How many actual number of Coronavirus - COVID-19 cases could be there in India and the World?

With COVID-19 declared as a pandemic, one big question in every body’s mind is just how many COVID-19 positive cases are out there. At the outset let me state that as of 18^th March, 2020 there could be more than 800 thousand COVID-19 cases in the world and more than 140 thousand in India. While professionals and researchers differ in estimate there seems to be a consensus that the COVID-19 cases are far higher than what is being reported. For instance, Dr. Mathew Carter from Connecticut health officials hints that there could be 100 untested positive cases for every confirmed case. In the subsequent part, I will present my analysis of the number I claim.

There are serious reasons to believe, that the number of confirmed cases are hugely under-reported and doesn't represents the true picture. The number of confirmed COVID-19 cases depends upon how many suspected cases are being tested for the disease and what is the criteria to determine suspect. It can be argued that, since the disease is novel and with the great speed with which it spread across the world, most countries did not had enough time to plan for detecting suspects and for arranging the resources to conduct lab tests on a required massive scale. The number of labs and the test kits available with many countries are minuscule compared to the number of tests that would ideally be required to be done in the given scenario. As a result, most countries have put stringent criteria to decide who can be tested. This means, many patients with actual COVID-19 will not get tested, due to the criteria and hence will not appear in the count.

With this understanding of resource constraints, it is reasonable to believe that the countries with sound economy will be better off in arranging resources and conducting tests at a larger scale, compared to countries with poor economy. To examine this, I ran a correlation between COVID-19 reported cases per million population with the GDP (PPP) per capita income of various countries. As per my expectation, the correlation came positive at 0.26, which means that per-capita income of country is positively associated with the reported confirmed COVID-19 cases per million. In simple words, richer countries are reporting more number of confirmed COVID-19 cases compared to poorer countries. While the correlation coefficient is mild to moderate, it does indicates that there could be significant number of undetected positive COVID-19 cases, specially in countries with low per-capita income. A comparison of cases per million population of top and bottom 25% countries by economy also showed a statistically significant difference (p = 0.007), with top 25% countries showing much higher number of cases compared to bottom 25% countries. To ensure that other factors are not confounding the result, I checked for the effect of geographic location and population. For geographic location, countries located nearby and having different economy, did showed remarkably different number of cases per million population. For instance, USA has reported 23 confirmed cases per million population which is a staggering 32.8 times that of Mexico, which has reported just 0.7 case per million. This is despite the fact that they share border and could be posibly because USA is much stronger economy than Mexico. In general also it can be observed that, irrespective of the countries location in the world, the rate of COVID-19 penetration was generally high in high income countries and generally low in low income countries. The co-orelation between population and cases per million population also does not exist, with correlation coefficient coming at -0.03. Thus geography or population doesn’t seems to have any role in the penetration rate of COVID-19.

There is no justifiable reason to believe that poor countries will have significantly lower number of COVID-19 cases, as is being reported by respective governments and it just suggests that the data on number of COVID-19 is highly under-reported. As data is key for fighting this menace, it is imperative that we have an idea of a more reliable number of COVID-19 cases. Estimating the actual number of cases would be difficult as it would require several assumptions to be made. One approach could be to assume that COVID-19 infections spreads at a similar rate in all countries irrespective of their population, economy, geography or climatic condition and apply the most reliable rate to all countries. As I have argued in first paragraph that resource rich nations are in better position to test COVID-19 in large numbers, we can use their figures as somewhat reliable and estimate the number of cases for other countries. For this, I took the top 50% countries by economy, using GDP (PPP) per capita, and calculated the COVID-19 cases per million population by combining all of their cases and all of their population. The result comes to 112.7. In contrast, the cases per million population of bottom 50% countries by economy is mere 37.4. If we ignore the rate of bottom 50% countries, considering the lack of tests being conducted, and use the rate obtained from top 50% countries, we can estimate how many COVID-19 cases could be there.

This would mean that for India, with a population of 1.3 billion and 112.7 COVID-19 cases per million, there could be 146,510 people who would have acquired COVID-19 till date, as against the reported number of 168 confirmed cases reported. This is not even the tip of the iceberg. Similarly, for the world with population of 7.7 billion, the number of COVID-19 cases could be alarming 867,790 against 216,425 reported so far.

