Chapter 4 ADVANTAGE OF COST OF HEALTHCARE SERVICEshodhganga.inflibnet.ac.in/bitstream/10603/8367/10/10_chapter 4.pdfChapter 4 ADVANTAGE OF COST OF HEALTHCARE SERVICE ... CARE and Dr

Globalisation of Indian Healthcare Services Acharya Nagarjuna University

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Chapter 4

ADVANTAGE OF COST OF HEALTHCARE SERVICE

India is considered the leading country promoting medical tourism-and now it

is moving into a new area of "medical outsourcing," where subcontractors provide

services to the overburdened medical care systems in western countries. India's

National Health Policy declares that treatment of foreign patients is legally an

"export" and deemed "eligible for all fiscal incentives extended to export earnings."

Government and private sector studies in India estimate that medical tourism could

bring between $1 billion and $2 billion US into the country by 2012. The reports

estimate that medical tourism to India is growing by 30 per cent a year.

India's top-rated education system is not only churning out computer

programmers and engineers, but an estimated 20,000 to 30,000 doctors and nurses

each year. The largest of the estimated half-dozen medical corporations in India

serving medical tourists is Apollo Hospital Enterprises, which treated an estimated

60,000 patients between 2004 and spring 2010. It is Apollo that is aggressively

moving into medical outsourcing. Apollo already provides overnight computer

services for U.S. insurance companies and hospitals as well as working with big

pharmaceutical corporations with drug trials. Dr. Prathap C. Reddy, Chairman,

began negotiations in the spring of 2004 with Britain's National Health Service to

work as a sub-contractor, to extend operations and medical tests for patients at a

fraction of the cost in Britain for either government or private care. Apollo's

business began to grow in the 1990s, with the deregulation of Indian economy,

which had cut the bureaucratic barriers to expansion and made it easier to import the

most modern medical equipment. The first patients were Indian expatriates who

returned home for treatment; major investment houses followed with money and

then patients from Europe, the Middle East and Canada began to arrive. Apollo now

has 37 hospitals, with about 7,000 beds. The company is in partnership in hospitals

in Kuwait, Sri Lanka and Nigeria. Western patients usually get a package deal that

includes flights, transfers, hotels, treatment and often a post-operative vacation.

Apollo has also reacted to criticism by Indian politicians by expanding its services to


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India's millions of poor. It has set aside free beds for those who can't afford care, has

set up a trust fund and is pioneering remote, satellite-linked telemedicine across

India

The idea of the health holiday is to offer an opportunity to get away from one’s

daily routine and come into a different relaxing surroundings. Here one can enjoy

being close to the beach and the mountains so as to nature. At the same time the tourist

will be able to receive an orientation that will help to improve their life in terms of

health and general well being. It is like rejuvenation and clean-up process on all levels

- physical, mental and emotional.

Another reason for India emerging as a major destination for healthcare is the

low cost of treatment prevailing in India. Indian hospitals are cost effective than many

developed countries such as USA and Europe. Even when compared to other South-

East Asian countries, such as Thailand and Singapore, India scores better, with the

cost of procedures cheaper by around 20 percent. There are estimates that by 2008,

companies in USA will be spending as much on healthcare as they made profits,

forcing the scaling back or withdrawal of benefits. As precaution, some firms have

begun considering treatment for their employees in low cost destinations. Thus, low

cost healthcare services coupled with internationally acceptable medical practices

would position India as an attractive healthcare destination. Estimates show that the

average success rate of cardiac surgeries in Indian hospitals compares favorably with

developed countries. The success rate of Indian physiotherapists helping patients

regain their physical fitness and prevent cardiac problems is at an average of 99.5

percent, at par with leading cardiac centers around the world.

Table 4.1: Foreign Tourists Arrival In India 1999-2009

Year Foreign Tourists

Arrival

Annual Growth

1999 2481928 5.2

2000 2649378 6.7

2001 2537282 -4.2

2002 2384364 -6.0

2003 2726214 14.3

2004 3457477 26.8

2005 3918610 13.3


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2006 4447167 13.5

2007 5081504 14.3

2008 5282603 4.0

2009 5108579 -3.3

Source: Bureau of Immigration, India

Around 5 millions of tourists visited India to seek Medical care. Many people from the

developed world come to India for the rejuvenation promised by yoga and Ayurvedic

massage, but few consider it a destination for hip replacement or brain surgery.

However, a nice blend of top-class medical expertise at attractive prices is helping a

growing number of Indian corporate hospitals lure foreign patients, including from

developed nations such as the UK and the US. As more and more patients from

Europe, the US and other affluent nations with high medicare costs look for effective

options, India is pitted against Thailand, Singapore and some other Asian countries,

which have good hospitals, salubrious climate and tourist destinations. While Thailand

and Singapore with their advanced medical facilities and built-in medical tourism

options have been drawing foreign patients of the order of a couple of lakhs per

annum, the rapidly expanding Indian corporate hospital sector has been able to get a

few thousands for treatment. But, things are going to change drastically in favour of

India, especially in view of the high quality expertise of medical professionals, backed

by the fast improving equipment and nursing facilities, and above all, the cost-

effectiveness of the package.

Indian Corporate hospitals can excel in Cardiology, Joint-replacement,

orthopedic surgery, gastroenterology, ophthalmology, transplants and urology to name

a few. The various specialties covered are Neurology, Neurosurgery, Oncology,

Ophthalmology, Rheumatology, Endocrinology, ENT, Pediatrics, Pediatric Surgery,

Pediatric Neurology, Urology, Nephrology, Dermatology, Dentistry, Plastic Surgery,

Gynecology, Pulmonology, Psychiatry, General Medicine & General Surgery

The various facilities in India include full body pathology, comprehensive

physical and gynecological examinations, dental checkup, eye checkup, diet

consultation, audiometry, spirometry, stress & lifestyle management, pap smear,

digital Chest X-ray, 12 lead ECG, 2D echo colour doppler, gold standard DXA bone


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densitometry, body fat analysis, coronary risk markers, cancer risk markers, carotid

colour Doppler, spiral CT scan and high strength MRI. Each test is carried out by

professional M.D. physicians, and is comprehensive yet pain-free.

There is also a gamut of services ranging from General Radiography, Ultra

Sonography, Mammography to high end services like Magnetic Resonance Imaging,

Digital Subtraction Angiography along with intervention procedures, Nuclear

Imaging. The diagnostic facilities offered in India are comprehensive to include

Laboratory services, Imaging, Cardiology, Neurology and Pulmonology. The

Laboratory services include biochemistry, hematology, microbiology, serology,

histopathology, transfusion medicine and RIA.

All medical investigations are conducted on the latest, technologically

advanced diagnostic equipment. Stringent quality assurance exercises ensure reliable

and high quality test results. 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 may become 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

The Apollo Group, Escorts Hospitals in New Delhi and Jaslok Hospitals in

Mumbai are to name a few which are established names even abroad. A list of

corporate hospitals such as Global Hospitals, CARE and Dr L.V. Prasad Eye Hospitals

in Hyderabad, The Hindujas and NM Excellence in Mumbai, also have built

capabilities and are handling a steadily increasing flow of foreign patients. India has

much more expertise than say Thailand or Malaysia. The infrastructure in some of

India's hospitals is also very good. What is more significant is that the costs are much

less, almost one-third of those in other Asian countries

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

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and public. Medical tourism refers to traveling to other countries to obtain medical,

dental, and surgical treatment. At the same time they could also tour, and fully

experience the attractions of the countries they visit. Exorbitant costs of healthcare in

industrialized nations, ease and affordability of international travel, favorable currency

exchange rates in the global economy, rapidly improving technology and standards of

care in many countries of the world, and most importantly proven safety of healthcare

in select foreign nations have all led to the rise of medical tourism.

