A hospital is an institution for health care providing patient treatment by specialized staff and equipment, and often, but

not always providing for longerterm patient stays. Today, hospitals usually are funded by the public sector, by health organizations, (for profit or non-profit), health insurance companies or charities, Today, hospitals usually are funded by the public sector, by health organizations, (for profit or non-profit), health insurance companies or charities, including by direct charitable donations. In history, however, hospitals often were founded and funded by religious orders or charitable individuals and leaders. Similarly, modern-day hospitals are largely staffed by professional physicians, surgeons, and nurses, whereas in history, this work usually was performed by the founding religious orders or by volunteers. In ancient cultures, religion and medicine were linked. The earliest documented institutions aiming to provide cures were Egyptia Temples. In ancient Greece, temples dedicated to the healer-god Asclepius, known as Asclepieia functioned as centres of medical advice, prognosis, and healing. In the Asclepieion of Epidaurus, three large marble boards dated to 350 BC preserve the names, case histories, complaints, and cures of about 70 patients who came to the temple. Some of the surgical cures listed, such as the opening of an abdominal abscess or the removal of traumatic foreign material, are realistic enough to have taken place. The worship of Asclepius was adopted by the Romans According to the Mahavamsa, the ancient chronicle of Sinhalese royalty, written in the sixth century A.D., King Pandukabhaya (fourth century B. C.) had lying-inhomes and hospitals (Sivikasotthi-Sala) built in various parts of the country. This is the earliest documentary evidence we have of institutions specifically dedicated to the care of the sick anywhere in the world. Mihintale Hospital is the oldest in the world. Ruins of ancient hospitals in Sri Lanka are still in existence in Mihintale, Anuradhapura, and Medirigiriya

The Romans created valetudinaria for the care of sick slaves, gladiators, and soldiers around 100 B.C., and many were identified by later archaeology. The adoption of Christianity as the state religion of the Roman Empire drove an expansion of the provision of care. The First Council of Nicaea in 325 A.D. ordered the construction of a hospital in every cathedral town. In the medieval Islamic world, the word "bimaristan" was used to indicate a hospital establishment where the ill were welcomed, cared for and treated by qualified staff. Medieval hospitals in Europe were religious communities, with care provided by monks and nuns. The first hospital founded in the Americas was the Hospital San Nicols de Bari [Calle Hostos] in Santo Domingo. This hospital apparently incorporated a church. In the modern era, hospitals are, broadly, either funded by the government of the country in which they are situated, or survive financially by competing in the private sector (a number of hospitals also are still supported by the historical type of charitable or religious associations). Nowadays, the health care industry is one of the largest and fastest-growing industries. Consuming over 10 percent of gross domestic product of most developed nations, health care can form an enormous part of a country's economy. The healthcare industry includes the delivery of health services by health care providers. The structure of healthcare charges can also vary dramatically among countries. For instance, unlike the United States, Chinese hospital charges tend toward 50% for drugs, another major percentage for equipment, and a small percentage for healthcare professional fees. There are many ways of providing healthcare in the modern world. The most common way is face-to-face delivery, where care provider and patient see each other 'in the flesh'. This is what occurs in general medicine in most countries. However, healthcare is not always face-to-face; with modern telecommunications technology, in absentia health care is becoming more common. This could be when practitioner and patient

communicate over the phone, video conferencing, the internet, email, text messages, or any other form of non-face-to-face communication

