Medical Tourism

AMITY UNIVERSITYAMITY SCHOOL OF BUSINESS

DISSERTION ON MEDICAL TOURISM

IN INDIA

UNDER THE GUIDANCE OF

Mrs. Radhika Meenakshi

SUBMITTED IN PARTIAL FULFILLMENTOF THE 3 YEAR COURSE OF BACHELOR OF

BUSINESS ADMINISTRATION (2005-2008)

SUBMITTED BY-Sharanjeet Singh BaathA111OIO8C52

1

ACKNOWLEDGEMENT

My gratitude goes to my mentor Ms. Radhika Menakshi, who has guided me through out this project and also my respected teachers Professor Alka Munjal, Ms. Ekta Kapoor and Ms.Supriya Bhasin at the Amity University for giving me the substantial knowledge and inspiration.

I would also like to thank Marketing Executives of indraprastha Apollo , Max Hospital, Fortis and Escorts for constant guidance to conduct the present arduous project and untiring cooperation which they extended to me throughout the duration of my dissertation.

I am thankful to the Amity Business School Library for allowing me access to information and knowledge

My special thanks are for those who spared time for providing information and responding to the questionnaire.

Sharanjeet singh BaathA1110108C-63

2

Amity University

--------Uttar Pradesh--------

Amity School of Business

CERTIFICATE

This Dissertation report on _______________________________ is submitted

in partial fulfillment of the requirement of Bachelor of Business

Administration (BBA), Of Amity School of Business, Amity University

Uttar Pradesh.

This is a bonafide work conducted by

_________________________ enrollment number

_____________________of BBA class of 2008; under the

guidance of ______________________ (industry guide) and

_____________________(faculty guide).

3

TABLE OF CONTENTS

CHAPTER 1.

INTRODUCTION 6- 9

a) Brief description of Healthcare industry.b) Healthcare in Indiac) Tourism in Indiad) Medical tourisme) Review of literature

CHAPTER 2

MEDICAL TOURISM 10-39

CHAPTER 3

Objective and sub objectives 40 Research methodology 41 Research design Data collection sources Primary data Secondary data Sample size 42 Limitations of the study Parameters and criteria for the viability of the project 43

CHAPTER 4

MARKET VIABILITY OF INDIAN HEALTHCARE INDUSTRY 43-55

4

Segmentation Marketing mix Demand forecast

CHAPTER 5

SAMPLE BACKGROUND

a) Apollo 55-58b) FORTIS 58-60c) Max Hospital 60-61d) Escorts 61-64

CHAPTER 6

Analysis and interpretation 65-71

CHAPTER 7

Findings 72-73Conclusion 74-75 Recommendation 76

CHAPTER 8

APPENDIX

Bibliography 77-78 Questionnaire 79-80

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CHAPTER 1

HEALTHCARE INDUSTRY

The health care industry is considered an industry or profession which

includes peoples exercise of skill or judgment or the providing of a service

related to the preservation or improvement of the health of individuals or the

treatment or care of individuals who are injured, sick, disabled, or infirm.

The delivery of modern health care depends on an expanding group of

trained professionals coming together as an interdisciplinary team.

HEALTHCARE IN INDIA

Healthcare in India is the responsibility of the individual Indian states. The

Indian constitution charges those states with "the raising of the level of

nutrition and the standard of living of its people and the improvement of

public health". There is also a National Health Policy, endorsed by

Parliament in 1983.

TOURISM IN INDIA

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Welcome to Incredible India, where culture echoes, tradition speaks, beauty enthrall and diversity delights.

Indian tourism is one of the most diverse products on the global scene.

India has 26 world heritage sites. It is divided into 25 bio-geographic

zones and has wide ranging eco tourism products. Apart from this,

India has a 6,000 km coastline and dozens of beaches. . It also has

one of the world's biggest railway systems opening possibilities for

those interested in rail tourism. India also has excellent hospitals

offering affordable Medicare and traditional healthcare systems like

Ayurveda.

MEDICAL TOURISM

Medical Tourism refers to movement of consumers to the country providing

the service for diagnosis and treatment. During the past few years, the

number of people going out of their home country to consume health

services has significantly increased. The size of this market is estimated to

be $40 billion based on a Saudi Report in 2000. During the past four years,

the market grew at a whopping rate of 20-30% and is expected to grow

further. Considering this growth the current market size is estimated to be

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$100 billion. Medical Tourism industry offers tremendous potential for the

developing countries because of their low-cost advantage. The advantages of

medical tourism include improvement in export earnings and healthcare

infrastructure.

Medical tourism can be broadly defined as provision of ‘cost effective’

private medical care in collaboration with the tourism industry for patients

needing surgical and other forms of specialized treatment. This process is

being facilitated by the corporate sector involved in medical care as well as

the tourism industry - both private and public.

REVIEW OF LITERATURE

An estimated 150,000 "medical tourists" visited India last year, representing a 20 per cent jump over the previous year.

The CII-McKinsey report suggests that medical tourism could fetch as much as $2 billion by 2012, compared to an estimated $333 million currently.

Ayurveda tourism earned RS.6000 crore last year A Famous Mumbai and Goa based cosmetic surgeon says his practice

goes 1200 international patient last year, double the number from

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previous year

Source- http://en.wikipedia.org/wiki/Healthcare_in_India

Medical Treatment in USA Equals toA tour to India + Medical Treatment + Savings

(SOURCE CII-MCKINSEY REPORT)

"First World treatment' at Third World prices".

Patients from the UK and North America make up a little more than a trickle right now, but there is big potential for growth," said Mr Anil Maini, head of healthcare business marketing at the Escorts Heart Institute and Research Centre, New Delhi

Source -The Washington.Thursday October 21st 2004.

National Health policy 2002, for example, says: “To capitalise on the comparative cost advantage enjoyed by domestic health facilities in the secondary and tertiary sector, the policy will encourage the supply of services to patients of foreign origin on payment.

Source- www.indiamedicaltourism.com

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CHAPTER 2

Medical Tourism

Introduction:

The purpose here is to provide you with up to date

information and resources about the rapidly growing

industry known as "medical tourism" so that you may

make educated and well informed decisions regarding

your travel, accommodations, and medical, dental, and

surgical care.

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It is my sincere hope that the information provided here will assist and

empower you to make confident decisions regarding your health and well

being.

Why India?

The countries where medical tourism is being actively

promoted include Greece, South Africa, Jordan, India,

Malaysia, Philippines and Singapore. India is a recent

entrant into medical tourism. According to a study by

McKinsey and the Confederation of Indian Industry,

medical tourism in India could become a $1 billion business by 2012. The

report predicts that: "By 2012, if medical tourism were to reach 25 per cent

of revenues of private up-market players, up to 2,297,794,117 USD will be

added to the revenues of these players". The Indian government predicts that

India's $17-billion-a-year health-care industry could grow 13 per cent in

each of the next six years, boosted by medical tourism, which industry

watchers say is growing at 30 per cent annually.

