Comparative Analysis Of Private And Government Hospital..docx

PROJECT REPORT ON “COMPARATIVE ANALYSIS OF PRIVATE AND GOVERNMENT HOSPITAL” WITH REFERENCE TO MEKAHARA AND RAMKRISHNA CARE HOSPITAL, RAIPUR

SUBMITTED IN THE PARTIAL FULFILLMENT FOR THE AWARD OF BATCHLOR OF COMMERCE (B.COM) 2015-16 MATS UNIVERSITY, RAIPUR

Under the supervision of: Mrs POOJA RATHI

Submitted By: priya singh

ACKNOWLEDGEMENT

With great pleasure I would like to present my sincere gratitude to Mrs. Pooja rathi maam our teacher for helping me throughout my project and providing her guidance to me. I would also like to take this opportunity to thank our H.O.D Mr. T.G Madhusoodhanan, coordinator of Mats School of Business Studies, for giving us this project which made us gain practical knowledge in the field. I express my heartiest thanks to the faculties for giving me an opportunity to work under their guidance in their esteemed organization and providing me necessary resources for my project. I would like to extend my sincere thanks to all the respondents to whom I visited for giving their support and valuable information which helps me in completing my project work. I would also thank my institution and my faculty members without whom this project would have been a distant reality. I would also like to thank my parents and friends who helped me to make this project and motivated me to complete it on time.

MAHIMA TOPPO

B.Com Vth Semester

CERTIFICATE

This is to certify that this project entitled “COMPARATIVE ANALYSIS OF PRIVATE AND GOVERNMENT HOSPITAL”, Submitted in partial fulfillment of the degree of Bachelor of Commerce to MATS University, Raipur, done by Mahima Toppo, ID No. MU14BCM184 is an authentic work carried out by her at MEKAHARA AND RAMKRISHNA CARE HOSPITAL IN RAIPUR, under my guidance. The matter embodied in this project work has not been submitted earlier for award of any degree or diploma to the best of my knowledge and belief.

Signature of Student Mahima Toppo MU14BCM184 University

Signature of Guide MRS. POOJA RATHI Faculty

of

Mats

CERTIFICATE

T.G.MADHUSOODHANAN Head of the Department Mats School of Business Studies Date:

APPROVAL CERTIFICATE This is to approve that the work presented in the project titled “Comparative Analysis of Private and Government Hospital” was carried out by Mahima Toppo and submitted for the partial fulfillment of the requirement for the award of the degree of Bachelor of Commerce in Mats University is the original work carried out under the guidance and supervision of MRS. Pooja Rathi maam and that no part of this work has been submitted elsewhere for the award of any degree or diploma.

T.G.MADHUSOODHANAN Head of the Department

DECLARATION BY CANDIDATE

I Mahima Toppo hereby declare that this project is record of authentic work carried out by me during the academic year 2016-2017 Submitted in partial fulfillment of the degree of bachelor of commerce to Mats University has not been submitted to any other university or institute towards the award of any degree to the best of my knowledge and belief. The entire data, figure and information belong to selected hospitals, based on collected by myself.

Signature of student Mahima Toppo

CONTENTS

CHAPTER

TITLE

PAGE NO.

INTRODUCTION

I

Introduction

1-2

Conceptual Background

2-6

Significance of the study

7-8

Scope of the Study

9

Objectives of the study

9

Research Design & methodology

10-11

THEORATICAL FRAMEWORK Selection of the Hospitals

13-14

History of selected Hospitals

II

1. MEKAHARA HOSPITAL 2. RAMKRISHNA CARE HOSPITAL

15-41 42-48

Cost-Benefit Analysis

49-50

Feedback

51-53

Expenditure pattern

53-56

Limitations

57

III

DATA ANALYSIS INTERPRETATIONS

IV

SUGGESSIONS

AND

59-65

67-70

SUMMARY AND CONCLUSION

71

BIBILIOGRAPHY

72

CHAPTER ONE INTRODUCTION

Introduction Each child born in a country is human resource who will add to the productivity and prosperity of the nation. However, the responsibility of converting this latent resource in to an active workforce lies with the Government, private sector and NGOs. They should be made responsible for health care development in the country. A child suffering from poor health lacks attendance in the school. Workers who suffer from childhood malnutrition are less productive than healthy workers. India has one of the youngest populations in the world. India is experiencing high growth since a decade. The sustainability of this high economic growth rate requires huge investment in education and health care of the population Government hospitals, some of which are among the best hospitals in India, provide treatment at taxpayers’ expense. Before economic reforms in 1991, most essential drugs were provided free of charge to all patients in these hospitals. Government hospitals provide treatment either free or at minimal charges. For example, an outpatient card at AIIMS (one of the best hospitals in India) costs a onetime fee of rupees 10 (around 20 cents US) and thereafter outpatient medical advice is free. In-hospital treatment costs in these hospitals depend on financial condition of the patient and facilities utilised by him but are usually much less than the private sector. For instance, a patient is waived full treatment costs if he/she is below poverty line. Another patient may seek for an air-conditioned room, if he is willing to pay extra for it. The charges for basic in-hospital treatment and investigations are much less in public hospitals as compared to the private hospitals. The cost for these subsidies comes from annual financial allocations from the Central and State Governments. In addition to the network of public and private hospitals, there are charitable dispensaries and hospitals, many of which provide treatment and facilities parallel to those provided by

private hospitals at highly concessional rates or in some cases free of costs to the needy population. Primary health care is provided by city and district hospitals and rural primary health centres (PHCs). These hospitals provide treatment free of cost. Primary health care is focused on immunization, prevention of malnutrition, care during pregnancy, child birth, postnatal care, and treatment of common illnesses. Patients who receive specialised care or have complicated illnesses are referred to secondary care centres (often located in district and taluka headquarters) and tertiary care hospitals (located in district and state headquarters or those that are teaching hospitals). In post-independence period, India has eradicated mass famines, however the country still suffers from high levels of malnutrition and disease especially in rural areas. Water supply and sanitation in India are also major issues and many Indians in rural areas lack access to proper sanitation facilities and safe drinking water. However, at the same time, India's health care system also includes facilities that meet or exceed international quality standards. The medical tourism business in India has been growing in the recent years and as such India is a popular destination for medical tourists who receive effective medical treatment at lower costs than in the developed countries.

Conceptual Background:

The health care industry, or medical industry, is an aggregation of sectors within the economic system that provides goods and services to treat patients with curative, preventive, rehabilitative, and palliative care. The modern health care industry is divided into many

sectors and depends on interdisciplinary teams of trained professionals and paraprofessionals to meet health needs of individuals and populations. The health care industry is one of the world's largest and fastest-growing industries. Consuming over 10 percent of gross domestic product (GDP) of most developed nations, health care can form an enormous part of a country's economy. For purpose of finance and management, the health care industry is typically divided into several areas. As a basic framework for defining the sector, the United Nations International Standard Industrial Classification (ISIC) categorizes the health care industry as generally consisting of: 1. hospital activities; 2. medical and dental practice activities; 3. "Other human health activities". As this is comparative study on government and private hospital in Raipur . We have seen lot of differences in both private and public in many terms no doubt with the data collected has shown more response towards private hospitals then public hospitals. Private sector seems to be much more effective in influencing policy making, satisfying the public at the local or national levels then the Public sector.

Health: World Health Organization’s (WHO) constitution defines health as “a state of complete physical, mental and social well being and not merely the absence of disease or infirmity”. Necessarily, health has to be defined from a practical point of view and therefore, it has been defined according to life expectancy, infant mortality, and crude death rate, etc.

Human Development Index (HDI):

The Human Development Index (HDI) is a comparative measure of life expectancy, literacy, education and standards of living for countries worldwide. It is a standard means of measuring well-being, especially child welfare. India ranked 134th among 187 countries ranked in terms of Human Development Index.

Health Expenditure per Capita (PPP; International $): Health Expenditure Per Capita is the sum of public and private health expenditure (in PPP, International $) divided by total population. The health expenditure per capita stood at 45 $ in the year 2009 in India, which lies much below the international standards.

Health Economics: Health economics is the study of how scarce resources are allocated among alternative uses for the care of sickness and the promotion, maintenance and improvement of health, including the study of how health care and health-related services, their costs and benefits, and health itself are distributed among individuals and groups in society.

Out-of-Pocket Expenditure on Health (% of Private Expenditure on Health): Out-of- Pocket Expenditure on Health is the direct outlays of households, including gratuities and in- kind payments made to health practitioners and to suppliers of pharmaceuticals, therapeutic appliances and other goods and services. The out-of-pocket expenditure on health stood at 74.4% as at the end of the year 2009 .

