Findings - INFLIBNETshodhganga.inflibnet.ac.in/bitstream/10603/7900/9/09_chapter 4.pdf · - 37 - Healthy employees add health and happiness to a business. The healthcare delivery

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Findings

Research objectives of the study are to study the factors contributing to brand building

in corporate hospitals in National Capital Region, the emergence and growth of

corporate hospitals in National Capital Region, to study the brand strategies and

challenges of corporate hospitals in National Capital Region and to study and suggest

the branding strategies for a modern corporate hospital in National Capital Region.

Although the management, doctors and the para- medical staff were not open about

discussing the brand strategies of their hospitals due to constraints of corporate

secrecy and medical ethics, the study resulted in the following findings based both on

the observations and research of the study and also the brand perceptions derived

from the survey of patients in both the hospitals Fortis and Max Healthcare.

Generally speaking, there are five key brand strategies to establish to create a strong

brand. These are developing the brand vision, establishing the brand position,

communicating the brand position, fulfilling the brand contract and measuring return

on brand investment. Analyzing on these lines, Fortis has made huge strides within a

decade of its commencement in terms of providing quality services. It has created an

image for itself for providing quality at an affordable price. Quality has been their

healthcare focus which is a key differentiator for them. Fortis’ brand strategy is to

make its brand presence felt through aggressive pursuit for quality accreditation and

certifications. Fortis works with the QCI (Quality council of India) to generate quality

standards and an accreditation system (NABH) which is practical and affordable.

Fortis, with its brand image and a large network, is focusing on academics and on

partnering with educational institutes and research centres to tap into its pool of talent.

Fortis actively explores the opportunities in medical education facilities to ensure the

availability of qualified and trained manpower for all prevailing and future needs.

Fortis brand strategy is to rightly offer unbeatable medical value propositions already

catering to international patients providing quality healthcare services at attractive

value propositions.

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Healthy employees add health and happiness to a business. The healthcare delivery

services at Fortis are catered to employee needs. All patient records are accessible at

all its hospitals across the country so that its employees have the convenience of

choosing the centre most convenient to them for accessing their healthcare records.

Fortis healthcare has built a tele-medical network, which connects its facilities

providing continuous expert healthcare. Fortis has also tied up with both public and

private partners in the Indian healthcare industry to provide specialty and quality

healthcare facilities. The Fortis group is empanelled with many top corporates, public

sector undertakings, multinational companies and insurance companies. The

employees of these empanelled companies are given special offers on health check up

programmes and medical management services.

Fortis has created a physical evidence of its expert and specialized services by

advertising and communicating their achievements in medical care thus reposing the

customer confidence in their services. Fortis healthcare is committed to providing the

healthcare services backed by state-of-the-art technology and trained technicians.

Another brand strategy which Fortis employs deliberately is its short stay surgery

programmes which make the stay in the hospital as short as possible enabling the

patient to walk out of surgery in just a couple of days through advances in medical

technology and adequate skilled staff.

When compared to its competition, Fortis maintains a stable price policy and there is

a very marginal difference when it comes to the amount charged thus becoming a

price- quality leader in the healthcare segment.

Analysing the Fortis healthcare services the price for visits for patients is reasonable

as compared to other corporate hospitals according to the perception of the

respondents .The price of major medical treatments is also subsidized according to the

income groups. Fortis also comes up with special healthcare programmers for senior

citizens and also discounts for its female patients over forty years of age.

Fortis also has many free clinics for the poor and also in the rural areas in the National

capital region.

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Another brand strategy Fortis employs is tying up with many companies and offices

and providing them with the health cards to its employees to be treated on No cash

basis. By this strategy Fortis made a huge amount of customer base and in the process

retained many a customer.

Fortis has opened many free health camps and free health check-up days in their

hospitals to increase the customer base. They celebrate special days as World Cancer

day and World Osteoporosis day in order to bring awareness among their patients

.During these days they give discounts on the services provided and thus adding on

their already existing promotions.

Fortis also sets up blood donation camps in different colleges and NGO’s and through

this, they are able to get into the eyes of the general public and the young blood of

India. They also organize road shows to create awareness and put in some very

attractive hoardings sending messages.