Price advantage is a major selling point. The slogan, thus is, "First World

treatment' at Third World prices". The cost differential across the board is

huge: only a tenth and sometimes even a sixteenth of the cost in the West.

Open-heart surgery could cost up to $70,000 in Britain and up to

$150,000 in the US; in India's best hospitals it could cost between $3,000

and $10,000. Knee surgery (on both knees) costs 350,000 rupees ($7,700)

in India; in Britain this costs £10,000 ($16,950), more than twice as

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much. Dental, eye and cosmetic surgeries in Western countries cost three to

four times as much as in India.

India have a lot of hospitals offering world class treatments in nearly every

medical sector such as cardiology and cardiothoracic surgery, joint

replacement, orthopaedic surgery, gastroenterology, ophthalmology,

transplants and urology to name a few. The various specialties covered are

Neurology, Neurosurgery, Oncology, Ophthalmology, Rheumatology,

Endocrinology, ENT, Paediatrics, Paediatric Surgery, Paediatric Neurology,

Urology, Nephrology, Dermatology, Dentistry, Plastic Surgery,

Gynaecology, Pulmonology, Psychiatry, General Medicine.

For long promoted for its cultural and scenic beauty, India is now being put

up on international map as a heaven for those seeking quality and affordable

healthcare. Analysts say that as many as 150,000 medical tourists came to

India in 2004. As Indian corporate hospitals are on par, if not better than the

best hospitals in Thailand, Singapore, etc there is scope for improvement,

and the country is becoming a preferred medical destination. In addition to

the increasingly top class medical care, a big draw for foreign patients is also

the very minimal or hardly any waitlist as is common in European or

American hospitals.

Leisure Tourism is already very much in demand in India as the country

offers diverse cultural and scenic beauty. India has almost all sort of

destinations like high mountains, vast deserts, scenic beaches, historical

monuments, religious temples etc. Known for its hospitality for tourists, the

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county has opened doors to welcome with the same hospitality f medical

patients/ service seekers.

MEDICAL TOURISM AS AN INDUSTRY

Medical tourism can be broadly defined as provision of ‘cost effective’

private medical care in collaboration with the tourism industry for patients

needing surgical and other forms of specialized treatment. This process is

being facilitated by the corporate sector involved in medical care as well as

the tourism industry - both private and public.

In many developing countries it is being actively promoted by the

government’s official policy. India’s National Health policy 2002, for

example, says: “To capitalise on the comparative cost advantage enjoyed by

domestic health facilities in the secondary and tertiary sector, the policy will

encourage the supply of services to patients of foreign origin on payment.

The rendering of such services on payment in foreign exchange will be

treated as ‘deemed exports’ and will be made eligible for all fiscal incentives

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extended to export earnings”. The formulation draws from recommendations

that the corporate sector has been making in India and specifically from the

“Policy Framework for Reforms in Health Care”, drafted by the prime

minister’s Advisory Council on Trade and Industry, headed by Mukesh

Ambani and Kumaramangalam Birla.

2.Overview Of Medical Tourism In Global Scenario

Countries from where people head for India are UK, Bangaladesh, Oman,

SriLanka, Indonesia, Mauritius, Nigeria, Kenya, and Pakistan etc. The

international patients can make decision by looking at the following table,

which shows charges against the type of surgery.

Cost Table

Procedure Charges (US $)

Category   US INDIA

Heart Surgery

Bone marrow transplant

30,000

250,000

8000

69,000

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Liver transplant

Orthopaedic Surgery

Cataract Surgery

300,000

20,000

2,000 

69,000

6,000

1,250

India offers a real good cost advantage over the western countries. This cost

factor becomes very important while formulating schemes to attract the

Indian diaspora as they generally compare the relative costs before going for

treatment.

Healthy Budget table  

Heart Surgery Costs $ 30,000 ( Rs 14.4 lakhs) in the

US, But Indian Hospitals charge Rs 4

Lakh. 

Orthopedic Surgery

In the west, the expense comes to

$20,000(Rs 9.6 lakh). The package in

India costs one third of that amount. 

Cataract Surgery  $20,000 is the price for surgery in the

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US. In India, it comes to just $500

Liver Transplant The cost comes to a whopping

$300,000 abroad while Indian super

specialty hospitals perform the

operation for

Global Medical Tourism 

Country

No of

Foreigners

treated last

year

From

Money

Earned

Strengths

THAILAND

600,000

US, UK $470 m

Cosmetic

surgery,

Organ

transplants,

Dental

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treatment,

Joint

replacements

JORDAN

126,000

Middle East

$600 m

Organ

transplants,

Fertility

treatment,

Cardiac care

INDIA

100,000

Middle East,

Bangaladesh,

UK,

Developing

countries

N.A

Cardiac care,

Joint

Replacements,

Lasik

MALAYSIA

85,000

US, Japan,

Developing

countries

$40 m

Cosmetic

surgery

17

SOUTH

AFRICA

50,000

US, UK

N.A

Cosmetic

surgery,

Lasik. Dental

treatment

Treatment Costs ($)*

Procedure

US

INDIA

SOUTH

AFRICA

THAILAND

Facelift

8000-20,000

10,000-

20,000

1,252

2,682

Hip 17,000 2,500 6,671 N.A

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replacement

Open heart

surgery

150,000

5,000-

10,000

13,333

7,500

Eye (Lasik)

3,100

7,000

2,166

730

Medical Travelers Clusters

Ø     The first is made up of the SAARC countries.

Ø     The second major group- the African (Nigeria ,Nambia etc)

Ø     The third big group of medical travelers comes from the Middle

East .

Ø     The last group of medical travelers from a motley lot

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OUTSOURCING

  Outsourcing of logistics has changed over the years we have seen business

models adapted to meet the needs of the buyer. Hospital major areas like

house keeping, Food and Beverage, Lenin, diagnostics labs, medical

equipment, ambulatory services etc are outsourced. Hospital focuses on core

activity of patient care.

Medical Business Process Outsourcing includes Medical coding, Billing,

Claims Processing, Transcription etc.

6.1 GROWTH OF THE MEDICAL TOURISM INDUSTRY

The countries where medical tourism is being actively promoted include

Greece, South Africa, Jordan, India, Malaysia, Philippines and Singapore.

India is a recent entrant into medical tourism. According to a study by

McKinsey and the Confederation of Indian Industry, medical tourism in

India could become a $1 billion business by 2012. The report predicts that:

20

“By 2012, if medical tourism were to reach 25 per cent of revenues of

private up-market players, up to Rs 10,000 crore will be added to the

revenues of these players”. The Indian government predicts that India’s $17-

billion-a-year health-care industry could grow 13 per cent in each of the next

six years, boosted by medical tourism, which industry watchers say is

growing at 30 per cent annually.

In India, the Apollo group alone has so far treated 95,000 international

patients, many of whom are of Indian origin. Apollo has been a forerunner in

medical tourism in India and attracts patients from Southeast Asia, Africa,

and the Middle East. The group has tied up with hospitals in Mauritius,

Tanzania, Bangladesh and Yemen besides running a hospital in Sri Lanka,

and managing a hospital in Dubai.