Equity in Health Sector: Equity in health implies providing equal access to health facilities, equal use of services and equal health status for all by distributing health services on the basis of need regardless of

income. There exist widespread disparities in India in providing health care services – disparities in health care infrastructure in rural and urban areas, disparities in access to health care services by men and women and also by rich and poor, disparities in health care expenditure by public and private sector and also be various state governments.

Morbidity Rate (Sickness): Morbidity rate shows the departure from the ideal condition of health, i.e. a state of complete physical, mental and social well being. Morbidity rate is high in slum areas than non-slum areas. One of the obvious explanations for this high morbidity in slums is the degradation of the physical environment.

Nutrition: Nutrition refers to food substances required to keep the body in good working condition, and to supply fuel for energy. Good nutrition can help prevent disease and promote health. On an average, per capita per day calorie intake is 2,496 and the per capita per day consumption of protein is 59 grams. So far as the people below the poverty line are concerned, their average per day calorie intake is not even 1,500 and many of them do not get even 30 grams of protein per day.

Illness: Webster’s International Dictionary defines illness as a state of being ill or sick, bodily indisposition disease. It refers to anything affecting the total well-being of the patient. Communicable diseases, maternal, peri-natal and nutritional disorders constitute 38 per cent of deaths in India while non-communicable diseases account for 42 per cent of all deaths. Injuries and ill-defined causes constitute 10 per cent of deaths each.

Primary Health Care (PHC): The concept of Primary Health Centre was introduced by Bhore Committee in 1946 as basic health unit to provide health services to people as close to people as possible. Primary health care means essential health care based on practical, scientifically sound and socially acceptable methods and technology which is made universally accessible. Primary health care in India is provided through a network of over 147,069 health sub-centres, 23,673 Public Health Centres (PHCs) and 4,535 Community Health Centres (CHCs).

Morbidity among Women: Morbidity among women is the major issue in recent health policies. Women are more prone to sickness due to neglect during puberty and at the reproductive age. Due to poor financial condition women consume inferior quality and inadequate food which leads to anaemia. In the allocation of food women always neglect themselves. The work burden is always more.

SERVICE TO MANKIND IS SERVICE TO GOD Expanding healthcare access is a critical priority for the Government of India and the private sector. Efforts to date have addressed numerous issues and much progress can be reported. Yet the gap between the aspiration - of providing quality healthcare on an equitable, accessible and affordable basis across all regions and communities of the country - and today’s reality is all too apparent. The extent of change and improvement in India’s healthcare system over the past decade is remarkable. The Government of India’s initiatives, as well as private sector actions and public-private-partnership programs, have all contributed to this progress. Yet much more remains to be done. Understanding the current state of

healthcare access is one important and foundational element for determining priorities, resource allocations and goals for the future.

THE STUDY The literature available, clearly indicates that much work has been done on various aspects of healthcare organizations such as its techniques regarding, maintenance of bed-nurse ratio, doctor-patient ratio etc Majority of the hospitals in India follow the western system of medicine and public hospitals today are exclusively run in the administrative framework designed by the Britishers in the 19th century1.This type of traditional management leads to crisis in hospitals owing to an increase in population and inadequate availability of facilities. Both the central and state Governments have multiplied their investments on health sector since the First Five Year Plan. Even though government spends crores of rupees in this area, patient satisfaction levels are very low and hospitals continue to deteriorate. The private hospitals exploit the patients without providing adequate facilities to the needy. These traditional and rigid organizations fail to respond effectively to the problems of developing needs of the society. At present, most of the hospitals are run by the Superintendent who is the senior-most physician, with a small number of administrative staff. The administrative body generally tends to rely on rules, procedures and techniques which have not changed over the years. A good doctor may not be a good administrator. He himself is a doctor and has to attend to many administrative matters. It is very difficult to attend to both kinds of duties effectively. Time has changed and specialization has become the order of the day. In view of the tremendous expansion in health services, it has become essential to have specialists or experts not only in their fields but also in other fields of hospital administration so that maximum efficiency can be achieved at a minimum cost.

The rapidly rising number of patients and the inadequate expansion of hospitals and medical services have thrown the administrative machinery completely out of gear. It is therefore, imperative to have separate specialists for general administrative and personnel functions in the hospitals. Moreover, earlier the patients used to favour a good doctor. In the recent years the patient shifted his interest to availability of facilities in a hospital. Now the patient trusts a hospital with well-reputed doctors. In this context, it is necessary to have a separate cadre of administrators who combine some knowledge of medical system with sound management principles. In the present changed scenario, the public shows interest on corporate hospitals which run their organizations on scientific principles. Some of the distinct features of these corporate hospitals are (a) provision of sophisticated services in various fields of specialization,(b) availability of all diagnostic facilities under one roof and (c) availability of different specialists without any delay or inconvenience. Corporate hospitals make these facilities possible only with proper administration of management functions. In practice, corporate hospitals also have some drawbacks. Basically, an average Indian citizen is not in a position to go to corporate hospital because of non-affordability. Middle-income group and lowincome group are not in a position to use this facility because if a patient wants to have a kidney transplantation, he has to spend Rs.1 50,000 to Rs.2, 00,000 as package amount. For coronary bypass surgery (CABG), one has to spend nearly Rs.1, 50,000. In this context, the question arises as to how many patients can utilize these services. The answer is clear. Only higher income group can afford, leaving all the other groups out of the reach.

Scope of the Study: The scope of the present study extends to analyze financial status of both the selected government and private hospitals and comparison between both the hospitals and how far the

management functions are carried out effectively to satisfy their Out and In-patients in sample units. The study however includes the comparative details of paramedical staff, finance related aspects , Bed capacity, size, in- patients and out-patients super specialties offered are taken as basis for sample selection of both the hospitals. In the next step, an attempt has been made to elicit the opinions from patients about both government and private health care because every human being carries a particular set of thoughts, feelings and needs. It gives new ideas and suggestions. One must admit that there are lots of things which could be altered. Moreover, the concept, scope and philosophy of the hospital of today are far different from those of the past. Once upon a time, the hospitals were regarded as curative institutions and today these hospitals are being recognized more and more as social institutions and the focal point is patient’s satisfaction.

OBJECTIVES OF THE STUDY 

To compare and contrast the differences in healthcare standards and facilities in private and public sector hospitals in Raipur.



To know the perceptions of out-patients and in-patients of selected hospitals and availability of patient care in selected hospitals.



To draw attention of policy makers of healthcare system and make suggestions for the betterment with the help of public advices.

RESEARCH DESIGN

This study is mostly exploratory in nature and it aims at comparing the hospitalss. In this part, an attempt has been made to explain the research design, the procedure of sample selection, methodology used in data collection, analysis, and presentation.

Public Perceived Difference in Public and Private Hospital at Raipur Cost: Cost of treatment at a public healthcare facility is more affordable than that available at a private healthcare facility, and is dependent on the nature of treatment. The economic burden of a treatment is significant for both poor and affording class of people , However, due to lack of physical reach, availability of quality treatment, and other practices, people are forced to use more expensive private hospitals. Quality of Services: The standard of something as measured against other things of a similar kind; the degree of excellence of something. Patient Satisfaction: The study shows that the first important factor that influences the overall service quality as perceived by people is satisfaction. Hospitals need to focus on patient giving them personal attention, providing in correct help and suggestion easy in and out service, doctor availability, behaviour of doctors and staff emergency service and ensuring the accuracy of billing system etc as per the study and the feedback taken this was effectively practices in private then the public hospitals. Timeliness: It includes observation of patients according to appointment, availability of the doctors according to promised time, and delivery of reports according to promised time. Behaviours of Staff and Doctors: Importance of understanding the high need for discipline professionalism empathy towards individual is very important this is high requirement both in private and public hospitals.

METHODOLOGY-

The present study is an attempt to explore both public and private healthcare hospitals in Raipur, and examine the performance of each sector. For this study a private hospital and a government hospitals comparative feedback has been taken. Private, in this study refers to the corporate sector in health care and government sector are used interchangeably. The scope is so vast that the effort in this study is limited to private and Government hospitals. This study answers many structured problems that the public faces. This study has been done through primary data and secondary data

CHAPTER TWO THEORITICAL FRAMEWORK

Selection of Sample Hospitals There are more than 70 hospitals in Raipur alone. It is difficult for a researcher to take up all the hospitals and study the existing financial analysis. For this reason a detailed study of two hospitals that run on different lines were taken up for study.( i.e private hospital and public hospital.)

Private hospital A private hospital is one which is owned and governed by a person or many people who are managing the whole finances on their own. Not just finances, even the whole funds process and the administration, staff, all the doctors, everything is under control of that private body. It has been seen that most of the people go for private hospitals and they prefer them over any other option. This might be due to the facilities provided and the perception that all the equipment used are reliable, of good quality, and better. However, the fact of private hospitals being much more expensive and costly can also not be denied. The number of facilities and the kind of individual care and attention given to the patient in a private hospital is undeniable. These little yet highly paying services provided in a private hospital makes it the first choice for any patient who can afford the price. Since no one wants to risk their lives and get into more trouble caused by even the slightest of negligence on the part of treatment, private hospitals remain to be popular.