More and more people are traveling abroad as an affordable, enjoyable,

and safe alternative to having treatment in their home countries. Medical tourists are

generally residents of the industrialized nations of the world and primarily come from

The United States, Canada, Great Britain, Western Europe, Australia, and The Middle

East. But more and more, people from many other countries of the world are seeking

out places where they can combine vacationing and obtaining their medical care at an

affordable cost. Non resident Indians form a big group of medical tourists to India.

Reasons to travel to another country for treatment

Currently medical tourists are traveling in large numbers abroad where the quality of

healthcare is equal to anywhere else in the world and yet the cost is significantly

lower. These regions also offer numerous options for touring, sight-seeing,

shopping, exploring, and yes, even lounging on sun drenched beaches. Although

India, the East Indies, and South America are currently the most popular choices for

medical tourists, the industry is growing so rapidly that more and more countries and

medical centers around the world are beginning to tailor services aimed specifically

at medical tourists, and the expectation is that the options for where medical tourists

can choose to travel will continue to increase at a rapid pace.

In general the reasons to choose medical tourism include:

Avoid waiting list in native countries

Less cost

Quality accommodation and nursing care

Touring the place

Medical Treatment in West = A tour to India + Medical Treatment + Savings

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Popular treatments do Medical Tourists obtain

The ranges of treatment the medical tourists obtain vary widely. They start from

simple comprehensive medical check up to elective procedures such as rhinoplasty,

liposuction, breast augmentation, orthodontics, and LASIK. Often they do visit for

larger and life-saving procedures such as joint replacements, bone marrow

transplants, and cardiac bypass surgery etc. Medical tourists can now obtain

essentially any type of medical or surgical procedure abroad in a safe and effective

manner for a fraction of the cost that they would face in their home countries.

Cost effectiveness through Medical Tourism

The average cost of private heart surgery in the United States is $50,000. That same

operation with comparable rates of success and complications costs only $10,000 in

the finest and most state-of-the-art hospital in Bombay. A bone marrow transplant

that costs $250,000 in the U.S. costs only $25,000 in India. For the same price as a

week long vacation for two in Hawaii, a couple can travel to India's south coast to

include airfare, boarding & lodging, personal tour guide/concierge, and have LASIK

corrective surgery for two. Large price disparities such as these exist across the

board for numerous medical and surgical procedures. And because of favorable

currency exchange rates for medical tourists, the costs associated with

accommodations, food, shopping, and sight-seeing are similarly very favorable.

Destinations for Medical Tourism

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 $2

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.

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150

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

2011. However, the current market for medical tourism in India is mainly limited to

patients from the Middle East and South Asian economies. 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.

Methods to identify a hospital abroad: The check list-

India has one of the best qualified professionals in each and every field, and this fact

has now been realized the world over. Regarding Medical Facilities India has the

most competent doctors and world class Medical Facilities. With most competitive

charges for treatment, India is a very lucrative destination for people wanting to

undergo treatment. Before entering the hospital and package, one has to identify

with prior mail communication regarding:

Whether the specialist in that area is available

Whether the hospital has all investigations required within campus

The credentials of the hospital

The credentials of the specialist

In summary, India offers World Class Medical Facilities, comparable with any

of the western countries. India has state of the art Hospitals and the best qualified

doctors. With the best infrastructure, the best possible Medical facilities,

accompanied with the most competitive prices, the treatment can be done in India at

the lowest charges. In a country as diverse and complex as India, it is not surprising

to find that people here reflect the rich glories of the past, the culture, traditions and

values relative to geographic locations and the numerous distinctive manners, habits

and food that will always remain truly Indian.

The reasons patients travel for treatment vary. Many medical tourists from the

United States are seeking treatment at a quarter or sometimes even a 10th of the cost

at home. From Canada, it is often people who are frustrated by long waiting times.


151

From Great Britain, the patient can't wait for treatment by the National Health

Service but also can't afford to see a physician in private practice. For others,

becoming a medical tourist is a chance to combine a tropical vacation with elective

or plastic surgery. And more patients are coming from poorer countries such as

Bangladesh where treatment may not be available.

Medical tourism is actually thousands of years old. In ancient Greece, pilgrims

and patients came from all over the Mediterranean to the sanctuary of the healing

god, Asklepios, at Epidaurus. In Roman Britain, patients took the waters at a shrine

at Bath, a practice that continued for 2,000 years. From the 18th century wealthy

Europeans travelled to spas from Germany to the Nile. In the 21st century, relatively

low-cost jet travel has taken the industry beyond the wealthy and desperate.

Countries that actively promote medical tourism include Cuba, Costa Rica, Hungary,

India, Israel, Jordan, Lithuania, Malaysia and Thailand. Belgium, Poland and

Singapore are now entering the field. South Africa specializes in medical safaris-

visit the country for a safari, with a stopover for plastic surgery, a nose job and a

chance to see lions and elephants.

Critical look at India’s Potential:

India is considered the leading country promoting medical tourism-and now it

is moving into a new area of "medical outsourcing," where subcontractors provide

services to the overburdened medical care systems in western countries. India's

National Health Policy declares that treatment of foreign patients is legally an

"export" and deemed "eligible for all fiscal incentives extended to export earnings."

Government and private sector studies in India estimate that medical tourism could

bring between $1 billion and $2 billion US into the country by 2012. The reports

estimate that medical tourism to India is growing by 30 per cent a year.

India's top-rated education system is not only churning out computer

programmers and engineers, but an estimated 20,000 to 30,000 doctors and nurses

each year.

The largest of the estimated half-dozen medical corporations in India serving

medical tourists is Apollo Hospital Enterprises, which treated an estimated 60,000


152

patients between 2001 and spring 2004. It is Apollo that is aggressively moving into

medical outsourcing. Apollo already provides overnight computer services for U.S.

insurance companies and hospitals as well as working with big pharmaceutical

corporations with drug trials. Dr. Prathap C. Reddy, the chairman of the company,

began negotiations in the spring of 2004 with Britain's National Health Service to

work as a subcontractor, to do operations and medical tests for patients at a fraction

of the cost in Britain for either government or private care.

Apollo's business began to grow in the 1990s, with the deregulation of the

Indian economy, which drastically cut the bureaucratic barriers to expansion and

made it easier to import the most modern medical equipment. The first patients were

Indian expatriates who returned home for treatment; major investment houses

followed with money and then patients from Europe, the Middle East and Canada

began to arrive. Apollo now has 37 hospitals, with about 7,000 beds. The company

is in partnership in hospitals in Kuwait, Sri Lanka and Nigeria.

Western patients usually get a package deal that includes flights, transfers, hotels,

treatment and often a post-operative vacation. Apollo has also reacted to criticism by

Indian politicians by expanding its services to India's millions of poor. It has set

aside free beds for those who can't afford care, has set up a trust fund and is

pioneering remote, satellite-linked telemedicine across India

Increased options for healthcare Financing

The reach of Insurance has been increasing. The premiums collected from Health

Insurance are predicted to increase by around 50% from last year. Two exclusive

Health insurance companies have already started selling policies. Indian companies

now started expanding their horizons in to international health Insurance. Recently

Star Insurance has come up with far affordable insurance policy that covers many

diseases.


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Table: 4.2 Indian Companies ventured in to Healthcare Insurance

In Rupees Crores

Insurance

Companies

Half Year Ended

Septembet 2006

Half Year Ended

Septembet 2007

%

Growth

Royal Sundaram 42 54 28%

TATA-AIG 19 35 83%

Reliance 32 148 365%

IFFCO Tokio 32 45 41%

ICICI Lombard 296 425 43%

Bajaj Allianz 74 125 69%

HDFC Chubb 4 21 415%

Cholamandalam 16 56 255%

New India 348 483 39%

National 182 313 72%

United India 206 276 34%

Oriental 210 262 25%

Star Health & Allied

Insurance 2 45 2152%

Total Premium 1462 2287 56%

Source: IRDA Journal, Dec 07.