HOSPITAL INDUATRY IN INDIA India has a long history of organized health care. Before the advent of European medicine, families of practitioners of indigenous systems like Ayurveda handed their traditions from generation to generation. King Ashoka is said to have founded at least eighteen hospitals ca. 230 B.C., with physicians and nursing staff, the expense being borne by the royal treasury. In this modern era, the healthcare industry comprises hospital and allied sectors, is projected to grow 23 per cent per annum to touch US$ 77 billion by 2012 from the current estimated size of US$ 35 billion. The sector has registered a growth of 9.3 per cent between 2000-2009, comparable to the sectoral growth rate of other emerging economies such as China, Brazil and Mexico. The growth in the sector would be driven by healthcare facilities, private and public sector, medical diagnostic and path labs and the medical insurance sector. Healthcare facilities, inclusive of public and private hospitals, the core sector, around which the healthcare sector is centered, would continue to contribute over 70 per cent of the total sector and touch a figure of US$ 54.7 billion by 2012 Hospital industry is an important component of the value chain in Indian Healthcare industry. The size of the Indian healthcare industry is estimated at Rs. 1,717 billion in 2007. It is estimated to grow by 2012 to Rs. 3,163 billion at 13% CAGR. The private sector accounts for nearly 80% of the healthcare market, while public expenditure accounts for 20%. Newfound prosperity of many Indian households is spurring demand for high-quality medical care, transforming the healthcare delivery sector into a profitable industry. Medial tourism is changing the face of traditional healthcare industry in India. Indias excellence in the field of modern medicine and its ancient

methods of physical and spiritual wellbeing make it the most favorable destination for good health and peaceful living. Indias cost advantage and explosive growth of private hospitals, equipped with latest technology and skilled healthcare professionals has made it a preferred destination for medical tourism. COMPETITIVE LANDSCAPE Demand for hospital services is driven by demographics and advances in medical care and technology. The profitability of individual companies depends on efficient operations, since many hospitals offer similar services. Large companies have advantages in buying supplies, sharing best practices, and negotiating contracts with health insurers. Large hospitals may offer a wider variety of services. Small hospitals can compete successfully by serving a limited geographical area or offering specialized services. Hospitals are labor-intensive: annual revenue per employee is close to $100,000. PRODUCTS, OPERATIONS & TECHNOLOGY Major services include in-patient hospital care (55 percent of industry revenue) and outpatient services that typically don't require an overnight stay (30 percent). Other sources of revenue include prescription drug sales, ambulatory surgeries, and contributions from private donors, nonprofit foundations, and the federal government. On average, close to 60 percent of hospital revenue comes from in-patient services, and 30 percent from outpatient. Most hospitals provide general medical and surgical care, but about 20 percent provide special services such as for psychiatric illnesses or substance abuse. Hospitals can be government- or privately-run, either by a charitable organization or a for-profit corporation. Around 60 percent of hospitals are non-governmental general medical and surgical hospitals, accounting for 75 percent of total industry revenue. A traditional view is that improvements in health result from advancements in medical science. The medical model of health focuses on the eradication of illness through

diagnosis and effective treatment. In contrast , the social model of health places emphasis on changes that can be made in society and in peoples own lifestyles to make the population healthier. It defines illness from the point of view of the individuals functioning within their society rather than by monitoring for changes in biological or physiological signs In India, the hospitals are run by government, charitable trusts and by private organizations. The government hospitals in rural areas are called the primary health centre (PHC) s. Major hospitals are located in district head quarters or major cities. Apart from the modern system of medicine, traditional and indigenous medicinal systems like Ayurvedic and Unani systems are in practice throughout the country. PHCs are existent in most places, due to poor pay and scarcity of resources. Patients generally prefer private health clinics. These days some of the major corporate hospitals are attracting patients from neighboring countries such as Pakistan, countries in the Middle East and some European countries by providing quality treatment at low cost. There are a number of challenges faced by this industry ranging from competition from other developing countries like Singapore & Malaysia to unhygienic standards outside hotels and hospitals resulting in common infections. For the hospitals therefore the key issues is marketing the concept of medical tourism to the developed countries, providing quality services both pre operative, post operative and the other incidental services which are provided along with the treatment. Innovative ideas like offering a total package which includes medical services plus tourism packages are the key areas for success. Health care in Kerala Kerala has made remarkable achievements in health almost comparable to that of even developed countries. The widely accepted health indicators like crude death rate, infant mortality rate, and life expectancy evidence this. Most analysts have seen Keralas achievements in health as something of an enigma. Keralas achievements in health in spite of its economic backwardness has prompted many analysts to talk about a

