AMITY UNIVERSITY

AMITY SCHOOL OF BUSINESS

DISSERTION ON MEDICAL TOURISM

IN INDIA

UNDER THE GUIDANCE OF

Mrs. Radhika Meenakshi

SUBMITTED IN PARTIAL FULFILLMENT

OF THE 3 YEAR COURSE OF BACHELOR OF
BUSINESS ADMINISTRATION (2005-2008)

SUBMITTED BY-
Sharanjeet Singh Baath
A111OIO8C52

1
 ACKNOWLEDGEMENT

My gratitude goes to my mentor Ms. Radhika Menakshi, who has

guided me through out this project and also my respected teachers
Professor Alka Munjal, Ms. Ekta Kapoor and Ms.Supriya Bhasin at
the Amity University for giving me the substantial knowledge and
inspiration.
I would also like to thank Marketing Executives of indraprastha
Apollo , Max Hospital, Fortis and Escorts for constant guidance to
conduct the present arduous project and untiring cooperation which
they extended to me throughout the duration of my dissertation.
I am thankful to the Amity Business School Library for allowing me
access to information and knowledge
My special thanks are for those who spared time for providing
information and responding to the questionnaire.

Sharanjeet singh Baath

A1110108C-63

2
 Amity University
--------Uttar Pradesh--------
Amity School of Business

CERTIFICATE

This Dissertation report on _______________________________ is submitted

in partial fulfillment of the requirement of Bachelor of Business
Administration (BBA), Of Amity School of Business, Amity University
Uttar Pradesh.

This is a bonafide work conducted by

_________________________ enrollment number
_____________________of BBA class of 2008; under the
guidance of ______________________ (industry guide) and
_____________________(faculty guide).

3
TABLE OF CONTENTS
CHAPTER 1.

• INTRODUCTION 6- 9

a) Brief description of Healthcare industry.

b) Healthcare in India
c) Tourism in India
d) Medical tourism
e) Review of literature

CHAPTER 2

• MEDICAL TOURISM 10-39

CHAPTER 3

• Objective and sub objectives 40

• Research methodology 41
• Research design
• Data collection sources
• Primary data
• Secondary data
• Sample size 42
• Limitations of the study
• Parameters and criteria for the viability of the project 43

CHAPTER 4

MARKET VIABILITY OF INDIAN HEALTHCARE INDUSTRY 43-55

4
 • Segmentation
• Marketing mix
• Demand forecast

CHAPTER 5
SAMPLE BACKGROUND

a) Apollo 55-58
b) FORTIS 58-60
c) Max Hospital 60-61
d) Escorts 61-64

CHAPTER 6

Analysis and interpretation 65-71

CHAPTER 7

Findings 72-73
Conclusion 74-75
Recommendation 76

CHAPTER 8

APPENDIX

Bibliography 77-78
Questionnaire 79-80

5
CHAPTER 1

HEALTHCARE INDUSTRY

The health care industry is considered an industry or profession which

includes peoples exercise of skill or judgment or the providing of a service
related to the preservation or improvement of the health of individuals or the
treatment or care of individuals who are injured, sick, disabled, or infirm.
The delivery of modern health care depends on an expanding group of
trained professionals coming together as an interdisciplinary team.

HEALTHCARE IN INDIA
Healthcare in India is the responsibility of the individual Indian states. The
Indian constitution charges those states with "the raising of the level of
nutrition and the standard of living of its people and the improvement of
public health". There is also a National Health Policy, endorsed by
Parliament in 1983.

TOURISM IN INDIA

Welcome to Incredible India, where culture echoes, tradition speaks, beauty

enthrall and diversity delights.

6
 Indian tourism is one of the most diverse products on the global scene.
India has 26 world heritage sites. It is divided into 25 bio-geographic
zones and has wide ranging eco tourism products. Apart from this,
India has a 6,000 km coastline and dozens of beaches. . It also has
one of the world's biggest railway systems opening possibilities for
those interested in rail tourism. India also has excellent hospitals
offering affordable Medicare and traditional healthcare systems like
Ayurveda.

MEDICAL TOURISM

Medical Tourism refers to movement of consumers to the country providing

the service for diagnosis and treatment. During the past few years, the

number of people going out of their home country to consume health

services has significantly increased. The size of this market is estimated to

be $40 billion based on a Saudi Report in 2000. During the past four years,

the market grew at a whopping rate of 20-30% and is expected to grow

further. Considering this growth the current market size is estimated to be

$100 billion. Medical Tourism industry offers tremendous potential for the

developing countries because of their low-cost advantage. The advantages of

medical tourism include improvement in export earnings and healthcare

infrastructure.

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Medical tourism can be broadly defined as provision of ‘cost effective’

private medical care in collaboration with the tourism industry for patients

needing surgical and other forms of specialized treatment. This process is

being facilitated by the corporate sector involved in medical care as well as

the tourism industry - both private and public.

REVIEW OF LITERATURE

• An estimated 150,000 "medical tourists" visited India last year,

representing a 20 per cent jump over the previous year.
• The CII-McKinsey report suggests that medical tourism could fetch as
much as $2 billion by 2012, compared to an estimated $333 million
currently.
• Ayurveda tourism earned RS.6000 crore last year
• A Famous Mumbai and Goa based cosmetic surgeon says his practice
goes 1200 international patient last year, double the number from
previous year

Source- http://en.wikipedia.org/wiki/Healthcare_in_India

• Medical Treatment in USA

Equals to
A tour to India + Medical Treatment + Savings

8
(SOURCE CII-MCKINSEY REPORT)

• "First World treatment' at Third World prices".

Patients from the UK and North America make up a little more than a trickle
right now, but there is big potential for growth," said Mr Anil Maini, head of
healthcare business marketing at the Escorts Heart Institute and Research
Centre, New Delhi

Source -The Washington.Thursday October 21st 2004.

• National Health policy 2002, for example, says: “To capitalise on the
comparative cost advantage enjoyed by domestic health facilities in
the secondary and tertiary sector, the policy will encourage the supply
of services to patients of foreign origin on payment.

Source- www.indiamedicaltourism.com

CHAPTER 2

9
 Medical Tourism

Introduction:

The purpose here is to provide you with up to date

information and resources about the rapidly growing
industry known as "medical tourism" so that you may
make educated and well informed decisions regarding
your travel, accommodations, and medical, dental, and
surgical care.
It is my sincere hope that the information provided here will assist and
empower you to make confident decisions regarding your health and well
being.

Why India?

10
The countries where medical tourism is being actively
promoted include Greece, South Africa, Jordan, India,
Malaysia, Philippines and Singapore. India is a recent
entrant into medical tourism. According to a study by
McKinsey and the Confederation of Indian Industry,
medical tourism in India could become a $1 billion business by 2012. The
report predicts that: "By 2012, if medical tourism were to reach 25 per cent
of revenues of private up-market players, up to 2,297,794,117 USD will be
added to the revenues of these players". The Indian government predicts that
India's $17-billion-a-year health-care industry could grow 13 per cent in
each of the next six years, boosted by medical tourism, which industry
watchers say is growing at 30 per cent annually.