Various Medical Packages Available in India:

The health care sector in India has witnessed an enormous growth in

infrastructure in the private and voluntary sector. The private sector which was very

modest in the early stages, has now become a flourishing industry equipped with the

most modern state-of-the-art technology at its disposal. It is estimated that 75-80% of

health care services and investments in India are now provided by the private sector.

Table 4.3 Medical Packages

Bone Marrow Transplant Vascular Surgery

Brain Surgery Joint Replacement Surgery


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Cancer Procedures (Oncology) Nuclear Medicine

Cardiac Care Neurosurgery & Trauma Surgery

Cosmetic Surgery Preventive Health Care

Dialysis and Kidney Transplant Refractive Surgery

Drug Rehabilitation Osteoporosis

Gynecology & Obstetrics Spine Related

Health Checkups Urology

Internal/Digestive Procedures Bone Marrow Transplant

Major hospitals in India have oncology units comprising surgical oncology,

medical and radiation therapy as well as the crucial Bone Marrow Transplantation

(BMT). The BMT unit with high pressure hipa filters has helped achieve a very high

success rate in the various types of transplantation.

Cord Blood Transplant and Mismatched Allogeneic Stem Cell Transplant have

been performed successfully, a feat that is remarkable and significant, considering the

fact that the treatment costs one-tenth of what it does in the west. Special surgeons are

available for individual organs. Plastic surgeons of repute provide treatment for head

and neck cancer, breast cancer and other malignancies. Facilities offered include tele-

therapy which includes simulation work stations to ensure high precision and safety

during treatment at the 18 MV linear accelerator or telecobalt machines, brachy

therapy and 3-D planning systems. In orthopaedics, the Ilizarov technique is practised

for the treatment of limb deformities, limb shortening and disfiguration.

Brain Surgery

Indian hospitals have received wide acclaim for achievements in research and

clinical innovations related to neurology and head injuries. This includes controversial

Stem Cell Research and treatment as well as services for intractable (hard to treat)

epilepsies, brain stem injuries and more. This includes the new Vagus Nerve

Stimulators. Gamma knife procedures are 1/5th the cost of most US hospitals but with

equal, contact us about exciting research being done in the field of neurology. Also

inquire about headache specialists. Planet Hospital can help you find a hospital that

can help you with the following:


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Table 4.4

S. No Type of Brain Surgery

1. Vascular/Brain Surgery

2. Gene therapies for brain tumors.

3. Stereotactic radio surgery

4. Chemotherapy (Brain tumors and lesions).

5. Carotid artery surgery and angioplasty for cerebro-vascular

ischemia.

6. Peripheral artery lesions, if suitable, are treated with angioplasty and

stinting.

Hyperbaric treatments for closed head injuries

Epilepsy:

Vagal Nerve stimulators

Stem-cell related treatments

Headache treatments Diagnosis through:

1 Spinal Fluid Analysis

2 CT/MRI Structural Brain Imaging

3 FMRI/SPECT/Functional Brain Imaging

4 Accupuncture or laserpuncture treatments.

5 Outpatient surgical and non-surgical treatments for headache relief.

6 Stem cell treatments for Alzheimer's and parkinsons

7. Beep Brain stimulation for parkinsons.

Treatments for brain tumors (including: Gliomas, Astrocytomas, Ependymomas,

Medulloblastomas, Oligodendrogliomas, Schwannomas, Pituitary adenomas, and

Meningiomas).

Gene therapies for brain tumors.

stereotactic radiosurgery

Chemotherapy (Brain tumors and lesions).


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While the FDA stalls on approving cancer treatments available in other countries with

great success and while politicians debate over the successful use of stem cells in

cancer patients, you are left to suffer in fright needlessly, let us introduce you to the

latest techniques being used around the world. Medical Oncology: Affordable chemo

and radio treatments are available with refrence. Surgical Oncology Complicated and

delicate tumor excisions, Brachy-therapy, In addition to intra-capillary and intra-

luminal treatments. Our hospitals use the Iodine 125 permanent Seed Implant

Technique using RAPID strand.

Stereotactic Radiosurgery and Radiotherapy

A non-invasive radiation technique employed to treat various types of intracranial

lesions like arteriovenous malformation, meningiomas and acoustic schwamins. This

is usually done where risks of open surgery offer unacceptable odds. Linear

accelerator assisted stereo tactic radio surgery is a widely accepted form of treatment

and is extremely cost-effective. Through this procedure deep seated lesions can be

identified, visualized, analyzed and treated precisely. Apollo is the first in the country

to offer this treatment.

IMRT

Many hospitals are among the pioneers to offer IMRT (Intensity Modulated

Radiotherapy) to the patients. Special type of radiotherapies like Whole Skin Electron

Irradiation or Whole Body Irradiation too are carried out. These are carried out in

support of the treatment of Leukemia or Skin Lymphoma patients. IMRT is an

enormously powerful tool in experienced hands of expert radiation oncologists.

Several forms of HPI are being used at our hospitals. The latest development is

modulation of radiation intensity with Multi leaf Collimator.

Bone Marrow Transplantation

Bone marrow transplants have been performed to treat conditions like acute myeloid

leukemia, lymphatic leukemia, myeloma and Hodgkin's disease. Our partner hospitals

have performed hi-tech BMT with 80 dedicated beds, the largest in the continent. The

BMT units perform both allogenic and auto logous BMTs.


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Cord Blood Cell Transplantation: Utilizing umbical cord blood in the treatment

of leukemia and post cancer surgery.

Stem Cell Based Cancer Treatments

Brain Tumor Surgery: Gamma Knife Surgery is offered for a lot less compared to

other countries.

Other Treatments

Also have access to hundreds of clinical studies and techniques including the latest

technique in brain cancer: Diphtheria therapy.

Brachytherapy

Breast Cancer

Oral Cavity Cancer

Cervical Cancer

Prostate Cancer

Stereo tactic Radio surgery

Cardiac Care

Cardiac care has become a specialty in India with institutions like the Escorts Heart

Institute and Research Centre, All India Institute of Medical Sciences and Apollo

Hospital becoming names to reckon with. They combine the latest innovations in

medical electronics with unmatched expertise in leading cardiologists and cardio-

thoracic surgeons. These centres have the distinction of providing comprehensive

cardiac care spanning from basic facilities in preventive cardiology to the most

sophisticated curative technology. The technology is contemporary and world class

and the volumes handled match global benchmarks. They also specialise in offering

surgery to high risk patients with the introduction of innovative techniques like

minimally invasive and robotic surgery.

Renowned Indian hospitals like Apollo and Escorts Heart Institute are

equipped to handle all phases of heart diseases from the elementary to the latest

clinical procedures like interventional cardiac catherisation and surgical cardiac

transplants. Their success rate at an average of 98.50% is at par with leading cardiac

centres around the world.


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Leading heart centres like The Escorts Heart Institute have Cardiac Care Units

with sophisticated equipment and investigative facilities like Echocardiography with

colored Doppler, Nuclear Scanning and Coronary Angiography. The Jayadeva

Institute of Cardiology in Bangalore, the Cardiology Hospital in Kanpur, the Heart

Hospital in Calicut and the Sree Sudihindra Medical Mission Hospital in Cochin are

some hospitals in India devoted exclusively to cardiac treatment.