unique Kerala Model of Health, worth emulating by other developing parts of the world. Kerala can be said to have made the transition from a society with high population growth rate, high crude death rate, and high infant mortality rate to one with moderate population growth rate, low crude death rate, and relatively low infant mortality rate. Another disturbing trend is that the Public Health System is getting alienated from the people and only 50% of the people even from the lower income group seek medical help from the Government hospitals. This is because of the fall in the quality of services at the Government hospitals. Apart from Modern Medicine, Ayurveda, Homeopathy, and other alternative systems are also very popular in Kerala. However, the widely acclaimed Kerala Model of Health has started showing a number of disturbing trends recently. Another disturbing trend is that the Public Health System is getting alienated from the people and only 50% of the people even from the lower income group seek medical help from the Government hospitals. This is because of the fall in the quality of services at the Government hospitals. Comparison of the infrastructure and health manpower development in the private and public sectors confirms the supremacy of the private sector in the state. The number of beds in the government institutions grew from around 36000 to 38000 in the 10-year period from 1986 to 1996, whereas in the same period, beds in private institutions grew from 49000 to 675000. This amounts to nearly 40% growth in the private sector beds in a period of 10 years as against nearly 5.5% in the Government sector. In the case of doctors about 5000 doctors work in the government sector whereas double the number work in the private sector. Because of the irregular supply of medicines and other materials, one patients seeking medical care from the government hospitals are forced to buy them from outside. Also the laboratory facilities are quite inadequate in the government hospitals and patients have to depend upon the private labs for getting investigations done in time.

In short, the important aspects of the present health Scenario in Kerala is: The simultaneous presence of the diseases of poverty and the diseases of affluence

or life style diseases. The decay of the public health system. The uncontrolled growth of the private sector. Escalation of health care cost. Marginalization of poor

Kerala is reputed for its high quality health care infrastructure and renowned medical personnel. Kerala, the "God's own country" is a major medical tourism destination in India. The Medical charges in Kerala is also competent so that people from other states, across the borders and from all parts of the world come here for the treatment of various health conditions which does not need an immediate emergency treatment. A patient can do his or her medical treatment in Kerala at a fraction of the cost that it is done in any other parts of the world. Medical tourism is a thriving activity in Kerala with huge employment potential.

HOSPITAL PROFILE
"Compassion for the world and devotion to God are not two but one; they are two faces of the same Truth. A true devotee is one whose legs rush to comfort the suffering ones, whose hands yearn to give solace to the sorrowful, whose eyes shed tears of compassion, whose ears listen to the woes of the distressed, and whose words bring relief to the ones in pain." - Mata Amritanandamayi Devi Mata Amritanandamayi Devi or AMMA is affectionately known in India and around the world, as an inspirational example of living a life of selfless service to others. She is dedicated to uplifting those in need with shelter, medical relief, educational assistance, vocational training as well as financial and material support. In the past 30 years, AMMA has physically embraced and blessed more than 24 million people. AMMAs compassion crosses all barriers of nationality, race, caste and religion. She has initiated and inspired a vast network of charitable activities which is drawing attention throughout the world. At the root of this services lies AMMAs teaching that the divine exists in everything, in every person, plant and animal. On the 17th of May 1998, Amrita Institute of Medical Science and Research Centre (AIMS), was inaugurated by the then Prime Minister of India, Shri Atal Bihari Vajpayee, in the presence of Her Holiness, Sri Mata Amritanandamayi Devi. The Amrita Institute of Medical Sciences is the adjunct to the term new universalism coined by the World Health Organization. AIMS humanity. Amrita Institute of Medical Science and Research Centre is one of the most sophisticated Multi super specialty hospitals in India. The hospital was build on Mata Amritanandamayi Devis aspiration to create a hospital ,where all could get the best is dedicated to the service of