Price advantage is a major selling point. The slogan, thus is, "First World
treatment' at Third World prices". The cost differential across the board is
huge: only a tenth and sometimes even a sixteenth of the cost in the West.
Open-heart surgery could cost up to $70,000 in Britain and up to
$150,000 in the US; in India's best hospitals it could cost between $3,000
and $10,000. Knee surgery (on both knees) costs 350,000 rupees ($7,700)
in India; in Britain this costs £10,000 ($16,950), more than twice as
much. Dental, eye and cosmetic surgeries in Western countries cost three to
four times as much as in India.

India have a lot of hospitals offering world class treatments in nearly every
medical sector such as cardiology and cardiothoracic surgery, joint
replacement, orthopaedic surgery, gastroenterology, ophthalmology,
transplants and urology to name a few. The various specialties covered are

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Neurology, Neurosurgery, Oncology, Ophthalmology, Rheumatology,
Endocrinology, ENT, Paediatrics, Paediatric Surgery, Paediatric Neurology,
Urology, Nephrology, Dermatology, Dentistry, Plastic Surgery,
Gynaecology, Pulmonology, Psychiatry, General Medicine.

For long promoted for its cultural and scenic beauty, India is now being put
up on international map as a heaven for those seeking quality and affordable
healthcare. Analysts say that as many as 150,000 medical tourists came to
India in 2004. As Indian corporate hospitals are on par, if not better than the
best hospitals in Thailand, Singapore, etc there is scope for improvement,
and the country is becoming a preferred medical destination. In addition to
the increasingly top class medical care, a big draw for foreign patients is also
the very minimal or hardly any waitlist as is common in European or
American hospitals.

Leisure Tourism is already very much in demand in India as the country

offers diverse cultural and scenic beauty. India has almost all sort of
destinations like high mountains, vast deserts, scenic beaches, historical
monuments, religious temples etc. Known for its hospitality for tourists, the
county has opened doors to welcome with the same hospitality f medical
patients/ service seekers.

12
MEDICAL TOURISM AS AN INDUSTRY

Medical tourism can be broadly defined as provision of ‘cost effective’

private medical care in collaboration with the tourism industry for patients

needing surgical and other forms of specialized treatment. This process is

being facilitated by the corporate sector involved in medical care as well as

the tourism industry - both private and public.

In many developing countries it is being actively promoted by the

government’s official policy. India’s National Health policy 2002, for

example, says: “To capitalise on the comparative cost advantage enjoyed by

domestic health facilities in the secondary and tertiary sector, the policy will

encourage the supply of services to patients of foreign origin on payment.

The rendering of such services on payment in foreign exchange will be

treated as ‘deemed exports’ and will be made eligible for all fiscal incentives

extended to export earnings”. The formulation draws from recommendations

that the corporate sector has been making in India and specifically from the

“Policy Framework for Reforms in Health Care”, drafted by the prime

13
minister’s Advisory Council on Trade and Industry, headed by Mukesh

Ambani and Kumaramangalam Birla.

2.Overview Of Medical Tourism In Global Scenario

Countries from where people head for India are UK, Bangaladesh, Oman,

SriLanka, Indonesia, Mauritius, Nigeria, Kenya, and Pakistan etc. The

international patients can make decision by looking at the following table,

which shows charges against the type of surgery.

Cost Table

Procedure Charges (US $)

Category US INDIA
Heart Surgery 30,000 8000

Bone marrow transplant 250,000 69,000

Liver transplant 300,000 69,000

Orthopaedic Surgery 20,000 6,000

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Cataract Surgery 2,000 1,250

India offers a real good cost advantage over the western countries. This cost

factor becomes very important while formulating schemes to attract the

Indian diaspora as they generally compare the relative costs before going for

treatment.

Healthy Budget table

Heart Surgery Costs $ 30,000 ( Rs 14.4 lakhs) in the

US, But Indian Hospitals charge Rs 4

Lakh.
Orthopedic Surgery In the west, the expense comes to

$20,000(Rs 9.6 lakh). The package in

India costs one third of that amount.

Cataract Surgery $20,000 is the price for surgery in the

US. In India, it comes to just $500

Liver Transplant The cost comes to a whopping

15
 $300,000 abroad while Indian super

specialty hospitals perform the

operation for

Global Medical Tourism

No of

Foreigners Strengths
Country From Money
treated last
Earned
year

600,000 US, UK $470 m Cosmetic

surgery,
THAILAND

Organ

transplants,

Dental

treatment,

Joint

replacements

16
 126,000 Middle East $600 m Organ

JORDAN transplants,

Fertility

treatment,

Cardiac care

100,000 Middle East,N.A Cardiac care,

Bangaladesh, Joint
INDIA
UK, Replacements,

Developing Lasik

countries
85,000 US, Japan,$40 m Cosmetic

Developing surgery
MALAYSIA
countries

50,000 US, UK N.A Cosmetic

surgery, Lasik.
SOUTH
Dental
AFRICA
treatment

17
Treatment Costs ($)*

Procedure US INDIA SOUTH THAILAND

AFRICA

Facelift 8000-20,000 10,000- 20,000 1,252 2,682

Hip 17,000 2,500 6,671 N.A

replacement

Open heart 150,000 5,000- 10,000 13,333 7,500

surgery

Eye (Lasik) 3,100 7,000 2,166 730

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Medical Travelers Clusters

Ø The first is made up of the SAARC countries.

Ø The second major group- the African (Nigeria ,Nambia etc)

Ø The third big group of medical travelers comes from the Middle

East .

Ø The last group of medical travelers from a motley lot

OUTSOURCING

Outsourcing of logistics has changed over the years we have seen business

models adapted to meet the needs of the buyer. Hospital major areas like

house keeping, Food and Beverage, Lenin, diagnostics labs, medical

19
equipment, ambulatory services etc are outsourced. Hospital focuses on core

activity of patient care.

Medical Business Process Outsourcing includes Medical coding, Billing,

Claims Processing, Transcription etc.

6.1 GROWTH OF THE MEDICAL TOURISM INDUSTRY

The countries where medical tourism is being actively promoted include

Greece, South Africa, Jordan, India, Malaysia, Philippines and Singapore.

India is a recent entrant into medical tourism. According to a study by

McKinsey and the Confederation of Indian Industry, medical tourism in

India could become a $1 billion business by 2012. The report predicts that:

“By 2012, if medical tourism were to reach 25 per cent of revenues of

private up-market players, up to Rs 10,000 crore will be added to the

revenues of these players”. The Indian government predicts that India’s $17-

billion-a-year health-care industry could grow 13 per cent in each of the next

six years, boosted by medical tourism, which industry watchers say is

growing at 30 per cent annually.

20
In India, the Apollo group alone has so far treated 95,000 international

patients, many of whom are of Indian origin. Apollo has been a forerunner in

medical tourism in India and attracts patients from Southeast Asia, Africa,

and the Middle East. The group has tied up with hospitals in Mauritius,

Tanzania, Bangladesh and Yemen besides running a hospital in Sri Lanka,

and managing a hospital in Dubai.

