Healthcare Sector in India

Why in News?

Healthcare has become more focused on innovation and technology over the past two years and
80% of healthcare systems are aiming to increase their investment in digital healthcare
tools in the coming five years.

What is the Scenario of the Healthcare Sector in India?

 About:
o Healthcare industry comprises hospitals, medical devices, clinical trials,
outsourcing, telemedicine, medical tourism, health insurance and medical
equipment.
o India’s healthcare delivery system is categorised into two major components -
public and private.
 The government (public healthcare system), comprises limited secondary
and tertiary care institutions in key cities and focuses on providing basic
healthcare facilities in the form of Primary Healthcare Centres (PHCs)
in rural areas.
 The private sector provides a majority of secondary, tertiary, and
quaternary care institutions with major concentration in metros, tier-I
and tier-II cities.
 Market Statistics:
o The Indian healthcare sector is expected to record a three-fold rise, growing at a
CAGR (Compound Annual Growth Rate) of 22% between 2016–22 to reach
USD 372 billion in 2022 from USD 110 billion in 2016.
o In the Economic Survey of 2022, India’s public expenditure on healthcare stood
at 2.1% of GDP in 2021-22 against 1.8% in 2020-21 and 1.3% in 2019-20.
o In FY21, gross direct premium income underwritten by health insurance
companies grew 13.3% YoY to Rs. 58,572.46 crore (USD 7.9 billion).
o The Indian medical tourism market was valued at USD 2.89 billion in 2020 and
is expected to reach USD 13.42 billion by 2026.
o Telemedicine is also expected to reach USD 5.5 billion by 2025.

What are the Challenges with the Health Sector?

 Inadequate Access:
o Inadequate access to basic healthcare services such as shortage of medical
professionals, a lack of quality assurance, insufficient health spending, and, most
significantly, insufficient research funding.
o One of the major concerns is the administrations' insufficient financial
allocation.
 Low Budget:
 o India’s public expenditure on healthcare is only 2.1% of GDP in 2021-22 while
Japan, Canada and France spend about 10% of their GDP on public healthcare.
 Even neighbouring countries like Bangladesh and Pakistan have over
3% of their GDP going towards the public healthcare system.
 Lack of Preventive Care:
o Preventive care is undervalued in India, despite the fact that it has been shown
to be quite beneficial in alleviating a variety of difficulties for patients in terms of
unhappiness and financial losses.
 Lack of Medical Research:
o In India, R&D and cutting-edge technology-led new projects receive little
attention.
 Policymaking:
o Policymaking is undoubtedly crucial in providing effective and efficient
healthcare services. In India, the issue is one of supply rather than demand, and
policymaking can help.
 Shortage in Professionals:
o In India, there is a shortage of doctors, nurses, and other healthcare professionals.
o According to a study presented in Parliament by a minister, India is short
600,000 doctors.
 Paucity of Resources:
o Doctors work in extreme conditions ranging from overcrowded out-patient
departments, inadequate staff, medicines and infrastructure.

What is the Potential of the Indian Health Sector?

 India's competitive advantage lies in its large pool of well-trained medical

professionals. India is also cost competitive compared to its peers in Asia and western
countries. The cost of surgery in India is about one-tenth of that in the US or Western
Europe.
 India has all the essential ingredients for the exponential growth in this sector,
including a large population, a robust pharma and medical supply chain, 750 million
plus smartphone users, 3rd largest start-up pool globally with easy access to VC
(Venture Capital Fund) funding and innovative tech entrepreneurs looking to solve
global healthcare problems.
 India will have about 50 clusters for faster clinical testing of medical devices to boost
product development and innovation.
 The sector will be driven by life expectancy, shift in disease burden, changes in
preferences, growing middle class, increase in health insurance, medical support,
infrastructure development and policy support and incentives.
 As of 2021, the Indian healthcare sector is one of India’s largest employers as it
employs a total of 4.7 million people. The sector has generated 2.7 million additional
jobs in India between 2017-22 -- over 500,000 new jobs per year

What are the Initiatives for the Health Care Sector?

 National Health Mission

  Ayushman Bharat.
 Pradhan Mantri Jan Arogya Yojana (AB-PMJAY).
 National Medical Commission
 PM National Dialysis Programme.
 Janani Shishu Suraksha Karyakram (JSSK).
 Rashtriya Bal Swasthya Karyakram (RBSK).