Cosmetic Surgery

A new dimension of the medical field taking off in India is cosmetic surgery which

utilises some of the latest techniques in corrective procedures. Some disfigurations

corrected include hair restoration (hair implants, hair flaps, and scalp reductions),

rhinoplasties (reshaping or recontouring of the nose), stalling of the aging process

(face life, cosmetic eyelid surgery, brow lift, sub-metal lipectomy for double chin),

demabrasions (sanding of the face,) otoplasty for protruding ears, chin and cheek

enlargement, lip reductions, various types of breast surgery and reconstruction and

liposuction. Non-invasive surgical procedures like streotactic radiosurgery and

radiotherapy for brain tumours are practised successfully.

Dialysis and Kidney Transplant

Common diseases like diabetes, hypertension and chronic glomerulo-nephritis can

lead to permanent loss of renal functions - with dialysis and renal transplantation being

the frequent outcome. The emergence of new therapeutic interventions has created

opportunities in India to manage the progression of renal diseases. Major hospitals in

India like Holy Family Hospital, Jaslok Hospital, Apollo Hospital, Sir Ganga Ram

Hospital, Batra Hospital, Bombay Hospital and Hinduja Hospital have departments of

Nephrology and Organ Transplant equipped with the latest computerised dialysis

machines, reverse osmosis water plant to provide pure and trace element-free water

supply, as well as state-of-the-art facilities in the operating rooms and Transplant

Intensive Care Units. For those who need renal replacement therapy, services like

Hemodialysis, Chronic Ambulatory Peritoneal Dialysis (CAPD) and Transplantation

are also available. In addition to the basic haemodialysis facilities, the patients'


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requirements for other modalities of treatment such as Continuous Arterio-Venous

Haemofilteration (CAVH), Continuous Veno-Venous Haemofilteration (CVVH),

Continuous Cycler-Assisted Peritioneal Dialysis (CCPD) are also available. Patients

can also avail of the bicarbonate dialysis facility at these centres. Round the clock

service is available at these hospitals for the critically ill patients in the intensive care

units who may need fluid, electrolyte management and renal supportive therapy. The

cost of getting a dialysis is around Rs. 1,700 to Rs. 1,800 per dialysis whereas the

same costs about $300 in the U.S.A. Similarly a kidney transplant package in India is

available for around Rs. 3 lakh which is comparatively much cheaper than what it

would cost abroad.

Drug Rehabilitation

Rehabilitation is a continuous process needed to improve ones quality of life after

injury or surgery. Our partner hospitals are world class in offering affordable and

comprehensive rehabilitation in:

Physical Rehabilitation

Stroke Rehabilitation

Spinal Cord Injury Rehabilitation

Brain Injury Rehabilitation

Physical, Occupational and Speech Therapy

Aquatic Therapy

Physical therapy for parapalegics and quadrapelegics.

Anorexia Nervosa treatments.

Drug Rehabilitation: Treatments include:

Anesthesia based detoxification program.

Methadone maintenance treatment

Inpatient long term detox programs

Rapid detox.

Gynecology & Obstetrics

Leading Indian hospitals with gynecology departments and women's hospitals have

facilities for the prevention and early detection of gynecological disorders. Many

hospitals have women check-up programmes designed to detect the earliest signs of


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disorders of the breast and the organs of reproduction as well as catering to the

contraceptive needs of women. A mammogram, an ultrasound of the pelvis and a pap-

smear of the cervix are an integral part of any good medical check-up for women.

Specialist medical as well as surgical care is available for all types of gynecological

problems like menstrual abnormalities, prolapse, fibroids and other tumors of the

uterus and ovaries, tubal recanalisation by microsurgery and care of the infertile

couple. State-of-the-art gynecological surgery is available with world class equipment

and expertise using minimally invasive techniques.

Ectopic pregnancies, ovarian cysts and tumors, fibroids endometriosis, tubal

blocks and even hysterectomies can be performed laproscopically. Hospitals like

Apollo have state-of-the-art IVF labs backed by highly experienced doctors who have

been involved in the field of infertility and assisted Reproductive Technologies

(ART). A full range of diagnostic procedures are available for infertile couples.

Treatment for the disorders of ovulation, controlled ovarian stimulation, controlled

ovarian stimulation, Intra-Utrine Insemination (IUI), Intra-Fallopian Tubal

Insemination (IFI), In Vitro Fertilization (VF) and Gamete Intra-Fallopian Transfer

(GIFT), Embryo Transfer (ET), Zygote Intra-Fallopian Transfer (ZIFT), sperm

donation, freezing egg/ oocyte donation, replacement of frozen embryos, full range of

treatment of male infertility including micro-manipulation technology - Intra

Cytoplasmic Sperm Injection (ICSI) and surrogacy. The emphasis is on optimizing

each couple's chance of achieving a pregnancy by combining the best scientific and

medical practice with the highest standard of care.

Health Checkup

Many common and life-threatening conditions can be treated successfully if detected

early. Many leading hospitals in India have health check-up programmes that screen

every part of the body meticulously and professionally. A proper health check-up

scans your bio-history, interprets signals and provides the opportunity for the

proverbial "stitch in time". A heart check-up constituting echocardiography,

consultation by a senior cardiologist, blood test, general test and haemogram can go a

long way in ensuring a healthy heart. The test can be done at any of the leading

cardiac hospitals or private clinics.


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Table 4.5 comprehensive health check-up contains the following tests:

S.No Check-up

1. Doctors consultation and full medical examination

2. Blood tests

3. Complete Haemogram (hb, TLC, DLR, ESR, Haemotocrit, Peripheral

Smear)

4. Blood group (ABO, RH)

5. Blood Sugar

6. Blood Urea

7. Serum Uric Acid

8. Serum Creatinine

9. Serum Cholesterol

10. Lipid Profile

11. Urine and Faeces Examination

12. X-Ray Chest PA

13. ECG

14. Exercise Stress Test (TMT)

15. Stress Screening by Psychologist

16. Eye Examination

17. Gynecologist Consultation and Pap Smear Test

18. Post Check-up consultation

19. Optional Test

Internal/Digestive Problems

If you are in desperate need of a transplant we might be able to help. With hospitals

located where organs are more readily (and ethically) available, the chances of finding

a match are significantly greater. We also treat several other internal organ related

ailments including:

Surgical Gastroenterology

Photo Coagulation Therapy

Laser Coagulation therapy


162

Drainage of pancreatic pseudo cyst H.S.V. & G.J.

Surgery for Oesophageal Stricture

Surgery for Hydatid disease

Surgery for achalasia cardia

Surgery for various liver cysts

Surgery for Hiatus Hernia

Total gastrectomy with Roux-En-Y Loop

Radical resections for cancer of the Bowel

Pouch surgery for inflammatory bowel disease

Stomach Surgery Removal: Surgery Removal of stoma complications such as prolaps,

hernias, retraction and misplacement reconnection of intestines after temporary stoma

surgery conversion of incontinent.

Gastric Surgery (Stomach)

Gastric Surgery stomach replacement (stomach pouches).

For Kidneys

Chronic Hemodialysis

Bedside Acute Dialysis with reverse osmosis

Ultrafiltration

Continuous Renal Replacement

AV Fistula (Shunt) & Management

Cyst removal

Kidney Transplant (We have the ability to find you a donor very rapidly and

ethically).

Pancreatic Surgery

Internal drainage of pseudocysts (cysto-enterostomy) functional resection and other

surgery in case of chronic pancreatitis curative and palliative surgery in cases of

pancreatic tumour

Intestinal Surgery

Surgery for Crohn's Disease: open and minimum invasive techniques, colectomy and

ileorectostomy, stricture-plasty. Surgery for Ulcerative Colitis and FAP (Familiar

Adenomatous Polyposis); Creation of ileo-anal pouches, continent ileostomy (Kock


163

pouch), pouch conversions: transformation of malfunctioning ileo-anal pouches into

Kock pouches. Continence Preserving Surgery Deep anterior resection,

intersphincteric resection, creation of colo-anal pouches, transanal microsurgery.