Fortis brand strategy is to adopt best corporate governance practices. They have a

strong board of independent directors advising and guiding policies and proposals

made by their operating management.

Max healthcare consists of eight hospitals that have advanced facilities and each

hospital concentrates on several specializations which address the patient’s needs.

Max Healthcare is the choice for medical tourism in India because it houses world

renowned specialized doctors. Max Healthcare hospitals have become the first in

North India to receive the prestigious National Accreditation from the NABH. The

hospital provides the highest level of professional expertise and world class care in all

major medical disciplines and support specialties. The hospital has a team of well

trained and highly experienced consultants, surgeons in various specialties providing

the highest standards of medical and patient care with a focus on service excellence.

The hospital uses the state-of-art-technology to provide excellence in delivery of its

services.

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Strategy 1 based on perception1

The respondents were asked to rate the two hospitals on various parameters. On the

question of service quality, majority of the respondents agreed that Fortis hospital

provides them with best service. Further the patients from Max healthcare also agreed

that they are provided with good quality service. The service quality plays an

important part in the satisfaction of the patients. Also as the people prefer to visit a

known and trusted hospital more, hence it makes all the business sense for the

hospitals to provide good quality of service.


Technology plays an important part in the treatment of patients in the current medical

practice. A number of sophisticated and advance instruments assist the doctors in

identifying the cause and providing the suitable cure. In addition the medical labs are

also using high end technology these days. Majority of the respondents from Fortis

hospital agreed that the hospital provides the latest technology treatment to the

patients. Further the patients from Max Healthcare also agreed that the hospital is

technologically advanced in providing treatment.


At times it happens in the hospital that a lot of time is spent in billing and other

formalities while the patient is moving out of the hospital. This becomes an irritant for

the patients and their attendants as they are asked to complete a lot of formalities.

However in case of Fortis, this is not the case as pointed out by the respondents.

According to the survey majority of the patients from Fortis agreed that the waiting

time is quite less. On the other hand in case of Max Healthcare, the patients had to

wait a long time for completing the formalities while getting discharged. This is one

of the important factors which impact the brand perception for the patients as pointed

out by them.

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Strategy4 based on perception4

With the new age hospitals, the accommodation has also become an area of concern

for the patients. The patients and their attendants prefer clean and well lit up rooms as

the charges are more in the corporate hospitals. Fortis has good quality

accommodation for the patients as pointed out by the respondents. Further Max is also

at a good position in terms of the accommodation as pointed out by majority of the

participants in the survey.


Nurses are the ones who mainly take care of the medication of patient. As such

having sufficient staff of nurses is an important factor for any hospital. Both Fortis

and Max are believed to have sufficient number of nurses for serving patients, as

pointed out by majority of the respondents in the survey.


Hospital charges have been rising continuously over the past few years and with the

corporatisation of the hospitals the charges have changed totally. A number of

hospitals overcharge the patient or in case of medical insurance they try to fleece the

company by giving inflated bills for a medication. The reason for this is apparently

that the insurance companies do not pay the full amount of the bills to the hospitals

and have certain fixed compensation packages for certain medical or surgical

conditions. In case of Fortis the patients believe that the hospital charges are in

accordance with the service provided and economical as against the other hospitals.

The same is however not true for Max. Majority of the respondents felt that the

charges are higher than that of other hospitals. The charges taken by a hospital play a

lot of role in the brand image of the hospital. If the customers perceive that a hospital

overcharges then it destroys the brand image of the hospital.

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The number of doctors that a hospital has impacts the time that a doctor can give to

every patient. The more the number of doctors, the more is the time for patients. On

this aspect both Max and Fortis were rated well by a large number of the respondents

in the survey. This implies that the two hospitals have good number of doctors.


Further the two hospitals also have sufficient number of rooms for the patients,

according to the responses of the participants in the survey.


In certain hospitals the medicines prescribed by the doctor are not available in the

hospital and the same has to be sourced from outside by the patient or his/her

attendants. This becomes an irritating factor for them. In case of Fortis the patients

pointed out that the hospital has sufficient availability of medicines. The same was

also said by the respondents from Max hospital.