Another corporate group running a chain of hospitals, Escorts, claims it has

doubled its number of overseas patients - from 675 in 2000 to nearly 1,200

this year. Recently, the Ruby Hospital in Kolkata signed a contract with the

British insurance company, BUPA. The management hopes to get British

patients from the queue in the National Health Services soon. Some

estimates say that foreigners account for 10 to 12 per cent of all patients in

top Mumbai hospitals despite roadblocks like poor aviation connectivity,

poor road infrastructure and absence of uniform quality standards.

Analysts say that as many as 150,000 medical tourists came to India last

year. However, the current market for medical tourism in India is mainly

limited to patients from the Middle East and South Asian economies. Some

21
claim that the industry would flourish even without Western medical

tourists. Afro-Asian people spend as much as $20 billion a year on health

care outside their countries – Nigerians alone spend an estimated $1 billion a

year. Most of this money would be spent in Europe and America, but it is

hoped that this would now be increasingly directed to developing countries

with advanced facilities.

Contribution to GNP

According to the World Travel and Tourism Council, India' s travel

and tourism (T&T) industry is expected to contribute 2.1 percent to
Gross Domestic Product in 2006 (INR 713.8 billion or US$16.3
billion).

In the first half of the Annual Plan period of 2005-2006, the Ministry
of Tourism has taken several initiatives in the field of infrastructure
development and positioning Indian tourism as a major engine for
economic growth. These include:

• Emphasis for developing the existing and new destinations to world-

class standards.
• Improvement of connectivity to important destinations.

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 • Identification of 10-15 new destinations / circuits by each state /
UT for development to world class standard with all the required
infrastructure components.

Benefits of Medical Tourism

Tangible

Foreign exchange earrings which enable economic wealth of nation

· Cost Advantage in Tariff over the Developed countries

· Improve information sharing

· Increase in efficiency of patient care process, cutting edge treatment.

· Improvement in hospital supply chain efficiency

· Strategic alliances with business partners within and outside the

country

· Technology and Knowledge Transfer

· Better logistics performance both in internal and external

· Creation of employment opportunities in the industry

· Better utilization of Infrastructure and skilled manpower

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· Opportunity for development in Infrastructure in Health, Tourism and

Travel.

· Economies of scale.

· Connectivity with air, road, rail and information and communication

industries

· Clustering of medical Travelers

· Health opportunities for foreign patients may lead to better standards at

home.

· Scope for Research and Development to offer comprehensive medical

solutions.

Intangible

· International acceptance of country as a global healthcare provider

· Social and cross cultural experience

· International customer relations

· Global Marketing and Medical Trade relations

· Brand image of nation as world-class healthcare destination.

· Competitive advantage

· Better coordination among the partners i.e. hospital and hospitality

industry.

24
· Public and Private Partnerships

· Patient satisfaction

Is India prepared for global medical tourism boom?

In recent years, India is being seen as an important player in the globally

growing "Medical Tourism", which is projected as a new segment in travel

and healthcare business. "Global health destination" .

In simple words, medical tourism provides state-of-the-art private medical

care in collaboration with tourism industry to patients from other countries

at highly competitive price when compared to those prevalent in the western

countries. The CII- McKinsey report mentions that the medical tourism

market has been growing at the rate of 15 per cent for past five years and by

2012, Rs 10,000 crore will be added to revenues of the private players.

Globally, medical tourism is said to be USD 40 billion industry and analysis

available project that people from Afro-Asian countries spend as much as

USD 20 billion every year on healthcare services from outside their

countries.

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Foremost, amongst the current private players, in medical tourism are

hospitals in the Apollo chain. Main destinations are Delhi, Mumbai,

Chennai, Bangalore and Hyderabad. These cities have private hospitals with

medical expertise that can offer world class healthcare that costs one fifth to

one tenth of the cost in US or Europe depending on the intervention

required.

In addition to above destinations, the country has many cities with advanced

medical facilities making India, a country with tremendous potential to

capitalise on to increase its earnings to more than USD 1 billion annually

and create hundreds of thousands new jobs in many sectors. This projection

excludes earnings from other products included in the wellness tourism

meant for rejuvenation of body and mind, eg herbal therapy, naturopathy,

yoga, aromatherapy, reiki, music therapy which does not require advanced

medical expertise.

The apprehensions expressed by some sections that "systematic development

of medical tourism will boost up earnings by catering to the wealthy

foreigners and Indians working in the foreign countries but it may adversely

hit the low income population" need to be addressed for gaining approval of

political opinions with varied views on liberalisation. From past ten years,

26
 India has entered a phase in medical expertise that is considered on par with

international standards. This is because of high quality doctors and medical

entrepreneurs who developed hospitals with required infrastructure and

management style. Some of these hospitals have marketing departments to

increase visibility and acceptance of their products in some countries.

Medical Tourism in India – The Current Scenario

Medical Tourism is poised to be the next Indian success story after

Information

Technology. According to a Mckinsey-CII study the industry’s earning

potential

estimated at Rs.5000-10000 Crores by 2012. Worldwide, healthcare is said

to be a $3-trillion industry, and India is in a position to tap the top-end

segment by highlighting its facilities and services, and exploiting the brand

equity of leading Indian healthcare professionals across the globe.

“Medical Tourism", the term refers to the increasing tendency among

people from the UK, the USA and many other third world countries, where

medical services are either very expensive or not available, to leave their

27
countries in search for more affordable health options, often packaged with

tourist attractions.

Tourism is an integral part of many economies’ services industry and is an

important source of foreign exchange. The labour-intensive nature of the

tourism industry also makes it an excellent generator of employment. In

2002, the travel-and-tourism industry is expected to generate some US$3.3

trillion of GDP and almost 200 million jobs across the world economy.

Approximately one third of this would come directly from the industry itself

and the remainder from the strong linkages to other related sectors such as

entertainment, retail and construction.

Medical Tourism is perceived as one of the fastest growing segments in

marketing ‘Destination India’ today. The equation is ‘ World Class

Healthcare ’ at 'Economical Price '. Stable economic growth will create an

increase in freight flows from, towards, through, and inside the country. All

this will stimulate the investments in roads and railroads. As globalization

advances, both domestic and international tourism pose new and

unprecedented challenges to the health sector and its various partners. The

28
size of the Medical Tourism industry stands between Rs 1200 Crore to Rs

1500 Crore and is growing at rate of 30 percent annually.

More importantly, Medical Tourism is growing rapidly and turning out to be

an immense business opportunity for nations that are positioning themselves

correctly. Last year, just five countries in Asia – Thailand, Malaysia, Jordan,

Singapore and India- pulled in over 1.3 million medical travelers and earned

over $1billion (in treatment costs alone). In each of these nations, medical

travel spends are growing at 20% plus year-on-year. Elsewhere around the

world, Hong Kong, Lithuania and South Africa are emerging as big

medical/healthcare destinations. And a dozen other nations including Croatia

and Greece plan to make themselves attractive healthcare destinations.

Five years ago, hardly 10000 foreign patients visited India for medical

treatment.