1. MEKAHARA or ( Dr. Bhimrao Ambedkar Hospital ) It is the largest government health care facility in Chhattisgarh. Located in the heart of the Raipur. Dr. Bhimrao Ambedkar Hospital is commonly known as MEKAHARA (Medical College Hospital Raipur). It is affiliated to Pt. Jawaharlal Nehru Memorial

Medical College, Raipur & functioning since 1995. It was started with the mission of providing better patient care, to the needy and poor.

Public HospitalA public hospital, on the other hand, is completely and entirely run by the government funding and money. Everything from the construction to the fees of the doctors to the equipment, medicines are based on the government budget. Hence, each and every single thing is being taken care of by the local government body. A public hospital is considered to be a preferable option for the not-so-rich lot of people who, despite acute illness, cannot afford the heavy fees of a private hospital. It is very ironical to see that a hospital that is governed by the government, which has obviously more funds than a group of people or one person alone, does not offer that level of service that can be counted on in most of the times. However, this can be due to the fact that a government has a limited budget allocation to health care as it has many things in its hands such as defense, education, economy, etc.

2. RAMKRISHNA CARE HOSPITAL It

is

the

private

health

care

located

in

Pachpedhi

Naka

Dhamtari Road Raipur. It provides various facilities to the patients. Hospital aims to grow the business while maintaining various levels of profitability, providing a basis for shareholder loyalty. It is functioning since 17 October 2004.

History of Sample Hospitals

1. MEKAHARA or (Dr. Bhimrao Ambedkar Hospital) -

INTRODUCTION Dr. Bhimrao Ambedkar Memorial Hospital, Raipur is the largest government health care facility in Chhattisgarh. Located in the heart of the city and within one kilometer from railway station & bus stand, Dr. Bhimrao Ambedkar Hospital is commonly known as MEKAHARA (Medical College Hospital Raipur). It is affiliated to Pt. Jawaharlal Nehru Memorial Medical College, Raipur & functioning since 1995.

Dr. Bhimrao Ambedkar Memorial hospital has medical facilities in all specialties and in super specialties of cardiology, nephrology, neurosurgery, plastic surgery & pediatric surgery. A highly developed radiotherapy & cancer department is the largest medical care facilities for the cancer patients in the state.

Besides OPD & general wards, hospital also has Medical ICU, Cardiac Care Unit, Post Operative Ward, well equipped Operation Theatres for routine and emergency surgeries, Critical Care Unit, Neonatal ICU, Labour Room, and Nephrology Unit with dialysis facilities. A 24 hour casualty & trauma unit is supported by round the clock laboratory & radiological services.

The hospital has state of the art equipments like latest 3 Tesla MRI, 128 Slice CT scan, Linear Accelerator, Cobalt Machine, Digital Subtraction Angiography (DSA) &Cath lab. A

model blood bank insures adequate supply of tested blood & blood components to the patients of the hospital.

The Hospital also provides services under Rashtriya Swasthya Bima Yojna (RSBY), Mukhya Mantri Swasthya Bima Yojna (MSBY), SanjeevaniSahayataKosh, BalshravanYojna, BalHridaySurakshaYojna (BHSY) and JananiShishuSurakshaYojna (JSSY).

Hospital has other patients care facilities like ambulances, help counter, canteen, generic medicine shop, pharmacy & injection room, mortuary and a separate OPD for senior citizens. The hospital has facilities for mechanized central sterilization, lift & generator. MRD (Medical Records Departments) has been established for registration and data recording of the patients.

The Dr. Bhimrao Ambedkar Memorial Hospital is committed to provide excellent medical care facilities and continuously growing opportunities for medical education, research & training in Chhattisgarh.

Objective providing comprehensive health care under one roof, the hospital is equipped with all sophisticated modern medical facilities.  Hospital provides high quality and cost effective medical services to all sections of the society.  Will give Personal Attention to all our patients, treating them as our friends and family members. We shall provide a good environment for our Healthcare Team.  Special provisions are also available to those who are unable to afford cost of medical treatment.

SUPPORT SERVICE Central Medicine Store The storage and description of medicines and the other medical equipments of Central Medicine Store are as follow:

1. Storage-

The medicines and other medical equipments are purchased by the purchase department of the hospital; the related firm supplies the medicines as per requirement. employees maintain the daily expenditure register, the batch expiry no., details of bill, stock and the other required information is maintained in it. At the time of supply, firm provide 3 bill copy to us. This is sent to Dispatch department to record received Information. After a remark by purchase department it is resend to our department. We keep one copy of bill and the other 2 is sent to the purchase officer for verification, and later sent to purchase department. We maintain the supply of medicine/article in our computer software regularly. The medicines, injection and the

other medical equipment are placed in rack according to alphabetical order and by their expiry date.

2. Description: During this procedure the computer software is placed central medicine store and to the wards of different department. As required by the various wards/department in which demand is online, which is also known as indent. According to the stock this indent ismade, the Central Medicine store generate an issue voucher which is kept by store. The 2 copy is released in which one is distributed to the related wards, and the other to sore for stock entry. The pharmacist matches the drugs volume through the medicine voucher. The related calculations are matched by the departmental nurse, officers and doctors.

3. Stock Management:

In stock management, dail entry the issue and distribution of medicines in expenditure register. And by the end of month, the stock register is maintained as the consumption of medicines is done. The expenditure and stock register of all materials like tablets, disposable, dressing material suture, soap cancer medicine, x-ray material and permanent artier are maintained separately. The expenditure of articles is daily the end of the month issue voucher and consumption of article is maintained in stock register. For the purchase of medicines as required by the central medicine store based on consumption of pharmaceuticals for 3month, a demand letter is given to Joint Director cum Superintendent, and as the demand letter is given by the wards, according to that from time to time we issue letter too as per demands.

Pharmacy-

Hospital pharmacies are within the premises of a hospital which provides a huge quantity of medications per day which is allocated to the main entrance, wards and to intensive care unit according to medication schedule. Hospital pharmacists were mostly engaged in traditional pharmaceutical activities such as dispensing and manufacturing. Then, the increasing range and sophistication of medicines available, awareness of medication errors and the widespread use of ward-based prescription charts brought pharmacists out of the dispensary and on to the wards in increasing numbers. Pharmacist and trained pharmacy technicians compound sterile products for patients including total parenteral nutrition (TPN), and other medications given intravenously e.g. Neonatal antibiotics and chemotherapy this is a complex process that requires adequate training of personnel, quality assurance of products, and adequate facilities. Hospital pharmacies typically provide medications for the hospitalized patients only, and are not retail establishments. They typically do not provide prescription service to the public.

KitchenKitchen of the hospital takes care of diet of the patients admitted in different wards. Every day breakfast, lunch & dinner of about 700 patients is prepared under hygienic conditions and under supervision of dietician. Fruits and milk are also included as per the requirement.

Special diets like Liquid Diet, Hyper Tension diet, Diabetic diet etc are provided as per the patient's requirement. Special diet is also provided to pregnant women and lactating mothers under Janani Suraksha Yojana.

LaundryHospital laundry is enticed with the reponsiblity of provided clean and hygenic linen to various wards, OTs and other pateint care area of the hospital. Laundry of Dr. Bhim Rao Ambedkar Memorial Hospital is equipedwith hydroextractors, washing machines, dryers and ironing press. The laundry service has been outsourced to an outside agency which ensure collections of dirty linen, washing, ironing and distribution of linen within different area of the hospital.

CSSD (Central Sterile Supply Department)The central sterile services department (CSSD) is an integrated place in hospital that performs sterilization and other actions on medical devices, equipment and consumables for subsequent use by health workers in the operating theatre of the hospital and also for other aseptic procedures, e.g. Catheterization, wound stitching and bandaging in a medical, surgical, maternity or pediatric ward. The operations usually consist of cleaning of previously used devices, like stainless steel tools, with a sterilizing liquid. After drying the device on a stand (not by hand or cloth) it gets wrapped in a specialized paper bag (called an aseptor bag), tape-sealed and then sterilized by gas or in a steam autoclave, according to the prescripts in place at the facility.

An expiry date gets written on the wrapped equipment or consumable, before being supplied to the end-user as a sterile product. If along the supply route, the sealed package got damaged or opened by a health worker, it needs to be returned to the CSSD for re-sterilization. A sterile processing technician is someone who cleans and sterilizes used surgical instruments and other [medical supplies] so that they can be safely redistributed and reused on additional patients. This work is usually centralized in a special department of the medical facility.