Continence Restoring Surgery of Rectum

Retropexy, sigma-resection (Goldberg-Frykman), perineal proctosigmoidectomy

Altemeier - for very elderly patients), Rehn-Delorme rectum surgery (in case of partial

or small prolaps).

Joint Replacement Surgery

Shoulder/hip replacement and bilateral knee replacement surgery using the most

advanced keyhole or endosopic surgery and anthroscopy is done at several hospitals in

India including the Apollo Hospital, Sir Ganga Ram Hospital and Holy Family

Hospital in Delhi, Bombay Hospital, Leelavati and Hinduja Hospital in Mumbai and

the Madras Institute of Orthoepaedics and Trauma Sciences. Some hospitals like

Apollo in Delhi have Operation Theatres with Laminar Air Flow System which

compares with the best in the USA and the UK. A knee joint replacement costs about

Rs. 2.50 Lakh in India wheras in the UK, a similar surgery using the same implants

and medical consumables costs around 10,000 pounds.

Nuclear Medicine

Nuclear medicine is now commonplace. As it involves use of radioactive isotopes in

very small doses in diagnosing and treatment of diseases, radioactive medicine

injected or administered orally and the distribution in the organ is scanned using a

Gamma camera. Tariffs are low starting from Rs. 4,000 for Thalluim rest (SPECT),

Rs. 1,800 for lung perfusion and venogram of upper or lower limbs, Rs. 14,000 for

Ventilation study, Rs. 1,500 for a whole body skeletal study and Rs. 700 for Tc-99m

Thyroid scan. Various non-cardiac planar/SPECT studies for bone, thyroid, liver and

lungs scanning functions are performed at specialised centres in India. Diagnostic

imaging of the brain, stomach, kidneys, heart, adrenal glands as well as sites of occult

infection with the help of sophisticated Gamma Camera with tomographic facilities

linked to computer systems can also be performed at many of these centres.


164

Neurosurgery & Trauma Surgery

Other routine procedures performed with excellent results are replacement

arthroplasties, diagnostic and operative arthoscopy, spinal surgeries including.

Harrington Rod Instrumentation for scoliosis, corrective and reconstructive procedure

for poliomyelitis and cerebral palsy, micro-cascular surgical procedures and

automated percutanneous lumbar discectomy. In addition, the advanced Luque

technique is employed for the correction of complex scoliosis, and decompression and

stabilisation of fractures of dorsal and lumbar spine with paraplegia, by neurosurgeons

with excellent training and background.

Many super-speciality hospitals in India like AIIMS, Ram Manohar Lohia

Hospital, Vidya Sagar Institute of Mental Health and Neuro Sciences, Bombay

Hospital, Jaslok Hospital, Nizam Institute of Mental Health and Neuro Sciences and

Apollo Hispitals have advanced faculities devoted to the treatment of the entire renge

of brain and spinal disorders with highly experienced neurosurgenons, neurologists,

neuro-anaesthetists and neuro-radilogists. Treatment of intra- and juxta-cranial, spinal

tumours and vascular malformations, aneurysms and thrombolysis for brain attacks are

done at these centres. Hospitals like Apollo employ state-of-the-art LINAC-based

stereotactic radiosurgery system outside the USA. The Clinac 6000SR Linear

Accelerator with XKNIFE system is a highly sophisticated computer-driven

technology used for removal of appropriately selected brain tumours, arteriovenous

malformations and other abnormalities.

Preventive Health Care

Preventive health care has been introduced for the first time in the country by Apollo

Hospitals with hospitals in the metros of Hyderabad, Chennai and Delhi, within easy

international air access. The professional chain also pioneered the concept of lifestyle

clincs, established the first organ registry in the country and introduced non-invasive

technique for treatment of lesions and tumours of the brain - Stereotactic Radio

Surgery and Radio therapy in the country. It recently installed a state of the art Cobalt

Unit. Apollo Heart Hospital provides a complete network for cardiac patients. It has a

total bed capacity of 500 beds distributed between Apollo Chennai, Hyderabad and

Delhi. Apollo is linked to the Mayo Clinic and the Minneapolis Heart Institute, a


165

premier heart institute led by the team of doctors who pioneered the Jarvik artifical

heart.

Probably the greatest conceptual advance of this century in Therapeutic

Oncology is the principle of the elimination of the neoplastic process with

conservation of both anatomy and physiology. Outstanding examples are conservation

of limbs in Osteosarcoma, preservation of female breast in malignancies of the organ

and the saving of the larynx in laryngeal cancer by a multimode approach in

management. Equally amazing has been the cure of certain acute leukemias by Bone

marrow transplantation. Imaging with MRI, a hypertension research centre and

facilities for haemodialysis and kidney transplantation are available at Akila Hospitals

at Trichy. The hospital boasts a transplant team with 8 specialists, bone marrow

transplant team along with five specialists on call to Sri Lanka, Sharjah, Kuwait and

major Indian cities. In Chennai, the Vijaya Heart Foundation's 79 beds has a state of

the art cardiology and cardo-thoracic surgical unit manned by competent and

experienced staff. The Vijaya Health Centre with 270 beds, offers diagnostic facilities

in laboratory, X-ray, ultrasound, treadmill, endoscopy. C.T. Scan, M.R.I. and nuclear

medicine.

Refractive Surgery

Refractive surgery is gaining popularity in India both among the public as well as

among ophthalmologists. Till a few years ago only a few centres performed high

volume radial keratotomy. Today, the highest international quality of eye care for

cornea, cataract, squint and glaucoma is available in over 40 centres all over India.

When it comes to reliability, India has the best ophthalmic surgeons with clinico-

academic expertise honed to perfection in the best possible institutions. Apollo

Hospital, Gurunanak Eye Centre, Dr. Rajindra Prasad Centre For Ophthalmic Sciences

and Mohan Eye Centre in Delhi, Shankar Naytralaya in Chennai, L. V. Prasad hospital

in Hyderabad are just some of the more popular eye care hospitals. The No Stitch

Cataract Surgery with the most modern way of removing cataract through the use of

Phacoemulsification procedure can be performed in India for as little as Rs. 20,000,

for both the eyes, whereas the same surgery costs $ 45,000 in the USA. Facilities for

PRK, myopia and astigmatism are now available in almost all parts of the country.


166

Hyperopics and LASIK are available and even supra hard cataracts are treated using

just 1 mm incision instead of the 3 mm incision size. Photorefractive keratectomy or

PRK treats the surface of the cornea with the Excimer laser while LASIK treats the

inner tissue of the cornea. For this reason, with LASIK there is less area to heal, less

risk of scarring, less risk of corneal haze, less post-operative pain and vision often

returns very rapidly.

Osteoporosis

Several drug therapies now easily available in the market have been shown to be

clinically effective in slowing down or reversing the bone-loss process. Leading

hospitals in India are well equipped to detect and treat bone loss in its earliest states,

so as to prevent the disease or lessen its impact. Doctors in leading hospitals have the

expertise for the diagnosis and treatment of osteoporosis that involves an objective,

quantifiable measurement of the patient's bone mass or bone density. Advanced

technology called the DXA for bone densitometry is available. During a

comprehensive bone valuation with DXA, the patient lies comfortably still on a

padded table while the DXA unit scans one or more areas, usually the fractured spine

or the hip. The entire process takes only minutes to scan depending on the number of

sites scanned. It involved no injections or invasive procedures and the patient remains

fully clothed.