Today India is a key player in medical tourism with 100,000 foreign patients

coming in every year and revenue of Rs.1500 Crores. The current market

growth-rate is around 30% per year and the country is inching closer to

major

players like Singapore and Thailand.

29
The following sections discuss in detail the

current state of the Medical Tourism in India:

India’s Medical Infrastructure

15000 Hospitals

875000 Hospital Beds

500000 Doctors

737000 Nurses

170 Medical Colleges

350000 Pharmacies

3.6 Health Tourism In India – Advantages and Opportunities

•The inflow of health tourists from the West, especially the UK, US and

some of the European countries has been on the rise for the last couple of

30
years. Price difference or affordability of the treatment, coupled with

quality of doctors are the main reasons for the growing western traffic .

• The quality of Indian hospitals has improved significantly and now

matches with the best in any part of the world. India has more than 100

healthcare institutions, which are of international standard.

• Many hospitals in India today have the infrastructure and equipment that

match with the best centers in the world, be it

transplantations(liver/kidney/heart or bone marrow), cancer treatment,

including radiotherapy, neurosurgery, including sterotactic surgery.,

angioplasty and cardiac surgery(bypass and paediatric)

• Public-Private Partnership combines internal hospital expertise with supply

chain and logistics expertise.

• The medical tourism industry which is estimated to be worth Rs 1500

crores annually has not only the potential to generate substantial forex

earnings but also provide employment opportunities for the large pool of

31
skilled labor available in India, according to Dr. PC Reddy, chairman,

Apollo Hospitals Group, India.

• According to Group President Pratap C.Reddy, the annual health bill of

people from Afro-Asian countries seeking treatment outside their country

is $10 billion. If India can tap even a fraction of that market, the potential is

enormous.

Joint Commission Accreditation of Healthcare Organizations (JCAHO)

India - Strategic Thrusts for the Future

The following section lays down the strategy for India to achieve leadership

position in medical tourism. The strategy largely draws from the discussions

in

previous section.

5.1 Role of Government

The role of Indian Government for success in medical tourism is two-fold:


Acting
 as a Regulator to institute a uniform grading and accreditation

system for hospitals to build consumers’ trust.

32
Acting as a Facilitator for encouraging private investment in medical

infrastructure and policy-making for improving medical tourism.

For facilitating investment the policy recommendations include:

1. Recognize healthcare as an infrastructure sector, and extend the benefits

under sec 80-IA of the IT Act. Benefits include tax holidays for five years

and concessional taxation for subsequent five years.

2. The government should actively promote FDI in healthcare sector.

3. Conducive fiscal policies - providing low interest rate loans, reducing

import/excise duty for medical equipment

4. Facilitating clearances and certification like medical registration number,

anti-pollution certificate etc.

The above measures will kick-start hospital financing, which is struggling

now

due to capital intensive and low efficiency nature of healthcare business.

For facilitating tourism the government should:

1. Reduce hassles in visa process and institute visa-on-arrival for patients

2. Follow an Open-Sky policy to increase inflow of flights into India

3. Create Medical Attachés to Indian embassies that promote health services

to prospective Indian visitors

33
Formation of National Association of Health Tourism (NHAT)

The promotion of medical tourism has so far been very fragmented with

initiatives

by few states and private hospitals. The earlier discussions clearly underline

the

need for presence of an apex body that can coordinate the promotion of

medical

tourism abroad. In the Indian context too, this has been successfully

demonstrated in the software industry by NASSCOM. It is therefore

essential to

form an apex body for health tourism – NAHT. The NAHT should be

formed as

an association of the private hospitals operating in the industry. The main

agenda

for NAHT will be:

1. Building the India Brand Abroad: Classify the target consumer segments

based on their attractiveness and position the India Brand based on the three

main value propositions – high quality service, value for money and

34
destination diversity. An integrated marketing Communications campaign

using print, media and road shows should be developed.

2. Promoting Inter-Sectoral Coordination: The NAHT should take up the

responsibility of aligning the activities of various players – Tourism

Department, Transport Operators, Hotel Associations, Escorts personnel etc.

3. Information Dissemination using Technology: NAHT should set up a

portal on medical tourism in India targeted at sharing information and

enabling online transactions.

4. Standardization of Services: NAHT should also focus on establishing

price

parity for similar kinds of treatments in various hospitals and ensure the

hospitals adhere to high hygiene and quality standards.

Role of Private Sector

The action items for private sector are:

1. Increased participation in building infrastructure: To achieve its full

potential, it is estimated that India needs an investment of Rs.100000 to

35
140000 Crores by 2012. Since the government can afford only a third of the

amount, the private sector should play an active role to fill the gap.

2. Integrate Horizontally: Private hospitals should also plan to integrate

horizontally for providing end-to-end healthcare solutions to consumers. For

example Apollo multi specialty hospitals is already planning to set up spas

and alternative mediclinics to attract more foreign tourists.

3. Joint Ventures / Alliances: To counter increasing competition, Indian

hospitals should tie-up with foreign institutions for assured supply of

medical

tourists. Specifically tie-ups with capacity constrained hospitals and

insurance

providers will provide significant competitive advantage.

5.4 Value Innovation Through MEDICITIES

Another successful example of the software industry is the establishment of

Export Oriented Software Technology Parks. This model can be successfully

replicated in the medical tourism industry by means of MEDICITIES. Each

MEDICITY could be a self-sustained healthcare hub with super specialty

36
hospitals of international standards, ancillary facilities, research institutions,

health resort, rehabilitation centers and residential apartments. This model

can

be floated through a public-private partnership. The government will provide

land

and ancillary services and the private players will provide infrastructure and

services. From the consumer’s point of view, the MEDICITIES will offer

superior

value at affordable prices. From industry’s point of view, this will offer

significant

competitive advantage for India.

37
The cartoon strip adds sarcasm to the upcoming

medical tourism in India.

38
CHAPTER 3

OBJECTIVE

• To study the feasibility of Medical Tourism in Delhi and NCR.

SUB OBJECTIVE

• To compare the performance of four hospitals in the region in

selected operations on the basis of following

i. Cost
ii. Value added services
iii. Popular operations
iv. Promotional activities
v. Approachability

• To Analyze trends Indian medical and healthcare Industry.

39
RESERCH METHDOLOGY

RESERCH DESIGN

The research will be qualitative in nature as a lot of data is required to back

the conclusion of the report.

DATA COLLECTION SOURCES-

This study proposes to collect data from

the Primary as well as the Secondary Sources.

PRIMARY DATA

Data collection tools like questionnaires have been used and also personal
interview with the executives and surgeons of hospital like
Apollo,Fortis,Escorts,Max Hospital were conducted to get detailed
information. Interaction with foreign tourist also helped in quantifying
various services provided by the Hospitals and the Indian Tourism Board.

SECONDARY DATA

Various sources like internet, Medical Journals, Magazines, Newspapers

have been used to collect Secondary data.

