HYDERABAD: In a rare case of heaping praise on India's healthcare, a study in Harvard Business Review (HBR) has urged the West to emulate India's economically viable healthcare facilities for its new-age innovation and cost-cutting techniques.
The study describes ultra-low costs and innovations in technology in Indian hospitals from constant experimentation, adaptation and necessity are pointing the way to move forward at a time when the global healthcare industry has been hit by the economic slowdown.
HBR, which is a wholly-owned subsidiary of Harvard University, reporting to Harvard Business School, published the study by authors Vijay Govindarajan and co-author Ravi Ramamurti, who hold key posts in top biz schools overseas, in its November 2013 issue.
The authors studied more than 40 hospitals practicing innovative strategies.
Nine among them, treating eye, heart, kidney, bones, cancer and maternity care, were selected for an in-depth study and were found to be providing world class healthcare at 95% lower costs compared to US hospitals.
"Necessity spawns innovation. Apollo Hospitals asked suppliers to shorten the length of sutures after it found that its doctors routinely discarded one-third of each suture," says Vijay Govindarajan, professor of International Business at Tuck School of Business at Dartmouth, Hanover, USA.
Many innovations, sparked by the need to overcome constraints in emerging markets have been highlighted.
While Aravind Eye Care has been picked for perfecting the manual small incision cataract surgery technique that requires less sophisticated equipment and less seasoned surgeons with cheaper lenses, Care hospital and other providers are said to be performing angioplasties by going in through the wrist, rather than the groin (which takes more time to heal).
The LV Prasad Eye Institute's (LVPEI) technology allowing a single cornea to be sliced and used for more than one transplant patient, has been the talking point in the research.
"If US hospitals often eliminate low-skill staff jobs to cut costs, which forces doctors to spend more time on routine tasks, Indian hospitals have taken task-shifting to a new level by creating low-cost healthcare workers at one end of the spectrum and highly focused specialists at the other," the survey says.
They said at Aravind, each doctor performs 1,000 to 1,400 eye surgeries annually compared to 400 by US doctors. Similarly, at Narayana Hrudalaya (NH), each surgeon performs 400 to 600 procedures annually compared to 100 to 200 by US surgeons.
Also, customizing healthcare to suit local conditions, doctors in India have pioneered the beating-heart method of surgery, by which they can operate without shutting down patient's hearts, the report says.
"US costs are much higher than they need to be, even after incorporating higher US salaries. The US uses doctors, equipment, and facilities much too inefficiently and there is waste all around. There is ample room to streamline processes and lower costs without lowering quality. They can learn a few things from the most innovative Indian hospitals," says Ramamurti, strategy director, Centre for Emerging Markets, D'Amore-McKim School of Business, Northeastern University, Boston.
Indian doctors earn anywhere from 20% to 74% of what their American counterparts do, the survey says.
The authors calculated the price of an open-heart surgery at NH after adjusting the salaries of NH doctors and other staff to match US levels. Even with the higher wages factored in; the cost was still only 4-18% of a comparable procedure in a US hospital.
"The accomplishments of a handful of Indian hospitals, usually founded and managed by Indian doctors, is every bit as laudable. More important, they should be emulated by other hospitals," added Ramamurti.
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