A Case Study on Medical Tourism in Hyderabad City
Introduction
Definition of Medical Tourism
Medical tourism can be broadly defined as provision of ‘cost effective’ private medical care in collaboration with the tourism industry for patients needing surgical and other forms of specialized treatment. This process is being facilitated by the corporate sector involved in medical care as well as the tourism industry – both private and public.
Ancient History-Indian Medical Tourism
Some might have difficulty categorizing yoga retreats, Buddhist pilgrimages, and meditation centers as medical tourism, but the unbelievable reach of India’s healing arts is not to be ignored. Ever since yoga’s birth more than 5,000 years ago, India has enjoyed a constant influx of medical travelers and spiritual students hoping to master and benefit from this most fundamental and revered branch of alternative medicine. When Buddhism came along roughly 2,500 years later, this only added fuel to the fire and helped position India as the epicenter of Eastern cultural, spiritual, and medicinal progress. Not only is India one of the world’s oldest medical tourism destinations, but it has now also become one of the world’s most popular ones as well.
Medical Tourism Industry Overview
The Indian healthcare market is Rs. 15 billion and growing at over 30% every year. Indian private hospitals are increasingly finding a mention in the travel itineraries of foreigners, with the trend of medical tourism catching up in the country. If industry estimates are to be believed, the size of the medical tourism industry stands at Rs 1,200 – Rs 1,500 crore (Rs. 12-15 billion).A recent CII-McKinsey study on Indian healthcare says medical tourism alone can contribute Rs 5,000- Rs 10,000 crore (Rs. 50-100 billion) additional revenue for tertiary hospitals by 2012, and will account for 3-5% of the total healthcare delivery market. This is a huge, untapped market, not just for therapeutic medical tourism like ayurveda, but also for curative treatment. India can lead the world in medical and health tourism since we have a tremendous advantage with a large pool of skilled manpower and technological edge.
Why India?
The countries where medical tourism is being actively promoted include Greece, South Africa, Jordan, India, Malaysia, Philippines and Singapore. India is a recent entrant into medical tourism. The Indian government predicts that India’s $17-billion-a-year health-care industry could grow 13 per cent in each of the next six years, boosted by medical tourism, which industry watchers say is growing at 30 per cent annually. Price advantage is a major selling point. The slogan, thus is, “First World treatment’ at Third World prices”. The cost differential across the board is huge: only a tenth and sometimes even a sixteenth of the cost in the West. India has a lot of hospitals offering world class treatments in nearly every medical sector. For long promoted for its cultural and scenic beauty, India is now being put up on international map as a heaven for those seeking quality and affordable healthcare. Analysts say that as many as 150,000 medical tourists came to India in 2004. As Indian corporate hospitals are on par, if not better than the best hospitals in Thailand, Singapore, etc there is scope for improvement, and the country is becoming a preferred medical destination. In addition to the increasingly top class medical care, a big draw for foreign patients is also the very minimal or hardly any waitlist as is common in European or American hospitals.
About Hyderabad
Hyderabad is the fifth largest city in India with an ancient civilization and culture. Hyderabad and Secunderbad are twin cities, separated by Hussain sagar which is a man made lake. A natural and sophisticated blend of old and new, an old ‘Nawabi’ culture with a new pro-active approach and hospitality. The teeming bazaars of the old city, in the midst of which stands the 400-year-old Charminar, the modern shopping complexes and ultra-modern malls in the newer areas of the city add to the charm of Hyderabad. The Golconda Fort, capital of the kingdom by that name, is today very much part of the city, as is Cyberabad (means Cyber City), a new local area created to keep pace with the zooming Information Technology and Tourism sector. Pearls, bangles, silks, computer software, handicrafts and above all a delectable cuisine add to the splendor of this great city. Hyderabad is one of the most densely populated cities in the country and is home to about 2.2 million people. Hyderabad has a mix of Hindu-Muslim culture with a number of monuments of historical importance, including the very famous Charminar. Hyderabad has too many tourist attractions that would often make it difficult for a tourist to set his priorities. While art lovers cannot defy the attraction of the huge repository of antiques displayed at the A.P. Museum, The Nizam Museum and the Salarjung Museum would offer a delightful insight to the rich imperial history.