The patients do not like to wait too long when visiting the hospital OPD. This is one

of the irritant factors which makes the patients to change the hospitals also and spoils

their brand image. On this aspect Max Healthcare was not given a healthy rating and

the patients found out that they had to wait long for consulting with the doctor in the

OPD. On the other hand the patients visiting Fortis responded that the waiting time in

OPD was within limit and reasonable. This had a lot of positive impact on the brand

image of Fortis.


The helpful and courteous nature of the staff at the hospital plays a very important

role. As the patient is already suffering, hence if the staff of the hospital is not helpful

and courteous then it can make the patient quite irritated. Fortis has courteous and

helpful staff as pointed out by the respondents in the survey. Further the patients from

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Max also said that the staff in the hospital was quite helpful and extended courtesy in

all respects.


Training is quite significant in the hospital sector as the hospital industry is quite

specialized and the staff needs to be well trained to handle the patients and their

queries. In case of Fortis it was found out that the staff had the requisite training, as

pointed out by the respondents in the survey. Further Max was also rated to be

satisfactory in terms of the training of staff, by a large number of participants.


As the patients are suffering from some or the other problem, therefore the kind and

compassionate nature of the nurses helps a lot in reducing their suffering. As the

nurses are the ones who are always around and if they are not kind then the patients

feel irritated and do not prefer to stay in that hospital. In case of both Max and Fortis,

majority of the patients agreed that the nurses are kind and compassionate.


Further if the doctors do not understand the problem the patient is going through and

do not take interest in what the patient is saying then it makes the patient feel irritated

and he or she does not prefer to take medication from that doctor. If the doctors

empathise with the patient then a psychological relief is provided to the patient

immediately. On this aspect majority of the respondents agreed that both Max and

Fortis have empathetic nature of the doctors.


Once the patient moves out, he or she comes back for check up or as per directions of

doctor. However in most of the cases there is no follow up from the hospital for

taking feedback of the customer or to remind the next visit. The same is true with

Max, with majority of respondents stating that the hospital did not follow up after

discharge. However in case of Fortis, the patients said that there was follow up from

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the hospital side. This is an important brand building exercise and plays a role in the

perception of the customers.

On the whole the survey provided a lot of important information regarding the brand

perception of the hospitals in the National Capital Region of Delhi and how the

corporatization has changed the brand images. The two hospitals – Max Healthcare

and Fortis are quite well known and have a corporate outlook. According to the

survey the respondents rated Fortis above Max in terms of brand perception on a

number of factors. The main aspects which impact brand perception include the

charges levied by the hospital with regards to the treatment provided, the time that the

patient has to spend while getting discharged, the time that the patient has to spend

while waiting for consultation in OPD and the follow up that the hospital does with

the patients after they are discharged from the hospital. On the whole the respondents

rated Fortis hospital as having a better brand image in comparison to Max Healthcare.

4.1Descriptive statistics:

The table given in Appendix II, shows that we have taken equal 50 percentage of

patients from two hospitals Max HealthCare and Fortis each.

From the table given in Appendix II, distribution of age researcher observes that 98%

of the individuals in our sample are of age from 18 to 60 years+ while only 2% are of

age less than 18 years. This is shown graphically in pie chart.

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From the table given in Appendix II, distribution of gender researcher observes that

66% of the individuals in our sample are males while only 34% are females. This is

shown graphically in pie chart.

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From the table given in Appendix II, distribution of occupation researcher observes

that 30% of the individuals in our sample are business persons, 24% are housewife

and 20% self-employed while only 15%, 9% and 2% are service workers,

unemployed and students respectively. This is shown graphically in pie chart.

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From the table given in Appendix II, distribution of educational qualifications

researcher observes that 80% of the individuals in our sample are either graduates or

post graduates while only 13% and 7% are 10th and 12th class students. This is shown

graphically in pie chart.

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From the table given in Appendix II, distribution of income researcher observes that

84% of the individuals in our sample are of income group either 6,00,001- 9,00,000

INR or 9,00,001-12,00,000 INR while only 2% are of income greater than

12,00,000INR income and 14% are of income less than 6,00,000 INR. This is shown


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From the table given in Appendix II, distribution of concern about going to same

hospital researcher observes that 79% are concerned about going to the same hospital

while 21% are not concerned about going to the same hospital. This is shown


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From the table given in Appendix II, distribution of going for regular checkups

researcher observes that 68% are concerned about going for regular checkups while

32% are not concerned about going for regular checkups. This is shown graphically

in pie chart.