Way Forward

 There is an urgent need to improve the infrastructure of public hospitals, which are
overburdened as a result of India's large population.
 The government should encourage private hospitals because they make a significant
contribution.
 Because the difficulties are severe and cannot be tackled just by the government, the
private sector must also engage.
 To improve the sector's capabilities and efficiency, more medical personnel must be
inducted.
 In order to connect the dots in the health system, technology must be used.
o Medical gadgets in hospitals and clinics, mobile health apps, wearables, and
sensors are only a few examples of technology that should be included in this
area.

The field of hospital administration encompasses both the technical aspects of the management
of healthcare delivery in hospitals and the social and public policy issues related to access to
care.
Hospital administration has emerged as a field with immense scope. Hospitals are havens of
hope for people suffering from pain and illness. It is not merely the treatment meted out to the
patient but the overall atmosphere of a hospital that a patient remembers after discharge.

What, then, makes a hospital good or bad? Is it the quality of doctors, medical facilities or
administration? The answer is: All. Inefficiency or inadequacy even in one area can mar the
image of an institution.
Owing to preoccupation with medical work, doctors cannot always be expected to be good
administrators. There is thus a need for professional management of hospitals.

Hospital Administration as a separate program was taken up for the first time in the US in the
1960s. Later, the concept spread to other countries and most hospitals in European countries
came to be headed by hospital administrators. Even in India, corporate hospitals now have a
good number of these professionals.

Though it is not highly visible like the work of doctors, nurses and the behind-the-scenes
management of a hospital entails a lot of responsibilities and is a round-the clock job. From
ensuring that the corridors are sparkling clean to keeping life-saving machines in working order
to attending to patients’ complaints and catering needs–the hospital administrators perform
multifarious tasks.

“It is to be stressed that Hospital Administrators failed to recognize two important division of
their work Human Relations and Business Techniques, (accounting, administrator statistics,
purchasing and handling of supplies”. Dr. Micheil David. University Of Chicago.

However traditionally, in majority of the Hospitals, administration is by practicing medical

professionals who are trying to keep pace with the newer challenges.

These administrators have a role conflict between the practice of medicine and the practice of
administration & this has led to short comings in the delivery of health services.

Challenge
With the increase in the number of patients requiring medical attention and the complexities
associated with medical treatment in recent times, the hospitals are faced with multi-fold
challenges. Amongst them are –

 To ensure best treatment is available to the patients

 To ensure compliance to medical process and documentation
 To ensure right doctors are associated with the hospitals
 To ensure they are ahead of the competition, overall
 To manage internal staff.

The Health Care Administrators as a result of social and demographic changes, changing
people’s expectations, rapid technological changes and intensive competitive pressure are facing
numerous challenges. The promoters of the care are becoming increasingly conscious of the
necessity to maximize the efficiency with which health care facilities are managed and
administered. Thus there is immediate need to develop the quality and caliber of health and
hospital care administrators and to seek ways and
means of improving knowledge and techniques of modern management.

The strategic planning process requires the health and hospital administrators to constantly study
of conditions that are and will influence the future survival of our health care organizations and
seek solutions to make the services accessible, affordable, comprehensive, need based, quality
adequate, effective and efficient...

Hospital Administrator Responsibilities (Including Roles)

Pursuing a career as a hospital administrator can offer a rewarding career with many
development opportunities. A hospital administrator can have various specialisation options,
essentially guiding the organisational needs of a hospital facility. Understanding some common
responsibilities of a hospital administrator can help you determine if this is a career path that
interests you. In this article, we list 10 hospital administrator responsibilities, discuss some of
their specialist roles and explain useful skills for this role.

10 hospital administrator responsibilities

Hospital administrator responsibilities can vary significantly depending on their employer,
experience or areas of specialisation. Here are 10 responsibilities of a hospital administrator:

1. Organise hospital services

A hospital administrator is often responsible for organising various hospital services. They might
coordinate services with patients and healthcare professionals. The hospital administrator
typically follows standardised procedures whilst organising services. Organising hospital
services might include triaging patients, taking patient information, authorising admissions,
setting appointments and organising procedures.

2. Oversee hospital development

Hospital administrators might be responsible for overseeing development within the hospital.
This can include the improvement and implementation of certain programs and procedures. They
might also conduct quality assurance and identify areas for improvement. Whilst overseeing
hospital development, a hospital administrator typically evaluates their public relations and
identifies how they can implement improvements.