Ambulance1. Hours AmbulanceThe ambulance service is an integral part of hospital. Have a fleet of ambulances with the necessary facilities, like monitors, defibrillators, ventilators and continuous oxygen supply. Ambulance services are available in the hospital for 7x24x365 days. Free Ambulance service is provided trauma patients as and when required. Our fleet of 4 ambulances. Have young, skilled emergency medical technicians who are trained in basic life support and advanced cardiac life support. They accompany the patient during transportation. The services of doctors trained in emergency medicine are always available to accompany the patients in the ambulance as and when the need arises.

2. sanjeevni 108The Sanjeevani Express is well equipped with basic and state of art instruments to handle the emergency cases on its way to hospitals - oxygen, suction machine, medicines, BP operator and delivery kits besides other high end equipments make these ambulances efficient to handle emergency cases. Along with the vehicle come four types of stretchers which help

in carrying patients in difficult cases like – rough roads, fire cases, commuting in hilly terrains and water bound regions. Previously, after a road accident or in other emergency cases there used to be a substantial delay in accessing the treatment. This used to be the reason for many deaths that were caused due to accidents. But since the advent of Sanjeevani it takes only 15 minutes in towns and 30 – 35 minutes in villages for an emergency ambulance to reach the patient. Toll free number 108 connects directly to Raipur located control room which carries out a conference call between the caller and the Sanjeevani ambulance which is already in a standby mode in the closest proximity and runs for the help of the caller after noting down the details of the location/accident spot.

4. Mahatari express 102-

In a frantic bid to coincide the launch of the 'Mahtari' Express service with the chief minister's Vikas Yatra, the Chhattisgarh health department on providing free transportation to pregnant women and children below the age of one year without the mandatory telephone number '102' getting operational.

The service of providing free transportation to pregnant women, which aims at promoting institutional deliveries, under the centrally sponsored National Rural Health Mission (NRHM), is available in almost all other states across the country on phone number 102.

5. Muktanjali 1099-

The service christened as ‘Muktanjali’ would be offered in all the district hospitals and the vans could be summoned by dialling toll free number ‘1099’. The ‘Muktanjali’ van would bring home the mortal remains of the person on account of his or her sudden death from the government hospital free of cost. The service launched by the Health and Family Welfare Department would provide great relief especially to the financial weaker families.

I.T. & NetworkingThe use of information and communication technologies has become widespread in the hospital. Technology has taken over the daily schedules of hospitals, and has allowed nurses and doctors to work more efficiently with patients and each other. In clinical implication IT is used in following task:



Assessment



Patient Monitoring



Documentation



Telemedicine



Medical Record Department



Doctor's Monthly Performa



Patient Registration



IPD/OPD Registration



Indent



E-Tender



Data gathering



Computer assisted instruction

The use of IT in assessment helps in gathering and storing data about the patient. IT is used in settings such as emergency, intensive care, ICCU, and the NICU for vital sign monitoring, calculations of cardiac output, and even pulmonary artery pressure. This allows the focus to be solely on the patient and helps in the comparison of a patient's present condition to earlier conditions. Computers are also useful in documenting nurses' observations. Right now we are having our new software Hospital Management System. This software was launched on 23rd July 2014. This software has been designed and developed by a programmer hired from a private company. This software targets to provide basic solution for Hospital services. In the category of telemedicine, the internet on computers is used to transfer medical information for consultation, examinations, and even some small medical procedures. In

Medical Record Department digitalization has increased the efficiency of hospital by making patient information readily available and saving office space for the storage of records. It has also eliminated illegible handwriting, decreases on data-entry errors, and automatically connects related records. Through means of security, only authorized individuals have access to medical records. The computer even keeps track of the history of those who have visited certain records. Most significantly, IT has dramatically reduced the need for paper and storage services. Programs such as Excel and QuickBooks allow hospitals to calculate the total cost of the services they are providing. These programs would also help with the comparison of the net values of money coming in and going out, and ensuring balance between the two. Computers help in the calculating of pay checks, the respective salaries of all workers, and the respective taxes to be taken out of each salary. This same financial system also keeps track of the bills the hospital needs to have paid. All of these items above would assist in the administrators making sure that the medical care they are giving their patients is as cost effective and efficient as possible. A local area network (LAN) is a computer network that interconnects computers within a limited area. LAN was installed in the year of 2008. Cat-5 category cable is used in it. There are 18 Switches installed. Switch is made 2622655652of HCL Model, HL524 Port - 10/100 Ethernet 24 port is used. Currently server is located in MRD (Medical Record Department). Server was installed by Hp Company on June 2013. Server AMC is being done by HP for 1 year. The manpower for server is provided by Call Me Services In addition to costs, computers evaluate quality assurance programs. These programs ensure that all the methods and procedures of the hospital are in proper installation. Computers additionally help to justify new roles for nursing in the health care system. This essentially means that the job of a nurse is enhanced through duties on the computer in addition to their

medical duties. So, computers are facilitating the nursing process. A job that used to be strictly hands on is now branching out to the technological. Advanced systems are bringing more advanced minds to our hospitals, which in turn, advances our medical treatments. The picture I see is mighty bleak. Thank you, IT, for transforming our medical system to the best that it can be in saving our citizens.

SecurityHospitals are one of the most active public places, When it comes to hospital security we have the expertise and experience required to address your most challenging problems. Having a security system in healthcare institutions is of critical importance, considering they are places with high-valued equipment, accessibility to drugs, and many entrances. A hospital needs common precautions against fire, attacks, and vandalism as any other large facility. At the same time, heightened security requires special electronic protection solutions such as control against abduction of infants from maternity wards or threats against patients or staff, and crimes of opportunity. Hospital is having extremely complex building that needs the strongest security solution. We are having a highly skilled team, experienced with evaluating a Hospital’s infrastructure and identifying threats and vulnerabilities. We focus on its specific weaknesses and offer the necessary hospital security solution to protect the institution’s people, property, and reputation. Having a fire alarms, access control, and CCTV security systems. 24*7 hours guards are always there in each and every gate and doors. Security guard view people entering and leaving the area. They are in entrance, lobbies, operating rooms, labs and pharmacies, wards, OPDs, OTs etc. Cameras are programmed to count the number of people moving through an area or identifying and reporting that an object has been removed or left behind.

In some specific areas of a hospital there is restricting access also a high priority for hospital security. A busy hospital is full of doctors, nursing and service staff, patients, relatives, friends and other visitors. Any of which may have a reason to access specific areas. The Hospital administration needs to assure that this access is restricted. Only authorized people can then access controlled areas (pharmacy/drug storage, ICUs, surgical areas, e.g.). If unauthorized personnel attempts entry to a restricted area, the security staff control the situation immediately.

Bio Medical DepartmentThe engineering department performs a wide image of functions which may be assigning to various unit of department. It is responsible for the operation of all equipment, machinery and repair specifically, the department performs the following functions. 

Technology assessment services & procurement



Routine maintenance



Breakdown maintenance



Design & development



Clinical services



Educational services



Acceptance testing



Maintenance planning



Risk analysis



Routine calibration and preventative maintenance



Equipment management systems



Organization of service contracts



Repairs



Monitoring of service contracts



Maintaining inventory of spare parts

As a relatively new discipline, much of the work in biomedical engineering consists of research and development, covering an array of fields: bioinformatics, medical imaging, image processing, physiological signal processing, biomechanics, biomaterials and bioengineering, systems analysis, 3-D modeling, etc. Examples of concrete applications of biomedical engineering are the development and manufacture of biocompatible prostheses, medical devices, diagnostic devices and imaging equipment such as MRIs and EEGs, and pharmaceutical drugs.

DEPARTMENTS - Trauma Center IntroductionTrauma/ Emergency Care at Dr. B.R.A.M. Hospital facility is a selective focus that offers quick treatment in any emergency with the most abnormal amount of consideration, roundthe-clock. All our emergency medicine specialists, trauma surgeons, nursing staff, caretakers pertaining to road side traffic accidents and mass casualties are exceedingly prepared to manage cases from minor wounds to cutting edge injury administer to patients needing brief consideration. Our emergency medicine specialists address the patient at the best time conceivable with the right care. The doctor's facility offers 24*7 service with every minute of every day access to present day operation theatres, imaging & demonstrative instruments and completely supplied 24-hour pharmacy stores for prompt and exact conclusion of the understanding's patient’s condition. Dr. B.R.A.M. Hospital Trauma/ Emergency Care is

recognized by its preparation, master coordination, and 24-hour accessibility of specific specialists, experts, and anaesthesiologists. The multi-disciplinary joint effort results in a superior and more successful patient experience. The authorities from different controls, for example, Orthopaedics, general surgery, neurosurgery, medicine, cardiology, paediatrics and radiology are promptly accessible all day, every day.