medical care possible from highly skilled physicians and supporting staff in an atmosphere of love and compassions. The Amrita Institute of Medical Sciences and Research Centre was established to provide affordable medical care in a patientfriendly atmosphere and in a spirit of compassion, previously beyond the reach of the common man. AIMS is a 1200 bed, charitable, super specialty hospital, equipped with state oftheart medical facilities. AIMS provide dedicated patient care and endeavor to improve its services on a constant, ongoing basis. Patient care is enhanced by a fully computerized and networked hospital information system (HIS) and a fully digitized Radiology Department. AIMS extensive infrastructure comprises of 22 modern operating theatres, 172 well equipped Intensive Care beds, a well advanced Molecular Biology and cytogenetic labs and a state- ofthe- art diagnostic imaging centre. The full range of primary and specialty care medical services provides cross specialty consultation, which assures outstanding treatment for each patient. AIMS' infrastructure comprises a reference diagnostic clinical laboratory including molecular biology and cytogenetic labs, a diagnostic imaging centre, a medical, dental, and nursing college, a pharmacy school and research facility, a computerized and networked hospital information system and radiology department. AIMS Mission The institutes mission is to provide outstanding and affordable medical care in a patient friendly environment and in a spirit of compassion to all, regardless of race, caste, religion etc. AIMS is a non-profit organization dedicated to establishing a center of excellence in health care and improving the well-being of the community through quality programs of preventive medicine, medical education and research. Modern medical technology and equipment are effectively integrated in a patientoriented environment to diagnose and treat complex medical problems. In the near

future, it is anticipated that AIMS will help to raise the medical standards in India as other hospital follow suit and modernize their equipment and techniques. AIMS seeks not only to relieve the immediate suffering of those in need, but to also pursue longrange solutions to the endemic health problems of the region. AIMS Philosophy The philosophy of AIMS is to offer free medical care to the truly poor with no financial alternative, extend highly concessional rate to those of limited means, and modestly charge those who are in a position to pay, underscoring the commitment to bring affordable health care to everyone. The rates charged are well below those prevailing for corresponding medical services elsewhere. HOSPITAL OPERATIONS AND SERVICES AIMS has a dedicated team of physicians, nurses and other health care professionals who provide an extra ordinary level of knowledge ,skill and compassion to every patient they serve. They welcome patient from all over the world and do their best to ensure the greatest patient comfort while providing outstanding comprehensive care. The major Specialties of the hospital include: 1) HEART INSTITUTE 2) ADULT CARDIAC SERVICES- Adult cardiology Adult Thoracic & Cardiovascular Surgery

3) PEDIATRIC CARDIAC SERVICES- Pediatric Cardiology Pediatric Thoracic & Cardiovascular Surgery Congenital Heart Surgery

4) CANCER INSTITUTE

Medical Oncology Surgical Oncology Radiation Oncology Pain and Palliative Care

5) NEUROSCIENCES INSTITUTE 6) NEPHROLOGY DEPARTMENT 7) EMERGENCY CARE 8) ENDOCRINOLOGY DEPARTMENT 9) EYE INSTITUTE 10) ANAESTHESIOLOGY DEPARTMENT 11) DERMATOLOGY DEPARTMENT

THE OTHER CLINICAL SERVICES INCLUDE Digestive Diseases Gastroenterology Gastro Intestinal Surgery Ear, Nose and Throat (ENT) Geriatrics Head and Neck Surgery Infectious Diseases Info Technology Integrated Medicine

Internal Medicine Laboratory Medicine Metabolic Medicine Molecular Biology Neonatology Nuclear Medicine Orthopedics Organ Transplants Pediatrics Pediatric Surgery Pharmacology Pulmonary Medicine Radiology Telemedicine Toxicology Urology Vascular Surgery

OTHER SUPPORT SERVICES INCLUDE Nursing Service Medical record Department Hospital Information System

