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Medical Tourism - Destination - India

General Informations

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Being a pioneer in the medical tourism industry, India offers new technology, alternative and experimental treatment alongside an internationally trained workforce who speaks English. Thanks to these reasons, India has a broad spectrum of specialisations including cardiology, cosmetic surgery, dentistry, ophthalmology, orthopaedics, transplants and assisted reproduction. Nowadays, India remains a leading medical tourism country that promotes widely at a governmental and private sector level as well as offering medical visas. Due to these factors India attracts around 450,000 medical tourists a year (mostly from the UK, US and South Korea) despite being a country that is often perceived by many to be underdeveloped and unsafe. Cost savings are prominent as one can expect to save 58% when compared to the US or 47% for the UK. Other driving factors are high quality of medical care, availability of treatments and reduced waiting times. By 2012, India aims to attract one million medical tourists.

India
Localisation South Asia, bordering Pakistan, Myanmar, China, Bangladesh, Nepal and Bhutan
Capital Delhi
Biggest cities (population) Mumbai (13,922,925), Delhi (12,259,230) and Bangalore (5,310,318)
Inhabitants 1,166,079,217
Politics federal parliamentary representative democratic republic
Religion Hinduism (80.5%), Islam (13.4%), Christianity (2.3%), Sikhism (1.9%), other (1.9%)
Currency Rupee (INR) = € 0.0144115
GDP € 806,121 millions, 1.98% of the world’s GDP
Official language(s) Hindi and English
Climate alpine, subtropical, tropical and arid. Winters have lows of 10°C and highs in summers of around 30°C
Time zone GMT +5.5
Happy Planet Index (HPI) 35

Cultural Aspects

General Culture

Indian culture is mainly based around the polytheist religious traditions of India. This also leads to a climate where strict taboos regarding behaviour exist. Family plays a large role in how Indians function with castes and extended family members also being important. Indian culture focuses largely on food with a unique cuisine famous for spices and vegetarian food.

Safety

India ranks 122 on the GPI as the country is fairly volatile due to terrorist attacks, increased tension with Pakistan and other neighbouring countries, and the Muslim community in India feeling threatened.

Tourists Attractions and Sights

  • Taj Mahal: a mausoleum located in Agra constructed between 1632 and 1653
  • Red Fort: also known as Lal Qil’ah, or Lal Qila is located in the walled city of Delhi
  • Lotus Temple: Bahá’í House of Worship in Delhi, popularly known as the Lotus Temple due to its flowerlike shape
  • Himalaya: meaning ‘abode of snow’, is a mountain range in Asia
  • Jaisalmer Fort: the largest desert fort in the world built in 1156 AD

Visa Requirements

Entrance to the country has become easier since India introduced the M (medical) visas and the MX (accompanying spouses) visas in 2006. Every foreign national will need a visa to enter India except Nepal and Bhutan.

Infrastructure

Transportation

Within India, a variable infrastructure exists. In major cities, roads are of high quality but in the rural areas, the quality is changeable. In general, India has a well-developed transport network comprising rail, road, coastal shipping and air transport. The latter is the most used method of arrival in India with over 20 international airports. Domestically trains are widely used with over 18 million travellers per day. In urban areas busses are the main source of public transportation taking up 90% of the market.

Accommodation

Accommodation in India ranges from youth hostels for back-packers to luxury hotels. The main chains present are Best Western International, the Taj Group, the Starwood Hotels and Resorts and the ITDC Ashok Group. For medical travellers, most private hospitals in India offer luxury hotel style stays with accommodation for an accompanying traveller.

Health Care System

WHO ranking 112
Physicians per 10,000 population 13.0 (2004)
Nurses per 10,000 population 6.0 (2004)
GDP spent on health care 1.0%
Education period of doctors 5 years, 6 months including residency
Education period of specialists additional 3 years

Health Care Providers

Health care is provided by the government, charitable trusts and by private organisations. The government provides 23,000 Primary Health Centre (PHC) in rural areas, 137,000 sub-centres serving the semi-urban and rural areas and 3,000 (CHC) Community Health Centres with major hospitals being located in large cities. Health care in the public sector tends to lack equipment and personnel. It is thought that 75-80% of health care services are provided by the private sector, which results in 82% of all health care spending being in the private sector (World Bank Study) as the population prefers private health care. Alongside modern medicine, traditional medicines are also practised such as yoga, ayurveda, yunani, siddha and homeopathy.

