QUESTIONNIARE HOME ICU Details of Respondent: Name: Gender: .. Address: .................... Age: . Income: Questionnaire 1 Ha!

a!e "ou #ot an" $ealt$ pro%le&s' If "es (((((((((((((((( 2. Whom you are staying with? a) Children b. Grand children #. Who is care ta$er o% you? a. Children b. Grand children c. c. elati!es elati!es d. "thers . d. "thers . Contact No:

&. What is your daily routine ? '. (ow o%ten do you !isit hos)ital? a) once a wee$ b)once in 2 wee$s c)once a month d)*uarter +,. which hos)ital you are most %amiliar with? I% yes- then s)eci%y +&. (ow much distance are you tra!eling to reach the hos)ital? a) . +$m b) + / 0 $m c) 0 / +, $m d) 1 +, $m 2. Who accom)anies you during your !isit to the hos)ital? a. Children b. Grand children c. elati!es d. "thers . 3. Are you satis%ied with your )resent medical care? a. 4es b. No (ow much do you s)end monthly on hos)ital..?

5. 6o u )re%er home ser!ice or hos)ital? And why .? +2. Are you willing to ta$e the medical care ser!ices at your home i% )ro!ided? a) 4es b) No

++. 6o you )re%er home IC7?8 9:)lain the res)ondent the conce)t o% (ome IC7) eason %or willingness a) you can stay with your %amily b) educes the stress o% tra!elling

+2. 6o you $now any o% the %ollowing home IC7 )ro!iders? +#. What )ercentage o% medical e:)enditure - you are e:)ecting to reduce on (ome IC7? a) ;ore than 2,< b) ;ore than 0,< c) ;ore than 3,< d) ;ore than +,,<
+2. ")inion about (ome IC7 ...

Observations: Home ICU is a well established market in western countries. It is a developing market in India at the moment. Big investors are showing their interest in home ICU market using technology. Employment growth is possible in medical ield through home ICU. In India !eople who know about home ICU are showing interests in home ICU services.