40
SAMPLE SIZE

The sample size taken for the study is four hospitals which have been
chosen selectively namely

FORTIS

APOLLO

MAX HEALTHCARE

ESCORTS

LIMITATIONS OF THE STUDY

The study was restricted due to the following points

• Denial to disclosure of exact statistical data by the concerned

authorities.
• Also one of the most renowned hospital in India AIIMS denied to
disclose any figures about medical tourism .
• Overall selection of 4 – 6 operations restricted the study.
• Locating less number of foreigner medical tourist around.
• Foreign tourist not in a state to interact as they come to India for
major operations.
• Lack of availability of empirical data on internet and medical
journals.

41
PARAMETERS AND CRITERIA FOR THE VIABILITY OF THE
PROJECT

The above mentioned hospitals were evaluated on the basis of following

operations and surgeries namely

• HEART SURGERY(Intervention cardiology

• KIDNEY TRANSPLANT
• LIVER TRANSPLANT
• ORTHOPEDIC SURGERY(Knee replacement)
• PLASTIES
• NEURO SURGERY

OTHER FACTORS

• Cost and value added offerings.

• After care amenities.
• Promotional activities done by the hospitals.
• Packages offered by hospitals
• Foreigners visiting there hospital.

CHAPTER 4

MARKET VIABILITY OF INDIAN HEALTHCARE INDUSTRY

42
The Indian consumers can be assessed or segmented as per the following
parameters..

Market Segmentation

A market is composed of different users having different responses to

market offerings. This makes it essential that hospital organizations,
especially for making a microscopic study of users’ needs and requirement,
make possible grouping of markets. The marketing strategy formulated on
the basis for segmenting the market is income. To some extent regional
considerations may also be adopted as a base for segmenting the market. The
below is the segmentation on the basis of regional consideration:

Regional Segmentation

Rural Users Urban Users

 Educated  Educated
 Illiterate  Illiterate
 Poor  Poor
 Rich  Rich

43
The aforesaid segmentation makes it clear that doctors would find a
variation in the living habits of both the segments.

Another important base for segmenting hospital services may be income

group. This helps hospital organisations in identifying the status of the users
of services. It is essential as the marketing principles recommend different
pricing strategies on the basis of level of income.

Segment

No- Income Low - Income Middle- Income High -Income

This would help hospital organisations in charging more from high and
middle income groups, charging equal to cost from the low income group
and making available free services to the no – income group. Another
important advantage of this segmentation is concerned with implementation
of modernization and expansion plan for the hospitals.

THE MARKETING MIX OF INDIAN MEDICAL TOURISM

• PRODUCT-
Some of the exclusive medical packages offered by the Indian
medical tourism are in the folowing treatments
MEDICAL PACKAGES
• HEART PACKAGES

44
CARDIAC SURGERY AND CARDIOLOGY
ANGIOPLASTY
ANGIOGRAPHY
CARDIOLOGY ROBOTIC SURGERY
OPEN HEART SURGERY
PAEDIATRIC INTERVENTION
• ORTHOPAEDIC SURGERIES
JOINT KNEE REPLACEMENT(UNILATERAL AND BILATERAL
• NEURO SURGERY
PARKINSONS
EPILEPSY
ESSENTIAL TREMORS
MALIGNANT TUMORS
• CARDIOLOGY
ECG
DOPPLER TEST
TEE
BEATING HEART SURGERY
VALVE SURGERY
STENTING
PERIPHERAL VASCULAR SURGERY
CONGENITIAL HEART DISEASE
• NEPHROLOGY
DIALYSIS
HAEMODIALYSIS
SLOW CONTINOUS ULTRAFICATION

45
 PLASMAPHERISIS
• DENTAL CARE PACKAGES
• UROLOGY
• COSMETIC TREATMENT ETC

PRICE
The price range offered by the Indian medical industry are
unbelievable because india offers the most reasonable prices..
India is not only cheaper but the waiting time is almost nil. This is due to
the outburst of the private sector which comprises of hospitals and clinics
with the latest technology and best practitioners.

Procedure Charges in India & USA –

Procedure United India (USD)

States (USD) Approx
Approx

Bone Marrow USD USD 69,200

Transplant 2,50,000

Liver Transplant USD USD 69,350

3,00,000

46
Heart Surgery USD 30,000 USD 8,700

Orthopedic USD 20,000 USD 6,300

Surgery

Cataract Surgery USD 2,000 USD 1,350

Smile Designing USD 8,000 USD 1,100

Metal Free USD 5,500 USD 600

Bridge

Dental Implants USD 3,500 USD 900

Porcelain Metal USD 3,000 USD 600

Bridge

Porcelain Metal USD 1,000 USD 100

Crown

Tooth USD 2,000 USD 125

Impactions

Root Canal USD 1,000 USD 110

Treatment

Tooth WhiteningUSD 800 USD 125

47
 Tooth Colored USD 500 USD 30
Composite

Fillings / Tooth USD 300 USD 90

Cleaning

INDIA V/S UK

Significant cost differences exist between U.K. and India when it comes to
medical treatment. Accompanied with the cost are waiting times which exist
in U.K. for patients which range from 3 months to over months.

United
Kingdom India (USD)
Procedure (USD) Approx Approx

Open Heart
USD 18,000 USD 4,800
Surgery
Cranio-Facial
surgery and skull USD 13,000 USD 4,500
base
Neuro- surgery
USD 21,000 USD 6,800
with Hypothermia
Complex spine
surgery with USD 13,000 USD 4,600
implants
Simple Spine
USD 6,500 USD 2,300
Surgery

48
 Simple Brain
USD 4,300 USD1,200
Tumor -Biopsy
USD 10,000 USD 4,600
-Surgery
Parkinsons
USD 6,500 USD 2,300
- Lesion
USD 26,000 USD 17,800
- DBS
Hip Replacement USD 13,000 USD 4,500

• PLACE
All the hi tech hospitals like Apollo, escorts, max hospitals are located in all
the metro cities of the country and they are targeting the tier 2 cities due to
the extreme market potential. Indian healthcare industry is the second in the
country as its growing by leaps and bounds so the Indian hospital industry is
getting organized.

• PROMOTION
First and foremost it suggests that medical expertise in India
is at par with the developed world although the infrastructure to support it is
sadly lacking. This is the fact experienced by almost all Indian doctors who
come to seek work in the Western World.
PROMOTIONAL ACTIVITIES TO PROMOTE MEDICAL TOURISM

• CME ( Continuous medical education for doctors)

• Patient Education Progress
• Free health Checkup camps.

49
 • Tie ups with various hospitals and insurance companies abroad.
• Participation in Health Expo’s abroad.
• Tie ups Embassies.
• AD campaigns.
• Nodal centers in other countries.
• Reduction of Excise duty from 17% to 8% on all goods produced in
the pharmaceutical sector as per the Budget 2008-2009.