Another corporate group running a chain of hospitals, Escorts, claims it has

doubled its number of overseas patients - from 675 in 2000 to nearly 1,200

this year. Recently, the Ruby Hospital in Kolkata signed a contract with the

British insurance company, BUPA. The management hopes to get British

patients from the queue in the National Health Services soon. Some

estimates say that foreigners account for 10 to 12 per cent of all patients in

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top Mumbai hospitals despite roadblocks like poor aviation connectivity,

poor road infrastructure and absence of uniform quality standards.

Analysts say that as many as 150,000 medical tourists came to India last

year. However, the current market for medical tourism in India is mainly

limited to patients from the Middle East and South Asian economies. Some

claim that the industry would flourish even without Western medical

tourists. Afro-Asian people spend as much as $20 billion a year on health

care outside their countries – Nigerians alone spend an estimated $1 billion a

year. Most of this money would be spent in Europe and America, but it is

hoped that this would now be increasingly directed to developing countries

with advanced facilities.

Contribution to GNP

According to the World Travel and Tourism Council, India' s travel

and tourism (T&T) industry is expected to contribute 2.1 percent to

Gross Domestic Product in 2006 (INR 713.8 billion or US$16.3

billion).

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In the first half of the Annual Plan period of 2005-2006, the Ministry

of Tourism has taken several initiatives in the field of infrastructure

development and positioning Indian tourism as a major engine for

economic growth. These include:

Emphasis for developing the existing and new destinations to

world-class standards.

Improvement of connectivity to important destinations.

Identification of 10-15 new destinations / circuits by each state /

UT for development to world class standard with all the required

infrastructure components.

Benefits of Medical Tourism

Tangible

Foreign exchange earrings which enable economic wealth of nation

·        Cost Advantage in Tariff over the Developed countries

·        Improve information sharing

·        Increase in efficiency of patient care process, cutting edge treatment.

·        Improvement in hospital supply chain efficiency

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·        Strategic alliances with business partners within and outside the

country

·        Technology and Knowledge Transfer

·        Better logistics performance both in internal and external

·        Creation of employment opportunities in the industry

·        Better utilization of Infrastructure and skilled manpower

·        Opportunity for development in Infrastructure in Health, Tourism and

Travel.

·        Economies of scale.

·        Connectivity with air, road, rail and information and communication

industries

·        Clustering of medical Travelers

·        Health opportunities for foreign patients may lead to better standards

at home.

·        Scope for Research and Development to offer comprehensive medical

solutions.

Intangible

·        International acceptance of country as a global healthcare provider

·        Social and cross cultural experience

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·        International customer relations

·        Global Marketing and Medical Trade relations

·        Brand image of nation as world-class healthcare destination.

·         Competitive advantage

·        Better coordination among the partners i.e. hospital and hospitality

industry.

·        Public and Private Partnerships

·        Patient satisfaction

Is India prepared for global medical tourism boom?

In recent years, India is being seen as an important player in the globally

growing "Medical Tourism", which is projected as a new segment in travel

and healthcare business. "Global health destination" .

In simple words, medical tourism provides state-of-the-art private medical

care in collaboration with tourism industry to patients from other countries at

highly competitive price when compared to those prevalent in the western

countries. The CII- McKinsey report mentions that the medical tourism

market has been growing at the rate of 15 per cent for past five years and by

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2012, Rs 10,000 crore will be added to revenues of the private players.

Globally, medical tourism is said to be USD 40 billion industry and analysis

available project that people from Afro-Asian countries spend as much as

USD 20 billion every year on healthcare services from outside their

countries.

Foremost, amongst the current private players, in medical tourism are

hospitals in the Apollo chain. Main destinations are Delhi, Mumbai,

Chennai, Bangalore and Hyderabad. These cities have private hospitals with

medical expertise that can offer world class healthcare that costs one fifth to

one tenth of the cost in US or Europe depending on the intervention

required.

In addition to above destinations, the country has many cities with advanced

medical facilities making India, a country with tremendous potential to

capitalise on to increase its earnings to more than USD 1 billion annually

and create hundreds of thousands new jobs in many sectors. This projection

excludes earnings from other products included in the wellness tourism

meant for rejuvenation of body and mind, eg herbal therapy, naturopathy,

yoga, aromatherapy, reiki, music therapy which does not require advanced

medical expertise.

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The apprehensions expressed by some sections that "systematic development

of medical tourism will boost up earnings by catering to the wealthy

foreigners and Indians working in the foreign countries but it may adversely

hit the low income population" need to be addressed for gaining approval of

political opinions with varied views on liberalisation. From past ten years,

India has entered a phase in medical expertise that is considered on par with

international standards. This is because of high quality doctors and medical

entrepreneurs who developed hospitals with required infrastructure and

management style. Some of these hospitals have marketing departments to

increase visibility and acceptance of their products in some countries.

Medical Tourism in India – The Current Scenario

Medical Tourism is poised to be the next Indian success story after

Information

Technology. According to a Mckinsey-CII study the industry’s earning

potential

estimated at Rs.5000-10000 Crores by 2012. Worldwide, healthcare is said

to be a $3-trillion industry, and India is in a position to tap the top-end

segment by highlighting its facilities and services, and exploiting the brand

equity of leading Indian healthcare professionals across the globe.

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    “Medical Tourism", the term refers to the increasing tendency among

people from the UK, the USA and many other third world countries, where

medical services are either very expensive or not available, to leave their

countries in search for more affordable health options, often packaged with

tourist attractions.

    Tourism is an integral part of many economies’ services industry and is an

important source of foreign exchange. The labour-intensive nature of the

tourism industry also makes it an excellent generator of employment. In

2002, the travel-and-tourism industry is expected to generate some US$3.3

trillion of GDP and almost 200 million jobs across the world economy.

Approximately one third of this would come directly from the industry itself

and the remainder from the strong linkages to other related sectors such as

entertainment, retail and construction.

Medical Tourism is perceived as one of the fastest growing segments in

marketing ‘Destination India’ today. The equation is ‘ World Class

Healthcare ’ at 'Economical Price '. Stable economic growth will create an

increase in freight flows from, towards, through, and inside the country. All

28

this will stimulate the investments in roads and railroads. As globalization

advances, both domestic and international tourism pose new and

unprecedented challenges to the health sector and its various partners. The

size of the Medical Tourism industry stands between Rs 1200 Crore to Rs

1500 Crore and is    growing at rate of 30 percent annually.

More importantly, Medical Tourism is growing rapidly and turning out to be

an immense business opportunity for nations that are positioning themselves

correctly. Last year, just five countries in Asia – Thailand, Malaysia, Jordan,

Singapore and India- pulled in over 1.3 million medical travelers and earned

over $1billion (in treatment costs alone). In each of these nations, medical

travel spends are growing at 20% plus year-on-year. Elsewhere around the

world, Hong Kong, Lithuania and South Africa are emerging as big

medical/healthcare destinations. And a dozen other nations including Croatia

and Greece plan to make themselves attractive healthcare destinations.

