ACCESSIBILITY AND UTILIZATION OF HEALTHCARE SERVICES- A MICRO

STUDY OF GENERAL HOSPITAL, SAGAR

By Dr. T. S. Raghavendra*, H. M. Shivakumar* and Anitha P. H.

PART-I

INTRODUCTION
In the process of economic development, it is customary to attach more importance to the
accumulation of physical capital and human capital. Among many ways of developing human
resources, the first and the foremost one is providing health facilities and services, broadly
conceived to include all expenditures that affect the life expectancy, strength and stamina, and
the vigor and vitality of the people. Investment in human capital means expenditure on health,
education and social services in general. But on the eve of independence government took all
efforts to improve primary and secondary sectors. More recently it has realized the importance
of social sector in the development of an economy. Under this sector education, health and
family welfare, food and nutrition, drinking water, sanitation are the most important factors
which promotes the growth of an economy.
Moreover, health is one of the vital indicators reflecting the quality of human life. It is a
basic need along with food, shelter and education. And also it is a pre-condition for productivity
and growth. There is always a positive correlation between the health status of the people and
economic development of the country is a well established fact. It is also one of the key
variables that determine ‘growth with human face’ even as health economics has emerged as an
important area of research (Hans, 1997). There are three principal ways by which programmes
can affect the pace of development of developing countries. One, increasing the number of man
hours of works available, two, increasing the quality of productivity of the existing work force,
and three, changing the attitudes towards innovations and entrepreneurship.

*Associate Professors Lecturer

Department of Economics Department of Economics
L. B. & S. B. S. College K. H. S. I. P. G Studies
SAGAR L. B. & S. B. S. College
SAGAR

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 In recent years developing countries are evincing much interest towards human
development. Human development is the key issue so that people could lead a long and healthy
life, they could acquire knowledge so as to have better vertical mobility in life and achieve a
decent standard of living. Governments in many nations have assumed an important role in the
provision of health care to its citizens, necessitated by the nature of some health services which
are non-excludable in their character.
A healthy manpower is a great asset of a nation as it leads to greater output per man.
Efficiency of workers depends considerably on their health. Bad health and under nourishment
adversely affect the quality of manpower. According to the Directive principles of state policy
laid down in the constitution, raising the level of nutrition, and the standard of living and the
improvement of public health are among the primary duties of the state. In India, health
standards are still low despite forty years of planning. The recent Alma Ata Declaration of
‘Health for All’ by 2000 AD had made National Health Policy a top priority in socio-economic
development. Improvement in the health status of the population has been one of the major
thrust areas for the social and economic development programmes of the country.

IMPORTANCE OF HEALTH AND HEALTH CARE SERVICES

Health is important in every individual’s life and so we call it as ‘Health is wealth’.
World Health Organization (1948) defined ‘health as being a state of complete physical, mental
and social well being and not merely the absence of disease or infirmity’. This definition invited
nations to expand the conceptual framework of their systems beyond issues related to the
physical condition of individuals and their diseases and it motivated the nations.
Good health concerns both physical and emotional well-being. Being healthy is of prime
importance in life. Physically and mentally healthy people contribute more to the productivity of
a nation. Improved health contributes to economic growth in many ways. It reduces production
losses caused by worker illness, it permits the use of natural resources that had been totally or
nearly inaccessible because of disease, it increases the enrollment of children in schools and
makes them better able to learn and it frees for alternative uses of resources that would otherwise
have to be spent on treating illness. So the balanced and nutritious diet and medical care are
considered as the important attributes of good health.
Health care is normally refers to the management or treatment of any health problem
through the services that might be affected by medical, nursing or any other related service. The
importance of good health care can be seen in the hopes of the people who are yearning for
health. To become more productive there must be physical strength. Good health leads to
reduction in production loss, improved efficiency and higher productivity. Good health