Hyderabad is known worldwide for its diamond markets, glass embedded bangles and delectable Hyderabadi cuisine. Hyderabadi Cuisine can itself be a big reason for visiting Hyderabad. The delicious Biryanis and myriad of mutton and chicken dishes religiously followed by mouth-watering sweets will earn the accolades from all gourmets across the world.
Advantages of Coming to Hyderabad for Medical Treatment
- Internationally accredited medical facilities using the latest technologies
- Highly qualified Physicians/Surgeons and hospital support staff
- Significant cost savings compared to domestic private healthcare
- Medical treatment costs in India are lower by at least 60-80% when compared to similar procedures in North America and the UK
- No Wait Lists
- Fluent English speaking staff
- Options for private room, translator, private chef, dedicated staff during your stay and many other tailor-made services
- Can easily be combined with a holiday/business trip
Quality in Health Care
India the glorious country has found yet another way to contribute to the world through quality health care. Now is the time when it is giving its best through quality health care and medical tourism facilities. Increasing pressure on the medical facilities and the hike in the purchasing capacity of the Indians and the foreigners visiting India has led to the recent development in the quality health care and medical facilities.
The geographic conditions and the increase in the quality health care services are all conducive to boost the medical tourism facilities in India.
Importance of Accreditation
Obviously, you want to receive the best possible care that you can. When you stick with medical facilities that have reputable credentials and accreditation, you can be reasonably sure that they adhere to certain standards, medical codes, and professional ethics. Having accreditation does not necessarily mean that your doctor or dentist is a miracle worker, but it helps to weed out undesirable medical practitioners. In addition, many insurance companies will not pay for medical services performed at non-accredited health care facilities.
Joint Commission International (JCI)
Joint Commission International (JCI) is the global arm of the US-based Joint Commission on the Accreditation of Healthcare Organizations (JCAHO); the same body that certifies over 18,000 hospitals in the United States. Although JCI approval is not the only accreditation available for medical tourism facilities, it is a fairly good benchmark to use when researching foreign hospitals.
If you come across a medical tourism facility that doesn’t have JCI accreditation, there’s no need to be alarmed. Many countries have their own accrediting bodies that put forth standards and regulations that closely mirror (and sometimes exceed) the accrediting standards established by JCI.
International Organization for Standardization (ISO)
While ISO is not necessarily a health care accrediting body, it’s important that you stick with medical tourism destinations where ISO has representation. ISO and its member organizations help ensure that hospitals and dental clinics closely adhere to the strict international standards that they put forth. In this way, you have a much better chance of receiving optimal medical and dental care when you take your health vacation abroad.
Access to Hyderabad:
By Air: Indian Airlines has flights connecting Hyderabad with all major cities in India. The nearest airport is Shamshabad International Airport.
By Rail: The world’s second largest railway under one management the Indian Railways carries more than ten million people every day. Main railway stations are Begumpet Station, Hyderabad Station, Kachiguda Station and Secunderabad Station.
By Bus: The AP State Road Transport Corporation (APSRTC) has a busy district service that connects Hyderabad to every city, town and almost all villages.
