final hospital deep kamal jaiswal

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INTRODUCTION

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INTRODUCTION

Healthcare industry is a wide and intensive form of services which are related to

well being of human beings. Health care is the social sector and it is provided at State level

with the help of Central Government. Health care industry covers hospitals, health

insurances, medical software, health equipments and pharmacy in it.

Right from the time of Ramayana and Mahabharata, health care was there but with

time, Health care sector has changed substantially. With improvement in Medical Science

and technology it has gone through considerable change and improved a lot.

Health care service is the combination of tangible and intangible aspect with the

intangible aspect dominating the intangible aspect. In fact it can be said to be completely

intangible, in that, the services (consultancy) offered by the doctor are completely

intangible. The tangible things could include the bed, the dcor, etc. Efforts made by

hospitals to tangibles the service offering would be discussed in details in the unique

characteristics part of the report.

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OBJECTIVE OF THE

RESEARCH

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Objectives of the Research

The research objectives for the project undertaken can be defined as follows:

To determine the demographic variables of the patients of different hospitals

Examine the patients perception about the hospitals.

To judge the satisfaction level of hospitals of different administration like

governmental, private and missionary

The research tracks responses at following two layers

1. Services availability

2. Cost effectiveness

To analyze the psychographic variables of the customers of different types of

hospitals.

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SCOPE OF THE STUDY

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Scope of the study

It is aimed to study the hospitals at Sitapur and types of services available, availability of

specialized doctors and patients behavior regarding various hospitals. The project is

analyzed the demographic, psychographic and economic characteristics of the patients in

taking medication. It includes the detailed study of patients focusing on the various

parameters that lead to identifying and understanding the perception of the patients.

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EXECUTIVE SUMMARY

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outlay is for the control and eradication of diseases like malaria, , blindness being

implemented under Centrally sponsored schemes.

Another major component of the central sector health programme is purely Central

schemes through which financial assistance is given to institutions engaged in various

health related activities. These institutions are responsible for contribution in the field of

control of communicable & non-communicable diseases, medical education, training,

research and parent -care.

In our project our focus has been the hospital sector which is the major component

of the healthcare industry.

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Overview

The Hospital Industry

Some Facts

Indias healthcare industry is currently worth Rs 73,000 crore which is roughly 4

percent of the GDP. The industry is expected to grow at the rate of 13 percent for

the next six years which amounts to an addition of Rs 9,000 crores each year.

The national average of proportion of households in the middle and higher middle

income group has increased from 14% in 1990 to 20 % in 1999.

The population to bed ratio in India is 1 bed per 1000, in relation to the WHO norm

of 1 bed per 300.

In India, there exists space for 75000 to 100000 hospital beds.

Private insurance will drive the healthcare revenues. Considering the rising middle

and higher middle income group we get a conservative estimate of 200 million

insurable lives

Over the last five years, there has been an attitudinal change amongst a section of

Indians who are spending more on healthcare.

Corporate hospitals mushroomed in the late eighties. The boom remained short lived and

out of the 22 listed hospitals scrips, most are being trading below par. An increasingly

fragmented market, lack of statistics, capital intensive operations and a long gestation

period are all wise reasons to shy away from investing in the healthcare industry.

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Government and trust hospitals dominate the scene. Many of the trust hospitals suffer from

poor management. Good corporate hospitals are still too few to amount to a critical mass.

Corporate hospitals failed a decade ago because they emerged in isolation and werent part

of a larger phenomenon. However, now, there are the insurance companies, the hospital

hardware and the software companies that have come together to create the boom.

Factors Attracting Corporate In the Healthcare Sector

Recognition as an industry: In the mid 80s, the healthcare sector was recognized as an

industry. Hence it became possible to get long term funding from the Financial Institutions.

The government also reduced the import duty on medical equipments and technology, thus

opening up the sector.

Since the National Health Policy (the policys main objective was Health For All by the

Year 2000) was approved in 1983, little has been done to update or amend the policy even

as the country changes and the new health problems arise from ecological degradation. The

focus has been on epidemiological profile of the medical care and not on comprehensive

healthcare.

Socio-Economic Changes: The rise of literacy rate , higher levels of income and

increasing awareness through deep penetration of media channels, contributed to greater

attention being paid to health. With the rise in the system of nuclear families, it became

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necessary for regular health check-ups and increase in health expenses for the bread-earner

of the family.