Disclaimer – This is my independent analysis and is subjected to the assumptions stated in the article. Data taken from WHO situation reports, World Bank and the online site, www.worldometers.info. The data is as of 18th March, 2020

Arif Raza

Pricing of Hospital Services

A Hospital offers a large number of clinical services and some non-clinical services as well. Patients availing these services can be Out-Patient, Emergency Patient or In-Patient. In-patient can further be of categorized as per their choice of accommodation, such as deluxe, semi-deluxe or general ward patient. Justified charging of services and facilities availed by different categories of patients can be confusing at times, as it requires a clear understanding of what services or components to be charged and how to differ the charges for different category of patient. In this post, a simplified explanation of how to price hospital services to charge it to patient, is presented. This will also help hospitals in developing a comprehensive document on hospital’s tariff and relevant policies for billing. In addition, you may also like to check this post on 'How much does it cost to run a hospital?'

For pricing various services of a hospital, services can be grouped under following head.

1. OPD services
2. Emergency services
3. IPD services
4. ICU services
5. Surgical services
6. Medical/Surgical Procedures
7. Diagnostic services
8. Use of Medical Equipment
9. Materials and Consumables
10. Packaged services
11. Other services and facilities

A brief description of each of these services group along-with how are they charged is described below.      

Should private hospitals empanel for Ayushman Bharat – PMJAY?

The massive scale of Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana has caught the attention of every private hospital in India. Covering almost 500 million people to the extent of Rs. 5 lacs per family, is too big a pool for any hospital to miss. Yet, there are apprehensions, as there has been bitter experience by private hospitals in various public health financing scheme. RSBY, the predecessor scheme, for example, is mired with numerous cases where hospitals have not reveived their payments for many months or even years. Hence, while many hospitals have empanelled themselves with the scheme, many more are taking a cautious approach of wait and watch.

Based on the scheme design and the experience, here are the answers to some of the questions that bothers any private hospital evaluating whether or not to participate in this scheme.

    1. Are the rates at which hospital services are paid, adequate?

NABH accreditation statistics

NABH accreditation system was established in year 2006 and since then it is accrediting healthcare organizations. Here are some statistics on accreditation of hospitals in India as of June, 2019.

1. Total accredited hospitals         –     563
2. Total pre-accreditation entry level hospitals  – 718
3. Total accredited small healthcare organizations (SHCO)  – 220
4. Total pre-accreditation entry level SHCO   –  1497

Comments and suggestions on draft ‘Charter of Patients’ Rights’ by MoHFW

Ministry of Health and Family Welfare (MoHFW) plans to implement 'Charter of Patients Rights'. In this regard a draft document has been developed by National Human Rights Commission (NHRC). The draft has been put up on website (https://mohfw.gov.in/newshighlights/draft-patient-charter-prepared-national-human-rights-commission) on 30th August, 2018 and public opinion has been solicited on the same.

I have sent my suggestions and comments on the draft document which are as follows. Request readers to give feedback on this so that further improvements can be done.

    1.       Right to Information:

The first paragraph of the description given for the right to information states that ‘Every patient has a right to adequate relevant information about the nature, cause of illness, provisional / confirmed diagnosis, proposed investigations and management, and possible complications to be explained at their level of understanding in language known to them’. Following clarification is required in this regard

·      Is the right applicable for patients who are not capable or not in a situation of receiving or understanding the information? For eg. Child patient, mentally unstable patient or patient with altered sensorium.

·      If it is applicable then how to fulfil the same?

·     If in these cases the care-taker of the patient to be informed, then how to address those situations in which patient with above condition is without any designated care-taker. For eg. An accident victim getting treated in a hospital without any care-taker.

The last paragraph of the description under this right, states that caretakers of the patient also have a right to know the identity and professional status of doctors and other healthcare providers.  However, I think some more description shall be provided to clarify following points

·         Who shall be considered as a rightful care-taker of the patient?

·   In case of multiple care-takers (family, relatives etc.) of a patient, should the information be shared with everyone who asks for it, or should they be asked to designate some-one as a primary care-taker?