Five years ago, hardly 10000 foreign patients visited India for medical

treatment.

Today India is a key player in medical tourism with 100,000 foreign patients

coming in every year and revenue of Rs.1500 Crores. The current market

29

growth-rate is around 30% per year and the country is inching closer to

major

players like Singapore and Thailand.

The following sections discuss in detail the

current state of the Medical Tourism in India:

India’s Medical Infrastructure

15000 Hospitals

875000 Hospital Beds

500000 Doctors

737000 Nurses

170 Medical Colleges

350000 Pharmacies

3.6 Health Tourism In India – Advantages and Opportunities

30

 •The inflow of health tourists from the West, especially the UK, US and

some of the European countries has been on  the rise for the last couple of

years. Price difference or affordability of the treatment, coupled        with    

quality of doctors are the main reasons for the growing western traffic .

• The quality of Indian hospitals has improved significantly and now

matches with the best in any part of the world. India has more than 100

healthcare institutions, which are of international  standard.

• Many hospitals in India today have the infrastructure and equipment that

match with the best centers in the world, be it

transplantations(liver/kidney/heart or bone marrow), cancer treatment,

including radiotherapy, neurosurgery, including         sterotactic surgery.,

angioplasty and cardiac surgery(bypass and paediatric)

• Public-Private Partnership combines internal hospital expertise with supply

chain and logistics expertise.

• The medical tourism industry which is estimated to be worth Rs 1500

crores annually has not only the         potential to generate substantial forex

31

earnings but also provide employment opportunities for the large       pool of

skilled labor available in India,    according to Dr. PC Reddy, chairman,

Apollo Hospitals Group,          India.

• According to Group President Pratap C.Reddy, the annual health bill of

people from Afro-Asian countries seeking treatment      outside their country

is $10 billion. If India can tap even a fraction of that market, the potential is

enormous.

Joint Commission Accreditation of Healthcare Organizations (JCAHO)

India - Strategic Thrusts for the Future

The following section lays down the strategy for India to achieve leadership

position in medical tourism. The strategy largely draws from the discussions

in

previous section.

5.1 Role of Government

The role of Indian Government for success in medical tourism is two-fold:

Acting as a Regulator to institute a uniform grading and accreditation

32

system for hospitals to build consumers’ trust.

Acting as a Facilitator for encouraging private investment in medical

infrastructure and policy-making for improving medical tourism.

For facilitating investment the policy recommendations include:

1. Recognize healthcare as an infrastructure sector, and extend the benefits

under sec 80-IA of the IT Act. Benefits include tax holidays for five years

and concessional taxation for subsequent five years.

2. The government should actively promote FDI in healthcare sector.

3. Conducive fiscal policies - providing low interest rate loans, reducing

import/excise duty for medical equipment

4. Facilitating clearances and certification like medical registration number,

anti-pollution certificate etc.

The above measures will kick-start hospital financing, which is struggling

now

due to capital intensive and low efficiency nature of healthcare business.

For facilitating tourism the government should:

1. Reduce hassles in visa process and institute visa-on-arrival for patients

2. Follow an Open-Sky policy to increase inflow of flights into India

3. Create Medical Attachés to Indian embassies that promote health services

33

to prospective Indian visitors

Formation of National Association of Health Tourism (NHAT)

The promotion of medical tourism has so far been very fragmented with

initiatives

by few states and private hospitals. The earlier discussions clearly underline

the

need for presence of an apex body that can coordinate the promotion of

medical

tourism abroad. In the Indian context too, this has been successfully

demonstrated in the software industry by NASSCOM. It is therefore

essential to

form an apex body for health tourism – NAHT. The NAHT should be

formed as

an association of the private hospitals operating in the industry. The main

agenda

for NAHT will be:

1. Building the India Brand Abroad: Classify the target consumer segments

based on their attractiveness and position the India Brand based on the three

34

main value propositions – high quality service, value for money and

destination diversity. An integrated marketing Communications campaign

using print, media and road shows should be developed.

2. Promoting Inter-Sectoral Coordination: The NAHT should take up the

responsibility of aligning the activities of various players – Tourism

Department, Transport Operators, Hotel Associations, Escorts personnel etc.

3. Information Dissemination using Technology: NAHT should set up a

portal on medical tourism in India targeted at sharing information and

enabling online transactions.

4. Standardization of Services: NAHT should also focus on establishing

price

parity for similar kinds of treatments in various hospitals and ensure the

hospitals adhere to high hygiene and quality standards.

Role of Private Sector

The action items for private sector are:

1. Increased participation in building infrastructure: To achieve its full

35

potential, it is estimated that India needs an investment of Rs.100000 to

140000 Crores by 2012. Since the government can afford only a third of the

amount, the private sector should play an active role to fill the gap.

2. Integrate Horizontally: Private hospitals should also plan to integrate

horizontally for providing end-to-end healthcare solutions to consumers. For

example Apollo multi specialty hospitals is already planning to set up spas

and alternative mediclinics to attract more foreign tourists.

3. Joint Ventures / Alliances: To counter increasing competition, Indian

hospitals should tie-up with foreign institutions for assured supply of

medical

tourists. Specifically tie-ups with capacity constrained hospitals and

insurance

providers will provide significant competitive advantage.

5.4 Value Innovation Through MEDICITIES

Another successful example of the software industry is the establishment of

Export Oriented Software Technology Parks. This model can be successfully

replicated in the medical tourism industry by means of MEDICITIES. Each

36

MEDICITY could be a self-sustained healthcare hub with super specialty

hospitals of international standards, ancillary facilities, research institutions,

health resort, rehabilitation centers and residential apartments. This model

can

be floated through a public-private partnership. The government will provide

land

and ancillary services and the private players will provide infrastructure and

services. From the consumer’s point of view, the MEDICITIES will offer

superior

value at affordable prices. From industry’s point of view, this will offer

significant

competitive advantage for India.

37

The cartoon strip adds sarcasm to the upcoming

medical tourism in India.

38

CHAPTER 3

OBJECTIVE

To study the feasibility of Medical Tourism in Delhi and NCR.

SUB OBJECTIVE

To compare the performance of four hospitals in the region in

selected operations on the basis of following

i. Cost

ii. Value added services

iii. Popular operations

iv. Promotional activities

v. Approachability

To Analyze trends Indian medical and healthcare Industry.

39

RESERCH METHDOLOGY

RESERCH DESIGN

The research will be qualitative in nature as a lot of data is required to back

the conclusion of the report.

DATA COLLECTION SOURCES-

This study proposes to collect data from

the Primary as well as the Secondary Sources.

PRIMARY DATA

Data collection tools like questionnaires have been used and also personal

interview with the executives and surgeons of hospital like

Apollo,Fortis,Escorts,Max Hospital were conducted to get detailed

information. Interaction with foreign tourist also helped in quantifying

various services provided by the Hospitals and the Indian Tourism Board.

