It is a known fact that globalization is here to stay. Enhanced population mobility due to the change brought about by globalization has created a stir in every industry &ndash including healthcare driving a strong need and potential for healthcare delivery from national levels to across borders.
Overall impact of globalization on healthcare:
With the advent of technology and telemedicine the concept of &ldquoE-health&rdquo is coming of age. The doctor and patient no longer have to be sitting across one table for consultation. The ease of accessing medical opinion from a physician in another country is now only a click away. This also gives the globe-trotter security of being able to access opinion of his physician even when he is abroad.
Medical tourism has brought forward willingness to travel abroad for better treatment or quality treatment at a lesser cost. Commercialization of healthcare has lead to establishment of chains of hospitals and clinics across the world. Mergers and joint ventures in healthcare have built up partnerships across the globe delivering care in a foreign country setting that patients are comfortable with. All this in turn has created better opportunities across borders leading to a move of healthcare professionals &ndash physicians nurses technicians from one country to another.
Due to this increased mobility of population two scenarios have been created: requirement of medical care when abroad and going abroad for medical care. The former category consists of temporary visitors as professionals or NRIs who require emergency or episodic care or people with double residences as Diplomats students etc. who require full medical care or long term residents retiring and staying on in other countries who require chronic care.
The latter i.e going abroad to receive medical care is applicable to people who want to &ldquobe closer to home&rdquo for receiving medical care or in an environment which they are more comfortable with due to either comfort with language or culture knowledge of systems or having friends or families around. There is also a willingness to go farther abroad when there is a relative weakness in this category of patients' home system such as high out of pocket cost in one's own country perceived quality and trust abroad and very rarely bio-ethical legislations as abortion or euthanasia.
The benefits if summarized for patients choosing healthcare across borders are basically lesser waiting time a good cost to quality ratio for some a 2 in 1 holiday package and mostly being able to avail all this at centers of excellence. This has lead to a ripple-effect benefit for all stake holders as well. Sharing of capacities across borders is leading to a more efficient usage of the existing capacities in healthcare reduced health expenditure of the local country increased revenue to the receiving country mutual learning and exchange of best practices.
Also cross culturally healthcare is now discovering common solutions to common problems.India is now a growing attraction for healthcare travelers. This movement has recently gained momentum over past few years. India has a low-cost advantage. The revenue inflow estimated at US$ 333 million in 2004 is predicted to become a US$ 2 billion-a-year business opportunity by 2012. India is seeing a surge of patients from developed countries as well as from countries in Africa and South and West Asia that lack adequate healthcare infrastructure.
The note-worthy low-cost high value specialist medical care territories emerging are &bull New Delhi Mumbai Bangalore: prime destination for tertiary care: cardiac orthopedics plastic surgery etc. &bull Chennai: Eye care&bull Kerala and Karnataka have emerged as hubs for state-of-the-art ayurvedic healing.Some core competencies in the healthcare organizations in India are their at par &ndash with - the best - architectural and environmental standards state of the art equipment huge resource of trained healthcare providers strong emphasis on systems and processes multinational experience inherent culture of caring and hospitality a &ldquowalk-in&rdquo culture for doctor appointments with hardly any waiting time for initial or follow up care.
Not only this but the diagnostic report timings are on a &ldquosame day/next day&rdquo basis for routine tests. India also offers a lower drug cost and over-all a care cost 1/10th of some of the developed economies. India also earns its gold points for being able to deliver a unique holistic basket for health: that of Ayurveda naturopathy and other such sciences.
Not only this but accreditation through ISO Indian National standards (NABH) and JCI has ensured availability of standardized care comparable to any developed country in the world. All this and that too in a country that knows how to speak English fluently!Comparative cost of amongst different countries of some procedures shows that India is certainly the best choice as evidenced below.
Quality and Healthcare:
The Quest for quality is all pervasive in this day and age and never more apparent than in healthcare. Healthcare organizations all over the world are increasingly recognizing the need to evaluate and demonstrate the quality of what they do. There is a need for parity in quality care across countries. This has affected the national accreditation bodies in that most have strikingly similar goals.
Establishing International credibility for Indian National Accreditation standards:
The international Society for Quality in healthcare Inc (ISQua) is a WHO recognized body which aims at a global platform for assessing and recognizing national accreditations. To date several sets of healthcare standards are used in Australia Canada Egypt England and Wales France Ireland Japan New Zealand South Africa Taiwan R.O.C also the standards of Joint Commission International have already been successfully accredited by ISQua.
Indian National standards National Accreditation Board for Hospitals and Healthcare Providers (NABH) have been benchmarked with other accreditation standards as well such as that of UK Australia etc. NABH is a member of ISQua Accreditation Council and is participates in ISQua Annual Conference. They are under stage of review by ISQua for accreditation. Membership with ISQua has already been accepted and Accreditation is expected soon.
Also NABH collaboration with ACHS shows the evidence for Global Acceptance of the Indian Standards. A comparison of NABH and Joint Commission International (U.S.A) &ndash the most commonly accepted standard world wide shows that the majority of standards for both JCI and NABH are the same.
JCI has 366 standards 983 measurable elements and only 596 are mandatory. NABH has 100 standards 503 measurable elements and all are mandatory. The domain areas of the standards for both JCI and NABH are also the same. JCIA has 11 chapters and NABH 10.
A comparative analysis hence shows NABH to be at par with international standards. Healthcare in India:
The health care sector in India has witnessed an enormous growth in infrastructure in the private and voluntary sector. It is estimated that 75-80% of health care services and investments in India are now provided by the private sector.India can increase Medical Value Travel by earning accreditations standardizing medical practices and getting government hospitals and tourism agencies to work in tandem to $2.2 billion per year proving its great worth in the international scenario.
As Cross border patients continue to increase you will begin to see more seamless integration across borders at every level: provider system and professional. Dr. Arati Verma is the Chief Medical Quality and Training of Max Healthcare. Dr. Shalini Bhalla is the Manager of Medical Quality and Training at Max Healthcare in New Delhi India