DEMAND FORECAST-

Increasing globalization with reduction of travel times combined with added

tourist attractions puts India in a good position to promote Health Tourism.
India’s population crossed one billion in 1999 and is projected to exceed 1.5
billion in 2050. The infant mortality rate though having decreased from 225-
250 in the 1940’s to 72 in 1997, is still high. Mortality from Tuberculosis
and Acquired Immune Defeciency Syndrome are major problems.(3) There
is always the chance of the poor being exploited by unscrupulous element’s
for purposes such as organ transplantation though trade in organs is illegal in
India.(4)
The CII-McKinsey report suggests
that medical tourism could fetch as much as $2 billion by 2012, compared to
an estimated $333 million currently.
Reference:
.Mudur G. Hospitals in India woo foreign patients. BMJ 2004; 328:1338.

50
HEALTHCARE INFRASTRUCTURE

• India needs at least 750,000 extra beds to meet the demand for
inpatient treatment by 2012- opportunity in tertiary healthcare
facilities.
• India needs at least 1 million more qualified nurses and 500,000 more
doctors by 2012 as compared to existing number.- opportunity in
medical education.
• To raise this infrastructure, total additional investment to the tune of
US$ 25-30 billion is needed by 2012.
• Government and international agencies will only be able to gear up
US$ 7 billion and the rest of investment has to come from private
sector.

• FACTORS ENHANCING MEDICAL TOURISM IN

INDIA

Cost Competitiveness – The Key driver

The main reason for India’s emergence as a preferred destination is the

inherent

advantage of its healthcare industry. Today Indian healthcare is perceived to

be

51
on par with global standards. Some of the top Indian hospitals and doctors

have

strong international reputation. But the most important factor that drives

medical

tourism to India is its low cost advantage. Majority of foreign patients visit

India

primarily to avail of “First World Service at Third World Cost”.

Source: Business World India and Indian Brand Equity Foundation

As the table above shows, India has significant cost advantages in several

health

procedures making it a preferred destination

3.2 The Service Spectrum

52
India offers a variety of services for overseas patients. The table below

presents

a classification of the service spectrum.

3.3 Consumer Profile

The demand for Indian healthcare services primarily comes from three types

of

consumers. The table below presents the profile of these three consumer

groups:

53
Though tourism is not the primary need of these consumers, it offers

additional

attraction particularly for people traveling for cosmetic surgery and less

complicated procedures.

54
CHAPTER 4

HISTORY OF HOSPITALS

APOLLO HOSPITAL

Apollo Hospitals Group is the acknowledged leader in bringing super

speciality world-class healthcare to India. It is presently the largest
integrated healthcare company in Asia and the first to attract foreign
investment .

55
Indraprastha Apollo Hospitals is spread over 12 acres of land and has a
built-up area of 600,000 square feet. A joint venture between the Apollo
Hospitals Group and the Government of Delhi, it was founded in 1996. It
is the largest hospital of the group and was built at a cost of 44 million US
dollars.

With a bed-capacity of 560 (including 140 ICU beds and 44 HDU beds)
and 14 Operation Theatres, expert medical professionals and the latest
technology, the Indraprastha Apollo Hospitals is the automatic choice for
outstanding healthcare in the country’s capital.

The hospital handles close to 200,000 patients a year, of which 12,000 are
international patients. International patients come to Indraprastha Apollo
from the USA, UK, Europe, Middle East, Australia, Yemen, Africa and
CIS countries, among other countries.

Indraprastha Apollo Hospitals was the first Indian hospital to be awarded

the gold-standard certification from the Joint Commission International
(JCI) USA .

Highlights

• The first Indian hospital to receive the Joint Commission International

(JCI)
USA accreditation the gold-standard in hospital certifications
worldwide
• First successful liver-kidney transplant in the Indian sub-continent
• Grade A by CRISIL
• Rated Best Multi-speciality Private Hospital in Delhi by The Week
magazine
• BS EN ISO 14001: 1996 for Environmental Management System
• BS EN ISO 9001: 2000 for Quality Management System 56

Medical Milestones
FORTIS

One of India's leading tertiary level healthcare groups, Fortis Healthcare

comprises a network of 13 hospitals with a bed capacity of 1803 beds and 13
Heart Command Centres. Following the acquisition of the renowned Escorts
Healthcare System, Fortis Healthcare operates one of the world's largest
Cardiac programmes. The group's Fortis Hospital at Noida, next-door to
Delhi, is India's foremost tertiary care facility in Orthopaedics and Neuro
Sciences. The group also performs cutting edge surgeries in various
specialities ranging from cosmetology, woman & child health,
ophthalmology, dental, ENT, urology, and minimal invasive surgery. Our
facilities ensure that there is genuine Medical Value in health travel to India.

The Medical Value that we bring to our services is because the Fortis
Healthcare team of expert doctors, mostly western trained, is supported by
highly skilled nursing professionals, technicians,and aided by state-of-the-
art medical equipment at their command.

At Fortis Healthcare, we recognize that international patients have special

needs and requirements and desire real medical value when they travel to
India. To provide a highly specialized and dedicated service, we have
created the Fortis Healthcare international Patients Service Centre at New
Delhi, India.

Various medical specialties offered to our International patients are:

 Cardiology
 Cardio Thoracic & Vascular Surgery
 Orthopaedics
 Orthopaedic Surgery (Total Hip/Knee
Replacements, Joint Replacements)
 Plastic Surgery
 Cosmetic Surgery
 Bariatric Surgery (Gastric By Pass Surgery, Gastric Banding etc)
 Gynaecology & Obstetrics
 General Sugery

57
  Minimal Invasive Surgery
 Neurology & Neuro Surgery
 Nephrology (Dialysis)
 Paediatrics & Paediatric Surgery
 Pulmonology
 Renal Sciences (Renal Transplantation)
 ENT
 Opthalmology (Eye)
 Psychiatry

For you, this means a menu of seamless services that will make your
treatment and trip hassle-free, i.e. from greeting you at the airport, to your
registration & discharge, and even organizing the ground handling of any
post-treatment travel.

After all, taking care of guests is an ageless Indian tradition.

SPECIAL SERVICES(VALUE ADDED SERVICES)

• Doctor care coordination Before and after

• Airport transfer Service.
• Flight Arrangements & Extensions / Visa Assistance.
• Coordination of the admissions process.
• Cost estimates for anticipated treatment.
• Booking of Hotel/Service Apartments.
• Special dietary needs / religious arrangements.
• Providing news & information of patient's relatives back home.
• Remote Consultations via Telemedicine.
• Remote Consultations via Telemedicine.
• Financial Services.

58
MAX HOSPITAL

Overview - Max Healthcare - caring for you…for life

Max Healthcare is India's first truly integrated healthcare system, offering
three levels of clinical service (Primary, Secondary, Tertiary) within one
system.

We believe in the concept of total patient care and deliver care by combining
medical and service excellence.