SECONDARY DATA

40

Various sources like internet, Medical Journals, Magazines, Newspapers

have been used to collect Secondary data.

SAMPLE SIZE

The sample size taken for the study is four hospitals which have been

chosen selectively namely

FORTIS

APOLLO

MAX HEALTHCARE

ESCORTS

LIMITATIONS OF THE STUDY

The study was restricted due to the following points

Denial to disclosure of exact statistical data by the concerned

authorities.

Also one of the most renowned hospital in India AIIMS denied to

disclose any figures about medical tourism .

Overall selection of 4 – 6 operations restricted the study.

Locating less number of foreigner medical tourist around.

Foreign tourist not in a state to interact as they come to India for

major operations.

41

Lack of availability of empirical data on internet and medical

journals.

PARAMETERS AND CRITERIA FOR THE VIABILITY OF THE

PROJECT

The above mentioned hospitals were evaluated on the basis of following

operations and surgeries namely

HEART SURGERY(Intervention cardiology

KIDNEY TRANSPLANT

LIVER TRANSPLANT

ORTHOPEDIC SURGERY(Knee replacement)

PLASTIES

NEURO SURGERY

OTHER FACTORS

Cost and value added offerings.

After care amenities.

Promotional activities done by the hospitals.

Packages offered by hospitals

42

Foreigners visiting there hospital.

CHAPTER 4

MARKET VIABILITY OF INDIAN HEALTHCARE INDUSTRY

The Indian consumers can be assessed or segmented as per the following

parameters..

Market Segmentation

A market is composed of different users having different responses to

market offerings. This makes it essential that hospital organizations,

especially for making a microscopic study of users’ needs and requirement,

make possible grouping of markets. The marketing strategy formulated on

the basis for segmenting the market is income. To some extent regional

considerations may also be adopted as a base for segmenting the market. The

below is the segmentation on the basis of regional consideration:

43

The aforesaid segmentation makes it clear that doctors would find a

variation in the living habits of both the segments.

Another important base for segmenting hospital services may be income

group. This helps hospital organisations in identifying the status of the users

of services. It is essential as the marketing principles recommend different

pricing strategies on the basis of level of income.

44

Regional Segmentation

Urban UsersRural Users

Educated Illiterate Poor Rich

Educated Illiterate Poor Rich

Segment

High -IncomeMiddle- IncomeLow - IncomeNo- Income

This would help hospital organisations in charging more from high and

middle income groups, charging equal to cost from the low income group

and making available free services to the no – income group. Another

important advantage of this segmentation is concerned with implementation

of modernization and expansion plan for the hospitals.

THE MARKETING MIX OF INDIAN MEDICAL TOURISM

PRODUCT-

Some of the exclusive medical packages offered by the Indian

medical tourism are in the folowing treatments

MEDICAL PACKAGES

HEART PACKAGES

CARDIAC SURGERY AND CARDIOLOGY

ANGIOPLASTY

ANGIOGRAPHY

CARDIOLOGY ROBOTIC SURGERY

OPEN HEART SURGERY

PAEDIATRIC INTERVENTION

ORTHOPAEDIC SURGERIES

JOINT KNEE REPLACEMENT(UNILATERAL AND BILATERAL

NEURO SURGERY

PARKINSONS

EPILEPSY

ESSENTIAL TREMORS

MALIGNANT TUMORS

CARDIOLOGY

45

ECG

DOPPLER TEST

TEE

BEATING HEART SURGERY

VALVE SURGERY

STENTING

PERIPHERAL VASCULAR SURGERY

CONGENITIAL HEART DISEASE

NEPHROLOGY

DIALYSIS

HAEMODIALYSIS

SLOW CONTINOUS ULTRAFICATION

PLASMAPHERISIS

DENTAL CARE PACKAGES

UROLOGY

COSMETIC TREATMENT ETC

PRICE

The price range offered by the Indian medical industry are

unbelievable because india offers the most reasonable prices..

India is not only cheaper but the waiting time is almost nil. This is due to

the outburst of the private sector which comprises of hospitals and clinics

with the latest technology and best practitioners.

46

Procedure Charges in India & USA –

Procedure United States (USD) Approx

India (USD) Approx

Bone Marrow Transplant

USD 2,50,000

USD 69,200

Liver Transplant USD 3,00,000

USD 69,350

Heart Surgery USD 30,000 USD 8,700

Orthopedic Surgery

USD 20,000 USD 6,300

Cataract Surgery USD 2,000 USD 1,350

Smile Designing USD 8,000 USD 1,100

Metal Free Bridge

USD 5,500 USD 600

Dental Implants USD 3,500 USD 900

47

Porcelain Metal Bridge

USD 3,000 USD 600

Porcelain Metal Crown

USD 1,000 USD 100

Tooth Impactions

USD 2,000 USD 125

Root Canal Treatment

USD 1,000 USD 110

Tooth Whitening

USD 800 USD 125

Tooth Colored Composite

USD 500 USD 30

Fillings / Tooth Cleaning

USD 300 USD 90

INDIA V/S UK

Significant cost differences exist between U.K. and India when it comes to

48

medical treatment. Accompanied with the cost are waiting times which exist

in U.K. for patients which range from 3 months to over months.

Procedure  

United Kingdom (USD) Approx

India (USD) Approx  

Open Heart Surgery  

USD 18,000   USD 4,800  

Cranio-Facial surgery and skull base  

USD 13,000   USD 4,500  

Neuro- surgery with Hypothermia

USD 21,000   USD 6,800  

Complex spine surgery with implants

USD 13,000 USD 4,600

Simple Spine Surgery

USD 6,500 USD 2,300

Simple Brain Tumor -Biopsy -Surgery

  USD 4,300 USD 10,000

  USD1,200 USD 4,600

Parkinsons -         Lesion-         DBS

  USD 6,500 USD 26,000

  USD 2,300 USD 17,800

Hip Replacement USD 13,000 USD 4,500

PLACE

All the hi tech hospitals like Apollo, escorts, max hospitals are located in all

the metro cities of the country and they are targeting the tier 2 cities due to

the extreme market potential. Indian healthcare industry is the second in the

country as its growing by leaps and bounds so the Indian hospital industry is

getting organized.

49

PROMOTION

First and foremost it suggests that medical expertise in India

is at par with the developed world although the infrastructure to support it is

sadly lacking. This is the fact experienced by almost all Indian doctors who

come to seek work in the Western World.

PROMOTIONAL ACTIVITIES TO PROMOTE MEDICAL TOURISM

CME ( Continuous medical education for doctors)

Patient Education Progress

Free health Checkup camps.

Tie ups with various hospitals and insurance companies abroad.

Participation in Health Expo’s abroad.

Tie ups Embassies.

AD campaigns.

Nodal centers in other countries.

Reduction of Excise duty from 17% to 8% on all goods produced in

the pharmaceutical sector as per the Budget 2008-2009.

DEMAND FORECAST-

50

Increasing globalization with reduction of travel times combined with added tourist attractions puts India in a good position to promote Health Tourism.

