NARAYANA HRUDAYALAYA HEART HOSPITAL: CARDIAC CARE FOR THE POOR The Indian Health Landscape 2003: Indian Government spent approx 1% of its GDP on public health care {D overall expenditure on health — 5% of GDP (Asian average: 6.3%) (1.85% of the Indian population and 47% of children under 3 years of age didn’t receive enough nourishment ~ National Nutrition Monitoring Bureau 115,000 hospitals and 6,00,000 physicians — well equipped health care system Number of physicians per 1,000 population: 0.5 1.70% of doctors only in urban areas Government hospitals were underequipped and understaffedThe Indian Health Landscape SS 2003: (Less than 14% of the population was supported by health insurance Medical tourism: 1,50,000 foreign patients Y GHS would cost only $ 3,000 - $ 10,000 at the best Indian hospital as compared 9 $1,50,000 In the U.5 and $70,000 in UK 1.2.4 million people neaded heart surgery every year only 60,000 surgeries were performed each year Cl Approx 2596 of heart attacks occurred amang the under 40 population Around 2,24,000 newborns in India were affected by heart disease every year Present Scenario in Indian Health Care Industry LL Gi The indian healthcare sector is expected to reach US$ 100 billion by 2015 from the current US$ 65 billion, growing at around 20 per cent a year, according to rating agency Fitch Government is proposing an increase in public spending by half a percentage point to ‘make it 1.58% for the coming five years (2012-17) under the 12th Plan © Major factors driving the growth in the sector include : ¥ increasing population ¥ growing lifestyle related health issues ¥ Cheaper costs for treatment ¥ trust in medical tourism ¥ improving health insurance penetration ¥ increasing disposable income ¥ government initiatives Focus on Public Private Partnership (PPP) modelsPresent Scenario in Indian Health Care Industry A According to the Planning Commission's draft, the country’s government-run healtheare ‘system is short of the target by a jaw-dropping 76% There are 53% fewer nurses, specialist doctors are short by 887% 1 Radiographers are short by 85% and laboratory technicians are short by 80% According to union budget 2012-13, healthcare spending to be Increased from Rs.26,897 cr {to Rs. 30,702 er an increase of 14% 1 There are 12,760 Govt. hospitals having 5,76,793 beds in the country 6,795 hospitals are in rural area with 1,49,690 beds and 3,748 hospital are in Urban area with 3,99,195 beds A india has a total of 1,45,894 sub centers 23,301 PHCs and 4,510 CHCS there Is an 18% shortfall in PHCS, and an alarming 34% shortfall In CHES Present Scenario in Indian Health Care Industry “" Commune, aia porn Seana s According to the government's formula, we're supposed to one sub-centre for every 5,000 people (3,000 in hilly areas) one primary health centre for every 30,000 people (20,000 in hilly areas) one community health center for every 120,000 people (80,000 in hilly areas) According to the Global Atlas on cardiovascular disease prevention and control 2011, death rate due to ischemic heart disease (a condition which is characterized by reduced blood supply of the heart muscle) in India is 165.8 pper 100,000. Around 116.4 per 100, 000 people in India| die due to cerebrovascular diseasesAbout the Hospital 4 God's Compassionate Home 4. Situated in Bangalore, Karnataka Founded in 2001, by Br. Devi Shetty Aims at providing medical treatment to the oor 1 Vislon : “Affordable Quality Healthcare for the Masses Worldwide” Mission :“A dream to making quality healthcare accessible to the masses worldwide” © Around 40% ofall treatments were pediatric Wal-Martization of health care © Focused on volumes © Performed 19 OHS & 25 catherization procedures ‘everyday, almost & times the average at other Indian Hospitals 2 500 blood tests on a machine everyday, as compared to ‘other hospitals which run 2 tests on a machine © Negotiate better deals with suppliers- no long term, contracts 15 Took machines on monthly rent and paid for reagents used torun the machineWal-Martization of health care = 2 Management software which helped