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conditions provide a way for efficient utilization of natural resources that in turn provides
greater output and higher growth rate. Healthy people may also reduce the burden on the
government with regard to huge investment on health and health care services.
There are three different levels of health care. World Health Organization (1973) defined
three levels of health care and they are primary care comprises general health practice services
which are offered to the population at the point of entry in to health care system; secondary care
comprises the care provided through specialized services on referral from primary care services;
and tertiary care includes highly specialized services and eventually the super specialties such as
plastic surgery, neurosurgery and heart surgery.
Health sector in India is the responsibility of the state, local and also the central
government. But in terms of service delivery it is more concerned with the state. The centre is
responsible for health services in union territories without a legislature and is also responsible
for developing national standards and regulations, linking the states with funding agencies and
sponsoring numerous schemes for implementation by state governments. Finally, both the center
and the state have a joint responsibility for programs listed and the concurrent life.
About three fourth of the expenditure on public health is incurred by the state or local
governments and the remaining one fourth of the total expenditure is spent by the central
government.
The government (state, local and central) provides publicly financed and managed
curative and preventive health services from primary to tertiary level throughout the country and
from of cost to the consumer. These account for about 18 per cent of the overall health spending
and 0.9 per cent of the GDP. However, a free levying private sector that plays a dominate role in
the provision of individual. Curative care though ambulatory services accounts of about 82 per
cent of the overall health expenditure and 4.2 per cent of the GDP. It has been found that private
health services are directed mainly at providing primary health care and financed from private
resources, which could place a disproportionate burden on the poor.
One of the most common proxies used to measure access to healthcare services is
utilization. Utilization may be measured by such indicators as the average number of
consultations or hospital admissions. (William. D. Savedoff, 2009) Health service utilization is a
concept of expressing the extent of interaction between the service and the people for whom it is
intended. (Dr. B. N. Sharath, 2006). Availability considers the supply of health care services, in
terms of the amount and quality relative to the population’s needs. (William. D. Savedoff, 2009)

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STATEMENT OF THE PROBLEM
The health ‘question’ is variously described in the literature as illness, physical and mental
disorder, diseases, malnutrition, poverty and infant mortality. India is a country where the size of
its population is characterized by heterogeneity in respect of physical, economical, social and
cultural conditions. It is a developing country with a high prevalence of infectious and other
diseases. India is such a country where the available resources are unevenly distributed among
different regions. For this reason, the majority of citizens has very limited access to quality
health care and has poor health indicators. Further, there are massive inequities in access to
health care- while the rich avail of most modern and expensive health services, the poor,
especially in rural areas do not get even rudimentary health care. In a country like India, people
really have poor health care at high cost, considerable health care services, but very poor health
care access for the majority of the people. Not only the poor, but also the middle class can not
easily afford hospitalization and operations.
Here strong link between poverty and ill health needs to be recognized. The onset of a long
and expensive illness can drive the non-poor in to poverty. Ill health creates immense stress even
among those who are financially secure. High health care costs can lead to entry in to or
exacerbation of poverty.

OBJECTIVES OF THE STUDY

The present study is mainly based on the following objectives.
1. To study the nature and level of accessibility of health care services in the study area.
2. To analyze the utilization and cost of health care services.
3. To study the level of expenditure made by the government on health care services in the
study area.

METHODOLOGY
The methodology of the present study can be broadly outlined with the help of both primary
and secondary source of data and information. Secondary data has been collected from the
published sources such as government publications, reports of health and family welfare
departments, and internet sources. The primary data is collected directly from Sagar General
Hospital by personal approach. The data collected were analyzed by using simple statistical
techniques such as percentage, average and growth rates.