·     Should an explicit/implicit permission be taken from the patient that information related to his/her healthcare will be shared with the care-taker?

    2.       Right to records and reports:

This right states that ‘Every patient or his caregiver has the right to access originals / copies of case papers, indoor patient records, investigation reports (during period of admission, preferably within 24 hours and after discharge, within 72 hours). Following points must be incorporated and improved in this description,

·         The first statement shall be made gender neutral by stating ‘his/her’.

·         24 hours limit for making records available during period of admission, should be there only if the patient needs a photocopy of his/her records. In case the patient just wants to see the original file, it should be made readily available without any need of giving 24 hours’ time-frame.

·         In case hospital is planning to discard old records of patient, should the patient be informed before that?

·         Reasonable restrictions on care-takers accessing patient’s file shall be stated. If patient refuses the care-taker cannot access the patient’s file.

In the second paragraph the description states that ‘The relatives / caregivers of the patient have a right to get discharge summary or in case of death, death summary along with original copies of investigations.’ It is suggested that following points be incorporated/clarified in this description

                ·         Time frame for issuance of death summary must be stated.

             ·        Who should be a rightful care-taker to whom these documents can be given shall be explained.

               ·         Whether or not hospital/doctor can withhold death/discharge summary, if the full payment is not done?

     3.       Right to Emergency Medical Care

This right mandates provision of basic care without demanding payment/advance. Some suggestions on this are as follows,

·         I think, it is extremely important to define and describe what should be considered as basic care. In absence, of clear understanding on basic care, I fear that many hospitals may provide sub-optimal emergency care to those whom they think may not pay for the emergency care services.

·         It should also be made clear that life saving measures, if required on an emergency basis shall be provided, irrespective of payment, even if such measures incorporates performance of a cost intensive measure such as life-saving surgery or providing ventilator support.

·         A clarification is also required on ‘who determines the emergency’? Is it the patient’s right to determine their condition as emergency and seek emergency care or is it the doctor’s right to assess the patient and decide whether or not the patient be considered as an emergency patient?

    4.       Right to Informed Consent –

This right states that ‘Every patient has a right that informed consent must be sought prior to any potentially hazardous test/treatment (e.g. invasive investigation / surgery / chemotherapy) which carries certain risks’. The description must clarify how this rights shall be fulfilled in following situations

·         Patient unconscious/mentally unstable/children or not in a situation to give consent

·         A potentially hazardous clinical intervention is required on an urgent basis and there is no time to obtain informed consent

    5.       Right to confidentiality, human dignity and privacy

As per my understanding ‘confidentiality’ and ‘privacy’ are two very different things and should be stated as two separate rights. While confidentiality deals with the secrecy of data and information, ‘privacy and human dignity’ is related to behavioural and physical aspects. I also think that many elaborations are required in the description of this right, such as

·         Which data and information shall be kept confidential?

·         Situations where exceptions will be made to the right of confidentiality (such as legal matters, research requirements etc.)

·         Within healthcare organization, who all can have access to patient’s data?

·         Privacy and human dignity needs to be explained (for example, will the act of not informing the patient before touching him/her for  assessment be considered as violation of privacy? An OBG doctor performing PV examination without explicit consent of patient, should it be considered as a privacy and dignity issue?

    6.       Right to non-discrimination

The first paragraph of the description of this right states that ‘Every patient has the right to receive treatment without any discrimination based on his or her illnesses or conditions, including HIV status or other health condition, religion, caste, ethnicity, gender, age, sexual orientation, linguistic or geographical /social origins’. I suggest following basis shall be added in addition to those that are already written

·         Economic status of the patient

·         Category of accommodation in which patient is admitted

·         Affiliations of the patient (For example other patients shall not be neglected when a VIP patient gets admitted in a hospital)

    7.       Right to safety and quality care according to standards

One of the statement in first paragraph of the description states that ‘Patients have a right to receive quality health care according to currently accepted standards, norms and standard guidelines as per National Accreditation Board for Hospitals (NABH) or similar’. I think this should be removed, as majority of NABH standards are not prescriptive in nature. Also, as of today, NABH is being adopted voluntarily and a very small proportion of hospitals in India are NABH accredited. By stating that patient has a right to expect NABH standard level of service from hospital, it may not be realistic.