Urology

Several super-specialty hospitals in India offer comprehensive Urological services to

diagnose and treat stone disease, urological cancer, incontinence, infertility, impotency

and other urinary difficulties. Advanced methods such as lithotripsy for treating

kidney and ureteric stones without surgery are available with complementary methods

of treating stones endoscopically. Advanced machines like the Lithostar obvert the

need for anesthesia in the treatment of kidney and ureteric stones. High tech facilities

for the treatment of prostate, bladder cancers, urethral strictures are also available.

Investigation and treatment facilities for impotence and male/female infertility exist

with specialised facilities for pharmacotherapy, cavernosometry and cavernosography,

in addition to doppler studies for the assessment of blood flow.


167

Vascular Surgery

Removal of the gall bladder, the spleen, the bowel and other organs like the adrenals,

an operation for prolapse rectum and hiatus hernia repair have become fairly

commonplace in almost all the major speciality hospitals in India. Experts are easily

available and accessible and the workload at most of these hospitals ensures that the

doctors have enormous experience. High intensive care treatment at much cheaper

rates than in the west is available at most of these centres.

Spine Related

Are you suffering from bone spurs? Are you parapelegic? Did you know that there are

treatments such as artificial disks and stem cell injections that are NOT available in

the US and several other countries? And at surprisingly affordable prices? For

example, read the article about Dr, Huang Hongyun, who uses olfactory ensheathing

stem cells to treat neurological damage. We want to help you end the pain that you are

enduring, we know the top orthopedic doctors in this field that have had renowned

successes. Look at some of the procedures that we can do below and then discover

how surprisingly affordable they are. We will also help you with your transport needs

in total comfort and dignity.

Endoscopic Discectomy

An alternative to surgery that can provide an effective way to decompress and repair

damaged discs without open surgery

Disk Herniation: Treatments through artificial disks. Recovery in one week in

most cases.

Radiosurgical Treatment of Spinal Tumors

A procedure where Non-invasive proton beam is used for the treatment for a number

of tumors of the spine including chordoma and chondrosarcoma. This is not Star Trek,

this procedure is excellent for targeting target unusually shaped lesions and lesions

outside of the cranium.


168

Fusion

Indian surgeons surgically remove pressure on the spinal cord and spinal nerves, and

fuse vertebrae using bone graft and/or spinal instrumentation. The result is a relief

from pain, more natural movement and a restoration of nerve function so you feel

better followed by top notch post operative therapy.

Spinal Cord Injuries

Affordable and intensive physical therapy for Spinal Cord Injuries and parapelegics

are extensively available.

Laminectomies

By removing a small area of the spine, which is referred to as a "laminectomy,"

surgeons are able to "decompress" or release pressure on the nerve as it exits the spine.

Also known as radiculopathy.

Stem Cell Treatments: For paraplegics and quadriplegics.

Scoliosis: Correcting a lateral curvature of the spine.

Stonosis Relief: Procedures include: Laminotomy, Foraminotomy, Medial

Facetectomy Anterior, Cervical Discectomy and Fusion.

Leading Hospitals in India offering above treatments:

- AIIMS

- Apollo Hospital

- B.M.Birla Heart Research Centre

- Christian Medical College

- Tata Memorial Hospital

- Apollo Cancer Hospital

- Indraprastha Medical Corporation

- Institute Cardiovascular

Why is India most suitable?

Indian corporate hospitals excel in cardiology and cardiothoracic surgery, joint

replacement, orthopedic surgery, gastroenterology, ophthalmology, transplants and

http://www.medical-tourism-india.com/hospitals_india.htm

http://www.medical-tourism-india.com/icd.htm


169

urology to name a few. The various specialties covered are Neurology, Neurosurgery,

Oncology, Ophthalmology, Rheumatology, Endocrinology, ENT, Pediatrics, Pediatric

Surgery, Pediatric Neurology, Urology, Nephrology, Dermatology, Dentistry, Plastic

Surgery, Gynecology, Pulmonology, Psychiatry, General Medicine & General Surgery

The various facilities in India include full body pathology, comprehensive

physical and gynecological examinations, dental checkup, eye checkup, diet

consultation, audiometry, spirometry, stress & lifestyle management, pap smear,

digital Chest X-ray, 12 lead ECG, 2D echo colour doppler, gold standard DXA bone

densitometry, body fat analysis, coronary risk markers, cancer risk markers, carotid

colour doppler, spiral CT scan and high strength MRI. Each test is carried out by

professional M.D. physicians, and is comprehensive yet pain-free.

There is also a gamut of services ranging from General Radiography, Ultra

Sonography, Mammography to high end services like Magnetic Resonance Imaging,

Digital Subtraction Angiography along with intervention procedures, Nuclear

Imaging. The diagnostic facilities offered in India are comprehensive to include

Laboratory services, Imaging, Cardiology, Neurology and Pulmonology. The

Laboratory services include biochemistry, hematology, microbiology, serology,

histopathology, transfusion medicine and RIA.

All medical investigations are conducted on the latest, technologically






hardly any waitlist as is common in European or American hospitals.

The Apollo Group, Escorts Hospitals in New Delhi and Jaslok Hospitals in

Mumbai are to name a few which are established names even abroad. A list of

corporate hospitals such as Global Hospitals, CARE and Dr L.V. Prasad Eye Hospitals

in Hyderabad, The Hindujas and NM Excellence in Mumbai, also have built

capabilities and are handling a steadily increasing flow of foreign patients. India has

much more expertise than say Thailand or Malaysia. The infrastructure in some of


170

India's hospitals is also very good. What is more significant is that the costs are much

less, almost one-third of those in other Asian countries.

Cost Comparison - India vs. United Kingdom (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.

Table 4.6 Cost comparison & waiting time USA & UK Vs India

Nature of Treatment Approximate Cost

in India ($) *

Cost in other Major

Healthcare Destination

($) *

Approximate

Waiting Periods in

USA / UK (in

months)

Open heart Surgery 4,500 > 18,000 9 - 11

Cranio-facial Surgery

and skull base 4,300 > 13,000 6 - 8

Neuro-surgery with

Hypothermia 6,500 > 21,000 12 - 14

Complex spine

surgery with implants 4,300 > 13,000 9 - 11

Simple Spine surgery 2,100 > 6,500 9 - 11

Simple Brain Tumor

-Biopsy

-Surgery

1,000

4,300

> 4,300

> 10,000

6 - 8

Parkinsons

-Lesion

-DBS

2,100

17,000

> 6,500

> 26,000

9 - 11

Hip Replacement 4,300 > 13,000 9 - 11

* These costs are an average and may not be the actual cost to be incurred.

Cost Comparison - India vs United States of America (USA)

Significant cost differences exist between U.S. and India when it comes to medical

treatment. India is not only cheaper but the waiting time is almost nil. Long waiting

times in US making lifes vulnerable. Where as in India it is a contrasting picture, this

is due to the outburst of the private sector which comprises of hospitals and clinics

with the latest technology and best practitioners.


171

Table 4.7 Procedure Charges in India & US (US $):

Procedure Cost (US$)

United States India

Bone Marrow Transplant 2,50,000 69,000

Liver Transplant 3,00,000 69,000

Heart Surgery 30,000 8,000

Orthopedic Surgery 20,000 6,000

Cataract Surgery 2,000 1,250

Table 4.8 Comparison of the cost of few of the Dental treatment procedures

between USA and India

Dental procedure Cost in US ($)* Cost in India

($)*

General

Dentist

Top End

Dentist

Top End

Dentist

Smile designing - 8,000 1,000

Metal Free Bridge - 5,500 500

Dental Implants - 3,500 800

Porcelain Metal Bridge 1,800 3,000 300

Porcelain Metal Crown 600 1,000 80

Tooth impactions 500 2,000 100

Root canal Treatment 600 1,000 100

Tooth whitening 350 800 110

Tooth colored

composite fillings

200 500 25

Tooth cleaning 100 300 75

* These costs are an average and may not be the actual cost to be incurred.