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 PART- II

CONCEPT OF ACCESSIBILITY, UTILIZATION AND COST OF HEALTHCARE

SERVICES:
Good health is so essential to a good life that people demand access to services that will
maintain it. However, the definitions of access are often vague and the state’s ability to comply
with this requirement is frequently limited.
Defining access: Access to healthcare services can be defined in many ways. Some definitions
focus on whether people are actually using services- utilization serving as a proxy for access.
Others focus on health insurance coverage or eligibility to receive health care services if a
person were to fall ill. And others focus on the probability that someone can get a health care
service when they need it. Some others focus on the individual’s perception of whether or not
they can get the services they want. In general, access to health care services in terms of
utilization, eligibility and the probability of getting a needed services
‘Access’ can also be measured on the basis of the availability of resources. Even if the
available resources are high, people may not have access if these resources are not located in
sufficient proximity to the people who need them. Similarly, access can be limited if the
individual who needs the services has to pay for it whether through enrollment in a health
insurance plan or out of pocket, i.e. affordability gap. Access may be limited when health care
services are provided in a way that conflicts with popular beliefs, religion or social norms i.e.
cultural acceptability gap. Access to health care services may also be limited if the quality of
services provided by health care professionals is inadequate or provide the wrong treatment.
There are four dimensions of access i.e. availability, accessibility, affordability and
acceptability. Availability considers the supply of health care services in terms of the amount
and quality relative to the population’s needs. Accessibility addresses the spatial distribution of
services relative to the population and its needs. Affordability addresses the financial factors that
can facilitate in getting necessary health care services. Acceptability refers to whether available
health care services are appropriate to the norms, expectations and cultural behaviour of the
population.
Utilization of health care services: Health service utilization is a concept of expressing the
extent of interaction between the service and the people for whom it is intended. The type of
treatment taken by people in India depends upon the availability and utilization of health
services in their area and these factors play a major role on the health of the people living in a
particular area.

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 Utilization of health care services is determined to a large extent by their availability and
accessibility. The role of space in defining equality to access is very important, as the distance
which an individual has to travel to reach a health care facility has a direct bearing on the extent
to which he or she will use it. Traveling a long distance to make use of a health care facility will
affect the actual use of it, for it involves loss of time, effort and money. Utilization pattern also
depends on quality, type and nature of ailment. The type of hospital used for inpatient and
outpatient were usually government hospital, private hospitals and PHCs. Utilization of health
care services also depends on the literacy status of women, waiting time, availability of drugs,
behaviour of the hospital staff, prescriptions by doctors whether they are reasonable or costly,
timings of the hospitals etc.
Cost of health care services: Cost plays a very important role in utilizing the available health
care services. In India, majority of the population lives below the poverty line, limiting their
access to critical health care and other basic needs. Illness and ill health may result in substantial
medical expenses and trigger impoverishment of households. Cost of health care services may
deter or delay patients, especially the poor, from seeking appropriate care. Affordability or
perceived costs of care are significant factors in influencing health care behaviour such as choice
of the provider and time of care. Among various costs, direct costs of treatment for all curative
diseases are very important. It includes health care costs for medicine, diagnostics, transport
cost, fees and loss of workdays for illness. The indirect costs represent the loss of earnings
associated with workdays lost due to illness. Costs of health care services can be analyzed by
cost of treatment by formal or informal health care providers, costs for different types of
diseases, differences in costs by gender, differences in costs by socio-economic status etc.

PART-III
PROFILE OF THE STUDY AREA
Sagar is one of the resourceful Malnad taluk of Shimoga district in Karnataka State. The
taluk is bounded by Soraba - Siddapur in the north, Hosanagara taluk in the south, Honnavar and
Bhatkal in the west and Shikaripura, Shimoga taluk in the East. The taluk consists of one each
Nagarasabha and Pattana Panchyath, 6 Hobalies, 35 Grama Panchyaths, 230 inhabited villages
and 238 revenue villages.
The total population of the Sagar Taluk is 200995 out of which 100977 are males and
remaining is female i.e.100018, the taluk consisting of 12.2 per cent of total districts population.
The total literacy of taluk 136850 with male litterateurs being 75990 and female being the 60860
density of the population in the taluk is 104 per sq.kms. The sex ratio being 991 women for over

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one thousand men, Out of 41915 habited houses, 10789 are in urban areas and 28288 are in the
rural areas.
The taluk consists of 10 private hospitals, 8 primary health centre’s, 5 primary health
units, 2 dispensaries, one community health center, 3 veterinary and 3 artificial inspection
centers. The Sub-divisional Hospital of Sagar is located in the heart place of the city. It was
started in 1893 as “Local Fund Dispensary”. It has become Composite Hospital in 1958 with
available facility of 40 beds. On the April 11, 1998 the availability of bed increased from 40 to
100. The new building was constructed under the plan of K.H.S.D.P (Karnataka Health Service
Development Plan).
It has become modernized year to year; it is the second highest modernized hospital after
Mc.Gann Hospital in Shimoga District. It is giving services not only to the people of Sagar taluk
but also the people of Soraba, Hosanagar, Shikaripura, Siddapura, Haveri, Hangal and Hirekerur.

