India (4) 1

HLTH 2100-Group 4-Submission 3

Madison Lucas, Noah Isles, and Marlee Anne Hopkins
Professor Patterson
Intro Healthcare Sys and Admn
November 9, 2019
 India (4) 2

Comparative Health Project- Submission 3

Healthcare workforce demographic information.

“India’ health care sector is battling a major crisis —inadequate infrastructure and

human resource. Over the last nine years, shortage of medical staff, especially doctors,

claimed lives of 72,000 infants in government hospitals of Madhya Pradesh.” (Goswami, L.).

That is a lot of infant lives in India over the past nine years. According to the NIH, in India

there are 2.1 million healthcare workers of which 0.82 million were doctors, 0.63 million were

nurses and midwives, and 0.024 million were dentists. A physician’s duty and goal is

someone who is a professionally practices medicine, which is concerned with promoting,

maintaining, or restoring health through the study, diagnosis, prognosis and treatment of

disease, injury, and other physical and mental impairments. That is the same for physicians

everywhere including the U.S and India. It’s harder in India because sometime supplies are

limited and they don’t have the same technology the U.S does. They have to make do with

what they are given to help people.

The basic role of a nurse is to advocate and care for individuals of all ethnic origins

and religious backgrounds and support them through health and illness. Collaborate with team

to plan for patient care. Advocate for health and wellbeing of patient. Monitor patient health

and record signs. This statement shows the basic role and ultimate goal of a nurse. The role is

practically the same in the U.S. and in India. According to the NIH, in India there are 4.9

nurses per 10,000 population. This translates to 1.6 nurses per allopathic physician. After

adjusting for unqualified workers, the nurse density reduces to 1.7 per 10 000 population
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making the nurse-doctor ratio as low as 0.5. There is a shortage of nurses and doctors

everywhere.

The basic role of the dietitian is the same everywhere but how the role is specialized is

different. According to Aarogya, “The dietician, on the other hand, provides guidance on the

development of healthy eating habits, for example, with overweight persons–advising on how

to modify food consumption patterns, what high nutrition supplements to include in the diet

and drawing up a personalized food plan to ensure that individual dietary requirements are

met” (Aarogya). This statement shows the basic role and ultimate goal of the dietitian. The

specialized role is different in the US and India because India has a greater percentage of

children under the age of five who are underweight while the US has a greater percentage of

adults with obesity. Dietitians in India may specifically need to help children have a more

substantial and healthy diet so they can no longer be malnourished. Dietitians in the US may

specifically need to help adults have a diet that brings them down to a healthy weight. That is

the biggest difference between the roles of dietitians in the US and India.

Role of healthcare technology and informatics

India is working on adopting EHRs and the US has already adopted them. There are

still a few areas in the US that are mostly rural that have not implemented EHRs in their

healthcare system but EHRs are widely used in the US. India is in the process of having EHRs

as widely used tools in their country. Srivastava says, “Although some steps have been

initiated, several new steps need to be taken up for the successful adoption of EHR. It requires

a coordinated effort from all the stakeholders” (Srivastava). This shows that India is in the

beginning process of adopting EHRS. The biggest difference of EHRs usage in India and the

US is that the US uses them a lot more than India does.

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There are policies set in place that make sure that a patient's personal information is

not leaked or anything like that. But yet still especially in India patients is leaked. The only

time it is okay for a patient's healthcare information shared between providers and healthcare

facilities is when care coordination is going on for what is best for that patient. Health

information systems are being used across the public and private sectors, in which the

National eHealth Authority to set regulations and standards for sharing information.

According to the The Commonwealth Fund, 53 States would be able to develop systems to

suit their needs and priorities, provided they were consistent with standards set by the

authority. The authority also would be responsible for developing health information systems

and enforcing laws and regulations related to the privacy and security of patient health

information. The U.S has more security than India making it easier in the U.S more private.

Access to care

I believe the barriers that those trying to see their healthcare provider in a timely are

lot more extreme in India than in the US. Nayyar says, “Half the people in India and over

three-fifths of those who live in rural areas have to travel beyond 5 km to reach a healthcare

center. Availability of healthcare services is skewed towards urban centers with these residents,

who make up only 28% of the country’s population, enjoying access to 66% of India’s available

hospital beds, while the remaining 72%, who live in rural areas, have access to just one-third of

the beds. Poor patients receiving outpatient care for chronic conditions at a private facility spent

on an average 44% of their monthly household expenditure per treatment, against 23% for those

using a public facility” (Nayyar). These three barriers are quite extreme in some parts of India;

therefore, making it very hard for those in India to see their healthcare provider on the same day.