    8.       Right to choose source for obtaining medicine or test

I suggest a re-thinking on this right. I believe hospitals should be given flexibility to make a policy that a patient in their hospital should take medicine or test from their own pharmacy or laboratory. Otherwise how can a hospital be made accountable for a treatment outcome, if patient is taking medicine or test from another place on which the hospital has no control on.

    9.       Right to take discharge of patient, or receive body of deceased from hospital

I think some more clarity is required in the description. As of now it is stated that a patient cannot be detained in a hospital, on procedural grounds such as dispute in payment of hospital charges. But what in case patient has not paid at all.

Moreover, stating that patient has a right to get discharge irrespective of whether or not he/she settles payment, gives a very different message. In-fact it shall be stated as a responsibility of the patient to settle bills before getting discharged from the hospital.

    10.   Other points to be added

Besides the points stated for each rights there are few more things that needs to be modified in the charter

·         As Advance Directive for Passive Euthanasia has been made legal in India, this should also be incorporated in the patient rights charter

·         The charter must specify the scope such as ‘Who shall be considered as patient’, ‘Which kind of healthcare professionals/providers’ does it applies to’ and ‘What could be some exceptions to the various rights described’

Rape victim's examination at hospital

38,947 rape cases were registered in India in 2016 (data from National Crime Records Bureau). That translates into 106 rape cases every-day or about 4-5 rapes every hour. The data also shows that incidence of rapes is on rise. On the other hand, the conviction rate in rape cases is just 25.5%, as of 2016, which is a reduction from 29.4% of the previous years. With such low conviction rate, the heinous crime of rape is difficult to be contained. One of the biggest reason for low conviction rate is the insufficiency of evidence due to poor quality of medical examination of rape victim. Many doctors and hospitals are not updated and prepared for proper examination of rape victim. Doctors and hospitals can play a big role in increasing the conviction rate in rape cases, thus reducing the number of rape cases occurring in our country. This post is intended to make hospitals aware about how to properly handle the medical examination of rape victims. The detailed protocol of medical examination, as issued by Government of India can be accessed here.

Tracer survey method – A great tool for achieving operational excellence in hospital

Providing healthcare to a patient involves multiple departments, professionals and functions. This increases the operational complexity and leads to a variety of problems such as errors, inefficiencies, and even harm to patients. To address such problems, hospitals often follow best practices and standards, recommended by national/international bodies and accreditation programmes. While these standards and practices are well researched, whether or not it improves operational efficiency, depends upon how well have they been implemented or the level of compliance. There are various methods of assessing compliance; such as audits, reviews, surveillance, patients' feedback, indicators and gemba walk. However, one problem with these compliance assessment methods, is that most of them assess each specific function independent of others and fail to assess, how is it translating into actual patient care.

Tracer survey is a unique methodology as it is an integrated assessment of compliance to standards and practices that were required to be followed during care of a particular patient. It gives a comprehensive understanding of hospital’s operational performance and effectiveness in translating standards into actual patient care. Tracer survey is one of the prime survey method used by The Joint Commission in their on-site survey for accreditation.

So how can hospital managers can make good use of this method in achieving operational excellence for their organization? Here is a step by step guide for using Tracer methodology.

Features of a disabled friendly hospital

A disabled friendly hospital is one which enables people with disabilities to freely and safely move and access facilities within the hospital. Such hospital building provides an environment of independence to individuals with disability, which is their right granted under Persons with disability act, 2016. Patient with a disability is considered as a vulnerable patient and hospitals are required to take care of their safety. Being disabled friendly uplifts the image of a hospital and is also expected by various accreditation agencies.

So what are those features that makes a hospital, ‘disabled friendly’? Well, such hospital building typically accounts for the need of two kinds of disabilities, i.e. loco-motor disability and visual disability. People with loco-motor disability will either be on wheelchair or crutches and which requires a disabled friendly hospital to make its interior easily accessible for wheelchair. People with limited vision will need mechanism to understand ways and areas within the hospital. This is typically achieved by strategically placing tactile floor (guiding block) and using braille, which the visually disabled person can sense.