STAFF MEMBERS OF THE HOSPITAL

The sanctioned staff is 110. At present 58 members are working and there is a vacancy of
52 members. Nine Doctors are working as against the sanctioned post of 12. 13 nurses are
working in the total number of 20. The hospital has appointed on contract basis 8 Nurses and 3
Computer assistants temporarily.
In other words the working staff is only 53 percent and there is a shortage of 47 percent
of staff.
DETAIL OF OUTDOOR PATIENTS
Out door patients refers to the patient who do not admit to Hospital. They just visit the
Doctor and take the medicine from medicine supply room. The following Table 1 reveals the
details of outdoor patients.
TABLE -1 DETAIL OF OUTDOOR PATIENTS
Year No. of Patients
2005 1,12,445
2006 1,19,754
2007 1,22,009
2008 95,363
2009 1,13,598
Source: Govt. Sub-divisional Hospital, Sagar.
Table 1 explains the total number of outdoor patients since 5 years. The number of
outdoor patients is 1, 12,445 in 2005. The number of outdoor patients further increased to
1, 22,009 in 2007. But the number of outdoor patients decreased to 1,13,598 in 2009. The

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development of private hospitals may be one of the reasons and the other is shortage of Doctors
in the Government Hospital.

DETAIL OF INDOOR PATIENTS

Indoor patient means the patients who are admitting to the hospital. Doctors will suggest
admitting the patient in hospital. There are separate rooms for women and men. There are 100
beds available in this hospital. Each bed has one table for patient to keep medicine and food. The
blanket and fan facility is also given to each patient. Food has given to each patient. There is
separate room for cooking the needed food of patient. The food contains milk; tea, bread, and
rice Sāmbhar have given to each patient. Doctors daily take two rounds for indoor patients. The
cleanliness in the indoor patient hall is good. The numbers of indoor patients since 5 years are
given in Table – 2
TABLE –2 INDOOR PATIENTS
Year No. of Indoor Patients
2005 8,092
2006 8,006
2007 8,459
2008 8,229
2009 8,689
Source: Govt. Sub-divisional Hospital, Sagar.
Table –2 explains that the number of indoor patients. 8,092 patients were admitted in
2005. The number of indoor patient increased to 8,459 in the year 2007. The number of indoor
patients increased year to year. The annual compound growth rate of indoor patient is 1.71 per
cent. The reason for this slow growth is limited number of beds in the hospital.
X-RAY FACILITIES IN GOVERNMENT HOSPITAL
X - Ray is an important tool to know diseases or fractures of bones and muscles. This ray
gives the picture of the problematic part of human body through which the doctor can decide
about the treatment of such problems faced by the patient. Table – 3 explains the beneficiaries of
X-Ray facilities.
Table – 3 explains that the number of patient who have benefited from X-ray facility.
6571 patients who have received benefit of X-ray in 2005. The number of patient increased to
7135 in 2007. The number of patient further increased to 6726 in 2009. The number of
beneficiaries is increasing year to year. There are two employees in X-ray Department. They
depict X-rayed part in Block Sheet with the help of X-ray machine.

TABLE – 3 X-RAY FACILITIES IN GOVERNMENT HOSPITAL

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 Year No. of X-Ray
2005 6,571
2006 6,851
2007 7,135
2008 6,003
2009 6,726
TOTAL 33,286
Source: Govt. Sub-divisional Hospital, Sagar.
FAMILY PLANNING SURGERY
The population is growing rapidly. Government has taken various programmes to check
the population growth. Family planning surgery is free in all government hospitals. The
following table explains the progress of family planning surgery.