Insurance

Insurance in India is not compulsory. Treatment from the government is paid for when needed by the individual citizens. This results in only 10% of the population having insurance.

Reforms/Policies

On a national level, the government aims to double the amount of GDP spent on health care from 1.0% to 2.0% over the next year in an aim to boast quality as well as increase the amount of preventative treatment. Treatment is also outlined in India’s five year plan (2007-2012) which aims to tackle areas of health care.

It was also announced in July 2009 that the Finance Minister of India has proposed a tax on plastic and cosmetic surgeries. This might see prices rise in India which could mean a decline in medical tourism appeal.

General Medical Tourism Information

India sees a large influx of tourists every year resulting in around 4,977,000 arrivals in 2007. This figure declined by 16.6% by January 2009 as a result of the terror attacks in Mumbai and the credit crunch hitting in 2008. 123 Nevertheless, India remains a hub for medical tourism with the market growing at 30% annually and patients coming from from 55 countries. In 2008, around 450,000 medical tourists generated USD 1 billion (€ 668 million) revenue. By 2010, the income from medical tourism is expected to account for 5% of the country’s GDP. By 2012, this is expected to become 1.1 million people and USD 2.4 billion (€ 1.6 billion) in revenue. India’s share in the global medical tourism industry will climb to around 2.4% by the end of 2012.

India is promoted as a medical tourism destination by both the governmental bodies and the private sector via exhibitions and conferences worldwide. Alternative treatments are also presented at trade shows and are broadcasted on television.

Flows

The most common groups of medical tourists are from the UK, US and South Korea. The percentage distribution is not known although South Koreans are not as frequent as UK or US patients.

Reasons

  • Cost savings/Quality: the slogan ‘First World Health Care at Third World Prices’ outlines that the quality is high and yet cost savings can be 58% when compared to the US or 47% for the UK.
  • Availability: more flexibility to develop technologies and expertise due to less strict regulations than in Europe and the US allows to practise therapies, such as stem cell treatment.
  • Holiday destinations: being a popular tourist destination, packages combining treatment, with high quality aftercare and a highly developed holiday industry are also making India attractive.
  • No waiting times: treatment in India is booked ahead of time and planned in detail so that one arrives a few days before treatment.
  • Language skills: English is an official language.

Specialisation

The main areas of medical specialisation in India include:

  • Cardiology
  • Cosmetic and plastic surgery
  • Dentistry
  • Ophthalmology
  • Orthopaedics
  • Transplants
  • Assisted reproduction

Top Facilities

The top facilities have been selected using the following criteria’s, listed in order of importance: JCI Accreditation, ISQua accreditation, international orientation. In general national accreditation systems have not been taken into consideration, due to the fact that there are too many and judging them is out of scope of this study. India has 13 JCI accredited hospitals, the following five are considered in this report:

  • Apollo Hospital, Chennai
  • Apollo Hospital, New Delhi
  • Wockhardt, Mumbai
  • Fortis, Mohali
  • Sri Ramachandra Medical Centre, Chennai

SWOT

Strengths Weaknesses
  • Cost savings can be 58% compared to the US or 47% compared to the UK
  • Quality of medical procedures and staff
  • Established holiday destination
  • No waiting times for medical treatment
  • English is an official language
  • Alternative and experimental treatment
  • Pioneering and leading medical tourism hub
  • Medical and accompanying spouses’ visas
  • 13 JCI accredited medical facilities within established hospital groups
  • Taboos regarding behaviour exist
  • Safety of the country is low as it ranks 122 on the GPI
  • Variable quality of road network throughout the country
  • Every foreign national will need a visa to enter India except those from Nepal and Bhutan

Conclusion

India was one of the pioneering countries that took advantage of the medical tourism market by offering new technology, alternative and experimental treatment alongside an internationally trained workforce who speak English. Nowadays, India remains a leading medical tourism country that promotes widely at both a governmental and private sector level as well as offering medical visas. These factors together have meant that India attracts around 450,000 medical tourists a year (mostly from the UK, US and South Korea) despite being a country that is often perceived by many to be underdeveloped and unsafe. Cost savings are prominent as one can expect to save 58% when compared to the US or 47% for the UK. By 2012, India aims to attract one million medical tourists.