Here is a list of features that goes into making of a disabled friendly hospital.

Passive Euthanasia in India and Making Advance Medical Directives: Details that hospitals and patients must know

Passive Euthanasia has been legal in India since 2011 after Supreme Court issued its judgement in Aruna Shanbaug’s case. Although the plea of the petitioner, Journalist Pinki Virani, was rejected, supreme court gave directives on when and how passive euthanasia can be allowed and executed in Shanbaug’s case, making passive euthanasia as legal in India.

A case on similar line, filed by an NGO ‘Common Cause’ was also going on whose plea was to make it legal for people to make Advance Directive for passive euthanasia. On March 9, 2018 Supreme Court of India upholds passive euthanasia and issued regulations for executing Advance Directive for passive Euthanasia.  The regulation passed through this judgement will remain binding across the country till the time, Parliament of India comes up with a bill or law on this subject.

The hospitals and medical fraternity (specially those that provide end-of-life care) need to make themselves aware about the legally correct way of handling advance medical directives for passive euthanasia. This post explains the legal directives in simple language for its correct implementation. The information presented here is derived directly from the 538-page official judgement report of the Supreme Court of India.
(Check - Advance Medical Directive Form for Passive Euthanasia)

      1.   What is Euthanasia and what is India’s legal stand on it?

How to choose right health insurance provider?

While we take great care in selecting best health insurance plan for ourselves, how to choose the health insurance provider is an equally important question to consider. If you observe carefully, you will find that most health insurance plans from different companies have similar terms and conditions. Their premiums, coverage limit and diseases inclusion/exclusion will also appear to be similar.

However, there are quite a few things about healthcare insurance providers (insurance companies) that could differ and provide you a sound basis of selecting or rejecting them. They are described below.

Also check - How to select a good hospital and How to select a good doctor

How Pharmacist can improve quality care in hospitals

By - Pallvit Jain, Student of PGDM-Healthcare Management at Goa Institute of Management

Consider the following statement:

Doctor to Patient, “Take Omeprazole 20mg on empty stomach every day for 5days”

Would you consider this statement enough for giving direction of dosage to patient?

Now consider another statement:

“Take the tablet omeprazole 20mg empty stomach, every day for next 5days. Have meal only after 20min of dosage”.

Need for transforming voice of customer into action in hospitals

By - Akshata P. Nadkarni, Student of PGDM-Healthcare Management at Goa Institute of Management

In today’s world, where the technology is being updated every single day, the need to inculcate the same in hospitals to improve the quality of care is also increasing. The corporate hospitals now aim at providing better services than what their competitors provide. Indian population is slowly moving from prevalence of communicable diseases to non-communicable or rather one can put it as lifestyle diseases. These patient bases mostly belong to upper and middle socio economic background and now as people are much aware and educated, they choose which hospital to go to. Therefore, understanding the patient and listening to their need that can be put into action is of utmost importance for hospitals to gain customer satisfaction.

Check - Sample Patient Satisfaction Feedback Form

What is VoC? And is it really required?

Voice of Customer (VoC) is term used to study in depth about customers’ needs and expectations. It is primarily used in Business and Information technology as a part of marketing strategy while launching a new product.

VoC can play a crucial role determining where the hospital is lacking, as patients are after all customers of the hospital. Survey shows that, among 20 people who give feedback 15 people will rate the hospital satisfactory but will not return and rest five will give genuine complaints about the hospital. Hence, by implementing VoC, the hospital can gather accurate information about patients experience in the hospital. VoC is mode of measurement for the hospital to see their capability in satisfying need and expectations of the patient.

Many hospitals in United States who uses VoC services through some or the other tool has good patient flow, smooth functioning, increased communication with patients and high efficiency.

There are different Six Sigma tools that collects Voice of Customer data. Some of the examples are Surveys, Customer complaints, data based on ”moment of truth” encounters (moment-of-truth situation is defined as the time when customer interacts with the administration and forms his impression on the quality of services provides by the organization) and Quality Function Development.

Need for putting VoC in action:

The tertiary and quaternary care providers in India gives high end services but may lack in quality of care and sometime are ignorant of many issues faced by patients. Now that hospitals are integrating IT in healthcare such as Electronic Medical Records and Telemedicine, this can be the next step by incorporating VoC and putting it into action.