India’s population crossed one billion in 1999 and is projected to exceed 1.5 billion in 2050. The infant mortality rate though having decreased from 225-250 in the 1940’s to 72 in 1997, is still high. Mortality from Tuberculosis and Acquired Immune Defeciency Syndrome are major problems.(3) There is always the chance of the poor being exploited by unscrupulous element’s for purposes such as organ transplantation though trade in organs is illegal in India.(4)

The CII-McKinsey report suggests that medical tourism could fetch as much as $2 billion by 2012, compared to an estimated $333 million currently.

Reference:

.Mudur G. Hospitals in India woo foreign patients. BMJ 2004; 328:1338.

HEALTHCARE INFRASTRUCTURE

India needs at least 750,000 extra beds to meet the demand for

inpatient treatment by 2012- opportunity in tertiary healthcare

facilities.

India needs at least 1 million more qualified nurses and 500,000 more

doctors by 2012 as compared to existing number.- opportunity in

medical education.

To raise this infrastructure, total additional investment to the tune of

US$ 25-30 billion is needed by 2012.

Government and international agencies will only be able to gear up

US$ 7 billion and the rest of investment has to come from private

sector.

51

FACTORS ENHANCING MEDICAL TOURISM IN

INDIA

Cost Competitiveness – The Key driver

The main reason for India’s emergence as a preferred destination is the

inherent

advantage of its healthcare industry. Today Indian healthcare is perceived to

be

on par with global standards. Some of the top Indian hospitals and doctors

have

strong international reputation. But the most important factor that drives

medical

tourism to India is its low cost advantage. Majority of foreign patients visit

India

primarily to avail of “First World Service at Third World Cost”.

52

Source: Business World India and Indian Brand Equity Foundation

As the table above shows, India has significant cost advantages in several

health

procedures making it a preferred destination

3.2 The Service Spectrum

India offers a variety of services for overseas patients. The table below

presents

a classification of the service spectrum.

53

3.3 Consumer Profile

The demand for Indian healthcare services primarily comes from three types

of

consumers. The table below presents the profile of these three consumer

groups:

54

Though tourism is not the primary need of these consumers, it offers

additional

attraction particularly for people traveling for cosmetic surgery and less

complicated procedures.

55

CHAPTER 4

HISTORY OF HOSPITALS

APOLLO HOSPITAL

Apollo Hospitals Group is the acknowledged leader in bringing super

speciality world-class healthcare to India. It is presently the largest

integrated healthcare company in Asia and the first to attract foreign

investment .

Indraprastha Apollo Hospitals is spread over 12 acres of land and has a

built-up area of 600,000 square feet. A joint venture between the Apollo

Hospitals Group and the Government of Delhi, it was founded in 1996. It

is the largest hospital of the group and was built at a cost of 44 million US

dollars.

With a bed-capacity of 560 (including 140 ICU beds and 44 HDU beds)

and 14 Operation Theatres, expert medical professionals and the latest

technology, the Indraprastha Apollo Hospitals is the automatic choice for

outstanding healthcare in the country’s capital.

The hospital handles close to 200,000 patients a year, of which 12,000 are

international patients. International patients come to Indraprastha Apollo

from the USA, UK, Europe, Middle East, Australia, Yemen, Africa and

56

CIS countries, among other countries.

Indraprastha Apollo Hospitals was the first Indian hospital to be awarded

the gold-standard certification from the Joint Commission International

(JCI) USA .

Highlights

The first Indian hospital to receive the Joint Commission International

(JCI)

USA accreditation the gold-standard in hospital certifications

worldwide

First successful liver-kidney transplant in the Indian sub-continent

Grade A by CRISIL

Rated Best Multi-speciality Private Hospital in Delhi by The Week

magazine

BS EN ISO 14001: 1996 for Environmental Management System

BS EN ISO 9001: 2000 for Quality Management System

Medical Milestones

Performed 1,24,908 Preventive Health Checks

Performed 836 kidney transplants

Performed 90 liver transplants

Performed the first successful liver transplant in the Indian sub-

continent

Centres of Excellence

57

The Centres of Excellence at the hospital are:

Cardiology

Neurosciences

Oncology

Orthopedics

Pediatrics

Organ Transplants

Minimal Access Surgery

FORTIS

One of India's leading tertiary level healthcare groups, Fortis Healthcare comprises a network of 13 hospitals with a bed capacity of 1803 beds and 13 Heart Command Centres. Following the acquisition of the renowned Escorts Healthcare System, Fortis Healthcare operates one of the world's largest Cardiac programmes. The group's Fortis Hospital at Noida, next-door to Delhi, is India's foremost tertiary care facility in Orthopaedics and Neuro Sciences. The group also performs cutting edge surgeries in various specialities ranging from cosmetology, woman & child health, ophthalmology, dental, ENT, urology, and minimal invasive surgery. Our facilities ensure that there is genuine Medical Value in health travel to India.

The Medical Value that we bring to our services is because the Fortis Healthcare team of expert doctors, mostly western trained, is supported by highly skilled nursing professionals, technicians,and aided by state-of-the-art medical equipment at their command.

58

At Fortis Healthcare, we recognize that international patients have special needs and requirements and desire real medical value when they travel to India. To provide a highly specialized and dedicated service, we have created the Fortis Healthcare international Patients Service Centre at New Delhi, India.

Various medical specialties offered to our International patients are:

← Cardiology ← Cardio Thoracic & Vascular Surgery ← Orthopaedics ← Orthopaedic Surgery (Total Hip/Knee

Replacements, Joint Replacements) ← Plastic Surgery ← Cosmetic Surgery ← Bariatric Surgery (Gastric By Pass Surgery, Gastric Banding etc) ← Gynaecology & Obstetrics ← General Sugery ← Minimal Invasive Surgery ← Neurology & Neuro Surgery ← Nephrology (Dialysis) ← Paediatrics & Paediatric Surgery ← Pulmonology ← Renal Sciences (Renal Transplantation) ← ENT ← Opthalmology (Eye) ← Psychiatry

For you, this means a menu of seamless services that will make your treatment and trip hassle-free, i.e. from greeting you at the airport, to your registration & discharge, and even organizing the ground handling of any post-treatment travel.

After all, taking care of guests is an ageless Indian tradition.

SPECIAL SERVICES(VALUE ADDED SERVICES)

59

Doctor care coordination Before and after Airport transfer Service.

Flight Arrangements & Extensions / Visa Assistance.

Coordination of the admissions process.

Cost estimates for anticipated treatment.

Booking of Hotel/Service Apartments.

Special dietary needs / religious arrangements.

Providing news & information of patient's relatives back home.

Remote Consultations via Telemedicine.

Remote Consultations via Telemedicine.

Financial Services.

MAX HOSPITAL

Overview - Max Healthcare - caring for you…for life

Max Healthcare is India's first truly integrated healthcare system, offering

60

three levels of clinical service (Primary, Secondary, Tertiary) within one system.

We believe in the concept of total patient care and deliver care by combining medical and service excellence.