An article from 'Hindustan Times' dt. Feb 16, 2005

Americans flock to India for treatment

Robert Walter Beeney was unable to walk due to a stiff hip when he landed

in India January 24. Twenty days later, he not only recovered after a rare hip

replacement surgery at Apollo Hospital here but also visited the famous Taj

Mahal in Agra after that.

The 64-year-old real estate consultant from San Francisco underwent

successful surface replacement surgery using the anatomic surface

replacement (ASR) hip system January 27, reportedly becoming the first US


172

national to come to India for the treatment.

Another patient from Florida will be landing in Chennai for a similar

procedure at the Apollo Hospital there later this week.

A team of doctors, led by orthopaedic surgeon Vijay Bose, carried out the

procedure for Beeney.

Jayaramchander Pingle, a member of the medical team, told a news

conference on Tuesday that while in the conventional hip replacement

surgery, the total hip was replaced, in the new system, the patient's original

head and neck of femur were preserved and only their surface is replaced

with metal on metal articulation.

With the use of very advanced metallurgy in this device, the wear and tear is

reduced to a fraction in the artificial joint as opposed to the conventional

total hip replacement.

Another advantage of the latest procedure is that in the event of any problem

that may occur in the long term, the conventional total hip replacement can

be done at a later stage.

Beeney, who came to know about the procedure in India through the

Internet, said that since this was not yet cleared by the US Food and Drug

Administration, he decided to come to India.

"This is despite the fact that the device that is fixed in the hip is made in the

US," he said.

He also had other options like going to Britain or Belgium for treatment.

"But I preferred India as the treatment costs there are huge," he said.

The treatment in India cost him $6,600 (Rs 300,000) while the same as a part

of clinical trial in US would have cost $24,000. Even in Britain, where this

procedure was first developed a few years ago, it would have cost 12,000

pounds.

Cost comparison between India vs. UK

Medical healthcare trip to India may be beneficial in many aspects. The standard

healthcare sector in India offers quality treatment to the patients. The team of efficient

surgeons at different hospitals who are experienced enough performs treatment to

many complicated diseases142

. With the development of science and technology, the

medical treatment services has enhanced to a great extent. In addition to that the cost

of the treatments in India is comparatively low in comparison to the European

countries. Below is the table that shows the cost comparison of different treatment

procedure in UK and India.

142

http://www.tsiindia.com/medicare-india/india-vs-uk.html


173

Table: 4.9 Cost comparison with UK exclusively

Procedure India ($) UK ($)

Heart bypass 10000 18000

Heart valve replacement 9000 -----

Hip replacement 9000? 13000

Knee replacement 8500

Spinal fusion 5500 6500

Open Heart Surgery

(CABG)

7500 43000

Total Knee Replacement 6300 52000

Hip Resurfacing 7000 48000

LA Hysterectomy 4000 24000

Lap Cholcystectomy 3000 20000

Spinal Decompression

Fusion

5500 65000

Obesity Surgery (Gastric

Bypass)

9500 70000

Source: http://www.tsiindia.com/medicare-india/india-vs-uk.

The methodologies of the treatment in India are latest and at per to the international

standards. That is why, patients from the abroad come to India to get the best of

medical treatment services.

Cost Comparison - India vs United Arab Emirates (UAE)

Significant cost differences exist between UAE and India when it comes to medical

treatment. 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.

India vs. Thailand

Medical tourism in India is advantageous in terms of cost saving and standard

treatment facility. Indian hospitals offer low treatment cost compared to medical


174

treatment cost in Thailand143

. The staffs of different standard hospitals in India

communicate in English which enables the treatment procedure much easier for the

patient. In addition to that, the standard Indian hospitals seems to offer cheapest

medical services, while the same treatment costs more in Thailand. You can compare

some treatment cost in both the countries from the below furnished table that shows

medical cost comparison in India vs. Thailand.

Table 4.10 cost comparison India Vs Thailand

Procedure Cost in Thailand ($) Cost in India ($)

Cardiac Surgery 14,250 4,000

Bone Marrow Transplant 62,500 30,000

Liver Transplant 75,000 45,000

Orthopedic Surgery 6,900 4,500

Coronary Angioplasty 13,000 11,000

Heart Bypass 12,000 10,000

Hip Replacement 12,000 9,000

Gastric Bypass 13,000 11,000

Source: http://www.tsiindia.com/medicare-india/india-vs-thailand.

The above statistics justifies choosing medical tourism in India instead of going for

medical tourism in Thailand. The standard of various treatment procedures are at par

to the international standards. So, the patients can ensure best treatment facility from

the Indian hospitals.

India vs. Singapore

Treatment cost saving is the reason why patients avail medical tourism in India. It is

advantages in terms of treatment cost. Indian hospitals offer low treatment cost for

various surgeries at different standard hospitals in India. The cost of medical treatment

in India is quite low in comparison to the medical cost in Singapore144

. Different

hospitals in India seem to offer surgeries at cheap cost and reliable services. Here is

143

http://www.tsiindia.com/medicare-india/india-vs-thailand.html 144

http://www.tsiindia.com/medicare-india/india-vs-singapore.html


175

the comparison of treatment cost in Singapore and India from the below furnished

table.

Table: 4.11 Cost comparisons with Singapore Vs India

Procedure Cost in Singapore ($) Cost in India ($)

Cardiac Surgery 14,000 4,000

Liver transplant 75,000 45,000

Heart Bypass 12,000 10,000

Hip Replacement 12,000 9,000

Gastric Bypass 13,000 11,000

Source: http://www.tsiindia.com/medicare-india/india-vs-singapore

The standard of treatment procedures at different Indian hospitals are at par to

the international standards. So, the patients can ensure best treatment facility in Indian

hospitals.

Healthcare in India excels in treatments relating to cardiothoracic surgery, joint

replacement, transplants, orthopedic surgery, ophthalmology, and urology to name a

few. Indian medical institutes offer gamut of services ranging from general medicine

& surgery for many diseases and complications. Some of the hi-tech treatments at

Indian hospitals include pathology, comprehensive physical and gynecological

examinations, dental checkup, eye checkup, cancer risk markers, spiral CT scan and

MRI. All the above mentioned treatment processes are carried out with standard and

latest medical technology and equipment at par with the international treatment

standards.

The standard of medical investigations that are conducted in the Indian

healthcare centers are at par with the international standards. The advanced diagnostic

equipment that is used in different Indian hospitals is very sophisticated and updated.

Treatment quality at Indian hospitals ensures reliable and high class test results. The

corporate hospitals in India offer a group of renowned hospitals like Escorts Hospitals

in New Delhi, the Apollo Group, and Jaslok Hospitals in Mumbai to name a few of


176

them. India is a preferred medical destination by the foreign tourists. The costs of any

medical treatment in India healthcare centers are cheap as compared to the treatment

cost in Thailand, Singapore, UK, USA, etc. The priority in treatment standard at an

affordable price at the Indian healthcare centers makes it the most preferable medical

tourism destination in the entire world.

THEME-BASED FINDINGS OF THE INTERVIEWS OF DOCTORS &

SENIOR HEALTHCARE MANAGERS OF THE MULTI-SPECIALTY/

CORPORATE HOSPITALS IN INDIA HAVE BEEN PROVIDED IN THE

TABLE BELOW.