It is observed that 18% out of total hospitals that are closed are due to patient dissatisfaction. Many hospitals go for surveys, but surveys, even with high accuracy can be biased based on organizations perception towards the value of patient is, rather than what patient actually values. Whereas tools such as Quality Function Development will give the organization details of patient’s needs, importance of those needs to the hospital, technical description for each of the listed needs by patient and finally the rating for the strength of relationship between the needs and level of importance for the hospital.

For Voice of customer process to  correctly identify patient needs, the management should put into action a staffed six sigma process team which will get solicit information from patient or relatives, assemble the collected data, analyse it and interpret the results, list out actionable goals and finally execute the project to realize the goals.

Implementation of such tool can face lot of challenges such as human resources accountable for Voice of Customer process, cost of implementation and time taken to incorporate it but in the long run it can provide lot of useful data to the hospital for its improvement and continuous upgradation.

REFRENCES:

Voice of Customer (patient) for six sigma processes in Healthcare https://www.processexcellencenetwork.com/lean-six-sigma-business-transformation/columns/voice-of-the-customer-patient-for-six-sigma-proces

The real value in voice of customer : customer experience http://www.cmo.com/opinion/articles/2016/3/29/the-real-value-in-voice-of-the-customer-the-customer-experience.html#gs.gqddros

Making of a loyal customer

By - Nupur Kajarekar, Student of PGDM-Healthcare Management at Goa Institute of Management

Nowadays customers make healthcare decisions based on Easy access, Quality of service offered and Cost effectiveness, as there is a wide range of options and choices available to the customers in the healthcare industry. Thus, health care providers have to provide their services with high standard of care in order to retain their customers in this growing and competitive industry which was once ignored with the notion that patients do not have choices to make when it comes to hospitalization and treatment. With growing demand and fast change in technology, even the expectations of customers have gone up wherein they demand services like online booking of appointments, self-access to medical details, health education and tips, reminders for follow-ups etc. whereas some customers still rely upon the prevalent assisted service. So here the role of health care providers is to balance between the needs and demands of customers so as to keep their growing expectations fulfilled.

How to create a winning hospital marketing strategy?

By - Bipin Srivastava, Student of PGDM-Healthcare Management at Goa Institute of Management

With the ever-increasing corporatization of healthcare services, it has now become imperative on the part of hospitals to strategically market themselves, in order to survive the competition and emerge profitable. True, hospitals cannot and should not market themselves as any other business would do, but that most certainly does not mean that hospitals should not market themselves at all. Indeed, in this day and age, no hospital can afford not to advertise its services, unless of course, it is a government hospital. 

Here, I list down several ways that could be used to market your hospital. 

5 things you must check while getting discharged from hospital

Nobody likes to stay in hospital and patients eagerly wait for their day of discharge. After spending days or weeks in hospital the doctor’s order to discharge brings cheers to patient and their family members. The phase of troublesome treatment in hospital is over and patient wishes to go home as soon as possible. But wait, here are few things which must be taken care of before leaving the hospital to save you any troubles later on.

1.       Get your discharge summary – 

Although it is a routine for any hospital to hand over the discharge summary of patient before they leave, it gets missed many time. The discharge summary contains all important details related to patient’s disease, tests results, condition at the time of discharge, treatments given, further treatments to be taken and follow up advice. This is a very important piece of medical document that will be required for future medical treatments. In hospitals the process of discharge is pretty complex and preparation of discharge summary can take time and delay the entire discharge process. Hence, sometimes to avoid delay staff may let the patient go without discharge summary. Hence, as a patient you must ask for discharge summary and ensure it is with you before you leave hospital.

2. Collect documents related to health insurance claims – 

If you have health insurance and have not availed the cashless facility, make sure you collect necessary documents related to treatment for settling your claim with your insurer. You must enquire from insurance agency about specific documents required which generally includes, detailed itemized bills of treatment, individual investigation results, statement of doctor/hospital and of-course discharge summary. Some insurance agency also asks for a copy of complete medical record of the patient during the treatment. As a patient you have a right to get all these documents from the hospital.