FACILITIESWe have devoted groups arranged to start quick and propelled look after:  Trauma Emergency especially extreme head wounds.  Emergency care for mass casualties.  Facility for treating poly – trauma.  Sepsis Emergency  Vascular Emergency  Stroke Emergency Other emergencies like:  Emergency care at death's door, debilitated/elderly, or patients with multi-framework disappointments.  Environmental emergencies (medication misuse/harming/poisoning)  Obst & Gynae Emergency.  Paediatric Emergency  Cardiac Emergency Facilities available:

 Fully equipped 24/7 blood bank, laboratory, diagnostics and ventilator management  22 beds in old trauma & with 12 ICU beds, and 2 aseptic major OT and 21 beds in new trauma.  Mobile Ultra Sound, X-ray, 2D echo, etc for critically sick & emergency patients  State-of-the-art Intensive care unit / operation theatre  Easy to remember emergency number: 108  Ambulances with state-of-the art monitoring equipment.

Medical Officer-

DEPARTMENT

NUMBER OF DOCTOR

CANCER OPD (59-63)

2

CARDIOLOGY

2

ENT OPD (233-252)

3

GYNAE OPD (70-83)

5

MEDICINE OPD (140)

6

NEPHROPLOGY

1

NEURO SURGERY (129)

3

OPTHAMOLOGY (231)

3

ORTHO OPD (50)

2

PAEDIA SURGERY (124-131)

2

PAEDIATRICS OPD (124-131)

3

PLASTIC SURGERY (51-67)

1

PSYCHIATRIC(205)

2

SURGERY OPD (51-67)

5

Total

40

Casulity Medical Officer1.

Dr. Sunil Gupta M.D. Anaesthesiology & Resasitation Specialist in Trauma & critical care

2.

Dr. Anil Kumar Baghel M.B.B.S. M.D. M.D.(Radiotherapy)

3.

DR. ROHIT DUBEY M.S. ORTHOPAEDICS OPD Day:- ALL DAYS

4.

DR. ANSUIYA DUTT M.S. OPTHALMOLOGY OPD Day:-All Days

5.

DR. M.P. MAHESHWARI M.D. MEDICINE SPECIALIST OPD Day:-All Days

6.

DR. HEMLAL MEENPAL DIPLOMA IN ORTHOPAEDICS ORTHOPAEDICS OPD Day:-All Days

7.

DR. BIDHI TEMBULKAR M.B.B.S. M.D. GENERAL MEDICINE MEDICINE SPECIALIST OPD Day:-All Days

8.

DR. G.S. BAGCHU B.S.C. M.B.B.S. M.S. ORTHOPAEDIC SURGERY OPD Day:-All Days

9.

DR. D.K. TANDON

M.B.B.S. M.S. OPD Day:-All Days

Hospital Setup (Organization Structure)-

DEAN

Medical Superintendent

Assistant Superintendent

In charge establishment

Dy. Medical Superintenden t

In charge purchase

Assistant Medical Superintendent

In charge CMO

In charge nursing

In charge legal

DDO

Office Superintendent

Public information

Maintenance support services

Establishment Branch

Purchase Branch

Casualty Medical Officer

Account Branch

Nursing Department

OPD RegistrationThe out patient department (OPD) in Dr. Bhim Rao Ambedkar Memorial Hospital provides out patient services to the patient coming to the hospital from Raipur Chhattisgarh. On an average 15001600 patients visit the hospital daily for OPD service.

Charges of Hospital Services & Investigations-

SERVICES, FACILITIES & INVESTIGATIONS (1) OPHTHALMOLOGY:-

All Minor Surgeries.

RATE

200/-

(Probing, Skin tear repair, Chalazion, I & D orbital cellulites) All Major Surgeries of Eye

400/-

(Cataract plain, D.C.T., Glaucoma filtering surgery, Cyclo cryotherapy, Entropion/ Ectropion, Dermoid, Enucleation/ Evisceration, Tear repair) Super Major Surgeries of Eye

600/-

(I.O.L. Implantation surgery, Detachment of Retina, Exenteration, D.C.R., I.O.F.B. Removal, Squint Surgery, Ptosis Surgery, Plastic Reconstructive (Lid.), Keratoplasty) Diagnostic Fluoroscein Angiography

250/-

Yag laser Photocoagulation

250/-

Phacoemulsification Surgery

1000/-

(2) SURGERY:-

RATE

All operation in Minor O.T. Under L.A.

100/-

Surgery in Major O.T.: (Minor Operation under Anesthesia,

200/-

Hydrocoel,

Piles,

Fissure,

Cyst

Excision,

I

&

D

Circumcision, Dilation Under G.A. etc. Abscess & GA etc. Abscess & G.A. Lenigh, Breast Tumour, Suprapublic cystostemy) Medium Surgery: (Burrhole, Appendix, Hernia,

400/-

Laparotomy, Amputation, Bladder Stone, Perforation, Simple Mastectomy, Cleftlip, Meningocoel, Lumbersympathectomy, Fistula) Major Surgery: (Brain Operation, V.P. Shunt, Maxillectomy, Cervical Sympathectomy, All Resection and Anastamosis on GIT, Liver, Spleen, GB Pancreas, Kidney Bladder, Prostate, Uret- hroplasty, Hypospedia, Thyroid Operation, Carotid & Radical neck Dissection, Radical Mastectomy, Large Soft Tissue Sarcoma and Incisional Hernia repair with mesh, Lung and Heart operations etc.) Specialist Surgery:

500/-

Endoscopy – Upper GIT

300/-

Endoscopy – Lower GIT

500/-

Laparoscopy

(3) MEDICINE:-

1500/-+

Rate

Hemoglobin (Hb)

5/-

TLC & DLC

15/-

E.S.R.

5/-

Urine R/M

10/-

Solubility test

FREE

Cellulose Acetate paper Electrophoresis

25/-

Hb variant Analysis

400/-

C.T./B.T.

10/-

Sputum for AFB

30/-

Urine Albumin

5/-

Urine Sugar

5/-

E.C.G.

20/-

Lumber Puncture

50/-

Pleural Aspiration

100/-

Peritoneal Aspiration

100/-

Liver Biopsy Peritoneal Dialysis Pace maker transplantation Echo Colour Doppler

100/500/- per day 500/500/- & 400/-(without print)

(4) PEDIATRICS:-

Rate

Aspiration (Pleural/Peritoneal)

55/-

Pericardial Aspiration

110/-

Lumber Puncture

50/-

Bone Marrow

55/-

Liver Biopsy

55/-

Nebulizer Therapy

55/-

Phototherapy

55/-

exchange transfusion

300/-

Incubator Charge

110/-

Oxygen Therapy

25/-

Ventilator charge

200/-

Nursery Bed Charge

55/-

E.C.G.

10/-

(5) ORTHOPADICS:

Rate

Minor Procedures Under LA Joint Aspiration

60/-

Steroid Infiltration Bone Marrow Infiltration: Ganglion/cyst Excision BIOPSY Removal of Pins/Fixator Repair of L.W./I.W./with or without Debridement Incision & Drainage of pus Under GA Steroid Infiltration Bone Marrow Infiltration Ganglion/Cyst Excision

120/-

BIOPSY Removal of Pins/Fixator Repair of L.W./I.W./with or without Debridement Incision & Drainage of pus Minor Surgeries : Tendon repair GA/regional block External fixator GA Jess/Wire Fixation Shoulder Amputation/Disarticulation Arm/Forearm Amputation/Disarticulation Wrist Amputation/Disarticulation Hip Amputation/Disarticulation Above/below knee Amputation/Disarticulation Ankle/foot internal fixation Excision of radial head Patella Excisional Arthroplasty Arthroscopy (Diagnostic)

750/-

Fixator

500/-

Neurolysis/Neuroraphy Arthrodhesis of small joints (Hand & Foot) Skin grafting All reductions under image control

All bone grafting Procedures done under C Arm Bone Curettage

Sequesterectomy

350/-

350/-

Major Surgeries: Forequarter amputation Hindquarter amputation Shoulder internal fixation Arm/Elbow/Forearm internal fixation Pelvis internal fixation Hip internal fixation with or without fibular graft Thigh/Knee/leg internal fixation

1000/-

Hemiarthroplasty Ring Fixator Reconstruction CTEV correction Pseudoarthroses High tibial osteotomy

Polio joint fusion with reconstructive surgery Tendon transfer with or without external

1000/-

slab/cast Hybrid fixation Spine laminectomy/Fenestration Open reduction of dislocated joint with or Without internal fixation Arthorodhesis of major joints (Spine/Hip/Knee/Ankle/Shoulder/elbow wrist) Osteotomies with or without internal fixation