Max Healthcare is committed to quality care that not only addresses the
illness but also concentrates on the overall wellness of the patients

Salient Features

• A team of highly qualified and trained doctors, nurses and patient care
personnel to provide the highest standards of care
• Latest medical equipment and hospital information system
• Medical collaboration with Singapore General Hospital in areas of
medical practices, research and training
• Over 400 leading doctors, 280 corporate clients and a patient base in
excess of 5,80,000
• Clean and comfortable facilities at all locations
• Fully computerised health records
• 24 hour- Chemist, Ambulance, Patient Diagnostic and Emergency
Services

59
 • Regular educational and health camps to help educate patients on
various health issues, so that they make informed choices
• Max Happy Family Plan- Annual Health Plans covering domiciliary
medical needs
• A complete preventive healthcare programme - MAX 360°
• 24 Hour Emergency

Comprehensive Healthcare System

Max Healthcare model visualizes setting up of a world-class healthcare

model offering the best medical assistance delivered seamlessly through
state-of-the-art medical facilities.

NO SPECIAL SERVICES FOR INTERNATIONAL PATIENTS, ALL

THE PATIENTS ARE SAME FOR THEM.

ESCORTS
Welcome to the comforting world of Escorts Heart Institute and Research
Centre, where the medical treatment is truly world-class and our approach
towards our patient is warm and sensitive. We Assure, that you are in trusted
hands and your journey, will be a pleasant one.

Escorts Heart Institute & Research Centre (EHIRC), was born to bring to
India the best cardiac care and systems, training of cardiac surgeons and
cardiologists and to conduct research as per International standards. It has

60
completed 20 years of excellence in providing highest standards of cardiac
care in India. .

Centres of Excellence

• Cardiac Bypass Surgery

• Minimally Invasive Surgery (Robotics)
• Interventional Cardiology
• Non-invasive Cardiology
• Pediatric Cardiology

Medical Highlights

• 20 years of Cardiac Care

• Hospital has 332 Beds, 9 Operation Theatres, 5 Cath Labs, 3 Heart
Command Centres, 2 Heart Stations
• Done Over 114,700 Angiographies
• Over 27,000 Angioplasties Completed
• Over 65,000 Cardiac Surgical Procedures
• Success rate of Cardiac Procedures is 99.6%
• Infection Rate of less than 0.3%

The Infrastructure of Excellence

Escorts Heart Institute is equipped with modern facilities, equipment and

systems like:

• Operation Theatres (OTs) with Laminar air flow that eliminates the
chances of infection
• Intensive Care Units (ICUs), under the charge of critical care
specialist that has a ratio of one nurse for every ICU patient
• High-tech systems for Imaging, Radiology and Pathology Testing
• Sophisticated Information Technology systems at Escorts Hospital
enable better efficiency and greater patient convenience
• Convenient support facilities such as: ATMs, Cafeterias, Round the
clock Pharmacy

International Patient Care

61
Patient safety is our top priority, Escorts recognizes that international
patients have special needs and requirements. Escorts offers seamless patient
services of world-class quality. From the warmth of our greeting at the
airport, to your registration and discharge, we strive to deliver unparallel
services to aid you.

All services are provided to International patients through a single window

assistance cell, from arrival till departure. The activities related to this
important area of our business are:

1. Visa Assistance

• Coordination and Liaising with Foreign Offices.

2. Medical Needs

• Arranging meeting on priority with the concerned Consultant.

• Arranging any specific medical needs, while traveling to New Delhi.
• Smooth discharge procedure under single window.
• Medical certificates/reports.
• Follow up visits/tests/reports.

3. Lodging/Boarding Arrangements

• Lodging the patient/attendant in EHIRC/Hotel/Guest House.

• Diet requirement as per patient needs.
• Regular supervision of all lodging facilities.

4. Information Needs

• EHIRC Brochures/Information.
• Delhi City Map /City Guide.
• Providing news & information of patient to their relatives, back home.

5. Value Added Services

• Dedicated Patient care coordinators to assist Patient/Attendant.

• Travel/ticketing arrangements for patients and relatives.
• Receive the patient from Airport - Car/Ambulance.
• Arranging sight seeing / shopping / prayer.
• Local travel needs for patient's relatives.

62
 • Prepaid Cell phone Card.
• Interpreters.
• Internet.
• Comprehensive Health Check Ups.
• Foreign Exchange.
• All finance related matters under single window.

6. Our insurance partnerships

• BUPA International
• AETNA
• CIGNA
• International SOS
• Vanbreda International
• GMC Services

CHAPTER 5

ANALYSIS AND INTREPRETATION

As per the data collected from the four hospitals

• GRAPH1

63
Apollo-3000
Fortis-36
Escorts-240
Max hospital-1000
Total international patients coming to India-
4276

• GRAPH 2

64
 PREFFERED SURGERIES BY
INTERNATIONAL TOURIST

45%
40%
40% Heart surgery-
PERCENTAGE VALUE

35% 32%
Neuro surgery-
30%
25% Orthopedic
20% surgery-
15%
15% Nephro surgeries-
10% 8%
5% Liver transplant-
5%
0%
TYPES OF SURGERIES

• Heart surgery- 40%

• Neuro surgery- 8%
• Orthopedic surgery-15
• Nephro surgeries-32%
• Liver transplant-5%

• GRAPH 3

65
 Investment required to bridge the gap in next 10 years

ESTIMATES

0.5-0.7 0.5-1
22-30
7-9 0.5-0.7

Medical equipment
could account for 20-
13-20 30% of investment in
Beds (Rs.20,000 to
40,000 crore)

Investment Investment Investment Investment Investment Total

in secondary in tertiary in medical in nursing for other investment
beds beds colleges* schools health professionalsrequired
(e.g., pharmacists,
technicians,
administrators)

* Excludes investment in bed capacity to avoid double count with investment in secondary/tertiary beds
(Source: CII-McKinsey & Company Report 2005)

Escorts Heart Institute & Research Centre Ltd,

PROMOTIONAL ACTIVITIES DONE BY HOSPITALS TO

ENHANCE MEDICAL TOURISM

66
INDRAPRASTHA ESCORTS FORTIS MAX
APOLLO HOSPITAL HOSPITAL HOSPITAL
Attending World Tie ups with Conduct Tie up with
Travel Marts and various agencies CME(continuous most of the
World Medical abroad involved Medical embassies ,free
Fairs. in medical Education for cardiac camps in
tourism. doctors), Free various
Participation in health checkups countries, CME,
Health Expos in for doctors, On Nodal centers in
UK. Ad campus patient UK,US etc.
campaign for education Hospitals in gulf
India. programmes,Ad countries, Tie
campaign ups with most of
Dhakan on TV. the insurance
companies.

GRAPH 4

67
• GRAPH 5

68
 Comparison - India Vs other countries
Beds Physicians Nurses

Per ’000 population,

Per ’000 population, Per ’000 population,
2006*
2006* 2006*
0.5**

1.5 1.2*** 0.9

India

1.5 1.6
Other low income countries 1.0
(e.g., sub-Saharan
Africa)
4.3 1.9
Middle income countries 1.8
(e.g., China, Brazil
Thailand, South
Africa, Korea) 7.4 7.5
1.8
High income countries
(e.g., US, Western
Europe, Japan)

World average 3.3 1.5 3.3

• GRAPH 6

69
 Comparison India Vs other countries

Healthcare spend as % of GDP Healthcare spend per capita

Per cent, 2006* US$, PPP, 2006*

Korea 6.7 Korea 720

Brazil 6.5 Brazil 453

Thailand 5.7 Thailand 349

5.2 143
India China

China 2.7 India 94

* Most recent data available has been used (2001-2006)

70
FINDINGS

After the analysis and interpretation of the data we can figure out the
following

• Graph 1(Total international patients coming to India)

We can witness that majority of the international patient
Prefer Indraprastha Apollo at the first place followed by Max hospital,
Escorts and only a minority of them prefer Fortis

• GRAPH2 (Preferred surgeries by international tourists)

It very clearly depicts that majority of the tourist consider India (Delhi)
as a destination for heart surgery followed by Nephro surgeries(kidney
related problems) then orthopedic, Neuro and only a fraction of them
come for kidney transplants.