Cost Comparison: Preventive Health Checks
| Preventive Health Checks | Charges in Hyderabad |
|---|---|
| Master Health Check | $45 |
| Executive Health Check | $90 |
| Cardiac Checkup | $130 |
Procedure Charges In Hyderabad and USA (US $):
| Procedure | Cost (US$) | |
|---|---|---|
| United States | Hyderabad | |
| Bone Marrow Transplant | 2,50,000 | 69,000 |
| Liver Transplant | 3,00,000 | 69,000 |
| Heart Surgery | 30,000 | 8,000 |
| Orthopedic Surgery | 20,000 | 6,000 |
| Cataract Surgery | 2,000 | 1,250 |
Dental Procedure Charges between USA and Hyderabad
| Dental procedure | Cost in US ($) | Cost in Hyderabad ($) | ||
|---|---|---|---|---|
| General Dentist | Top End Dentist | Top End Dentist | ||
| Smile designing | – | 8,000 | 1,000 | |
| Metal Free Bridge | – | 5,500 | 500 | |
| Dental Implants | – | 3,500 | 800 | |
| Porcelain Metal Bridge | 1,800 | 3,000 | 300 | |
| Porcelain Metal Crown | 600 | 1,000 | 80 | |
| Tooth impactions | 500 | 2,000 | 100 | |
| Root canal Treatment | 600 | 1,000 | 100 | |
| Tooth whitening | 350 | 800 | 110 | |
| Tooth colored composite fillings | 200 | 500 | 25 | |
| Tooth cleaning | 100 | 300 | 75 | |
Cost Comparison – Hyderabad Vs United Kingdom (UK)
| Procedure | United Kingdom (USD) Approx | Hyderabad (USD) Approx |
|---|---|---|
| Open Heart Surgery | USD 18,000 | USD 4,800 |
| Cranio-Facial surgery and skull base | USD 13,000 | USD 4,500 |
| Neuro- surgery with Hypothermia | USD 21,000 | USD 6,800 |
| Complex spine surgery with implants | USD 13,000 | USD 4,600 |
| Simple Spine Surgery | USD 6,500 | USD 2,300 |
| Simple Brain Tumor -Biopsy -Surgery | USD 4,300 USD 10,000 | USD1,200 USD 4,600 |
| Parkinson’s – Lesion – DBS | USD 6,500 USD 26,000 | USD 2,300 USD 17,800 |
| Hip Replacement | USD 13,000 | USD 4,500 |
٭ These costs are an average and may not be the actual cost to be incurred.
RESEARCH METHODOLOGY
Objectives
- To study the factors which are attracting the International Patients to Hyderabad.
- To study the satisfaction level of International Patients
- To compare the cost of the treatment in Hyderabad with foreign Countries.
Data Collection
This study was conducted in a corporate multi-super specialty hospital at Hyderabad.
Primary Data – Primary Data is collected using methods such as interviews, questionnaires and observations of the admit patients in the study hospital for the year 2007 randomly.
Secondary Data – All methods of data collection can supply quantitative data (numbers, statistics or financial) or qualitative data (usually words or text). Quantitative data may often be presented in tabular or graphical form. Secondary data is data that has already been collected by someone else for a different purpose. For example-Data supplied by a marketing organization, Annual hospital reports, Government statistics.
Sources of Data Collection – Paper-based sources, Electronic sources, Official or government sources, Unofficial or general business sources.
Findings and Interpretations – Specialty wise International Patients Received Treatment in Study Hospital- (2007)
| Sr.No. | Specialty | No. of Patients |
|---|---|---|
| 1 | Cardio-Thorasic Surgery | 38 |
| 2 | Plastic Surgery | 49 |
| 3 | Ophthalmology | 58 |
| 4 | Gynecology & Obstetrics | 09 |
| 5 | Orthopedics | 68 |
| 6 | Surgical Gastroenterology | 38 |
| 7 | Laparoscopic Surgery | 49 |
| 8 | Health check | 60 |
| 9 | Kidney Transplant Surgery | 00 |
| 10 | Oncology | 62 |
| 11 | Dental | 32 |
| TOTAL | 463 |
From the above data we can say that the international patients are coming to Hyderabad to get the world class treatment at negligible cost without any waiting time by the world class western qualified and trained Doctors for the major health issues and tourism. There is more demand for Orthopedics, Ophthalmology, Plastic Surgery, Cardio-thoracic and Oncology Surgeries as these are the most expensive surgeries in their countries with more waiting time.
Nationality wise International Patients Received Treatment in Study Hospital (2007)
Nationality wise International Patients Received Treatment in Study Hospital (2007)
| Sr.No. | Country Name | Number Of Patients |
|---|---|---|
| 1 | NRI–USA | 31 |
| 2 | NRI-UK | 32 |
| 3 | KSA | 78 |
| 4 | UAE | 82 |
| 5 | Tanzania | 63 |
| 6 | Nigeria | 38 |
| 7 | Ethiopia | 53 |
| 8 | Kenya | 32 |
| 9 | Afghanistan | 12 |
| 10 | Uganda | 36 |
| 11 | China | 06 |
| TOTAL | 463 |
From the above data we can say that the Non-Residents-Indians from the developed world and from the Arab Countries and African Countries Hyderabad is getting good number of patients in all specialties. Patients are paying from their own pockets to escape from the diseases and the huge waiting time in their countries.