Marketing Materials Purchase HRD

CLINICAL SUPPORTIVE SERVICE Biomedical Central Sterile Supply Department (CSSD) Dietary Medical Records Medical Social Work Medical Transcription Medical Library Physiotherapy Patient Movement Services House Keeping Laundry Custodial

Community service outreach programmes AIMS has won claim for its highly sophisticated surgical and diagnostic capabilities. Now many departments are being appreciated for their role in providing free or low cost community based programmes and medical camps. Out reach medical services, health awareness campaigns, and projects for the poor in the remote parts of Kerala

ensures that AIMS facilities reach the wider community of Kerala. The community service programmes include: Curable Blindness Camps Amrita Mobile Medical Assistance Camps Amrita Diabetes Welfare Society Free Cleft Lip Surgery Screening Camps Palliative Home Care Services Disaster Response Team Rural Medical Clinics Telemedicine support to remote medical facilities Emergency Medical Services Significantly Reduced Cost of Free treatment for poor patients

DEPARTMENTS IN DETAIL Corporate Office Under the guidance of the Directors, performs planning, direction and coordination of the operational, financial and personal activities for all the clinical departments within the hospital .Performs variety of tasks related to overseas purchases and co-ordinates the purchase of capital equipments from abroad. Performs all Human Resources related functions of Physicians. Marketing Plans, schedules and directs marketing efforts towards increasing patient turnover to the hospital. Medical Administration

Functions include Patient bed allotment, segregation and pricing, patient complaint handling and co-ordinating medical conferences. Besides departments of Emergency Services and Trauma Care, medical Transcription, ECG, CSSD, Physiotherapy, Dietary and Medical Social Work are under the direct supervision of the Medical Administrators. Admitting and Patient Services Finance Assists in providing financial help and guidance to patients belonging to the lower income category. Determines their eligibility for concession/ free treatment. Interacts with the concerned specialty and arranges for obtaining date for procedure/ surgery, depending on the patients clinical condition. Finance Computes the actual costs of various medical procedures carried out at the Hospital on a continuous basis , prepares MIS Reports, performs confidential payroll function, general accounting and insurance matters provides information relating to tariff and advance payments to patients obtains financial undertakings from patients and checks and finalizes the in patient bills. ISO Researches, interprets and communicates the ISO requirements to all levels of personnel in the organization. Ensures that all the processes in the Hospital adhere to the ISO Standards Purchase Purchases all required material at lowest cost, consistent with approved quality and delivering standards. Materials

Organizes and maintains storage of materials. Ensures uninterrupted supply of required material to all the departments by maintaining an optimum inventory level. Accepts delivery of all incoming goods to the hospital.

Public Relation Appointment Help Desk -Guides the patients in identifying the specialty/ department and schedules appointments accordingly. Registration-Helps the patients with the registration formalities and facilitates their movement to different departments in an efficient, customer focused manner. OP Counter- Receives patients and facilitates patients to see the doctors. IP Admission- Receives patients and admits them in respective wards under different doctors. Catering Services Prepares and cooks food, performs quality checking, dispatches and serves food for patients and by- standers on time. The department also provides employee canteen services. Pharmacy Amrita pharmacy has 110 sub-store including IP & OP Pharmacy and 24 hour Pharmacy. IP Pharmacy supplies medicines and other materials for the in-patients and the OP Pharmacy caters to the needs of the OP patients. IT Services The department comprises of Computer Department, Telephone Exchange and Telephone Operator Section who caters to all the IT requirements of the hospital. AIMS features one of the most advanced hospital computer networks in India. AIMS