Super Major Surgeries: Spine

dissectomy/laminectomy/fenestration

2000/-

with Instrumentation Instrumentation in spinal trauma

2000/-

-------- ant/post decompression/debridement

2500/-

-------- on with or without instrumentation

(6) X-Ray(Radiodiagnosis) Department:-

Rate

Upper Lower Limb

50/-

Chest, Spine, Skull

50/-

Special X-Ray per film

60/-

Sonography Screening

100/-

Sonography with film

150/-

Colour Doppler

300/-

C.T. Scan Extremities Upper or Lower Limb without Contrast

1400/-

C.T. Scan Extremities Upper or Lower Limb with Contrast

1800/-

Minor Interventional U.S.G. Procedure (F.N.A.C. Biopsy,

200/-

Therapeutic Aspiration) Major Interventional U.S.G. Procedure (Tube Drainage)

300/-

Private Ward per Film

60/-

MRI (Plain)

3500/-

MRI with Contrast

5000/-

(7) RADIOTHERAPHY:-

Rate

Radiotheraphy (Cobalt) total cost of 30

3000/-

seating Biopsy Procedure

200/-

Chemotheraph per day

250/-

Brachytherapy Machine Cost per Procedure

1500/-

Mammography Machine Cost Per Procedure

800/-

(4 films)

Ramkrishna Care Hospital

Ramkrishna CARE is virtually a descendent of Ramkrisna Surgical Nursing Home, founded in July 1992 by Dr.Sandeep Dave as a 25 bedded un-disciplinary mediocrity, raised to 215 bedded multidisciplinary super specialties by 2004 through immaculate and arduous team work, innovative pursuits, effervescent enterprises and intuitive foresight. Dr. Sandeep Dave's dream had ever been to build a hospital with dedicated posture, meticulously designed , futuristically styled with an eco-friendly and patient-friendly bearing, unparalleled in skill and specialization, exemplary in nursing care, and affordable to all classes of society of this region. Inaugurated on 17 October 2004 in a new building in a different and versatile habitat and in a new grab of Private Company at Pachpedi Naka, Raipur, with 20 upgradable and sustainable super-specialties commanding absolute faith of patients, Ramkrishna Surgical Nursing Home

never compromised while rendering quality health service, with state of the art equipment, dexterity and technology. Infused with kindled and stirring rationality, reasonability, solidity, judgment and profundity each and every molecule of this hospital was in perfect harmony while inviting the searching glances of Care Group of Hospitals, Hyderabad, which ultimately culminated in a wedlock and interlacing of Ramkrishna and Care on 10th may 2007 being renamed as Ramkrishna Care Medical Sciences Pvt. Ltd. This confluence of these two entities pursuing the same goal of preparing a crucible for amalgamization of new ideas and research for human care, concern and benevolence has made Ramkrishna Care a Hospital of advantages and opportunities, a friend for life, that touches and lifts, a companion in solitude that caresses and fondles, a team partner that supports and upholds and blows a new meaning into life which never betrays. The visible contours of our venture and transformation forecast that Ramkrishna Care is going to serve as a growth island and catalyst for the development of Chhattisgarh.

Our Hospitals Ramkrishna Care Specialty Hospitals, India, provide world class services for all medical super specialties. Unit-I

Aurobindo Enclave, Pachpedi Naka, Dhamtari Road, NH - 43 Raipur (C.G.) 492001 Phones: 0771-3003300/01/02/03 Fax: 0771-4004037 Email: [email protected]

Unit-II

Raigarh Metro CARE Hospitals, Near Pahad Mandir, Chakradhar Nagar Raigarh – 496001 Phones: +91-7762-220222/220666

Fax: +91-7762-220222 Email: [email protected] For Emergency Call: +917762-220222 For Appointments Call : +917762-220222 Timings: 6AM to 10PM

Patient Facilities Emergency Care

24x7 Emergency care with ambulance and emergency team Critical Care

Fully-equipped 5 Intensive Care Units (MICU, ICCU, NICU, SICU, Cardiothoracic ICU) Cardiology

All cardiac emergencies, angiography, angioplasty, cardiothoracic surgery, paediatric cardiac intervention & surgery and foetal and neonatal cardiology Laparoscopy

Advanced laparoscopic surgery Gastroenterology

Endoscopy, pylotest, sigmoidoscopy, colonoscopy, ERCP and endosonography, entroscopy, fibroscan, hepatology and pancreatobiliary procedures Pulmonology

Sleep apnea study, Pulmonary Function Test , bronchoscopy Orthopaedics

Complicated fractures, total hip and knee replacement, arthroscopic surgery, foot and ankle surgery, spine surgery, ligament injuries and bone grafting Neurology

EEG, ECD, EMG Urology

Uroflowmetry, Urodynamics Nephrology

Dialysis, chronic kidney diseases, acute renal failure, renal biopsy, plasmapherisis, CAPD, perm cath SLED, peritoneal dialysis Laboratory services

Pathology, Haematology, Microbiology, Biochemistry

Diagnostics

ECG, Echo, EEG, TMT, Spiral CT scan, digital X-ray and ultrasonography Other Facilities Laboratory Medicine

Ramkrishna CARE Hospitals offers investigations in Haematology, Pathology, Clinical Biochemistry and Microbiology round-the-clock. All these disciplines provide qualitative analysis of biological fluids such as blood, serum or plasma, tissue, urine, stool, etc. for specific constituents to support clinicians in the practice of medicine. Ambulance

The emergency department has a fully equipped ACLS ambulance, which works round-theclock and is managed by a team comprising a doctor, nurse and paramedical staff. Emergency Care

The Trauma & Emergency Unit works round-the-clock. There are 5 beds with all life-saving equipment. The department also deals with medico-legal cases, medical emergencies and minor surgical work. Pharmacy

The hospital runs a 24*7 pharmacy with qualified and trained pharmacists who help patients to comply with the prescription instructions.

Charges Of Health Check-up Download Brochure Package Cost : Rs 1500/- Kidney Check-up Haemogram, Urine study, Blood Sugar (Fasting & PP), Serum Potassium, Serum Sodium, Serum Urea Serum Creatinine, Serum Total Protein & Albumin, Serum Phosphorus, Uric Acid, Sodium Bi Carbonate, Nephrologist Consultation Package Cost : Rs 1700/Gynaecology Check-up Haemogram, Urine study, Blood Sugar (Fasting & PP), T3, T4, TSH, Ultra Sound (Whole Abdomen), PAP Smear Package Cost : Rs 1300/Executive Health Check-up Haemogram, Haemoglobin, Lipid Profile, Liver Function Test, Kidney Assessment, Serum Urea, Serum Creatinine, Complete urine study, Blood Sugar (Fasting & PP,) , X-ray(Chest), ECG , Ultrasound Screening (Whole Abdomen), Stool Test, Blood Group & RH, Doctor Consultation

Master Health Check-up-I Haemogram, Haemoglobin, Lipid Profile, Liver Function Test, Kidney Assessment, Serum Urea, Serum Creatinine, Blood Sugar (Fasting & PP), X-ray (Chest) ECG, 2D Echo , Ultrasound Screening (Whole, Abdomen), Stool Test, Complete Urine Study, Blood Group & RH, Physician Consultation Package Cost : Rs 2500/Master Health Check-up-II Haemogram, Haemoglobin , Lipid Profile , Liver Function Test, Kidney Assessment, Serum Urea Serum Creatinine, Serum Uric Acid, Blood Sugar (Fasting & PP) ,X-ray (Chest), ECG , 2D Echo, TMT, Ultrasound Screening (Whole Abdomen), Stool Test, Complete Urine Study, Blood Group & RH, Physician Consultation ,Cardiologist Consultation Package Cost : Rs 3500/-

CARE Smart Health Check-up Haemogram, Haemoglobin ,Lipid Profile , Liver Function Test, Kidney Assessment, Serum Urea , Serum Creatinine, Serum Uric Acid, Blood Sugar (Fasting & PP) , X-ray (Chest), ECG , 2D Echo or TMT, Ultrasound Screening (Whole Abdomen), Stool Test, Complete Urine Study, Blood Group & RH, PSA (For Men), PAP Smear (For Women), PFT, Physician Consultation, Cardiologist Consultation Package Cost : Rs 5000/Prostate Check-up (Above 45 Years) Haemogram, Urine study, Urea, Serum Creatinine Ultrasound of KUB, PSA for Men, Urologist Consultation. Package Cost : Rs 1600/Gastro Check-up Haemogram, L FT, Urea, Serum Creatinine, Uric Acid, Stool Test, UGI Endoscopy, Gastroentrologist Consultation Package Cost : Rs 2100/Liver Gastro Check-up Haemogram, L FT, Urea, Serum Creatinine, Uric Acid Stool test, UGI Endoscopy,Fibro Scan, Gastroentrologist Consultation Package Cost : Rs 4200/-

OBJECTIVESS 1. Improve the services provided by the association for the members through improving the financial resources and by increasing the number of staff. 2. To analyze the factors responsible for creating patient centered hospitals 3. To elicit the feelings and problems of the doctors, nursing staff, paramedical staff and administrators of selected hospitals in the creation of patient centered hospitals. 4. To know the perceptions of out-patients and in-patients of selected hospitals and availability of patient care in selected hospitals. 5. Enhance the quality and safety of hospital services provided to patients. 6. Increase the hospital’s medical centers capibilities to become competitive internationally. 7. Aim to grow business while maintaining sustainable levels of profitaibility providing a basis for stakeholder loyalty.