Brand Development: Many family run business houses have set-up charity hospitals. By

lending their name to the hospital, they develop a good image in the markets which further

improves the brand image of products from their other businesses.

Extension To Related Business: Some pharmaceutical companies like Wockhardt and

Max India, have ventured into this sector as it is a direct extension to their line of business.

Opening Of The Insurance Sector: In India, approx. 60% of the total health expenditure

comes from self paid category as against governments contribution of 25-30 %. A majority

of private hospitals are expensive for a normal middle class family. The opening up of the

insurance sector to private players is expected to give a shot in the arms of the healthcare

industry. Health Insurance will make healthcare affordable to a large number of people.

Currently, in India only 2 million people ( 0.2 % of total population of 1 billion), are

covered under Mediclaim, whereas in developed nations like USA about 75 % of the total

population are covered under some insurance scheme. General Insurance Company has

never aggressively marketed health insurance. Moreover, GIC takes up to 6 months to

process a claim and reimburses customers after they have paid for treatment out of their

own pockets. This will give a great advantage to private players like Cigna which is

planning to launch Smart Cards that can be used in hospitals, patient guidance facilities,

travel insurance, etc.

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The Consultants, Financiers and Insurance Agencies are to benefit from this boom. The

insurers will use PPOs, that will grow into HMOs, to assume insurance risks on clients

behalf. Medical Equipments, Medical Software and Hospitals will see the biggest boom.

THE SERVICE MARKETING TRIANGLE:

Company : Here, the hospital is the company that dreams up an idea of

service offering (treatment), which will satisfy the customers (patients)

expectations (of getting cured).

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Customer : The patient who seeks to get cured is the customer for the hospital as he

is the one who avails the service and pays for it.

Provider : Doctor, the inseparable part of the hospital is the provider, as he is the

one who comes in direct contact with the patient. The reputation of the hospital is

directly in the hands of the doctor. A satisfied patient is a very important source of

word of mouth promotion for the organization.

Classification of Hospitals

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HOSPITALS

Objective Ownership Path Size

Teaching-

cum-

Research

General

Special

Government

Semi-Govt

Voluntary

Agencies

Private

Charitable

Allopath

Ayurved

Homeo

Unani

Others

District

Taluk

PrimaryHealth

Centre

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7 Ps of marketing for hospitals

Product:

The service product is an offering of commercial intent having features of both

intangible and tangible, seeking to satisfy the new wants and demands of the consumer.

Hospital industry is action oriented and there is a lot of interaction with the customers

(patients). The service product of the hospitals normally have the following features:

o Quality Level: When we talk about marketing hospitals, it is natural that we

are very particular about managing our services in the right fashion.

Supportive services play an important role in improving the quality of

medicare. These services which include laboratory, blood-banks, catering,

radiology and laundry, in a true sense determine the quality of services

made available by medical and para-medical personnel. They get a strong

base for treatment since the diagnostic aspect determines a direction. To get

the best result from OT, it is natural that equipments are properly sterlised.

In addition, the dresses and clothes are also required to be made bacteria

free. The patients are required to wear disinfected linen which should be

made available. The radiology department should have hi-tech facilities

keeping in view the pressure of work. Of late, we find sophisticated

equipments and unless hospitals make the same services available the same,

the quality of services cannot be improved.

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o Accessories: This is a very good way of segmenting customers. Many

hospitals provide additional services such as catering, laundry, yoga

sessions, cafeterias, etc. for the customers (patients)who are willing to pay

extra. Hospitals have different wards - General and Special. Certain

hospitals provide services for the family members of the patients (when

they are not from the same city) accommodation and catering.

o

Packaging: It is the bundling of many services into the core service. Eg:

Apollo hospital offers a full health check-up to the patients. Similarly other

hospitals also offer package deals for health check-ups. For example if a

person has to undergo a bypass surgery, he can pay a lump sum amount

during admission, say rupees 1 lakh for all procedures, tests, stay, etc, at

once.

o Product line: hospitals through their services offer many choices to the

patients and cover a wide range of customer needs. For example: Apollo

hospital has dental department, cardiology department, etc. and within the

dental department it has dental surgery, root canal, etc.

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o Brand name: The hospitals, to differentiate themselves, and their services

from others use a brand name. The intangibility factor of the service makes

it all the more important for the hospitals to do so.