Top Facility Chart

India Apollo Hospital, Chennai Apollo Hospital, New Dehli Wockhardt Mumbai Fortis Mohali Sri Ramachandra Medical Centre
Location and website Chennai www.chennai. apollohospitals. com New Dehli www. delhi.apollohospitals. com Mumbai www. wockhardthospitals. net Mohali www. fortishealthcare.com Chennai www.srmc.edu
Accreditations or certifications JCI, ISO 9002, ISO 14001 JCI JCI JCI JCI, NAAC
Capacity of hospital beds >1,000 beds 640 beds 250 beds 215 beds 600 beds
Possible for accompanying person to stay in room Yes, in private rooms Yes, in private rooms Yes, in private rooms Yes, in private rooms Yes, in private rooms
Medical tourists 2,000 from Bangladesh, Maldives, Sri Lanka, Seychelles, Mauritius 12,000 annually from SAARC (30%), Africa (25%), Middle East (25%), US (15%), EU (5%) 3,500 annually 80% US 10% of all patients, mostly from UK and US, and neighbouring countries 400 annually, mainly neighbouring countries and UK
Number of medical staff doctors/nurses 205 physicians 287 physicians and 1,304 nurses 153 physicians 170 physicians 2,500 physicians, nurses and administration
Type of rooms available (prices) Private single/ deluxe/ executive rooms, suites and Semi-private rooms Private single/ deluxe rooms, suites and Semi-private rooms Private single and deluxe rooms 30 private rooms and 2 suites Private single/deluxe rooms, suites and Semi-private rooms
International patient department Yes, they organise all the arrangements Yes, they organise all the arrangements Yes, they organise all the arrangements Yes, they organise all the arrangements Yes, they organise all the arrangements
Adaptations to cultures and nations Yes, in food and religious habits Yes, in food and religious habits Yes, in food and religious habits Yes, in food and religious habits Yes, in food and religious habits
Languages spoken by staff English and Hindi English and Hindi English and Hindi English and Hindi English and Hindi
Marketing of the facility/USP Part of the Apollo chain, chain marketing & brand awareness, attendance of trade shows and seminars, Apollo Information Centres in Middle East etc. Part of the Apollo chain, chain marketing & brand awareness, attendance of trade shows and seminars, Apollo Information Centres in Middle East etc. Active promotion world-wide, agents participate at conferences especially in the US, co-operation with Harvard Medical International in Boston Tailor made experience, launching "Caring Hands" Programme that specialises in patients' needs Promoted through the connection with the university as it is a university hospital
Specialisations Orthopaedics, oncology, spine surgery, gastroenterology, neurology, nephrology and urology Cardiology, orthopaedics, oncology, neurology, paediatrics, reproductive medicine and transplantation Cardiology, orthopaedics, spine surgery and obesity surgery Cardiology, oncology, paediatrics and orthopaedics Urology, radiology, transplantation, neurology, cardiology and assisted reproduction

Price Chart (in €uro)

Treatment Average Price Apollo Hospital, Chennai Apollo Hospital, New Dehli Wockhardt Mumbai Fortis Mohali
Cardiac bypass 7,349 4,008 6,213 5,678 1,556
Gastric bypass 7,349 4,810 6,213 6,547 5,044
Knee replacement 5,678 5,612 5,678 4,676 2,882
Hip replacement 6,012 6,346 5,812 6,012 2,882
Hip resurfacing 4,676 6,614 5,812 5,678 2,882
Botox treatment 94 N/A N/A N/A 7
Breast augmentation 2,505 2,873 3,006 N/A 2,162
Facelift 3,006 3,808 2,873 N/A 2,522
Liposuction 1,837 1,219 2,138 N/A 3,963
Dental implants 2,004 735 802 N/A 721
Rhinoplasty 1,136 N/A 2,271 N/A 1,441
Lasik eye surgery 781 541 N/A N/A 360

Note: All prices are estimates, and may vary widely from source to source depending on services included in the estimate (i.e. doctor’s fees, hospitalisation, administration costs or the patient’s age and medical history). Due to non-disclosure strategies of the various locations, it was not possible to make a clear separation between those factors. All prices given for the specific facilities have been provided by the hospitals/clinics themselves via email or telephone contact. The prices are given in Euros (€).

N/A means either that treatment are not available in the specific hospital, that a price estimation cannot be found or that the medical facility did not disclose the information. For the average prices, printed literature has been used before researching sources on the internet.