SERVICESMeshKitchen of the hospital takes care of diet of the patients admitted in different wards. Every day breakfast, lunch & dinner as per patients requirement,

prepared under hygienic

conditions and under supervision of dietician. Fruits and milk are also included as per the requirement. Special diet is also provided to pregnant women and lactating.

Medical Store-

Medical store is available in the hospital for patients to purchase medicines.

BedRamakrishna CARE Hospitals is a well-equipped, 227-bed hospital with 6 world-class Operation Theatres and 5 Intensive Care Units.

StaffsSamarpan Hospital contains 15 doctors, 42 nursing staffs and 2 medical officers.

DoctorsConsultant and There Specialty Dr. Vinod Ahuja Cardiac Sciences Dr. N Gopi Cardiac Sciences ( Cardiothoracic & Vascular surgery ) Dr. Javed Ali Khan Cardiac Sciences Dr. Shailesh Sharma Cardiac Sciences Dr. Prashant Thakur Cardiac Sciences ( Pediatric Cardiology ) Dr. Shradha Sharma Dietetics & Nutrition Dr. Asma Faridi Dietetics & Nutrition Dr. Juli Pandey Dietetics & Nutrition

Dr. Sumit Mandal Emergency Medicine Dr. Sandeep Pandey Gastroenterology Dr. Rajesh Gupta General Medicine Dr. Abbas Naqvi General Medicine Dr. I U Rahman General Medicine Dr. Prakash Chouhan Lab Medicine (Biochemistry, Pathology, Microbiology) Dr. Sandeep Dave Laparoscopic & Bariatric Surgery ( Laparoscopic Surgery ) Dr. Jawwad Naqvi Laparoscopic & Bariatric Surgery Dr. A R Vikram Sharma Laparoscopic & Bariatric Surgery Dr. Siddharth Tamaskar Laparoscopic & Bariatric Surgery ( Laparoscopic Surgery ) Dr. Prawash Chaudhary Nephrology Dr. Sanjay Sharma Nephrology Dr. Sanjeev Kumar Neuro Sciences Dr. S N Madhariya Neuro Sciences ( Neurosurgery ) Dr. Parag Radhey Neuro Sciences Dr. J Roy Choudhary Orthopedics

Dr. Pankaj Dhabaliya Orthopedics Dr. Lalit Jain Orthopedics Dr. Girish Kumar Agrawal Pulmonology Dr. Sharad Chandak Radiology Dr. Neelesh P Gupta Radiology Dr. Hulesh Mandle Radiology Dr. Ajay Parashar Urology Dr. Ashish Kumar Sharma Urology

PATIENTSHospital has aprox. 115 in-patients and 55 out-patients, with having OPD charges 300Rs.

INCOMEMonthly income of hospital is Rs 800000 to rs 1000000 including smart card patients.

FACILITIES 24 hours facility  Intensive Care Unit  Ventilator and dialysis facility  24 hours ambulance

 24 hour Medical store  X-ray and Sonography  Skilled and caring staff  6 operation theatre  Special trauma unit  Free treatment and treatment of smart card holders

Cost-Benefit Analysis of Visit to Private Clinics and Government Hospitals during Minor Illness: Time Consumption in Accessing Private and Government Hospitals:

Table Indicating Comparison of Time Required in Accessing Healthcare Services of Private Clinics and Government Hospitals in case of Minor Illness

Sr. No.

1.

Average Time Taken to Access Healthcare Services in case of Minor Illness

Private Hospital

Government Hospital

commuting

20 min

10 min

waiting

15 min

70 min

Total

35 min

80 min

. 2.

The above table indicates the comparison of average time taken to access healthcare services of private hospitals and government hospitals. It can be seen in the above table that the average time taken to access healthcare services of private hospital is only 50 minutes on an average while it is around 80 minutes in the case of government hospitals. Thus, the time wasted in accessing healthcare services of government hospitals is around 2 times of that of the time taken to access the services of private hospitals. Thus, it can be concluded on the basis of above analysis that it is time consuming to access government hospitals for minor illness.

(A)Sample:

A sample of 50 respondents has been selected randomly from areas in to seek responses on healthcare services provided by the government hospitals vis-à-vis private in their areas. The government hospitals and private hospitals which are generally visited by people for their health-related problems are: Government Hospital: Mekahara hospital Private Hospital: Samarpan hospital The researcher found it difficult to collect information from illiterate and some aged respondents. Some respondents refused to part with information due to their severe and prolonged illness. Thus, wherever respondents refused to part with information or where the researcher found it difficult to extract information, such respondents were substituted with other respondents. The technique used to collect sample for the present research was random sampling technique A sample of 50 in-patients and out-patients selected randomly from government sponsored hospital in the area was interviewed to have in-depth investigation and analysis of the problem under consideration

(B). Feedback

(1) Feedback on Testing and Evaluation facilities in Government Hospitals: Although 63% of the respondents reported that they could get hospitalisation on emergency basis in government hospitals, 72% of them reported that government hospitals lacked adequate infrastructure and evaluation and testing facilities. Many advanced testing facilities are not available in these hospitals and therefore, poor patients have to shell out huge money on getting these tests done from private hospitals and clinics. When inquired reason for such breakdowns, the hospital staff reported that there is heavy pressure of patients on these machines and therefore, they are used round the clock. They also reported that most of these machines are purchased through government rate contracts who generally supply substandard machines and instruments and there is no maintenance contract for these machines. For efficient functioning, these machines need regular up keeping and maintenance. Under these circumstances, they have to recommend their patients to private hospitals and clinics for testing and evaluation. (2) Feedback on Standards of Cleanliness, Food, Sanitation and Hygiene in Government Hospitals: On an average, most of the respondents found the standards of cleanliness, food, sanitation and hygiene in Government hospitals to be satisfactory but not at par with the hygiene and cleanliness standards maintained by private hospitals. While government hospitals are charitable institutions and in many cases refrain from adopting “scientific cleaning practices” as it comes at a price, the private set ups claim a handsome price for both treatment and the clean factors. But on the whole respondents were found to be satisfied with the standards of cleanliness and sanitation maintained by the government hospitals.

(3) Feedback on Services of Doctors in Government Hospitals:

More than half the respondents who visited a Government hospital for treatment found the quality of services of doctors and their approach towards patients to be above average with 17% of the respondents rating it to be excellent and 40% rating it to be good. Empirical evidences show that patients are generally satisfied with the quality of services of government doctors and in many cases people have complaints against other staff and absence of infrastructural facilities in hospitals. 15% of the respondents who were dissatisfied with the services of doctors in Government hospitals were in-patients. Accessibility of a doctor is a vital factor, especially in case of emergency. But, according to these respondents, who personally or their family members utilised government hospital for treating their major illnesses, revealed that doctors were not accessible during emergency, although many of them were inmates. (4) Feedback on Services of Nurses and Administrative Staff in Government Hospitals: On a whole, services of nurses and administrative staff in Government hospitals are found to be satisfactory which is supported by the responses of 70% of the respondents. But when compared to satisfaction with the quality of doctors in government hospital, the satisfaction with quality of the services of nurses and administrative staff was found to be poor. 22% of the respondents who rated the quality of services of nurses and administrative staff to be poor reported that the nurses and administrative staff

in government hospitals behave

arrogantly and are insensitive and unsympathetic to the needs of patients. (5) Feedback on Overall Services in Government Hospitals vis-a-vis: Experience evidences through various researches have been suggestive of failure of public sector as one of the prime reasons for growth of the private sector in India. In the present study, majority of the respondents have rated the services provided by public hospitals vis-àvis private clinics to be poor. The reasons for this are:

• Although services in government hospitals are free or are provided at concessional rate, long waiting time, long distance, inadequate infrastructure, irresponsible behaviour of staff (sometimes), comparatively poor standards of cleanliness and hygiene are some of the factors that contribute to the dissatisfaction of patients.