maintain "minimum inventory & quicker processing of tests © Used generic drugs which were 80% cheaper than ‘the market rate for similar medication © Spent only 22% ofits revenue on staff salaries © Doctors get fixed salary and not % of the revenue 2 Monitored funds on a daily basis- helped in planning Wal-Martization of health care = 15 Break even price for an Open Heart Surgery Rs.90,000~ adults “ s.1,30,000- children 19 Basic package including surgery & hospitalization charges: Rs. 1, 10,000 ~ cheapest in the country 1 Treatment and care same irrespective of general or private ward 1a Karuna Hrudaya: Financially constrained patients could pay Rs. 65, 000 for OHS and the rest will be paid by NH Narayana Hrudayalaya Trust: For patients who couldn't afford to pay anything, this trust would help them in getting funds via donations “ Never turn away a patient for lack of funds”Company Background Fact Sheet 25 acre area ¥ 2 storey housing ¥ Beds: 280 ¥ Operation Theatres: 5 ¥ Beds: 1,000 ¥ Operation Theatres: 24 ¥ Infrastructure to perform 50 heart surgeries dally ¥ Treat patients from 73 countries ¥ NH Group has 12 hospitals, 2 care centers and 5 upcoming hospitals Beds: 500 Operation Theatres: 10 ¥ Catherization Labs: 2 ¥ Open heart surgeries: 11,228 (half were pediatric) Surgeries: 4,276 (1,467 on children} ¥ Catherization procedures: 5,430 ¥ Cardiac surgeons & cardiologists: 90Heart Disease — 1B occurs when supply of blood te the heart stops ‘Methods to cure coronary heart disease: Saeed Beery ‘Aspropiasty Intelemedicine a surgeon or a specialist instruct another doctor who is operating the patient. Itis. basically used when a specialist is not able to reach and operate. When a general practitioner feels that a heart patient need for immediate treatment, s/he may use telemedicine ‘The state government planned to sponsor 29 more CCUs. Between 2001 and July 2004, the NH facility performed 9,591 tele-consultations and the CCUs hhad 4,077 inpatients Both NH and ATI started outreach campus for cardiac diagnosis and care, Each weekend, two buses were sent out to rural areas, up to 800 kilometers in order to give best possible help onsiteYeshasvini NH started 29 postgraduate courses. In 2005, collaborate with Indira Gandhi National Open University (IGNOU) and scheduled to affer Indias first diplama in cardiology. Dr. Shetty developed an Insurance program “Yeshasvini™ The team of NH Set up an insurance scheme or 1.7 millon farmers and their families in Karnataka Surgeries Angiogram ‘According to Dr. Shetty, they managed to reduce the cost of bone marrow transplant from Rs. 1.2 million (USD 27,000) to Rs. 400,000 (USD 8,900), this time they Used the blood which can’t be used for cardiac surgery after 10 days but can be used for transplant up to 26 days. According to Dr. Shetty our three line of business: » Heart hospital and associated activities > Yeshasvini insurance scheme > Finally Health CityUpdates > NH group of hospital have following hospitals: INH Institute of Cardiac Sciences, Bangalore, RTIICS NH, Kolkata, NH Multispecialty Hospital, Gangalore, Brahmananda NH, Jamshedpur, Mazumdar Shaw Cancer Center, Bangalore, NH Hospital, Hyderabad, MS Ramaiah NH, Bangalore, Narayana Hrudayalaya, Jaipur, Chinmaya NH, Bangalore, Rotary Narayana Hrudayalaya, Kolkata, SDM NH, Dharwad, NH Devraj Urs Hospital, Kolar > NH hospital comes in 010 best hospitals of Bangalore city The telemedicine network of the hospital connects to countries like Malaysia, ‘Mauritius and Pakistan > Narayane Hrudayalaya Dental Chain Started in 2008, NHDC has expanded to 25 dental clinics, 19 in Bengaluru and 6 in Kolkata > Bangalore-based Narayan Hrudayalaya Hospitals (NHH) which Is setting up Rs 600 cr. health city Updates rT ] > Soon they will implement the 300-bed health ‘are facility in eastern part of the city > Multispecialty hospital and cancer center > Proposed health city, Amadabad > They are planning to build low-cost heart hospitals across India with collective capacity of 30,000 beds in the next 5-7 years’ time ‘Sermon buanan stn con daceerenan natn sont ba ae)