3. Use financial acumen

This might relate to the management of hospital budgets. It's necessary for them to know how to
make logical decisions, use good judgement and understand budgeting concepts. Having the
ability to identify and understand the financial relations and effects of various aspects within the
hospital is often necessary to manage budgets effectively.

4. Maintain documentation

An important aspect of a hospital administrator's role is to maintain accurate documentation.

Completing detailed medical records for each patient is essential for this responsibility. A
hospital administrator is likely to be responsible for the receiving and dispersing of medical tests
and results. When handling documentation, a hospital administrator then follows an organised
filing system to ensure documents are easily retrievable.

5. Monitor stock levels

Many hospital administrators complete the task of monitoring stock levels throughout the
hospital facility where they're employed. They might check stock levels physically whilst also
maintaining specific records to monitor the stock levels. A hospital administrator then manages
the timely ordering and receiving of stock when necessary.

6. Managing staff

Hospital administrators are responsible for managing the non-medical staff such as cleaners,
administration staff and security.

7. Ensure compliance

Often, a hospital administrator is responsible for ensuring the medical facility they're working for
is compliant with certain policies and regulations. This can include monitoring practices to verify
they comply with government-determined regulations. They also make sure they follow
insurance company policies to help establish insurance reimbursement where necessary.

8. Assist with recruitment and training

Many hospital administrators assist with the recruitment and training of personnel. They might
be involved in the screening process of potential candidates, which can include reviewing
resumes, testing skills, conducting interviews, checking references and searching for candidates
online. After determining a successful candidate, a hospital administrator might be responsible
for providing the recruit with an overview of the facility, their responsibilities, any probation
periods and their targets or goals. These professionals may also assist with the training and
development of new and current staff.

9. Serve as a liaison
Serving as a liaison is often a responsibility of a hospital administrator. Specifically, they may
serve as a liaison between governing boards, healthcare staff and department managers. This
responsibility is important because it allows the team of professionals to work simultaneously,
communicate effectively, minimise conflict and resolve issues effectively.

10. Coordinate staff scheduling

This can involve determining employee availability and ensuring adequate staffing throughout
various departments. Coordinating staff schedules can also include organising coverage for both
planned and unplanned leave. The hospital administrator often organises the staff schedule by a
certain time and date, then publishes it for each staff member to view.

Hospital administrator roles

Some hospital administrators complete a range of various roles, but there are often opportunities
to specialise in a particular area. Here are some examples of hospital administrator role
specialisations:

Patient advocacy

Improving patient experiences and providing solutions for patients who have had poor hospital
experiences is something a hospital administrator specialising in patient advocacy might do.
They often work to improve the hospital system for future patients. When specialising in patient
advocacy, a hospital administrator makes themselves available to assist patient, their families and
their caregivers. They can assist with patient rights, grievances or complaints, crisis intervention,
customer service and satisfaction, conflict resolution and communication.

Finance

A hospital administrator who is interested in the financial aspect of the role might choose to
specialise in finance and budgeting. Depending on the size of the hospital facility and its
prerequisites, there might be a requirement for additional training before specialising in this area.
This specialisation role can include managing budgets, purchasing, costs and forecasting. It can
also involve working with patients and their families to ensure they understand their entitlements
and options through both public and private benefits.

Information processing

Information processing is often a specialised role for hospital administrators because of the
heavily digitised nature of record storage. A hospital administrator who specialises in
information processing might be responsible for correctly storing medical documentation. They
can use their technological skills to properly utilise the features of the record-keeping software.
This helps them to easily access the documents and communicate the information within them to
the required personnel.
Public health policy

Some hospital administrators can dedicate their specialisation to public health policy. This means
they have a deep understanding of the law and public policy and can use their knowledge to
influence government regulations and policies. Many hospital administrators who specialise in
public health policy work to educate both the community and the government to reach ideal
policy outcomes. In addition to working to influence government policies, this type of hospital
administrator can ensure strict policy compliance within their facility because of their thorough
understanding.

Healthcare marketing

Sometimes, a hospital administrator can choose to specialise in healthcare marketing. This means
they work to deliver important health-related messages to the community. These messages can
help to deliver important, educational information to consumers. They can also help to build a
brand for the healthcare facility. To specialise in healthcare marketing, a hospital administrator
might keep up to date with industry trends, current events and economic changes. This helps to
ensure the information being communicated remains relevant, informative and helpful.