Limitations of the Study: The present study is constrained by the limitation of time and cost. The study is restricted to the public and private Hospital in the city of Raipur. Due to the size of the problem, the study is limited to patient satisfaction only. It has become difficult for the researcher to collect data from different hospitals. Another basic limitation of behavioural sciences is that they would deal with attitudes. These attitudes differ from individual to individual. Even though utmost care has been taken in selecting the sample, the results derived from a study may not be exactly equal to the true value of the population. Hence results of the study are considered to be true, and relationships hold good, only for this study. Perceptions of the respondents are measured through observation, personal interview, questionnaire and schedules. It became very difficult to meet and elicit opinion of administrators due to their busy schedules. Majority of administrators are under the impression that research on analysis of hospital means probing into their internal affairs especially in healthcare Sector. With this opinion they hesitated in providing required data. However, administrators of different hospitals did co-operate. This research project would not have been possible without the help received from them.

CHAPTER THREE DATA ANALYSIS AND INTERPRETATIONS

ANALYSIS OF THE STUDY The data was analyzed by simple statistical way to present the study in a meaningful way. The analysis reveals that there is more positive feedback from the public on private working hospitals then the government. Based on the study some suggestion has been outlined on the way of working and management of hospitals.

The below chart 1:Time Management in Government and Private Hospitals

50

40 Series 1 30

Series 2 Series 3

20

Series 4 10 0 GOVT

PRIVATE

Chart 2: illustrate accommodation rate on the ward with regard to private and Government hospital in Raipur:

60 50 40 30

Always

20

Sometime

10

Never

0 govt private

Chart 3: Rate the cleanliness in private or Government Hospital?

60 50 40

EXCELLENT VERY GOOD

30

GOOD ADEQUATE

20

10 0 GOVT

PRIVATE

Chart 4: Rate of the bathroom facilities at Government and private hospital in Raipur:

50 45 40 35 30

EXCELLENT

25

VERY GOOD

20

GOOD

15

ADEQUATE

10 5 0

POOR GOVT

PRIVATE

Chart 5: pain management treated in a sympathetic manner in comparison with Government and Private hospitals?

60 50 40 VERY GOOD 30

GOOD POOR

20 10 0 GOVT

PRIVATE

Chart 6: How would you rate the quality of the food and canteen facility in Public and Private hospitals.

60 50 40

VERY GOOD

30

GOOD

20

POOR

10 0 GOVT

PRIVATE

Chart 7: Prefer hospital in public Government or private

50 40 30

Series 1

20

Series 2

10 0 GOVT

PRIVATE

Collection of Data:

The data was collected from both sources

primary data



secondary data.

For collection of data from primary sources, efforts were made to elicit the opinions of almost all key personnel in the organizations through observation, personal interviews, questionnaires and schedules. The researcher spent months together in sample hospital offices observing the management process in the selected hospitals. In depth interview technique was used here for collecting primary data. This was collected through personal observation and also from the hospital documents, Annual Reports & Budgets. The researcher visited and collected information from the two hospitals i.e., MEKAHARA Hospital and Ramkrishna care Hospital. The data for the study was collected by administering the questionnaire

schedules and through observation method. Observation method is one of the most important and extensively used methods in social sciences research. It is one of the primary research methods. All the time it is not possible to use quantitative techniques, in such circumstances, observation method bridges the gap. On the other hand Questionnaires are widely used for data collection in social sciences research particularly in surveys. It is a fairly reliable tool for gathering data from large, diverse, varied and scattered social groups. It is used in obtaining objective and qualitative data as well as in gathering information of qualitative nature. It is treated as the heart of the survey operation. The data for the study was collected by administering a two part questionnaire to administrative staff, doctors, and nursing staff and to both inpatients and outpatients. Part I of the questionnaire consisted of socio-economic information. Part II of the questionnaire which was distributed to administrative staff contained the data, regarding working and performance of office, different functions of management and different organizational patterns and structures. The instrument was tested for its reliability and validity. A Three point scale was used. It contained the column of Satisfied, Partially Satisfied and Not Satisfied Three point scale was used which contained Satisfied, Partially Satisfied and Not Satisfied. Relating to their satisfaction on services offered by the selected hospitals.

CHAPTER FOUR SUGGESTIONS

SPECIFIC SUGGESTIONS

1. Staff Behaviour: Employees are the important asset of the organization. Small but Significant number of health-care workers show disrespect for colleagues, dole out verbal abuse and engage in other unacceptable behaviour. Now a new report suggests this kind of poor workplace communication can also contribute to medical errors, even if other preventive steps are being taken.

2. Executing Quality Improvement Programs: Quality is one of the main ingredients of all successful organization it includes everything in the organization work environment as. Especially for hospitals as 10 % of GDP comes from this industry and there is a history of revelation of hospital worldwide.

3. Hospital Hygiene: As hygiene is one of the fundamental rights of every human being. That’s why the World Health Organization (WHO) has chosen May 5 as Save Lives: Clean Your Hands Day, its annual campaign to get health workers to practice better hygiene. The WHO has a simple five-step framework for getting health care workers to ensure they keep their hands clean, but it won’t worker until hospitals get serious about pushing hand washing, before and after a worker sees a patient.

4. Food Arrangements Needed To Be Strengthen: There are various factors which influence customer’s expectations of services. They include efficiency, confidence, helpfulness, personal interest reliability. The dietary units stand as the second major department of a hospital from the point of view of expenditure. Except the well-established hospitals, patients are not happy with the quality of food supplied to them. That is why most of them get food from their houses or from relatives. There is a problem of excess diet consumption when compared to the number of in-patients in the hospital resulting huge expenditure.

5. Personnel: Delegating the responsibility with authority to the personnel and establishing interpersonal relationship for the purpose of co-ordination of work, so as to get the work done together effectively, and in accomplishing the objectives of the organization.

6. Strong Policies and Practice: There are both excellent and poor performing hospitals worldwide. To promote greater use of practices and policies that enhance quality in hospitals, this study identifies and describes the key ingredients that have contributed to the success of hospitals that are sets as an example of many high-performing hospitals to those who do not have or practice the policies. The key elements of a successful strategy can be organized into the following categories:  Developing the right culture for quality;  Attracting and retaining the right people to promote working environment;  Updating the right in-house processes for improvement; and  Giving staff the right tools to do the job.

7. More Attention to Patients: Efforts should be made to reduce the patients load at the higher level facilities that doctors and other staff can give more attention to the patients.

8. Hospital Infrastructure: The efforts also needed to strengthen infrastructure and human resources.

9. Medicine Availability: Patients in are suffering due to non-availability of emergency drugs/ life saving drugs. The emergency drugs/life saving drugs is defined as drugs which require immediate administration within minutes post or during a medical emergency. These medicines have the potential to sustain life and/or prevent further complications and are prescribed for both outpatients and in-patients. The non-availability of these drugs in government hospitals has posed serious problems forcing patients to buy these drugs from outside.

10. Regular Patient Feedback and Implementation: Data need to be collected within or at the end of a visit, usually with a very brief written or even verbal question. It is used to find out patients’ experience when it is fresh in the mind, and usually focuses either on a specific area of interest to the team, or on the general experience of the patient during the visit. In our example of visit preparation, the medical assistant might give the patient a form asking their preferences when they begin the visit. It is helpful if the form is introduced by a team member. It is very important to set realistic expectations for the amount of time and effort needed to see results in this work once feed back of the patient is generated.

11. Public Hospitals Have Access To Safety Funds And Grants: Many public hospitals have reimbursed more suppliers then the private.

SUGGESTIONS

The present study indicates that there has been an extensive development in health care services in public and private hospital. However still there are many changes need to be acquired to reach the services to the public from government hospital. The cost of treatment at a public healthcare facility is much more affordable than at a private centre. However, due to lack of physical reach, availability of quality treatment and other practices, patients are forced to use more expensive private facilities, thus exacerbating affordability challenges. The majority of out of pocket expenses are due to medicines, though they have not increased their share of the affordability burden.

SUMMARY AND CONCLUSION:

Private hospitals are making better efforts as compared to the public hospitals. As the private hospitals have to depend on customers in order to meet the financial constraints and gain profitability. As results of this study shows that private hospitals like the other service organizations are focusing on their patients demands and developing themselves in order to provide maximum healthcare facilities to their patients. All these efforts led these hospitals towards continuous improvement in the processes, system and provide continuously quality of healthcare service to their patients. It can be concluded from the analysis and the responses of data collected that in private hospitals where compare to the government hospital are very satisfactory. Public health care system is very good in terms of space and operational equipment however services towards patient are inadequate in providing the good services, government hospitals must select a strategy that gives highest “healthcare access” benefit to the people Quality services need to be provided to the patient in order for quick recovery. Whereas the poor quality of healthcare services delivered to patients by public hospitals as compare to the private hospitals are due to the many factor. These factors include: government funding, lack of government interest in development of new healthcare projects and overburdened public hospitals due to rapid growth in population and Comparison of Service Quality between Private and Public Hospitals.

BIBLOGRAPHY

Websites: http://drbramhraipur.in http://wikimapia.org http://infohind.com www.zaubacorp.com

Reports: Government of India, National Health Policy.