Max Healthcare is committed to quality care that not only addresses the illness but also concentrates on the overall wellness of the patients

Salient Features

A team of highly qualified and trained doctors, nurses and patient care personnel to provide the highest standards of care

Latest medical equipment and hospital information system Medical collaboration with Singapore General Hospital in areas of

medical practices, research and training Over 400 leading doctors, 280 corporate clients and a patient base in

excess of 5,80,000 Clean and comfortable facilities at all locations Fully computerised health records 24 hour- Chemist, Ambulance, Patient Diagnostic and Emergency

Services Regular educational and health camps to help educate patients on

various health issues, so that they make informed choices Max Happy Family Plan- Annual Health Plans covering domiciliary

medical needs A complete preventive healthcare programme - MAX 360° 24 Hour Emergency

Comprehensive Healthcare System

Max Healthcare model visualizes setting up of a world-class healthcare model offering the best medical assistance delivered seamlessly through state-of-the-art medical facilities.

61

NO SPECIAL SERVICES FOR INTERNATIONAL PATIENTS, ALL THE PATIENTS ARE SAME FOR THEM.

ESCORTS

Welcome to the comforting world of Escorts Heart Institute and Research Centre, where the medical treatment is truly world-class and our approach towards our patient is warm and sensitive. We Assure, that you are in trusted hands and your journey, will be a pleasant one.

Escorts Heart Institute & Research Centre (EHIRC), was born to bring to India the best cardiac care and systems, training of cardiac surgeons and cardiologists and to conduct research as per International standards. It has completed 20 years of excellence in providing highest standards of cardiac care in India. .

Centres of Excellence

Cardiac Bypass Surgery Minimally Invasive Surgery (Robotics) Interventional Cardiology Non-invasive Cardiology Pediatric Cardiology

Medical Highlights

20 years of Cardiac Care

62

Hospital has 332 Beds, 9 Operation Theatres, 5 Cath Labs, 3 Heart Command Centres, 2 Heart Stations

Done Over 114,700 Angiographies Over 27,000 Angioplasties Completed Over 65,000 Cardiac Surgical Procedures Success rate of Cardiac Procedures is 99.6% Infection Rate of less than 0.3%

The Infrastructure of Excellence

Escorts Heart Institute is equipped with modern facilities, equipment and systems like:

Operation Theatres (OTs) with Laminar air flow that eliminates the chances of infection

Intensive Care Units (ICUs), under the charge of critical care specialist that has a ratio of one nurse for every ICU patient

High-tech systems for Imaging, Radiology and Pathology Testing Sophisticated Information Technology systems at Escorts Hospital

enable better efficiency and greater patient convenience Convenient support facilities such as: ATMs, Cafeterias, Round the

clock Pharmacy

International Patient Care

Patient safety is our top priority, Escorts recognizes that international patients have special needs and requirements. Escorts offers seamless patient services of world-class quality. From the warmth of our greeting at the airport, to your registration and discharge, we strive to deliver unparallel services to aid you.

All services are provided to International patients through a single window assistance cell, from arrival till departure. The activities related to this important area of our business are:

1. Visa Assistance

Coordination and Liaising with Foreign Offices.

2. Medical Needs

63

Arranging meeting on priority with the concerned Consultant. Arranging any specific medical needs, while traveling to New Delhi. Smooth discharge procedure under single window. Medical certificates/reports. Follow up visits/tests/reports.

3. Lodging/Boarding Arrangements

Lodging the patient/attendant in EHIRC/Hotel/Guest House. Diet requirement as per patient needs. Regular supervision of all lodging facilities.

4. Information Needs

EHIRC Brochures/Information. Delhi City Map /City Guide. Providing news & information of patient to their relatives, back home.

5. Value Added Services

Dedicated Patient care coordinators to assist Patient/Attendant. Travel/ticketing arrangements for patients and relatives. Receive the patient from Airport - Car/Ambulance. Arranging sight seeing / shopping / prayer. Local travel needs for patient's relatives. Prepaid Cell phone Card. Interpreters. Internet. Comprehensive Health Check Ups. Foreign Exchange. All finance related matters under single window.

6. Our insurance partnerships

BUPA International AETNA CIGNA International SOS Vanbreda International GMC Services

64

CHAPTER 5

ANALYSIS AND INTREPRETATION

As per the data collected from the four hospitals

GRAPH1

65

GRAPH 2

Apollo-3000Fortis-36Escorts-240Max hospital-1000Total international patients coming to India-4276

66

PREFFERED SURGERIES BY INTERNATIONAL TOURIST

40%

8%

15%

32%

5%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

TYPES OF SURGERIES

PE

RC

EN

TA

GE

VA

LU

E

Heart surgery-

Neuro surgery-

Orthopedicsurgery-

Nephro surgeries-

Liver transplant-

Heart surgery- 40%

Neuro surgery- 8%

Orthopedic surgery-15

Nephro surgeries-32%

Liver transplant-5%

GRAPH 3

67

PROMOTIONAL ACTIVITIES DONE BY HOSPITALS TO ENHANCE MEDICAL TOURISM

Escorts Heart Institute & Research Centre Ltd,

ESTIMATES

* Excludes investment in bed capacity to avoid double count with investment in secondary/tertiary beds

13-20

7-9 0.5-0.70.5-0.7 0.5-1

22-30

Medical equipment could account for 20-30% of investment in Beds (Rs.20,000 to40,000 crore)

Investmentin secondary beds

Investmentin tertiary beds

Investmentin medical colleges*

Investmentin nursing schools

Investmentfor other health professionals(e.g., pharmacists,technicians,administrators)

Total investment required

(Source: CII-McKinsey & Company Report 2005)

Investment required to bridge the gap in next 10 years

68

INDRAPRASTHA APOLLO

ESCORTS HOSPITAL

FORTIS HOSPITAL

MAX HOSPITAL

Attending World Travel Marts and World Medical Fairs.

Tie ups with various agencies abroad involved in medical tourism. Participation in Health Expos in UK. Ad campaign for India.

Conduct CME(continuous Medical Education for doctors), Free health checkups for doctors, On campus patient education programmes,Ad campaign Dhakan on TV.

Tie up with most of the embassies ,free cardiac camps in various countries, CME, Nodal centers in UK,US etc. Hospitals in gulf countries, Tie ups with most of the insurance companies.

GRAPH 4

69

GRAPH 5

70

GRAPH 6

Beds Physicians Nurses

Per ’000 population, 2006*

Per ’000 population, 2006*

Per ’000 population, 2006*

1.5

1.5

4.3

7.4

India

Other low income countries (e.g., sub-Saharan Africa)

Middle income countries (e.g., China, Brazil Thailand, South Africa, Korea)

High income countries (e.g., US, Western Europe, Japan)

1.2***

0.5**

World average 3.3 1.5 3.3

0.9

1.6

1.9

7.5

Comparison - India Vs other countries

71

6.7

6.5

5.7

5.2

2.7

Korea

Brazil

Thailand

India

China

Per cent, 2006*

720

453

349

143

94

Korea

Brazil

Thailand

China

India

US$, PPP, 2006*

Healthcare spend as % of GDP Healthcare spend per capita

* Most recent data available has been used (2001-2006)

Comparison India Vs other countries

72

FINDINGS

After the analysis and interpretation of the data we can figure out the

following

Graph 1( Total international patients coming to India)

We can witness that majority of the international patient

Prefer Indraprastha Apollo at the first place followed by Max hospital,

Escorts and only a minority of them prefer Fortis

GRAPH2 (Preferred surgeries by international tourists)

It very clearly depicts that majority of the tourist consider India (Delhi)

as a destination for heart surgery followed by Nephro surgeries(kidney

related problems) then orthopedic, Neuro and only a fraction of them

come for kidney transplants.

