“A COMPARATIVE STUDY TO ANALYZE THE CHOICE FOR

UTILIZE PUBLIC OR PRIVATE HEALTHCARE SECTOR OF

GANDHINAGAR RESIDENTS”

BY:
Ms.POOJA SHROTRIYA
000FSMSHA1718016
Master of Hospital Administration , Sem - IV
Institute of Forensic Science
GFSU, Gandhinagar
 ABSTRACT
• By the time of independence, usage of private sector in
India was around 15%, while in a recent study of World
Bank, this usage is increased up-to 80%.
• In order to understand the preference of hospitals of
ailing persons, we have used primary data collecting
during DECEMBER, 2018 – MARCH, 2019 in different
areas of Gandhinagar city.
• During this survey around 300 civilians have
interviewed from different area of the Gandhinagar
city.
• As per geographic characteristics of Gandhinagar , rural
population is more compare to urban population .
• We found that most of the urban civilians are willing to
pay for health as they have understood the value of life.
• On the other side, rural civilians are more in numbers,
in which I found lack of awareness towards their health.
• Also I found that they are forced to utilize the
government healthcare sector because of their
financial affordability.
 INTRODUCTION
• The public hospital is always become best option to get treatment even for poorest
person .
• While private hospital provides proper medical services and standardize healthcare
but at the same time it’s also recovering highest charge from the consumers
• Dhar mentioned that public health system will now need to face comparison with
private hospitals to attract patients.
• Duggal mentioned that private hospitals are classified with for profit and not for profit
ownership.
• The traditional health sector used to provide low cost treatment without
prescriptions. Most of those consumers believe in worship of God instead of
prescribed medicine.
• Practitioners of public hospitals are indirectly used to ask money as kindness to
patients
• Very big lacunas were found in the usage of public versus private hospitals in India.
• Thus, present study has been conducted with two specific objectives - to analyze the
choice for utilize the healthcare sector of Gandhinagar residents and factors that
affecting their choice.
 SCOPES OF THE STUDY
• As per the geographical characteristics, this city is
having more population in rural compare to
urban.
• So, Providing adequate, timely and cost effective
health care services to such a huge ailing
population from rural is a challenge indeed.
• This requires a comprehensive and well planned
health policy that can co-ordinate the plans and
programmes of the various public health care
providers in India.
OBJECTIVES OF THE STUDY
Differences in
healthcare
facilities &
standards
Draw
attention of
Expenditure
policy maker
pattern of
towards gaps
rural residents
in public
for health
healthcare
system OBJECTIVES

Problems
during
factors
utilization of
affecting
public
preference
healthcare
sector
METHODOLOGY
 RESULTS
SAMPLES COLLECTED FROM GANDHINAGAR CITY

60 60
VAVOL
PETHAPUR
BORIJ
60 60 SECTOR 16
INFOCITY

60
SOCIO-ECOMONIC BACKGROUND OF
THE RESPONDENTS
 GENDER AGE

18 - 25
22%
31% YEARS
138 FEMALE 26 - 35
162 MALE YEARS
Above 35
44% years

QUALIFICATION No schooling
SALARY Below 10,000 INR
3.66% Primary
7.33%
schooling
SSC
27.33% HSC 38.34% 44.33% Between 10,000 - 20,000
INR
33% Graduation
16.33%
Post
7% graduation 17.33%
Doctorate Above 20,000 INR
5.66%
General Findings about the Respondents
and their Accessibility of Health Services

Frequency of Visit Tendency to Avoid

to Doctor or Treatment on
Hospitals Falling Sick

Considerations for
Primary Source of
selecting a
Treatment on
healthcare sector
Falling Sick
for Treatment
 RESIDENCIAL AREA

130 Rural
Urban
170

SELECTION OF HEALTHCARE SECTOR

3%

Private
42% Public
55% Trust
 FACTOR THAT INFLUENCE MOST TOWARDS THE SELECTION OF
THE HEALTHCARE SECTOR

11
12 Cost
21
Quality
15

128 Infrastructure

Doctor's Recommondation

Past experiences

113
Reputation of the healthcare
sector
100%
93%
90% 85% Satisfaction level
81% on infrastructure
80% 77%

70%

60%
52%
50% 45% Satisfaction level
42% on Cost
39%
40%

30%
23%
20%

10% Satisfaction level

on Quality of care
0%
Public Private Trust
 Key factor : Infrastructure
100%
91%
90% 87%
83%
79% Public
80%
70%
60%
50%
40% 36% 37%
32% 31% 33% Private
29% 29%
30% 23%
20%
10%
0%
Satisfaction level Satisfaction level Satisfaction level Satisfaction level Trust
on cleanliness of on Sanitation of on Hygeinic on the ventilation
the hsopital the hsopital condition of the of hospital
hsopital
 KEY FACTOR : COST OF THE SERVICE
89%
90% 86%

80% 76% Public

70%

60% 54%

50%

40% Private
27% 26%
30% 22%
20% 16%
12%
10%

0% Trust
Satisfaction level on Problems regarding Problems regarding
cost of the service unexpected billing advance pay
 KEY FACTOR : QUALITY OF CARE
100% 87% 89% 91%
83% 86%
90% 81% 79%
80% 74%
70%
56% 52%
60% 47% 49%
50% 42%
35% 33% 31% 36% 30% 37%
40% 28%
30% 21% 23%
17% 13%
20%
10%
0%

Public

Private

Trust
 DISCUSSION
• OBJECTIVE 1: To analyze the factors affecting preference of the service utilizers for utilizing
healthcare service sector.