have computerized nearly every aspect of patient care including all patient information, lab testing and radiological imaging. The hospital network supports more than 600 computers. Insurance Administers the Medical Insurance Scheme Details of Medical Insurance Scheme will follow. Facilities Performs the maintenance of all Engineering Services in the Hospital, including Electrical, mechanical, Civil (masonry, carpentry plumbing etc.) maintenance. Responsible for the operation and maintenance of Medical Gas systems, Boilers, Compressors, HVAC Systems, Power Plant, Automation, Lifts, etc. Nursing AIMS has an organized nursing department that is administratively and functionally structured for the provision of high quality nursing service with compassion; encompassing curative, restorative, and preventive aspect of nursing by aiming at the development of optimal professional conduct Human Resource Department The Human Resource Management is concerned with the development of people at work. The Human Resource Department deals with the management function of recruitment, training and development of organization members. In AIMS there are two Human Resource Department. One caters to the need of doctors and Senior Executives, which is located in the corporate office headed by Medical Director. The other Human Resource Department caters to the requirement of all other employees other than the doctors and senior executives; this is headed by the General Manager. This department performs functions like Manpower Planning, Recruitment, Training, Industrial Relations, Wage & Salary Administration, Employee Welfare and other connected activities of Non-Physicians category.

SERVICE MARKETING
1) Marketing strategies adopted by the Org.

Hospital marketing is a specialized field that deals with connecting patients, physicians, and hospitals in mutual relationships. AIMS is a not-for-profit, specialty hospital and teaching campus providing state-of- the -art compassionate health care to patients from India and around the world. Amrita Institute of Medical Science and Research Centre is one of the most sophisticated Multi super specialty hospitals in India. Because of nonprofit hospitals' charitable contribution to communities, the great majority of these nonprofit hospitals deserve their tax-exempt status. In order for them to maintain this status, hospitals must promote their charitable image in the community. The hospital that is successful in promoting this image will benefit in several ways: 1. The citizens of the community will look on the hospital in a favorable light. 2. The local and state government officials will not feel compelled to vigorously pursue hospital tax dollars. 3. Those people in the community who need charity care will know of its availability. 4. New taxing legislation is less likely to be passed if the legislators know that their public is well educated on the benefits the hospitals provide. Over the years, the image of the hospital has become that of a business rather than that of a charitable service organization. The public has been inundated with information by the media on the business of healthcare rather than the social service role of the hospital. In order for nonprofit institutions to survive, they will need to communicate otherwise the public will remain ignorant, and the repercussions could be disastrous. 2) Service blueprint. Service blueprinting is defined as a tool for simultaneously depicting the service process, the points of customer contact, and the evidence of the service from the customers point of view. The proposed blueprint allows for a quantitative description of critical service elements, such as time, logical sequences of actions and processes,

also specifying both actions/events that happen in the time and place of the interaction (front office) and actions/events that are out of the line of visibility for the users, but are fundamental for the service. The sequential procedure for the service blueprint for AIMS hospital is
1) Patient goes to the main Reception desk and gets an OPD (Out Patient

Department) card after the registration process. 2) Depending on the complaint, patient is referred to the specialty department 3) Patient meets the receptionist of the specialty department and specialty department OPD is made 4) Patient is sent to a Consulting room 5) Patient is sent to a consultant/Intern or Post Graduate attend to the patient 6) Complaints are noted down and patient is sent to Examination room 7) PG and consultant discuss on the complaints mentioned and probable examinations to be made is decided 8) Patients total body examination is done by specific priority to area of complaint and vital signs are also noted down. 9) PG and Doctor make a provisional diagnosis 10) Required investigations are prescribed
11) If necessary, he will be admitted there and the further procedures for admitting

will be done. If patient is not willing to continue then his provisional diagnosis becomes his final diagnosis for the hospital. 12) If the Patient agrees for the treatment then patient is directed to concerned laboratory 13) At Lab a staff collects the OPD card from patients and conducts the test mentioned.

14) The test results are directly sent to the Consultant 15) Final diagnosis is done and treatment is prescribed 16) If he is an admitted patient, after the necessary treatments and care, he is discharged from the hospital.
17) Patient is given up a follow date.