3. Final talk with the treating doctor – 

The treating doctor or the consultant are busy people and they generally leave the discharge formalities to be completed by assistant doctors. However, he/she is the person who knows best about the condition of the patient and further course of treatment required. So, make sure to have a final discussion with the treating doctor to get an assurance about patient’s health and treatment.

4. Collect necessary information – 

As a patient you must ensure to get following information from the doctor/nurse at the time of discharge

a.       Medications to be taken at home

b.       Preventions to be taken (like food, activities etc.)

c.       Date of follow up, if required

d.       If the situation of patient worsen, how to get emergency help

e.       Signs and symptoms which can indicate patients to consult back

f.        Any other special or specific instruction related to patient’s disease

5.       Check the settlements – 

At the time of discharge all payments need to be settled. While settling the bills, take care of following

a.  Check if the bill is right and error free. 

b.  Check if you have received the refund for unused medicines returned to hospital
c. Check if the bill has reduced the advance amount or any security deposit paid by you

Other posts of interest

5 points on how to select a good hospital

What is accreditation in hospital and how does it matter to me as a patient?

4 points on how to select a good doctor

5 points on how to select a good hospital

When it comes to our healthcare we should not take chances with the hospital from where we are planning to get our treatment done. While recommendation (reference) from our primary doctor is important, following points must also be checked to ensure that the hospital we select is a good one and match our need.

4 points on how to select a good doctor

Doctor is the most important person on whom the fate of patient’s treatment depends upon. Hence for any major treatment it is absolutely important to select a doctor who is the best for you. But due to complexity and technicality of medical field, most common people find it difficult to decide about selection of doctor. Here are 5 points that one can use to select a good doctor for themselves. (Also check my post on ‘5 points on how to select a good hospital’)

6 points that should be taken care of while assessing online customer reviews of hospitals

Selection of good hospital is crucial to get a good medical treatment. My article on ‘5 points on how to select a good hospital’, describes important points that must be checked to select a good hospital. One of the key point in it is to check the online reviews of the hospital shared by other patients. While online reviews can give invaluable information about the hospital, it can sometimes be tricky in discerning right information. One need to be careful while basing their decision on online reviews. Here I have stated few important points that should be kept in mind while going through online reviews of hospitals.

How India performed in healthcare compared to other similar nations?

Since beginning of this century a large number of policy changes and initiative has been taken in healthcare sector of India. This had led to certain changes in healthcare infrastructure and population health status of the country. During the same time most other nations of the world has also done significant work in the field of healthcare. So how did India perform in healthcare in comparison to other countries that are economically similar to India? Based on the data from World Bank’s, world development indicators and WHO’s, Global health observatory data repository, I did a study to make this comparison, which was published in a healthcare research journal. The findings from this study are interesting and worth sharing with healthcare professionals.

For the sake of brevity, I have skipped the detailed design and methodology of the study (those interested can contact me for full paper). In brief however, the comparison was done between performance of India and overall performance of ‘Lower Middle Income Economies (LMIC)’ (as India falls in this category). Along-side a comparison with neighbouring countries (Pakistan, Sri-Lanka, Bhutan and Bangladesh) was also done. The parameters compared were healthcare infrastructure and health status of the population and within each parameter a group of indicators were chosen. The timeframe used for comparison was from year 2000 to 2015. The findings and learnings from the study are as follows.

How much does it cost to run a hospital?

Hospitals are places that operates 24 x 7 x 365. Crowded OPDs, long waiting time, queued up counters etc. are things that are considered a normal routine of any typical hospital. Many may wonder that the promoters of hospitals must be making big bucks out of this never slowing down business. While it’s true that hospitals generate big revenues from patients’ bills, they also spend a handsome amount on its operational expenses. The cost of running a hospital can be really high and fluctuating and can sometime result in financial losses instead of any gain. The cost at which hospitals operate leaves very thin margin and it is absolutely important that the business managers keep an eye on the expenses, or else the margin may vanish. Below, after going through the expense data of few large hospitals, I have listed down what are the important cost components and how much do they affect the overall expenses in a hospital.

(Read - Performance measures for hospital business)