I was discussing an assignment with a private equity fund manager with respect to the Indian Healthcare scenario, and the fact that the most common denominator used to indicate deficit facilities is the bed to population ratio. It is quite surprising that Eastern India has a better bed to population ratio than say, central and north India? Yet, people travel out from Eastern India to get treatment at places like Chennai, Vellore and even Mumbai! I found myself thinking about this long after the meeting.
The reason, which struck me later, was that this could only be attributed to Quality of The Asset that we consider as bed. Simply, it is poor in Eastern India. The same reason holds true even in the hinterland states like Bihar, UP, Jharkhand, Chattisgarh, MP and Rajasthan. The number of beds alone therefore may not be a good parameter to ascertain deficit/surplus beds and the asset quality will play a more vital role in deciding that count. By quality of asset one means the infrastructure that surrounds the bed viz: the distance between beds, availability of other clinical services like well equipped Operation Theaters, critical care units, lab, radiology etc. Similarly, other support services like kitchen, laundry, CSDD, 24 hours emergency power, safe water, air-conditioning plants etc. India already has a lower bed to population ratio of hardly 1:1000 and if we consider the quality of these assets, the ration may even go down further…. Now that is food for thought, because then the demand-supply gap would suddenly seem even wider than what we now presume.
I would appreciate your feedback on this topic. Please write.
Dear Sir.
The quality of bed is certainly a concern of a patient, and certainly apprehensive mind of the patient also drives to travel to get care. Most of the times a general consumer is driven to travel to other areas trapped by marketing mechanisms. e.g. an established brand from the nearby metro in down south conducts health camps and health check ups and which might create a need to avail patient care , This is just like creating a market need. For hospitals like CMC from whole north east and other parts of the country travel because of the trust on the Trust and missionary. There is a trend that from bordering districts of Westbengal e.g. Medinapore, lots of patients travel to Cuttack, instead of travelling to Kolkata. which is nearer to them.There are different mechanisms ( word of mouth / trust / cost of treatment)
If we come back to the point, we lack proper statistical research, data compiling and gathering, I hope the 2011 Census will put better lights and we need Healthcare intelligence building, for which considerable amount of fund allocation and involvement of multidisciplinary team is .needed.
The actual bed requirement per thousand in different level or tier of healthcare needs to be fixed and regularly be upgraded by a committee at national level, which would make it sound more authentic. e.g. We say the requirement is 3 per 1000, But There could be a requirement of 1 bed per thousand population at primary level, 2 beds in secondary care level per thousand population and 2-3 beds per 1000 at tertiary level ( including critical care , 1 bed per population for accident , emergency and other related casualties, , Then the total requirement is more than 6-7. While calculating the bed strength of the area usually , this stratification is missed out , and it seems some areas of the country, e.g. Kerala or Orissa is concentrated with beds , but considering the quality parameters and the total no required it may actually be far less than it is present.
Regards
Interesting observation–I had never looked at the Quality beds and below standard beds—–
Great stuff. thanks for this
OK nice to see- interesting comments are always helpful!
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