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From the table given in Appendix II, distribution of number of checkups in a year

researcher observes that 74% are concerned for every six months checkups, 16% are

concerned for monthly checkups while 10% are concerned for once in a year

checkups. This is shown graphically in pie chart.

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4.3 Statistical Analysis:

The researcher will apply the independent sample t-test to know whether there are

differences in the perceptions of the two hospitals. As our scale of measurement of

perception is scale with five categories from strongly disagree to strongly agree so

high value of mean indicates a good perception of the perception of that hospital.

From the following table researcher observes that for both the Fortis and Max

HealthCare the distribution of perceptions is non-normal but as our samples are of

size 100 for each of the hospitals so the independent sample t-test is robust against the

normality assumption and hence may apply independent sample t-test.

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Perceptions 1-5:

From the Levene’s tests of equality of variances researcher observes that the

distribution of perceptions from 1-5 have equal variances for both the hospitals which

is the requirement for the independent sample t-test.

Researcher observes that

1) The mean perception about the hospital service quality is not significantly

different between the Max and Fortis hospitals as t(198)=1.33, p=0.185>0.05.

From table of group statistics researcher observes that the mean perception of Max

and Fortis hospitals service quality are 4.49 and 4.33 respectively. So we conclude

that although the average service quality is not different in Max and Fortis

hospitals, there is a good perception amongst the customers about the service

quality of both the hospitals.

2) The mean perception about the hospital latest technology treatment is not

significantly different between the Max and Fortis hospitals as t(198)=1.838,

p=0.068>0.05. From table of group statistics researcher observes that the mean

perception of Max and Fortis hospitals latest technology treatment are 4.31 and

4.11 respectively. So we conclude that although the average latest technology

treatment is not different in Max and Fortis hospitals, there is a good perception

amongst the customers about the latest technology treatment of both the hospitals.

3) The mean perception about the hospital has reduced waiting time for out-patient is

significantly different between the Max and Fortis hospitals as t(198)=-22.914,

p<0.001. From table of group statistics researcher observes that the mean

perception of Max and Fortis hospitals about reduced waiting time for out-patient

are 1.90 and 4.24 respectively. So we conclude that not only the average waiting

time for out-patient is significantly different in Max and Fortis hospitals, but also

there is a good perception amongst the customers that Fortis has reduced waiting

time for out-patient as compared to Max.

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4) The mean perception about the Hospital accommodation is not significantly



and Fortis Hospital accommodation are 4.18 and 4.09 respectively. So we

conclude that although the average perception about accommodation is not

different in Max and Fortis hospitals, there is a good perception amongst the

customers that both the Hospital provides the best accommodation.

5) The mean perception about the number of nurses in the hospital is not



perception of Max and Fortis number of nurses in the hospital are 3.93 and 4.11

respectively. So we conclude that although the average perception that the

hospitals have enough number of nurses is not different in Max and Fortis

hospitals, there is a good perception amongst the customers that both the hospitals

have enough number of nurses.

Perceptions6-10:


distribution of perceptions from 6-10, except perception-8, have equal variances for

both the hospitals which is the requirement for the independent sample t-test. Also

here as the sample size is quit large so the assumption violation has a little effect.


6) The mean perception about the hospital charge is significantly different between

the Max and Fortis hospitals as t (198)=-16.22, p<0.001. From table of group

statistics researcher observes that the mean perception of Max and Fortis hospitals

charge are 1.83 and 4.09 respectively. So we conclude that not only the average

perception about the hospital charge is different in Max and Fortis hospitals, but

also on the average customers feel that Fortis hospital charges reasonable fees for

treatment compared to the Max hospitals

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7) The mean perception about the enough number of doctors in the hospitals is not



perception of Max and Fortis hospitals having enough number of doctors are 4.17

and 4.29 respectively. So we conclude that although the average perception about

the hospital having enough number of doctors is not different in Max and Fortis

hospitals, but on the average customers feel that both the hospitals have enough

number of doctors to treat the patients.

