Public or private, patient-centric care is non-existent in India
What do we mean by patient-centric systems? These are indicators that tell us whether patients are getting better. These parameters are based on the premise that no matter how much money is spent per patient, the chances of getting better will still remain low if some basic things are not taken care ofopinion Updated: Aug 30, 2017 17:29 IST
Every time there is a serious crisis in a State-run health facility, there is always a lot of discussion on how India is not spending enough on the sector. But this conversation does not focus on one critical aspect that needs to be fixed: The importance of patient-centric healthcare. At present, the country’s healthcare system is geared towards the needs of hospital managements and pharmaceutical companies. There is hardly any concern about doctors and other healthcare providers, and more importantly on curing a patient. Surprisingly, even patients do not take cure as an important matter till they have a bad experience.
What do we mean by patient-centric systems? These are indicators that tell us whether patients are getting better. These parameters are based on the premise that no matter how much money is spent per patient, the chances of getting better will still remain low if some basic things are not taken care of. For example, do hospital OTs have elbow-operated taps? Are there separate places for keeping medicines with similar-sounding names? Are equipment serviced and calibrated regularly? Do care-givers wash their hands? It is only when these things are followed scrupulously, the per patient expenditure made by the State becomes important.
How does one ensure the creation and existence of a patient-centric system? The only way to do so is by following protocols, by maintaining data within the patient care facility along all parameters of the protocol and reviewing them constantly. In India, these protocols are not followed because there is no law that compels the healthcare facilities to keep track of such data or to learn from it. Those few that do, report improvements in their abilities to cure patients. In the absence of laws, only expenditure-income data is maintained and the effort to create positive results revolves only around this data.
It will be too naive to focus only on the amount of money spent and the numbers of patients treated. So, why is there such persistent refusal to consider patient outcomes as an important parameter to judge the quality of health care? Is it possible that there is a fear that this would expose system-wide deficiencies? Is there a fear of discovering that even the five-star facilities that charge millions are no different in quality of care than the free-for-all public facility?
Meeta Rajivlochan is an IAS officer. M Rajivlochan is director, internal quality assurance cell, Panjab University, Chandigarh. The views are personal