Place

Under hospital marketing, distribution of Medicare services plays a crucial role. This

focuses on the instrumentality of almost all who are found involved in making services

available to the ultimate users. In case of hospitals the location of hospital plays a very

important role. The kind of services a hospital is rendering is also very important for

determining the location of the hospital.

Eg. Tata memorial hospital specializes in cancer treatment and is located at a centre place

unlike other normal hospitals, which you can find all over other places.

It can be unambiguously accepted that the medical personnel need a fair blending of two

important properties i.e. they should be professionally sound and should have in-depth

knowledge at psychology. A particular doctor might be famous for his case handling

records but he may not be made available for all the patients because of the place factor.

Now in this case the service provided, that is the doctor may be a visiting doctor for

different hospitals at different locations to beat the place factors.

Unlike other service industries, under hospital marketing all efforts should be for making

available to the society the best possible medical aid.

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In a country like India, which is geographically vast and where majority of the population

lives in the rural areas, place factor for the hospitals play a very crucial role. A typical

small village / town may be having small dispensaries but they will not have super

speciality hospitals. For that they will have to be dependent on the hospitals in the urban

areas.

People

Under hospital marketing the marketing mix variable people includes all the different

people involved in the service providing process (internal customers of the hospitals) which

includes doctors, nurses, supporting staff etc. The earliest and the best way of having

control on the quality of people will be by approving professionally sound doctors and

other staff.

Hospital is a place where small activity undertaken can be a matter of life and death, so the

people factor is very important. One of the major classifications of hospitals is private

and government. In the government hospital the people factor has to be specially taken care

of. In Indian government hospitals except a few almost all the hospitals and their personnel

hardly find the behavioural dimensions significant. It is against this background that even if

the users get the quality medical aid they are found dissatisfied with the rough and indecent

behaviour of the doctors.

Under hospital marketing a right person for the right job has to be appointed and they

should be adaptable and possess versatility. The patients in the hospitals are already

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Apart from this flow there are other allied activities like record keeping administration at

services etc which fall under the process factor. These stages do not exist separately but

are interlinked. The most important elements are lines of communication within the setup.

The experience of the patient depends on the final interplay of all these factors.

Physical evidence

It does play an important role in health care services, as the core benefit a customer seeks is

proper diagnosis and cure of the problem. For a local small time dispensary or hospital

physical evidence may not be of much help. In recent days some major super speciality

hospitals are using physical evidence for distinguishing itself as something unique.

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Physical evidence can be in the form of smart buildings, logos, mascots etc. a smart

building infrastructure indicates that the hospital can take care of all the needs of the

patient.

Promotion:

Hospitals for promotion use either advertisement or PR or both after taking into

consideration the target customers, media type, budget and the sales promotion.

Since a few years the prime times in T.V. are reserved for advertising social issues like

family planning, use of different types of contraceptives, care for the girl child and so

on. These commercials use the common man approach for reference group appeal. In

case of health care products and services use for common man appeal is widely

prevalent. The use of celebrities is not as effective as that of a common man. An

ordinary person thinks that if it works well for people like him, it will also work equally

well for him. The identification with the common man is easy and quick.

Besides TV, other media of promotion are to be used innovatively. Unlike the urban

area, in rural areas newspapers and magazines do not have the same impact in

conveying messages. In villages, hoardings and wall writings near the markets and

recreation centers attract the attention of villagers. This market consists of 180 million

strong middle income group and a small income group. This group has a large

discretionary income. These discerning consumers are very careful in choosing health

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care services. The last decade has witnessed a health, appearance and nutrition

conscious population.

The health care field has become very competitive. Although around one-fourth of our

population stays in urban India, three fourths of the total doctors have engaged

themselves in this part. Many of these doctors visit the contiguous rural areas, but they

may operate from the urban area. The patients of upper middle and upper income group

have a wide choice to make from a number of clinics and hospitals. Therefore, many

hospitals have abandoned traditions and adopted marketing strategies to woo more and

more patients to their clinics.

Word-of-mouth plays a very important role in promotion of hospitals. A person in need

of a health care service does not know for sure where to search for relevant

information. He consults his family members, relations and friends first. The patients

who come to a hospital generally have the old patients of that hospital as referrals.

Word-of-mouth plays an important role during information acquisition stage of the

customers as there are no objective performance measures to judge the various

alternatives available to them. Therefore, satisfied past patients of a hospital can bring

more number of patients to that hospital than a number of advertisements.