Whether one faces the barrier of transportation, lack of healthcare services, outrageous prices for
 India (4) 5

healthcare services, or all three, it really does make it hard for those trying see their healthcare

provider on the same day.

The wait time to see specialist providers vary not only by country but also by city

within each country. It is quite hard to determine an average waiting time with the many

various factors affecting each city. Viberg says, “Waiting times arise as the result of the

demand and supply imbalance. If demand exceeds supply, a form. Additionally, the waiting time

situation can also be difficult to improve long-term if the variation in supply does not adapt to

variation in demand. Excess demand during a certain period of time generates queues, whereas

temporary excess capacity cannot be saved up for future use” (Viberg). This statement shows

one factor affecting the wait to see specialist providers. I believe some places in

According to HBR, a country where the nominal per capita income is only $1,500 a

year, patients typically have to pay 60% of health care expenses from their own pockets.

People in India believe that good medical treatment is something everyone should have access

to regardless of their ability to pay. This is very hard to come by so more and more people are

denied care because they cannot pay their healthcare expensive. In the U.S not many people

are denied care.

Quality of care

Hospitals in India have very high infection rates. They are a lot higher than in the US.

The India Medical Times says, “The GARP research estimates that of the approximately

190,000 neonatal deaths in India each year due to sepsis – a bacterial infection that

overwhelms the bloodstream – over 30 per cent are attributable to antibiotic resistance.

Antibiotic resistant hospital infections can be especially deadly because antibiotics are used

intensely in hospitals compared with the community, and frequent use drives the development
 India (4) 6

of highly resistant bacteria” (India Medical Times). This shows one aspect of the infection

rates in hospitals in India.

Mortality rates are used to measure a population’s health status. Indicators of public

health efforts and medical treatments. According to HBR, psychiatric epidemiology, death is

one of the more important data points which can be used for research. Mortality is greater in

psychiatric patients that people would think. The rates have gone down though with modern

technology and modern treatments which means shorter duration of inpatient care. According

to the NIH, high mortality rates among individuals with mental illness have been reported in

various studies, but very little focus has been placed on the cause of death. These studies have

been on the epidemiological which have consistently found excess mortality rates among

individuals with serious mental illnesses (schizophrenia, schizoaffective disorder and bipolar

and unipolar affective disorders) compared with the general population. According to the

NIH, 333 psychiatric inpatient deaths, the researchers were able to trace and recruit the case

record files of 303 inpatients. That is a high rate of inpatient mortality rate in a psychiatric

hospital.

Care coordination is the organization of patient care between two or more healthcare

people involved in a patient’s care. To make sure that the person receiving care is receiving

the appropriate healthcare service him or her needs. According to the Commonwealth Fund,

patient care still is still fragmented in India. India has made very little effort in how care is

delivered or to promote patient centered care. Patients are also given very little health

coverage with very limited access to packages for health.

Readmission within 30 days of discharge India does have a problem with this

depending on the length of stay. Vasudeva says, “Patients who are admitted for longer
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durations have had appropriate treatment planning, follow-up, and lesser readmission after

discharge] There is a great likelihood that brief stay patients will be re-hospitalized within 30

days after discharge rather than patients treated for longer periods. An increase in the length of

stay from 9 to 26 days was associated with a 55% reduction in the rate of rapid readmission”

(Vasudeva). I believe this can be true for the US as well. Hospitals may try to release patients

early to protect themselves from unprecedented costs or patients may refuse extra treatment to

save money. If research is done to find that the right amount of days are spent in recovery and

the right treatment is given, there could be a possibility that the readmission rater within 30

days of discharge declines.

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References

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and-dietitian s.html [Accessed 6 Nov. 2019].

Goswami, L. (2019). India's health workforce crisis. [online] Downtoearth.org.in. Available

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Govindarajan, V. and Ramamurti, R. (2019). Delivering World-Class Health Care, Affordably.

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Math, S., Shinde, S., Nagarajaiah, Narayanaswamy, J., Viswanath, B., Kumar, N. and

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