Total Sample: 90 Respondents

No of Doctors: 56

Senior Managers: 34

Table 4.12 Distribution of Sample Gender wise: Total Sample: 90

SAMPLE

CATEGORY MALE FEMALE TOTAL

1. Doctors 42 14 56

2. Senior managers 29 5 34

Total 71 19 90

SAMPLE DISTRIBUTION

Doctors

Senior Managers


177

Table: 4.13

ADVANTAGE OF COST OF HEALTHCARE

S.

No

Implication

s

Yes No Yes No

No of

Doctor

s

%

No of

Doctor

s

%

No of

Manager

s

%

No of

Mana

gers

%

1.

Cost

effective

than other

countries

51 92 5 8 33 97 1 3

2.

Skilled staff

availability 53 95 3 5 31 91 3 9

3.

Superior

Technology

availability

at affordable

cost

37 67 19 3

3 19 55 15 45

4.

Scope to

attract

medical

tourists from

SAARC,

CIS &

Middle-

Eastern

48 86 8 1

4 28 82 6 18

5.

Scope to

attract

medical

tourists from

USA, UK

Japan and

Europe

44 79 12 2

1 16 47 18 53

6.

Mostly

referral

patients

47 84 9 1

6 20 58 16 42

7.

Mostly

Geriatric

patients

47 84 9 1

6 20 58 16 42

8.

Intensive

Promotion

of low cost

factor

required

56 10

0 0 0 34

10

0 0

9.

Expansion

of hospitals 11 20 45

8

0 19 55 17 45


178

abroad

needed

10.

Networking

of Hospitals

is need of

hour

(consortium)

49 88 7 1

2 31 91 3 9

11.

JCI and

NABH

accreditation

needed

28 50 28 5

0 12 35 24 71

Average 42 75 14

2

5 24 70 10 30

INTERPRETATIONS:

Ref: (S. No 1) From the above analysis it is evident that 92 percent of Doctors

strongly opined that Indian healthcare services have got vast scope to internationalize

their services abroad because of the factor Cost effectiveness of Healthcare service in

comparison with USA, UK & other counter parts and same has been said by 97

percent Senior managers of various corporate hospitals. But 8 percent of doctors & 3

percent of senior managers hold a different opinion. They said South East Asian

countries now have come up with better packages.

Ref: (S. No 2) From the above analysis one can understand that 95 percent of Doctors

are under impression that Indian Doctor & hospitals will score over their counterparts

in term of Skill & expertise. and same has been said by 91 percent Senior managers of

various corporate hospitals. But 5 percent of doctors & 9 percent of senior managers

hold a different opinion.

Ref: (S. No 3) From the above analysis it can be concluded that 67 percent of Doctors

are under impression that Indian Hospitals have better technology than competing peer

countries and same has been said by 55 percent Senior managers of various corporate

hospitals. But 33 percent of doctors & 45 percent of senior managers hold a different

opinion.


179

Ref: (S. No 4) From the above analysis it is clear that 86 percent of Doctors are under

impression that there is more Scope to attract medical tourists from SAARC, CIS &

Middle-Eastern countries that enhance revenue to country and same has been said by

82 percent Senior managers of various corporate hospitals. But 14 percent of doctors

18 percent of senior managers hold a different opinion.

Ref: (S. No 5) From the above analysis it is very interesting to note that 79 percent of

Doctors said there is less Scope to attract medical tourists from USA, UK Japan and

Europe and same has been said by 47 percent Senior managers of various corporate

hospitals. But 21 percent of doctors said there is Scope to attract medical tourists from

USA, UK Japan and Europe and 53 percent of senior managers hold a different

opinion.


are under impression that Indian hospitals will attract mostly referral patients by

aboard hospitals or healthcare providers and same has been said by 58 percent of

respondents among the sample of Senior managers of various corporate hospitals. But

16 percent of doctors & 42 percent of senior managers hold a different opinion.

Ref: (S. No 7) From the above analysis it can be stated that 84 percent of Doctors are

under impression that Indian hospitals will attract geriatric patients too from aboard

and same has been said by 58 percent of Senior managers of various corporate


opinion.

Ref: (S. No 8) From the above analysis very exciting to learn that all the doctors &

senior managers (100%) said Intensive promotion is required to Internationalise the

Indian Healthcare services, that will pave economic growth.


are under impression that Indian hospitals need to set up their extension hospitals

aboard to enhance better catchment of potential and same has been said by 55 percent

of respondents among the sample of Senior managers of various corporate hospitals.

But 80 percent of doctors & 45 percent of senior managers hold a different opinion. It

can be inferred that majority of doctors are not in favor of establishing offshore

hospitals abroad.


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Ref: (S. No 10) From the above analysis it can be stated that 84 percent of Doctors are

under impression that Indian hospitals will attract geriatric patients too from aboard

and same has been said by 58 percent of Senior managers of various corporate


opinion.

Ref: (S. No 11) From the above analysis it can be concluded that 88 percent of

Doctors are suggested that Indian hospitals need to form in to consortium which will

give symbiotic edge through expertise and resource sharing and same has been said by

91 percent of respondents among the sample of Senior managers of various corporate


opinion.

Conclusion:

India is emerging as a major destination for healthcare because of the low cost

of treatment and advanced technology prevailing in India. Indian hospitals are cost

effective than many developed countries such as USA and Europe. Even when

compared to other South-East Asian countries, such as Thailand and Singapore, India

scores better, with the cost of procedures cheaper by around 30 percent. There are

estimates that companies in USA will be spending as much on healthcare as they made

profits, forcing the scaling back or withdrawal of benefits. As precaution, some firms

have begun considering treatment for their employees in low cost destinations. Thus,

low cost healthcare services coupled with internationally acceptable medical practices

would position India as an attractive healthcare destination. Estimates show that the

average success rate of cardiac surgeries in Indian hospitals compares favorably with

developed countries. The success rate of Indian physiotherapists helping patients

regain their physical fitness and prevent cardiac problems is at an average of 99.5

percent, at par with leading cardiac centers around the world.

Healthcare in India excels in treatments relating to cardiothoracic surgery, joint

replacement, transplants, orthopedic surgery, ophthalmology, and urology to name a

few. Indian medical institutes offer gamut of services ranging from general medicine


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& surgery for many diseases and complications. Some of the hi-tech treatments at

Indian hospitals include pathology, comprehensive physical and gynecological

examinations, dental checkup, eye checkup, cancer risk markers, spiral CT scan and

MRI. All the above mentioned treatment processes are carried out with standard and

latest medical technology and equipment at par with the international treatment

standards.

The standard of medical investigations that are conducted in the Indian

healthcare centers are at par with the international standards. The advanced diagnostic

equipment that is used in different Indian hospitals is very sophisticated and updated.

Treatment quality at Indian hospitals ensures reliable and high class test results. The

corporate hospitals in India offer a group of renowned hospitals like Escorts Hospitals

in New Delhi, the Apollo Group, and Jaslok Hospitals in Mumbai to name a few of

them. India is a preferred medical destination by the foreign tourists. The costs of any

medical treatment in India healthcare centers are cheap as compared to the treatment

cost in Thailand, Singapore, UK, USA, etc. The priority in treatment standard at an

affordable price at the Indian healthcare centers makes it the most preferable medical

tourism destination in the entire world.

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. 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.

In India, all medical investigations are conducted on the latest, technologically






hardly any waitlist as is common in European or American hospitals.

Documents

Chapter 4 ADVANTAGE OF COST OF HEALTHCARE SERVICEshodhganga.inflibnet.ac.in/bitstream/10603/8367/10/10_chapter 4.pdfChapter 4 ADVANTAGE OF COST OF HEALTHCARE SERVICE ... CARE and Dr