Equipment management

A hospital administrator who specialises in equipment management might oversee the purchase
and maintenance of medical equipment. This role might involve checking the functionality of
equipment and materials, performing tests and inventory checks and ordering necessary
resources. Whilst doing this, a hospital administrator specialising in equipment management
monitors and maintains the financial budget for equipment and materials.

Useful skills for a hospital administrator

There are some skills that are likely to be useful for a hospital administrator, regardless of which
areas they specialise in. Here's a list of some practical skills for a hospital administrator:

 Organisational skills: Strong organisational skills can help a hospital administrator

prioritise tasks, keep track of documents and plan ahead.
 Attention to detail: Being detailed oriented can ensure a hospital administrator creates
accurate records and makes minimal mistakes.
 Critical thinking: Critical thinking skills can help a hospital administrator make logical
decisions when in high-pressure, time-sensitive scenarios.
 Teamwork skills: Many hospital facilities require their staff to work as part of a team to
improve productivity and ensure their patient's experience continuity and accuracy.
 Communication: Strong communication skills can help a hospital administrator provide
information to patients and communicate messages to their colleagues.
5 Ethical Issues in Healthcare Management

Health care in the 21st century is governed by a confusing array of:

 rules
 regulations
 laws
 ethical standards

Issues that involve confidentiality, informed consent and patient relationships can appear out of
nowhere, even when health care workers have the best of intentions. What’s legal today might
not be considered ethical. And there is the ever-present threat of being sued for negligence and
malpractice. There are unresolved issues around doctor assisted dying that have yet to be worked
out. For example, medical procedures considered ethical for adults might not be seen as ethical
for minors.

Here are the top five ethical issues that health care managers of today and tomorrow will be
facing in the course of delivering responsible and compassionate patient care.

1. Patient Confidentiality

Information about a patient’s medical condition is considered private. Violating a patient’s

confidentiality can hurt the patient and have legal and ethical consequences for the health care
worker. The Health Insurance Portability and Accounting Act (HIPAA) has drawn up specific
laws that govern the release of a patient’s medical information. These laws state clearly the type
of patient information that can be released to third parties and which information must be kept
confidential. The laws also set forth who can see the information and who cannot. These laws
appear straightforward. However, there are grey areas such as when withholding information
about a patient’s condition would be unethical because it could harm the patient or someone else.

2. Patient Relationships

Health care providers are ethically prohibited from entering into personal relationships with
patients in the course of providing treatment. Violating this policy, especially if it involves a
sexual relationship, can result in:

 losing a license to practice

 being sued
 being forbidden to provide any kind of healthcare services in the future

Entering into a sexual relationship with a patient is considered a serious violation of that
patient’s rights and an act of misconduct and abuse of power on the part of the health care
worker. When under medical care, a patient is considered vulnerable and unable to defend or
protect themselves. Even the appearance of a sexual relationship with a patient can have serious
consequences for a health care practitioner.
3. Malpractice And Negligence

Health care providers are always at risk for being charged with malpractice and negligence. A
patient can sue to recover their losses when they are:

 harmed by defective medical equipment or products

 injured in the course of a medical treatment
 placed in danger because of medication

Patients can also sue when health care providers fail to provide a critically needed treatment or
service. Due to the ever-present threat of litigation, health care providers must carefully cover all
the bases in the course of providing patient care.

4. Informed Consent

In order for any medical treatment to be considered legal, the patient must first provide the health
care worker with an informed consent. Unless a patient provides informed consent for a
procedure, that procedure can considered an assault or even a homicide if the patient were to die
as a result of treatment. Informed consent means that a patient has had all of their questions
answered and freely agrees to a treatment or procedure with full knowledge of the:

 risks
 benefits
 possible consequences

Informed consent also means that patients are informed about other options as well as about the
option of doing nothing.

5. Issues Related To Physician Assisted Suicide (PAD)

Most health care professionals are aware that physician assisted dying is already legal in states
like California and Oregon. Support for PAD is growing in momentum as the baby boom
generation gets older. Surveys show that roughly 50 percent of doctors now support some form
of physician assisted dying. These days, physicians are broadening the concept of “Do no harm”
to include providing relief for those who are dying and suffering as a result of a fatal illness.

We are moving into an era that will provide increasing options for medical care. Designed to
give people longer and more productive lives are:

 innovative technologies
 cutting-edge medical procedures
 state-of-the-art treatments

But as we move forward, concerns about the future of medical care and its effect on the patients
it was designed to treat will become increasingly important.