In a competitive market place, the images of the firms swill affect their competitive

standing. One factor that is likely to have a significant impact on the health care scene

is the growth of hospital chains such as Apollo Hospitals, Birla Health Centres ,etc.

Artificial heart transplants and other complex operations although are few in number

and generate a small portion of the total revenue, they help in generating word-of-

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mouth which health care providers are actually interested. Many of these companies are

spending a lot in corporate advertising for Image building.

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Marketing hospitals

Marketing in Hospitals Marketing is unethical was the frequent refrain in the eighties,

when very few hospitals realized that it was necessary to incorporate marketing as an

integral function in the hospital operations. But the major argument at that time lay in

understanding whether this professional orientation was really required for its

viability, profitability and sustainability. This argument however became favorable in

the late nineties as corporate companies like Wockhardt and Max India started

venturing into the hospital industry, apart from the ongoing mergers and acquisitions

that were already taking place at that time. Even the TPAs started building tie-ups

with corporate clients and there was already an abysmal utilization of resources in

the existing hospitals. In addition to the above a major factor that contributed to the

acceptance of marketing in hospitals was an increase in the delivery of services.

Perception of patients was another important consideration for hospitals, as they felt that

the patients would take them as profit oriented organization rather than service oriented

organization. Ultimately, marketing was accepted only by a few while the others discarded

the concept. Hospitals who accepted marketing also carried out their functioned by

concentrating around corporate clients. Lately it has been felt that many Indian hospitals

have a dilemma regarding the functions of marketing. In an era where hospitals are

experiencing a major shift in their clientele, they are worried more about the patients

perception of hospitals and therefore the concept of brand restructuring and brand

engineering is vital.

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As hospitals spend millions of rupees in technology and infrastructure, it becomes

necessary, that they attract patients and generate funds. In order, to do the same, the

hospitals follow various marketing and brand building exercises. Some of them are listed

below:

Many hospitals have eminent personalities from the industry in their Board of

trustees. This indirectly leads to increase in, inflow of patients, working in the

companies of these Trustees. Besides the presence of eminent personalities creates

a sense of confidence in the minds of people.

Private hospitals can attract their shareholders by offering discounts. For example,

a special discount of 20 % on all preventive health checks is offered to all

shareholders of Apollo Hospitals Limited.

Hospitals have long-term understanding with PPOs (Preferred Provider

Organization), which further have understanding with corporate. Any case of

sickness found in the employees of these corporate refer them to the PPOs , which

further sends them to the hospital for check-ups and treatment.

The success rate of crucial operations and surgeries, reflect the technological and

knowledge- based edge of the hospital over the competitors. Such successes are

discussed in health magazines and newspapers, which becomes a natural advantage

for the hospital.

Some hospitals by means of their past track record have created a niche market for

themselves. For example, Hinduja Hospital is known for its high-quality healthcare

at reasonable rates, whereas Lilavati Hospital is known for its five-star services.

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Hospitals hold seminars and conferences relating to specific diseases, where they

invite the doctors from all round the country, for detailed discussion. This makes

the hospital well known amongst the doctors, who could in future refer complicated

cases to the hospital.

Hospitals can also promote medical colleges. This helps them to generate extra

resources in form of fees, using the same infrastructure.

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HOSPITAL AT SITAPUR

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Hospitals at Sitapur

On basis of administration hospitals can be widely categorized into three types:-

Government Hospitals

Private Hospitals

Missionary Hospitals

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Government Hospitals at Sitapur

There are two government hospitals at Sitapur i.e. District Hospital & Female Government

Hospital.

District Hospital

This hospital is directly governed by Government of Uttar Pradesh and all the Doctors,

Administrative Staff, Nurses and Ward Boys are the employee of Government of Uttar

Pradesh.

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Departments at Government Hospital

Department Specialist

Administration Dr. Vijay Kumar Singh (M.B.B.S)

General Physician (General Ward) Dr. Awdhesh Chandra (M.B.B.S)

Department of Surgery Dr. H.K.Fuloria (M.S)

Dr. Shekhar Bharaddwaj (M.S)

Department of Cardiology Dr. B.R.Jaiswal (M.B.B.S , Dip (card.)

Department of Skin & Venereal Diseases Vacant

Department of ENT (Ear, Nose, Throat) Dr. Yashwant Singh (D.L.O)

Emergency Dr. Sharad Chandra (M.B.B.S)Department of Pediatrics Dr. S.P. Singh (M.D (Ped.)

