How home healthcare can address gaps in current Indian healthcare system?

The importance of healthcare had never been realized as acutely as in recent times. Awareness about diagnosis, testing, vaccination, insurance, health promotion & disease prevention – all of it has grown by leaps and bounds. India is also currently charting its path to develop as a Global Healthcare hub, but delivering healthcare efficiently remains a key challenge here.

Hospital industry in India

The hospital industry in India is expected to reach US$ 132 billion by FY22 from US$ 61.8 billion in FY17 at a CAGR of 16–17 percent. The growth is fueled by rising income, better health awareness and increasing access to insurance. The Indian healthcare sector is much diversified and is full of opportunities in every segment, which includes providers, payers, and medical technology. Newer technologies and better facilities have also shown a promising trend in the Indian medical tourism sector, especially in 2019-20.Along with this, we should also take into consideration the substantial issues and gaps in the healthcare system.

With better healthcare facilities and public health measures, the average age of the population has increased. India’s geriatric population is expected to constitute 11% of the population by 2025. Bigger geriatric groups also need a better healthcare system for monitoring and support.The Indian healthcare delivery system can be divided into two major components – public and private. The Government, i.e., the public healthcare system, focuses on providing basic healthcare facilities in the form of primary healthcare centers (PHCs) in rural areas and comprises limited secondary and tertiary hospitals in cities.

The private sector provides the majority of the secondary, tertiary, and quaternary care institutions with a major concentration in metros, tier I and tier-II cities. As per WHO (World Health Organization), the number of hospital beds in India is just 5.5 per 10,000 in population which is substantially lower compared to other countries – 43 in China and 29 in the USA.

Burden on Hospitals

With the Family Physician concept waning in India, it is the specialists who people reach out to in case of any issue. Almost all middle and high-income groups prefer the quality infrastructure of private and corporate hospitals. This increases the burden on hospitals because, in addition to surgeries, ICU care and other medical interventions, the load of basic interventions is also borne by these hospitals. After the patient needs to move out of the hospital, there is a continued requirement of clinical interventions in most cases.

In contrast to India, other developed countries have many alternative healthcare facilities to provide long term support to patients after they have been discharged from the hospital but need help in transitioning from hospital to home such as – LTACHs (Long-term acute care facilities), SNF (Skilled Nursing facilities) and IRF (Inpatient Rehabilitation Facility). Hence, there is a pressing need for complementary pathways of healthcare delivery in India, to offer a standardized quality of care.

Out of hospital care

In the ongoing pandemic, it has been well established that a large number of common medical issues and interventions can be managed at home. There is also a clear recognition that certain clinical conditions can, and should, only be managed in hospitals. Therein lies the opportunity for a bridge in the care continuum.Common ailments can be treated at home by clinical consultations, investigations, nursing care or physiotherapy. Once a patient is out of the hospital, there are various levels of interventions required in a patient’s journey to recovery. Post-surgery patients will have a regular need for injections/infusions/wound dressings, etc. Chronically ill patients might have a need for regular catheterizations, Ryle’s tube care, stoma care or PICC line care. Physiotherapy at home is immensely helpful for post-surgery patients. Patients find it very convenient to have speech therapy and sleep studies done at home.

When these services are done as per the defined protocols, regular monitoring and in-consultation with the treating doctor, it leads to better outcomes for the patient.It is also possible to manage step-down intensive care at home through well-established clinical protocols and experienced nurses along with 24*7 remote monitoring by intensivists. This direct access to consumers at home, powered through technology, is most suitable for enabling quality care and monitoring.

Home healthcare

If quality clinical services can be provided at home, it is a win-win situation for both hospitals and the patients. We, at Nightingales, recognized the need for quality home healthcare services many years back, and so developed a comprehensive suite of specially designed services across the spectrum of rehabilitation, nursing and caregiving, and have delivered these services to over half a million patients.

Many hospitals have realized this need and have partnered with home healthcare providers like us for providing clinical care to their patients. Over the years, this has led to improved clinical outcomes and convenience for the patient.Home health care can suitably help address the gaps in the current Indian healthcare system. It is an alternative yet complementary delivery channel, to not only widen and deepen the reach and deliver a standardized quality of care but also reduce the cost of care — thus addressing all the challenges together.

The writer, Dr Sweta Choudhary, is Head at Medical Products and Services, Nightingales Home Health Services. The views expressed are personal

This article first appeared in CNB CTV 18 –

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