Satisfaction Level of International Patients Received Treatment in Study Hospital:
| Sr.No. | Services | Very Good% | Good% | Average% | Below Average% |
|---|---|---|---|---|---|
| 1 | Medical Treatment | 85.52 | 13.82 | 0.64 | 00.00 |
| 2 | Medical Services | 88.12 | 11.44 | 0.43 | 00.00 |
| 3 | Nursing Services | 88.76 | 10.58 | 0.64 | 00.00 |
| 4 | Patient Service | 88.33 | 11.23 | 0.43 | 00.00 |
| 5 | Administrative Staff | 83.80 | 14.90 | 1.29 | 00.00 |
| 6 | Food And Beverage | 77.75 | 21.16 | 1.07 | 00.00 |
| 7 | House Keeping | 85.74 | 13.17 | 1.07 | 00.00 |
| 8 | Over All Facilities | 87.47 | 11.66 | 0.86 | 00.00 |
| Total | 85.68 | 13.49 | 0.80 | 00.00 |
Interviews were conducted in the study hospital of the international Patients, who are treated and those under treatment, in the conscious state of mind. This reveals that 85.68% patients rated the services provided by the study hospital are very good, 13.49% patients rated the services provided by the study hospital are good, 0.80% patients rated the services provided by the study hospital are average, 0.00% patients rated the services provided by the study hospital are below average.
Conclusion
The following factors are attracting the international patients to Hyderabad-India for treatment and tourism
1) Cost Benefit:
The prime advantage is the cost savings with respect to medical consultancy or surgeries. Many of the Hyderabadi hospitals, serving international patients, have state-of-the-art infrastructure, highly educated doctors and top-notch services but the figure on that price tag is a fraction of what it would be in developed countries. Even if the patient’s insurance does not cover the costs of treatment in India, the final bill in an Indian hospital would most probably be lower than patient’s out-of-pocket expenses.
2) Timeliness:
Another advantage is the possibility of getting immediate medical attention. There are no waiting lists or delays to contend with, due to insurance issues or unavailability of doctors etc.
3) Quality Health Care:
Hyderabadi doctors and paramedics are well trained and are one of the best in the world.
4) Personalized Care:
Here patients are monitored closely with a personal care of all age group.
5) Technological Sophistication:
All the corporate Hospitals in Hyderabad are having State-of-the-art equipment and infrastructure for the best treatment and diagnosis.
6) Facilitation by Government:
The Government of India has recognized the economic potential of medical tourism. It has facilitated travel by introducing a special visa category known as ‘medical visa’ for patients as well as introduced tax incentives for hospitals.
7) Ease Of Travel and Communication:
Travel to Hyderabad (India) has become easier and much faster due to introduction of private airlines. Access to Internet in Hyderabad is considered to be one of the cheapest in the world and communication facilities are well established. Travel agencies have a great online presence and can offer you package deals that include travel costs, boarding as well as treatment costs.
8) Easy Availability of Medicine and Drugs:
Certified drugs and medicines are easily available in Hyderabad, at comparatively lesser prices.
9) Modern &and Traditional:
Modern medical aid as well as traditional therapy, such as Ayurveda, Yoga, Naturopathy etc, is available at different locations in Hyderabad.
10) Tourism Potential:
People, who come for relatively simple, but important procedures, can consider packing in some travel too, with their doctor’s permission! This is an added advantage. Every part of the country is rich in history and diverse in geography.
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Dr. Zuber Mujeeb Shaikh, PhD, MPhil, MDHM, MAHA, DHM, PGDMLS, BAMS;
Dr. Sulaiman Al Habib Medical Group-Riyadh-KSA
Dr. Gazala Khan MDMH,
Sancheti Institute for Orthopedics and Rehabilitation, Pune-India