TABLE – 4 FAMILY PLANNING SURGERIES

Year No. of Surgery
2005 560
2006 694
2007 587
2008 746
2009 921
TOTAL 3,508
Source: Govt. Sub-Divisional Hospital, Sagar.
Table 4 clearly explains that the number of patients who have undergone family planning
surgery. Mainly there are two types of surgery in family planning. First one is vasectomy, it is an
operation for men, secondly Tubectomy, which is an operation for women. Both operations
prevent child bearing capacity of couple. 560 operations were taken place for men and women in
2005. The number of operations is increasing year to year. The number of operations, increased
to 587 in 2007. And the number of operations further increased to 921 in 2009. The annual
compound growth rate of family planning surgery is 11.03 per cent per annum. There are
numerous schemes; facilities are given for couple to encourage undergoing family planning
surgery. It is found that only 4-5 vasectomy has been conducted in a year and the remaining is
tubectomy.

ICTC DEPARTMENT OF HOSPITAL

ICTC is an acronym of Integrated Counseling and Testing Centre. This centre gives free
cost of testing of AIDS. The people who come to this centre can be divided in to two categories.
Firstly, the people who come voluntarily at this centre and secondly, the people who are sent to
the centre by doctors. Table 5 explains the information regarding the number of tested people.

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 TABLE – 5 DETAILS OF ICTC DEPARTMENT OF THE HOSPITAL
ICTC Clients PPTCT Clients
Year Counseled Positive Counseled Positive
Cases Cases Cases Cases
Apr - Dec 2004 303 33 886 04
2005 486 36 1006 10
2006 420 4 771 02
2007 816 52 1216 -
2008 1263 56 1203 07
2009 1831 63 1450 02
TOTAL 5119 284 6532 25
Source: Govt. Sub-Divisional Hospital, Sagar.
Table –5 reveals that the number of tested people. The ICTC counseled 303 cases in the
year 2004. It has showed 33 positive cases. The number of counseled cases increased to 816 and
it showed 52 positive cases. The number of counseled cases further increased 1831 in 2009 and
it showed 63 positive cases. The annual compound growth rate of counseled cases is 23.42 per
cent and positive cases are 12.71 per cent.
PPTCT is an acronym of prevention of parent to child Transmission. This is a test for
pregnant women. This is a test to know whether HIV is positive or not. The number of PPTCT
counseled cases is 886. It has proved 4 positive cases. The number of counseled cases increased
to 1,216 in 2007. The number of counseled cases further increased to 1450 in 2009 and it has
proved 2 positive cases.

THE DETAILS OF PHYSIOTHERAPY IN SAGAR SUB – DIVISIONAL HOSPITAL

The facility of physiotherapy is available in Sagar sub-divisional hospital. Physiotherapy
means treating the patients who have been suffering from body pain, pain in bone or even
massaging (tabbing of mussels). The people of Sagar have used this facility effectively. The
details regarding physiotherapy are as follows.
Table-6 explains that the number of patients who have used the physiotherapy. In the
year 2005, 2,732 patients who have taken physiotherapy treatment and it are declining in 2009.
The annual compound growth rate of beneficiaries of this facility is 12.2 per cent.
TABLE –6 DETAILS OF PHYSIOTHERAPY
Year No. of Cases
2005 2,732
2006 868
2007 1,732
2008 2,937
2009 2,641
TOTAL 10,910
Source: Govt. Sub-Divisional Hospital, Sagar.

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MAJOR OPERATIONS IN SAGAR SUB-DIVISIONAL HOSPITAL
Well facilitated and modern monitor facility is available in Sagar Sub-divisional hospital.
It is helped to major operation. Well experienced doctors are handling these machines. The
details regarding major operation are explained in Table-7.
TABLE –7 DETAILS OF MAJOR OPERATIONS CONDUCTED
Year No. of Operations
2005 1,148
2006 1,173
2007 1,133
2008 1,159
2009 1,301
TOTAL 5,914
Source: Govt. Sub-Divisional Hospital, Sagar.
Table-7 explained the major operations conducted in the last 5 years. 1,148 major
operations were taken place in 2005. The number of operations is increased year after year. The
number of operations increased to 1,133 in 2007. The number of operations further increased to
1,301 in 2009. As population increased, the number of major operations is also increased. The
growth rate of operation is 2.5 per cent per annum. There is a minimum charge for these
operations. It reveals that people believe in the efficiency of governmental hospital.