8) The mean perception about the enough number of rooms in the hospitals is not

significantly different between the Max and Fortis hospitals as t(198)=0.15,


perception of Max and Fortis hospitals having enough number of rooms are 4.10

and 4.08 respectively. So we conclude that although the average perception about

the hospital having enough number of rooms is not different in Max and Fortis

hospitals, but on the average customers feel that both the hospitals have enough

number of rooms for the patients.

9) The mean perception about the enough number of medicines available in the

hospitals is not significantly different between the Max and Fortis hospitals as

t(198)=-0.655, p=0.513>0.05. From table of group statistics researcher observes

that the mean perception of Max and Fortis hospitals having enough number of

medicines available are 3.90 and 4.00 respectively. So we conclude that although

the average perception about the hospital having enough number of medicines

available is not different in Max and Fortis hospitals, but on the average

customers feel that both the hospitals have enough number of medicines available

for the patients.

10) The mean perception about the waiting time in OPD in the hospitals is


p<0.001. From table of group statistics researcher observes that the mean

perception of Max and Fortis hospitals having waiting time in OPD are 1.94 and

3.93 respectively. So we conclude that not only the average perception about the

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hospital waiting time in OPD is different in Max and Fortis hospitals, but on the

average customers feel that waiting time in OPS is in limit in Fortis only and out

of limit in Max.

Perceptions11-15:


distribution of perceptions from 11-15, except perception-14, have equal variances for

both the hospitals which is the requirement for the independent sample t-test. Also

here as the sample size is quite large so the assumption violation has a little effect.


11) The mean perception about the hospital staff courteous and helpful behavior is


p=0.02<0.05. From table of group statistics researcher observes that the mean

perception of Max and Fortis hospital staff courteous and helpful behavior are

3.84 and 4.18 respectively. So we conclude that although the average perception

about hospital staff courteous and helpful behavior is different in Max and Fortis

hospitals, but also on the average customers feel that both hospitals’ staff have a

good courteous and helpful behavior although Fortis staff is slightly more

courteous.

12) The mean perception about the hospital staff training is not significantly different

between the Max and Fortis hospitals as t(198)=0.881, p=0.379>0.05. From table

of group statistics researcher observes that the mean perception of Max and Fortis

hospital staff training are 3.83 and 3.67 respectively. So we conclude that not only

the average perception about hospital staff training is different in Max and Fortis

hospitals, but also on the average customers feel that both hospitals’ staff training

is good.

13) The mean perception about the hospital staff nurses in the ward are kind and

compassionate is not significantly different between the Max and Fortis hospitals

as t(198)=0.672, p=0.502>0.05. From table of group statistics researcher observes

that the mean perception of Max and Fortis hospital staff nurses in the ward are

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kind and compassionate are 3.80 and 3.69 respectively. So we conclude that

although the average perception about hospital staff nurses in the ward are kind

and compassionate is not different in Max and Fortis hospitals, but on the

average customers feel that both hospitals’ staff nurses in the ward are kind and

compassionate.

14) The mean perception about the hospital doctors are empathetic is not significantly



and Fortis hospital doctors are empathetic are 4.04 and 3.77 respectively. So we

conclude that although the average perception about hospital doctors are

empathetic is not different in Max and Fortis hospitals, but on the average

customers feel that both hospitals’ doctors are empathetic.

15) The mean perception about follow up calls from the hospital is significantly

different between the Max and Fortis hospitals as t(198)=-13.608, p<0.001. From

table of group statistics researcher observes that the mean perception of Max and

Fortis hospital follow up calls from the hospital are 1.87 and 3.92 respectively. So

we conclude that not only the average perception about follow up calls from the

hospital is different in Max and Fortis hospitals, but on the average customers

feel that follow up calls from the hospital from Max hospital are not happening

whereas Fortis is better position in this case and provide follow up calls

Documents

Findings - INFLIBNETshodhganga.inflibnet.ac.in/bitstream/10603/7900/9/09_chapter 4.pdf · - 37 - Healthy employees add health and happiness to a business. The healthcare delivery