Service Quality Infrastructure Cost Patient Perceptions

• Chances of Risk • Roms • Subsidies • Influence

• HIC practices • Pharmacy • Policies • Past experience
• Dietary services • Noise cancellation • Profit • Mind set
• Waiting time • Ventilation • Commisions • Critisism
• Equipments and thier • Quality of lighting • Advance pay • History of perticular
conditions • Cleanliness • Mode of pay sector
• Patient to Doctor • Sanitation • Unexpected billing • Transperancy
ratio • Hygenic condition • Installment facilities • Trust
• Patient to Nurse ratio • Charges taken for
• Personalized care care
• Sop
• Accredations
• Availability of beds
• Availability of
doctors
 DISCUSSION
• Objective 2: To analyze and differentiate the
differences in healthcare facilities and standards in
private and public sector hospitals in the city of
Gandhinagar.
• The researcher has visited government and private
hospitals personally to assess the health standards and
facilities provided to patients. Assessed standards and
facilities provided by the public healthcare sector were
extremely poor in terms of hygienic conditions,
cleanliness, patient crowd in wards, long waiting hours,
long queues, etc
 DISCUSSION
• Objective 3: To study expenditure pattern of rural
residents towards health sector and their relish towards
private or public sector and also reasons thereof.
• Reasons were tried to found by the researcher during
survey for not using public healthcare sector even free
medical services have been provided for poor people. It is
found that 43% of the respondents do not prefer
government sector due to distance of the hospital from
their home. 79% of the respondents do not prefer public
healthcare sector due to long waiting time. 58% of the
respondents do not prefer government sector due to fixed
operating time. While 23% of the respondents do not
prefer government healthcare sector due to poor quality of
services.
 DISCUSSION
• Objective 4: To examines the problems faced by poor
people in utilizing public healthcare sectors for treatment
and their compulsion of using high cost private healthcare
sectors.
• Expenditure pattern of the poor rural respondents has
been analyzed somehow through the primary survey. As
per the responses of the poor rural residents of
Gandhinagar city, researcher found that each of their family
spent on an average 10-15% of their monthly income on
gaining routine medical care, 73% of the respondents
avoided treatment to prevent loss of subsistence even if
they are ill. Also found that none of them was medically
insured, 71% of the respondents found with debt to meet
medical expenditures.
 DISCUSSION
• Objective 5: To draw assiduity of policy makers towards
gaps in the public healthcare system and make
suggestions for the improvement of healthcare
infrastructure in the Gandhinagar city.
• The researcher has made an attempt to bring out the gaps
in the public healthcare system in the city of Gandhinagar
in front of policy makers. Even the Gandhinagar city has a
good network of public and private hospitals, these
facilities are not adequate to cater to large population of
the city due to lack of proper planning and controlling. At
the end of the study, the researcher has given some
recommendations which, if implemented in right
perspective, may go a long way in solving the health
problems of the city.
 SUGGESTIONS
• Redesigning the structure of public healthcare service in Gandhinagar
• Service facilitate by the government
• Straightening PHC
• Performance Guarantee and Maintenance Contract
AVAILABLE • Popularizing and Making People to Use the Indian Medical Systems
• Prevention rather than Cure

• Health for ‘All’ at the Doorstep of Needy of Population

• Mobile Health Vans
ACCESSIBLE • Point of Care Testing Facilities (POCT)

• Affordability of Healthcare Service during Minor Illness

• Affordability of Healthcare Service during Major Illness
AFFORDABLE • Filling Information Gap through Medical Helpline
 SUGGESTIONS
• Establishment of a Healthcare Assessment Cell within the Gandhinagar Public Health
Department
• Improving the Quality of Health Services in Public Hospitals
• Adopting International Standards in Health Sector
QUALITY • Compulsory Accreditation of Public and Private Hospitals
INITIATIVES • Health Sector Data Base and Management Information System

• Improving Staff Attitude and Approach towards Poor and Neglected Class
• Incentives for Working in Rural / Poor / Slum Areas
HR
DEVELOPMENTS
INITIATIVES
 LIMITATIONS
• The present study is constrained by the limitation of time and cost.
The study is restricted to the public, private and charitable hospitals
in the city of Gandhinagar. At the same time, individual capacity of
researcher in exploring a crucial social sector as healthcare
economics is a challenging task.
• Despite all constraints and limitations, the findings and conclusions
derived thereof and suggestions and recommendations given at the
end of the study would go a long way in improving and enhancing
health care facilities in the city. These suggestions will guide the
health care policies of not only the Gujarat government but also the
State Governments of the other states in the country. At the same
time, the results of the study will open new frontiers for young
researchers to carry this study further to other regions and states of
the country.
 CONCLUSION
• The Government should increase health expenditure to a
minimum of 2.5% of the GDP in order to achieve the
objective of “Health for All”. This requires integration
between the budgets of various local self government,
state governments and the Central government.
• The present public health infrastructure in the city must
being utilized properly by doing well centralized planning
and innovations in the tradition patter of healthcare
infrastructure. The entire system needs revamping to meet
the existing health care needs of the city population.
• Corporate hospitals should increase more tie – ups with
government to achieve the objectives of National Health
Policy.
THANK YOU