TYPE OF OPERATIONS CONDUCTED

Sagar sub divisional hospital is fully equipped with well operation theatre and a good
quality of expert surgeons. Here various types of operations are conducted so that not only the
sagar people take benefit but also from other taluks like Sorab, Shikaripur, Hosanagar and
Hirekerur. The following table gives the details.
TABLE-8 TYPE OF OPERATIONS CONDUCTED
Department Type of operation

Hysterectomy
Gynecology Ovarian cyst Excision
Cesarean operation
Surgery Appendectomy
Herniotomy and Herniorophy
Thyroidectomy
Cholecystomy

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 Prostatectomy
Bladder stones Removal
Haemorroidectomy
Tonsillectomy
Deviated Nasal Septum correction
Mastoidactomy
ENT Tymphanoplasty
Ophthalmology
Cataract operation
Lachrymal glands Removal
Source: Govt. Sub-Divisional Hospital, Sagar.

THE FEE COLLECTED FROM BENEFICIERIES

There is a minimum charge for each patient who takes service from hospital. That is ` 2
per patient. This fee directly goes to government. The detail regarding total amount of fees
collected are explained in Table 9. Table 9 explains that the fees collected by the Government
Hospital to give various services. The service includes Doctors check up, X-ray facility,
scanning, bed and other related charges. The total amount collected in the 2005 was ` 9, 76,460.
The amount increased to ` 12, 39,944 in 2007. The amount in the form of Fees and Charge of
various facilities is increasing year to year. The amount further increased to ` 15, 62,707 in the
year 2009. The amount of fees and charges are very low compared to other private hospitals.
The poor people are receiving benefit from the Government in the form of health care services.
TABLE –9 FEES COLLECTED BY BENEFICIARIES
Collected Fees
Year
(in ` )
2005 9,76,460
2006 12,29,934
2007 12,39,944
2008 13,57,084
2009 13,62,707
TOTAL 61,66,129
Source: Govt. Sub-divisional Hospital, Sagar.
There are no charges for BPL (Below poverty Line) card patients. But for the APL card
patients they may charge reasonable amount which is lower than the private hospitals. The
charges are ` 2 for OPD, `` 10 for admission and extra charges according to the type of service
provided by the hospital.
AMBULANCE FACILITY

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 Ambulance facility is available in the Sagar Sub-divisional Hospital for the people of
Sagar. The ambulance is used for the patient who is in very serious condition. Ambulance is also
used for the transportation of patients for the higher and specialized treatment. There are three
Ambulances in Sagar Sub-divisional Hospital. Two of them belong to 108 of AROGYA
KAVACHA. This 108 (AROGYA KAVACHA) is provided with public and private partnership.
The following Table 10 explains the details of Ambulance Facility, given to the patients.
TABLE –10 DETAILS OF AMBULANCE FACILITY
Oil
Kilometers No. of Patients
Year Consumed
Run Transferred
(in Ltrs.)
2005 30,735 6,324 136
2006 42,973 7,064 182
2007 42,108 6,700 213
2008 50,708 8,472 247
2009 72,756 12,109 381
TOTAL 239,280 40,669 1159
Source: Govt. Sub-divisional Hospital, Sagar.
Table 10 reveals the information of ambulance which has travelled 3,075 kms with using
6,324 liters of oils in 2005. It transferred 136 patients in the same year. Ambulance travelling is
increased to 42,108 Kms, with using 6700 liters of oil in 2007. It also transferred 182 patients in
2007. The total number of Kilometers travelled is increased to 72,756 in 2009 with using of
12,109 Ltrs. of Oils. It transferred 381 patients in 2009. The number of vehicles is enough in
Sagar Hospital. The annual compound growth rate is 20.08 per cent and transferred patient is
26.7 per cent Ambulance is servicing 24 hours in a day for all 365 days.
TABLE –11 Government Expenditure on Medicine
Year Amount Spent on Out Door Indoor Total Patient Per Capita
Medicine by Patient Patient Expenditure
Government
2005 886200 112445 8092 120537 7.35
2006 886200 119754 8006 127760 6.93
2007 886200 122009 8459 130468 6.79
2008 886200 95363 8229 103592 8.55
2009 886200 113598 8689 122287 7.24
Source: Government Sub divisional Hospital Sagar
Table-11 explains that per capita expenditure on medicine is almost constant. It is the
policy of the government that it will grant ` 10 lakh for all taluk hospitals and now it has
increased to ` 25 lakhs. Table shows the amount spent on medicine and the remaining amount is
for other expenses.
FINDINGS AND SUGGESTIONS

