Market moving the preventive and primary way in health care in India

February 9, 2012 by The Health Care Intelligence Team
Filed under: Health Care Quality Management, Health News, Healthcare General, Healthcare Management

Indian health system’s major drift towards the specialized and super-specialized care in last two decades has been a result of an incompetent preventive and primary health delivery system. The primary care has remained a concept of public health and the business hospitals have found little incentives to incorporate this into the service delivery, which is high end and technology driven. The growing business of health care in India, which is speeding at about 20 % CAGR, is about to touch $ 120 billion by 2015. However, the improvement in the health status of the country is still doubtful with IMR, MMR, anaemia, malnutrition and life expectancy improving at a slower pace than the industry growth. Moreover, we have added the burden of chronic and life style diseases before we could change the situation of highly prevalent communicable diseases. As we keep bringing in the high end tertiary care into the life of each level of patient, we are increasing the cost of health care enormously and largely following the path US has taken in last three decades and perhaps the cost bearing is going to be even more difficult to the Indian scenario, if we do not envisage innovative methods of health care delivery.

The answer can be sought in a decentralized model of delivery where the health care is a part of people’s regular life and is not sought after when the only choice is to avail tertiary care. The public health care system works with a decentralized model, which has not proved enough even after repeated policy and programme framing. The primary care available by the public health system is seen as no alternative to a high end private hospital or a private physician and the later two has been able to answer only a fraction of what a preventive and primary care delivery should be like.

As a welcome sign, the need of market seems to have started working in this direction and the realization that 80 % of the health care market can be served with a lost cost, high volume, preventive and primary care based model , the corporate set ups of this genre have started becoming visible. A variety of models have surfaced up in last couple of years and commonest of them is a ‘Chain of primary care clinics’.

Pathfinder international joined the movement recently with starting such ‘family care clinics’ in Delhi-NCR, following Razi clinics in Hyderabad, Vita life clinics in Bangalore, Glocal health care and few others in southern India. The response to these centres has been very good everywhere as they are reviving the ‘quality health care at your doorstep’ concept. They save time, money, effort and anxiety, provide health care for 60-70 % ailments, do a better patient- clinician bonding , show accountability and help in getting information for the higher level of care. Its major components are doctor consultations, ambulatory care, immunisation, basic diagnostics, and retail healthcare such as pharmacy, over-the- counter drugs, personal medical equipment, health food and physiotherapy. It mainly comprises care delivered by a general physician in an out-patient setting.

For the business case, the primary healthcare segment in the country accounts for 60 per cent of the healthcare delivery market and is growing at 15 per cent annually. The current market size is $30 billion, which is likely to reach $200-250 billion by 2025.

Now the balance in the health system is awaited through market interventions as all other mechanisms seem to have failed. While this market is expected to catch the pace very soon, we hope that our health care needs get the easy answers soon.

Dr Rakesh Parashar

Health Care & Hospital Management Consultant