GRAPH 3(Investment required to bridge the gap in next 10

years )

The graph clearly states that if proper investment will be made then India
will be at the top level in the healthcare industry. The graph shows in what
ratios the investment should be done like on mediacal equipment could
account for 20-30% of investment in beds.

71
 GRAPH 4 ( Cost advantage and list of various medical services)

It tells us about the various services offered under the umbrella of Indian
medical tourism and also the price comparison of dental treatments and
surgeries in India and US for eg getting a Glass Ceramic Crown fitted in
India would cost 35-40% less in India than US.

GRAPH 5 (Comparison - India Vs other countries)

This graph clearly shows the comparison of India with the other low, middle
and high level income countries in terms of beds, physicians and nurses with
the relation of per thousand populations in year 2006.

GRAPH 6 (Comparison - India Vs other countries)

This graph clearly shows the comparison of India with the other
countries in terms of healthcare spend as percent of GDP and healthcare
spends per capita respectively in year 2006.

72
CONCLUSION

• Medical Tourism in Delhi and NCR as per the study conducted is

booming and can be witnessed by the huge number of International
tourist visiting this region. Delhi and NCR is one of the worlds most
preferred region of the world in the case of medical tourism due to the
low cost of treatment, no waiting time, approachability, tourists spots
in delhi and nearby cities and other value added services. As the
Indian economy of growing so worlds best hospitals are coming to
India to encash the opportunity.

• Another relevant topic that has been covered in the study is the
performance of four hospitals in the region and it can be concluded
that indraprastha Apollo is the market leader in attracting the
maximum no of international patients because of the brand name
Apollo and its presence in various other countries. Apollo is followed
by Max which is considered as a five star hospital caters to patients
falling in the high income bracket followed by Escorts and Fortis.

• Also the trends in the Indian Healthcare has been studied and it can be
concluded that the healthcare industry has successfully managed to
maintain the interest and attention of not only the Indian government,
but also the common man.

• The top Indian hospitals such as Apollo, Escorts, Max, etc, are
investing immense time, effort, manpower and money in their R&D.

73
 As a matter of fact, several new innovative products have been
launched in the Indian market and have been patented. The Indian
consumer has ready access to new innovations in the field of health
and medicine. The companies are constantly acquiring latest
technology either through partnerships or developing them
indigenously. The government is fully supporting the cause of state of
the art infrastructure by providing support in setting up new hospitals
and financing them.

RECOMMENDATION

• All the hospitals in the region should accentuate on

promotional activities at the global level so as to enhance the
awareness of medical proficiencies in India. Other government
hospitals should also try to meet international standards. The
government should pass an act according to which the fee structure of
various medical colleges should be reduced so as to facilitate and
motivate lower and middle class students. The government should
also come up with various medical colleges in different parts of the
country. This will help India to cope up with the increasing demand
of medical tourism locally and internationally.

Create cost-effective facilities

To deliver quality healthcare to a greater number of people, providers

must create and operate more cost-effective facilities. Optimizing

74
 parameters such as area per bed and building cost per square foot can
reduce the initial cost of building a tertiary facility. In addition, operating
costs can be reduced through better purchasing and supply chain
management, as well as good management of patient flows and
utilization of expensive facilities and manpower.

• An active industry association can play an important role in the

development of the sector

To boost the overall growth and development of healthcare in India, the

sector needs a vibrant industry association. This need can be met by the
Indian Healthcare Federation (IHF), which will have to present a united
face to key stakeholders such as the government, insurers, policy
institutions and industry players.

To be effective, the IHF will need a full-time team of professionals on board.

There are three immediate priorities for the federation: driving the creation
and adoption of quality and accreditation standards for healthcare
infrastructure and delivery; working with insurers to accelerate the
penetration of health insurance; and collaborating wit the government on
policy issues. In addition, the federation should increase awareness about
industry-level issues among industry participants.

75
CHAPTER 8

APPENDIX

BIBLIOGRAPHY

BOOKS
Author's last name, first name middle name; "Title of journal,” (year of
publication)

Davenport Karen, “Health Care Benefits”, (2007)

Daschle Tom, “Achieving Universal Health Coverage”, (2007)
Seshamani Meena, “Opportunity Costs and Opportunities Lost:
Businesses Speak Out About Health Care”, (2007)
CII and Mekinsey, “Healthcare In India – The Road Ahead”, (2006)

JOURNALS
Author's last name, first name middle name; "Title of journal,” issue
number: (year of publication)

Alvarez, David P.; “Connecting people to the promise of healtchare”,

No. 15 (2000)
Hautea, Dr. Randy A.; Krattiger, Dr. Anatole F. And Van Zanten, Ir.
Jasper E; “Healthcare costs comparisons”, No. 18 (2000)

76
WEBSITES
<URL>

http://en.wikipedia.org/wiki/Healthcare_in_India

http://www.nature.com/nm/journal/v9/n4/full/nm0403-377a.html

http://www.cbc.ca/news/background/healthcare/medicaltourism.html

http://timesofindia.indiatimes.com/More_options_for_health_insurance/artic
leshow/1982238.cms

http://www.who.int/mediacentre/factsheets/fs172/en/index.html

http://www.indiatogether.org/2007/jan/hlt-hltcare.htm

http://www.deloitte.com/dtt/whitepaper/0,1017,sid%253D34239%2526cid
%253D71669,00.html

77
QUESTIONNAIRE

1) Name of the Hospital- ________________________________

2) Location- ____________________________________
____________________________________
____________________________________
___________________________________

3) Person Concerned- __________________________________

4) Designation- ____________________________

5) No of Foreigners visiting their Hospital Every Year/ Month- ________

6) Medical Travelers Clusters Country Wise-

a) ___________________________
b) ___________________________
c) ___________________________
d) ___________________________
e) ____________________________
f) _____________________________

78
7) Surgeries or Treatments they specifically come for-

• Heart Surgery-
• Kidney Transplant-
• Liver Transplant-
• Bone Marrow Transplant-
• Orthopedic Surgery-
• Face lift-
• Any other-

8) Duration of their stay in India? ________________

9) Various Packages offered by the hospital-

10) Promotional Activities done by the Hospital to enhance

Medical Tourism-

79
11) Value added offerings to an international patient compared to an
domestic patient.

__________________________________________________________
12)Provisions for aftercare follow-ups ?

___________________________________________________________

13)Payment modes

THANK YOU

80