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 There are 100 beds available in Sagar Hospital. All taluk hospitals are 100 bed hospitals.
But the number of indoor patient is increasing year to year. Some -times patients admit to private
hospitals due to non-availability of beds. So the study found that there is a necessity of
increasing the bed from 100 to 200. The hospital has developed well. But there is non-
availability of semi-special wards. Specialized doctors in the field of medicine are not available
in Sagar Hospital. At present there are 12 Doctors. The number of doctors is low as compared to
the hospital and population of Sagar Taluk. Some medicines are important to the patients at the
time of emergency. For Example: Snake bite. It requires Benthamine medicine, but it is not
available in Sagar Hospital. A blood bank is one of the important facilities for the hospital, but is
not available in Sagar hospitals. Other important findings are the corruption aspect which is
common even in Sagar hospital. Out patients as well as in patients argued about the absence of
the treatment in the recent branches of medicine and surgery like Urology, Endocrinology etc.

SUGGESSTIONS
1. The environment of hospital is satisfactory. There is a need to maintain the cleanliness
around the hospital.
2. Introduction of semi-special wards: the semi special wards have to be introduced in the
hospital as early as possible.
3. Introduction of recent branches of medicine and surgery along with the different
therapies pertaining to them.
4. Provision of basic necessities: the hospital should provide the basic necessities such as
the Uniforms, Deduction of P.F., Rest Rooms for the Staff etc. within its limits as it may
increase the efficiency of the works.
5. Introduction of a grievance cell and feed- back collecting cell: the hospital introduced a
grievance cell along with a feed-back collecting unit which collects the grievances and
complaints directly from the patients.
6. Organization of the Staff Welfare Programmes, Staff Welfare programs such as Staff
Day, Hospital Day and Staff Interaction Day etc. must be organized once in every six
months in which the staff are allowed to come out with their individuals’ problems.
7. Proper maintenance of patient pertaining records: the patient pertaining records should be
maintained with a greater care since it serves as the backbone in the development of the
hospital.
8. Total management computerization: the existing management should completely be
computerized so as to save the precious time and money of the Hospital.
CONCLUSION

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 Health care is a very important social infrastructure. In developing country health care
facility is not developed. Underdeveloped health care facility is one of the reasons for low
productivity. There is a strong relationship between Health and Economic Development. In
order to improve Health indicator, the State Government will have to spend more on Public
Health services.
Thus, in addition to raising public investment, policy should be developed to promote
equitable access to preventive and curative health services.
The Sagar Sub-divisional Hospital is providing health facility not only to the people of
Sagar, but also to the people from Soraba, Siddapur, Hosanagar. It has good facility such as bed,
medicine, room, and so on. In fact, the hospital is a second largest hospital in Shivamogga
District. The Hospital is maintaining cleanliness in the premises and in all the rooms. It has
newly constructed building. The hospital has been awarded as a “Best Taluk Hospital in the
State” in 2009-10 under First Referred Unit. So it is clear that being a public hospital, it has
provided good health care services to the people of Sagar.

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 Dasgupta Monica, B. R. Desikachari, Rajendra Shukla, T. V. Somanathan, P.

Padmanabhan and K. K. Datta (2010), ‘How might India’s public health systems be

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