18) Patient comes back on the specified date and meets the consultant 19) Consultant again checks the patient and if any other tests then it is noted on the OPD. If patient has recovered then also it noted on the OPD. 20) The patient is able to use the OPD card at their every visits.
3) Delivery of services through additional P?

1) People In hospitals, the marketing mix variable people includes all the different people involved in the service providing process (internal customers of the hospitals) which includes doctors, nurses, supporting staff etc. The earliest and the best way of having control on the quality of people will be by approving professionally sound doctors and other staff. Hospital is a place where small activity undertaken can be a matter of life and death, so the people factor is very important. AIMS is taking very much effort to take care the needs of their people. 2) Physical evidence It does play an important role in health care services, as the core benefit a customer seeks is proper diagnosis and cure of the problem. For a local small time dispensary or hospital physical evidence may not be of much help. AIMS is using physical evidence for distinguishing itself as something unique.

Physical evidence can be in the form of smart buildings, logos, mascots etc. a smart building infrastructure indicates that the hospital can take care of all the needs of the patient. Three Aspects of Physical Evidence are: Ambient Factors: Smell in the hospital, Effect of Colors used on walls Design Factors: Design of the rooms, plush interiors, ICU location, etc. Social Factors: Type of Patients that come to the Hospital 3) Process It is the way of undertaking transactions, supplying information and providing services in a way that is acceptable to the consumers and effective to the organizations. Since service is inseparable, it is the process through which consumers get into interaction with the service provider. Process generally forms the different tasks that are performed by the hospital. The process factor is mainly dependent on the size of the hospital and kind of service it is offering. 4) Productivity and quality RELIABILITY ASSURANCE Ensuring that Doctors are well trained and experienced Trust, the number of successful treatments

TANGIBLES EMPATHY RESPONSIVENESS

Gate of bldg, surrounding area, Surgery equipments, Rooms Courtesy shown by nurses, ward boys etc Emergency responsiveness

5) Pricing and promotional efforts of the Organization.

They are offering free medical care to the truly poor with no financial alternative, extend highly concessional rate to those of limited means, and modestly charge those who are in a position to pay, underscoring the commitment to bring affordable health care to everyone. The rates charged are well below those prevailing for corresponding medical services elsewhere. The communication is a key marketing activity that enables the organizations to achieve many of its marketing goals. Events, both indoors and out-reach programs, play a significant role in marketing of AIMS. Continuous medical education, awareness sessions for general public, check-up camps for public, organizing events on various health days, conducting interviews of specialists on visual media, informative and interactive website, printing and making readily available various emergency or appointment numbers are the commonest marketing tools. Aims free service activities are main communication element to the community. 6) Guarantee customization, service recovery and retention. They are trying to treat each patient individually. They have several medical departments to take care of their patients individually according to their needs and disease. Super deluxe rooms are available for patients who need more facilities and comforts and who can pay more. But they make it sure that each and every patients are getting same care and consideration from their side. They are ready to address their problems at any time. An organization's ability to correct service errors is an important factor in achieving success in today's service economy. Service recovery is an important section at aims which need a lot of improvement. Even though there are complaint boxes and information centers, patients are not so satisfied with its administration. Due to the quality of medical services provided by aims, they have lot of patients each day. Patient satisfaction is the important factor of retention. They are giving training and education for all their staff to give their best to patients. Each patient will get a

card having details of their name, department, MRD No. etc., at the time of registration. This card can be used for their entire visit to aims. History of each patient is saved in a centralized computer system. So a medical practitioner is able to get history of a person who is already a patient of aims

7) Segmentation, Positioning and Differentiation strategies by the Org.