GRAPH 3( Investment required to bridge the gap in next 10 years )

The graph clearly states that if proper investment will be made then India will be at the top level in the healthcare industry. The graph shows in what ratios the investment should be done like on mediacal equipment could account for 20-30% of investment in beds.

73

GRAPH 4 ( Cost advantage and list of various medical services)

It tells us about the various services offered under the umbrella of Indian

medical tourism and also the price comparison of dental treatments and

surgeries in India and US for eg getting a Glass Ceramic Crown fitted in

India would cost 35-40% less in India than US.

GRAPH 5 ( Comparison - India Vs other countries)

This graph clearly shows the comparison of India with the other low, middle

and high level income countries in terms of beds, physicians and nurses with

the relation of per thousand populations in year 2006.

GRAPH 6 ( Comparison - India Vs other countries)

This graph clearly shows the comparison of India with the other

countries in terms of healthcare spend as percent of GDP and healthcare

spends per capita respectively in year 2006.

74

CONCLUSION

Medical Tourism in Delhi and NCR as per the study conducted is

booming and can be witnessed by the huge number of International

tourist visiting this region. Delhi and NCR is one of the worlds most

preferred region of the world in the case of medical tourism due to the

low cost of treatment, no waiting time, approachability, tourists spots

in delhi and nearby cities and other value added services. As the

Indian economy of growing so worlds best hospitals are coming to

India to encash the opportunity.

Another relevant topic that has been covered in the study is the

performance of four hospitals in the region and it can be concluded

that indraprastha Apollo is the market leader in attracting the

maximum no of international patients because of the brand name

Apollo and its presence in various other countries. Apollo is followed

by Max which is considered as a five star hospital caters to patients

falling in the high income bracket followed by Escorts and Fortis.

Also the trends in the Indian Healthcare has been studied and it can be

concluded that the healthcare industry has successfully managed to

maintain the interest and attention of not only the Indian government,

but also the common man.

The top Indian hospitals such as Apollo, Escorts, Max, etc, are

investing immense time, effort, manpower and money in their R&D.

75

As a matter of fact, several new innovative products have been

launched in the Indian market and have been patented. The Indian

consumer has ready access to new innovations in the field of health

and medicine. The companies are constantly acquiring latest

technology either through partnerships or developing them

indigenously. The government is fully supporting the cause of state of

the art infrastructure by providing support in setting up new hospitals

and financing them.

RECOMMENDATION

All the hospitals in the region should accentuate on

promotional activities at the global level so as to enhance the

awareness of medical proficiencies in India. Other government

hospitals should also try to meet international standards. The

government should pass an act according to which the fee structure of

various medical colleges should be reduced so as to facilitate and

motivate lower and middle class students. The government should

also come up with various medical colleges in different parts of the

country. This will help India to cope up with the increasing demand

of medical tourism locally and internationally.

Create cost-effective facilities

76

To deliver quality healthcare to a greater number of people, providers

must create and operate more cost-effective facilities. Optimizing

parameters such as area per bed and building cost per square foot can

reduce the initial cost of building a tertiary facility. In addition, operating

costs can be reduced through better purchasing and supply chain

management, as well as good management of patient flows and

utilization of expensive facilities and manpower.

An active industry association can play an important role in the

development of the sector

To boost the overall growth and development of healthcare in India, the

sector needs a vibrant industry association. This need can be met by the

Indian Healthcare Federation (IHF), which will have to present a united

face to key stakeholders such as the government, insurers, policy

institutions and industry players.

To be effective, the IHF will need a full-time team of professionals on board.

There are three immediate priorities for the federation: driving the creation

and adoption of quality and accreditation standards for healthcare

infrastructure and delivery; working with insurers to accelerate the

penetration of health insurance; and collaborating wit the government on

policy issues. In addition, the federation should increase awareness about

industry-level issues among industry participants.

77

CHAPTER 8

APPENDIX

BIBLIOGRAPHY

BOOKS

Author's last name, first name middle name; "Title of journal,” (year of

publication)

Davenport Karen, “Health Care Benefits”, (2007)

Daschle Tom, “Achieving Universal Health Coverage”, (2007)

Seshamani Meena, “Opportunity Costs and Opportunities Lost:

Businesses Speak Out About Health Care”, (2007)

CII and Mekinsey, “Healthcare In India – The Road Ahead”, (2006)

JOURNALS

Author's last name, first name middle name; "Title of journal,” issue

number: (year of publication)

Alvarez, David P.; “Connecting people to the promise of healtchare”,

No. 15 (2000)

78

Hautea, Dr. Randy A.; Krattiger, Dr. Anatole F. And Van Zanten, Ir.

Jasper E; “Healthcare costs comparisons”, No. 18 (2000)

WEBSITES

<URL>

http://en.wikipedia.org/wiki/Healthcare_in_India

http://www.nature.com/nm/journal/v9/n4/full/nm0403-377a.html

http://www.cbc.ca/news/background/healthcare/medicaltourism.html

http://timesofindia.indiatimes.com/More_options_for_health_insurance/articleshow/1982238.cms

http://www.who.int/mediacentre/factsheets/fs172/en/index.html

http://www.indiatogether.org/2007/jan/hlt-hltcare.htm

http://www.deloitte.com/dtt/whitepaper/0,1017,sid%253D34239%2526cid%253D71669,00.html

79

QUESTIONNAIRE

1) Name of the Hospital- ________________________________

2) Location- ____________________________________ ____________________________________ ____________________________________ ___________________________________

3) Person Concerned- __________________________________

4) Designation- ____________________________

5) No of Foreigners visiting their Hospital Every Year/ Month- ________

6) Medical Travelers Clusters Country Wise-a) ___________________________

80

b) ___________________________c) ___________________________d) ___________________________e) ____________________________f) _____________________________

7) Surgeries or Treatments they specifically come for-

Heart Surgery- Kidney Transplant- Liver Transplant- Bone Marrow Transplant- Orthopedic Surgery- Face lift- Any other-

8) Duration of their stay in India? ________________

9) Various Packages offered by the hospital-

10) Promotional Activities done by the Hospital to enhance Medical Tourism-

81

11) Value added offerings to an international patient compared to an domestic patient.

__________________________________________________________12)Provisions for aftercare follow-ups ?

___________________________________________________________

13)Payment modes

THANK YOU

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