no time for the research component of their medical practice.
For those who do commence with research, they lose continuity or do not get funding and support. Unfortunately, they are left to rely on medical data from other countries for prognosis and diagnosis.
Challenges Faced by Hospitals in India
There are plenty of issues in the private and public hospitals in India that are affecting the quality of services provided. Top on the list is inefficient workforce management.
Improper Human Resource Management
The biggest challenge faced by general and private Indian hospitals is workforce shortage. Proper human resource management is not in place to hire and deploy the right staff for the right job. There is a huge shortage of doctors, nurses, and paramedical staff who have the requisite skills.
Even if resources are sufficient, training is mandatory as just the knowledge from medical schools will not suffice to handle real-time scenarios in a hospital. The Human Resources staff has to pull doctors and nurses from work and teach them new and supplementary skills.
Medical staff must also be paid well for the services provided, and continuous appraisals must be given as an effort to retain good doctors.
High Attrition Rate
The high attrition rate in hospitals makes it difficult to plan and allocate human resources. Healthcare specialists are finding opportunities abroad more lucrative and rewarding, prompting them to leave. The attrition rate for doctors and nurses is about 40%, the highest in any industry.
Less Acceptance of Technology
The whole world is becoming digitized, and hospitals and medical institutions are not far off. Digitization helps efficient and quick provision of treatment and services to the patients.
Inadequate Patient Interaction
Apart from the medical knowledge, soft skills are an essential part of treatment in a medical establishment. Training must be given to the medical staff in areas like how to speak to a patient with care, how to handle the relatives of patients, how to courteously address any queries and concerns of patients, etc.
There are special course modules for doctors, nurses and administrative staff that address these issues.
Getting Medical Staff to Work in Smaller Cities
Hospital in tier-2 and tier-3 cities struggle to keep their well-qualified doctors and nurses working for them. Most of them wish to relocate to bigger cities for better access to facilities, their children’s education and so on.
Restriction on the Age of Doctors
The government has made a restriction on the age of doctors to be above a certain level in government hospitals. This must be removed, and more young talent must be induced in hospitals.
Negligence and Error in Judgment
Mistakes can happen in any services industry, but in healthcare, mistakes will prove too costly. Improper diagnoses, treatment plans or errors in judgment are made by junior and sometimes even senior doctors in big hospitals. This can be avoided by consultation, discussion and second opinions of other doctors.
Along with the above, the following are major roadblocks or healthcare in India:
- India faces the epidemic of emerging chronic diseases and infectious diseases.
- The public health programs are not implemented properly in India, and due to demographic transition, life expectancy is reduced in some regions.
- There is minimal access to healthcare in some places due to poor economic conditions.
- Illiteracy and lack of awareness lead to non-usage of the available medical facilities.
- In most parts of India, there is poor sanitation and living conditions, malnutrition, and no access to preventive cures for diseases.
- Healthcare systems are not able to operate efficiently to serve all because of the lack of education, high population and gender bias.
- The government does not spend enough on healthcare. It is viewed more as a loss than an investment.
- Some states in India who have financial constraints do not have a budget for healthcare, and they cut down healthcare expenditure.
Some steps that can be taken to deal with the challenges in healthcare are:
- Innovation in healthcare must be supported. Government and private companies must support innovative disease control mechanisms and research for new medicines.
- Novel business models in healthcare need to be explored that are very specific to the medical scene in India like patient assistance programs, social entrepreneurship and so on.
- Affordable healthcare access to the aging population must be provided. Benefits and discounts must be made available to deserving senior citizens.
- Mass awareness must be created. The public must be aware of the treatment given even if it is free. They must be educated about the symptoms of the disease, the repercussions and the course of treatment.
- Insurance systems must be allowed to penetrate healthcare so that people will not need to pay hefty bills out of their pocket.
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