Amrita Institute of Medical Science and Research Centre is one of the most sophisticated Multi super specialty hospitals in India. The hospital was build on Mata Amritanandamayi Devis aspiration to create a hospital ,where all could get the best medical care possible from highly skilled physicians and supporting staff in an atmosphere of love and compassions. Thus the target customers are the people who need help to improve their health. They have a lot of patients from both inside and outside India. A market is composed of different users having different responses to market offerings. This makes it essential that hospital organizations, especially for making a microscopic study of users needs and requirement, make possible grouping of markets. The marketing strategy formulated on the basis for segmenting the market is income. To some extent regional considerations may also be adopted as a base for segmenting the market. The below is the segmentation on the basis of regional consideration:

Regional Segmentation

Rural Users

Urban Users

Educated Illiterate Poor Rich

Educated Illiterate Poor Rich

The aforesaid segmentation makes it clear that doctors would find a variation in the living habits of both the segments. Another important base for segmenting hospital services may be income group. This helps the hospital in identifying the status of the users of services. It is essential as the marketing principles recommend different pricing strategies on the basis of level of income.
Segment

No- Income

Low - Income

Middle- Income

High -Income

This would help the hospital in charging more from high and middle income groups, charging equal to cost from the low income group and making available free services to the no income group. Another important advantage of this segmentation is concerned with implementation of modernization and expansion plan for the hospitals.

Non-profit organizations usually benefit from being widely known in society. A nonprofits first task in competing for donations is becoming well-known to the community it serves. People are bombarded with commercial marketing messages throughout the day. Nonprofit marketers must define their organizations in this clutter of information. In the case of aims, it is well-known in the community. They welcome patient from all over the world and do their best to ensure the greatest patient comfort while providing outstanding comprehensive care. Their patients are mainly from Kerala. They have a lot of international patients also. Once the npo is known, the next task is to influence the publics perception of the organization. Positioning refers to implementing marketing activities aimed at influencing the publics perception of the NPO, that is, developing a specific image of the NPO in the mind of the public. In the case of aims people have a very favorable attitude towards aims. As aims is a part of the amrita charitable trust, it got an image like an affordable hospital for common man. Their free and charitable services, bring its presence to poor peoples mind. The philosophy of AIMS is to offer free medical care to the truly poor with no financial alternative, extend highly concessional rate to those of limited means, and modestly charge those who are in a position to pay, underscoring the commitment to bring affordable health care to everyone. The rates charged are well below those prevailing for corresponding medical services elsewhere. Modern medical technology

and equipment are effectively integrated in a patient-oriented environment to diagnose and treat complex medical problems The major differentiating factor of aims is its quality of service. AIMS has a dedicated team of physicians, nurses and other health care professionals who provide an extra ordinary level of knowledge ,skill and compassion to every patient they serve. They welcome patient from all over the world and do their best to ensure the greatest patient comfort while providing outstanding comprehensive care. 8) Measuring customer satisfaction measures and analysis. Developing strong patient relationships with high level of satisfaction is challenging but it is a realistic goal. The lessons learnt provide fresh insight into our approach with patient handling and lead us to a greater understanding of patients needs and increasing expectations. Majority of our physicians have confirmed in Amrita that patient satisfaction pays, economically and clinically. It solidifies loyalty and compliance, attracts new patients and can improve practice productivity and efficiency. We believe that quality service is not a fad but a long-term reality that directly affects medical care, patient outcome, and the success of institution. The claim for the measure of satisfaction may be final common pathway for all health care outcomes. Over a life time, patient expectations of health care may change dramatically. Some patients may place more emphasis on technical competence where as others; fulfillment of personal needs, comfort, dignity and supportive services will be of paramount importance. Understanding how things look through the patients eye should be central part of any quality improvement programme. Patient satisfaction is sometimes treated as an outcome measure i.e. satisfaction with health status following treatment and sometime as a process measure, i.e. satisfaction with the way in which care was delivered. At Amrita Institute of Medical Sciences, satisfaction ratings reflect three variables

1) the medical service quality 2) the hospital facilities 3) hospital administration effectiveness.

Patient satisfaction surveys were taken periodically to determine the service gap between the expectation and delivery of services. They are taking this measure seriously and using it for giving training and other quality improvement programmes.