Department of Tuberculosis & Chest Dr. A.K.Arya (D.T.C.D)

Department of Orthopedics Dr. S.P.Ojha M.D (Ortho)

Dr. D.K.Gangwar M.D (Ortho)

Department of Dental Dr. Sunita Ambust (B.D.S)

Fee Structure

Patient form of has to taken from outdoor of Re. 1 for any department which

is valid for 1 week. Basic medicine is for free. Prescribed medicine can be

taken from any medical store.

Other Facilities Available

X- Ray:- Rs. 55 per X-ray

Pathology

Normal Surgery

Oxygen

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Ambulance

Milk for Kids

DOTS (free Medicine for Tuberculosis)

AIDS Diagnosis (Free)

Wards for Admitting Patients (No of Total Beds 207)

General Ward:- Rs. 10 daily per bed

Private Ward :-Rs. 30 Daily per bed

Emergency:- Totally Free

Female Government Hospital

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This hospital was basically developed for birth operations, normal deliveries, various

vaccinations in kids and new born baby.

Basic medications available

Delivery

Surgery

Vaccination

Adolescence gynecological problems

General gynecological problems

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Departments at Government Hospital


Administration Chief Medical Officer

Dr. Suman Mishra

D.G.O

O.P.D Dr. Suvidha Singh

D.G.O

Department of Pediatrics Dr. Sushma Karanwal

M.B.B.S

Dr. Madhur Singha

M.B.B.S

Department of Gynecology Dr. Richa Pandey

D.G.O

Fee Structure

Patient form of has to taken from outdoor of Re. 1 for any department which is valid for 1

week. Basic medicine is for free. Prescribed medicine can be taken from any medical store.

Other Facilities Available

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Normal Surgery

Oxygen

Ambulance

Milk for Kids

Wards for Admitting Patients

Emergency Totally Free

Private Hospitals

There are many private hospitals and nursing homes in Sitapur. Some are detailed below:

1. Saksham Nursing Home

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Dr. Kanika Agarwal

D.G.O (Gayane)

Dr. Sameer Agarwal

M.S, Ortho

2. Pragati Nursing Home

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Dr. Anand Jaiswal

M.S (Ortho)

Dr. Neera Jaiswal

M.S

3. Vinod Nursing Home

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Dr. P.K. Rastogi

B.A.M.S

Dr. P.K.Dhawan M.D (Consultant on Call)

4. Amrit Nursing Home

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Dr. G.P. Gupta

M.S

Dr. Sikha Gupta

Gayane

5. Ishwar Mother & Child Care Nursing Home

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Dr, Sunil Vaish

M.D (Pediatrician)

Dr. Chitra Vaish

M.S (D.G.O)

6. Sethi Nursing Home

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Dr. Gagan Sethi

M.S (Ortho)

Dr. Seema Sethi

D.G.O

Dr. Manish Sethi

DCH (Pediatrician)

Dr. Shilpi Sethi

M.D (Anesthesia)

Missionary Hospital

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B.C.M hospital is the only one missionary hospital at dist. Sitapur, Situated at Khairabad,

nearly six kilometers from the city heart.

BCM hospital, was established by Fr. Gerard at Khairabad for serving people.

Departments at BCM Hospital


Administration

Dr. Sr, Mary Rose

Chief Administrator

Dr. Manish Rastogi

M.D, Physician

Assistant administrative

Department of Gynecology

Dr. Sr. Leena

D.G.O

Dr. Alka

M.B.B.S

Dr. Reena

M.B.B.S

Dr. Sushma

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M.B.B.S

Dr. Nancy

M.B.B.S

Dr. Mamta

M.B.B.S

General Physician

Dr. Vishal Bhatnagar

M.D

Dr. Rajeev

M.B.B.S

Dr. A.P Gupta

M.B.B.S

Dr. Shailendra Shukla

M.B.B.S

Special Facilities

Ophthalmology,

General Surgery,

Orthopedic,

Psychiatrist,

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Pediatrics,

X-ray,

Ultrasound,

Pharmacy

Skin Care.

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Methodology of Project

A survey process consists of stages or steps that guide the project from its conception

through the final analysis, recommendations and ultimate actions. The research process

provides a systematic, planned approach to the research project and ensures that all aspects

of the research project are consistent with each other.

SURVEY PROCESS

final hospital deep kamal jaiswal

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