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50% of healthcare beneficiaries travel over 100 kms to access quality care: Report

New Delhi: With a 22% shortage of primary health centres (PHCs) and 32% shortage of community health centres (CHCs), it is estimated that 50% of beneficiaries travel more than 100 kms to access quality care, reveals a NATHEALTH-PwC Report on ‘Funding Indian Healthcare – Catalysing the Next Wave of Growth’.

Healthcare Expenditure as percentage of GDPThe report, which was released here on Friday at NATEv2017, an annual seminar organised by the Healthcare Federation of India (NATHEALTH), further states that India has only 1.1 beds per 1,000 populations compared to the world average of 2.7.

Most physicians are located in urban areas, resulting in significant access issues in the rural regions, according to the report which examines the key challenges the Indian healthcare industry is facing and the opportunities with which the country’s healthcare system can overcome these challenges.

Commenting on the findings of the report, Anjan Bose, secretary general, NATHEALTH, said, “While the opportunity for improvement of health services in India as well as globally is huge, for it to fall into the right place the government and the entire healthcare ecosystem will have to work together even as they compete on other fronts so that the benefits percolate to the segment which most requires it.”

Out of pocket expenditure (OOPE) as a percentage of health expenditureDr Rana Mehta, partner and leader, Healthcare PwC India, said, “Access to capital has been one of the biggest roadblocks to the growth of the Indian healthcare sector. Today, the Indian government spends only about 1.5% of its GDP on healthcare, which is among the lowest globally for any country.”

While underlining the need for huge funding requirements, the report says the FDI (foreign direct investment) in the sector has been significantly increased in the last three years. However, healthcare expenditure’s share in GDP (gross domestic product) remained around 1.6% in the financial year 2015-16 and innovative funding modes would support the target of taking it to 2.5% by 2030.

Number of NABH accredited hospitalsIt also highlights the fact that private equity deals are supporting the funding in the sector and value of transactions has increased from $94 million in 2011 to $1,275 million in 2016 — a jump of 13.5 times.

The report recommends four scaling innovative modes, which should be introduced for funding Indian healthcare. These include fund of funds such as pension funds, investment route through PPP, long-term debt. It also suggested funding through business trust entity like real estate investment trusts along with bilateral investment treaties.

According to the report, ensuring healthcare delivery through traditional methods will require additional investments of $245 billion by the year 2034. This amount can be reduced by $90 billion by focusing on preventive care, leveraging technology (mHealth) to deliver care and shifting care from hospitals to homes.

Percent shortfall of specialist doctors in Community Health Centres (CHCs)“If we get this right, 340 million more people will have access to quality healthcare, 4.3 million additional employment opportunities will be generated, and Rs 141 billion will be saved for the country by preventing daily loss due to heart disease, stroke and diabetes in the next five years,” the report states.

According to the report, while the success of four key IPOs (initial public offerings) over the last 18 months — Dr Lal PathLabs, HCG, Narayana Hrudayalaya and Thyrocare (all these four IPOs were oversubscribed) — reinforced investor confidence in the healthcare sector, the price control on stents could impact investor sentiments.

The National Pharmaceutical Pricing Authority (NPPA) recently capped the price of coronary stents, which is inclusive of a maximum of 8% of trading charges and hospital handling charges, if any. The prices of bare metal stents and drug-eluting stents have been capped at Rs 7,260 and Rs 29,600 respectively excluding local taxes.

The report also highlights the following points:

• India still accounts for 16% of the global share of maternal deaths and 27% of global newborn deaths.
• Deaths continue to occur due to communicable diseases, with 22% of global TB incidence in India.
• India’s non-communicable disease (NCD) burden continues to expand and is responsible for around 60% of deaths in India.
• Every fourth individual in India aged above 18 years has hypertension.
• Age standardised obesity prevalence increased by 22% in the past 4 years.
• India has the world’s second highest number of diabetic patients.
• Cardiovascular diseases (coronary heart disease, stroke and hypertension) account for 45% of all NCD deaths.
• The probability of dying from NCDs between ages 30 and 70 years is 26%.
• Out of pocket expenditure (OOPE) constitutes more than 60% of all health expenses.
• Approximately 63 million people fall into poverty each year due to lack of financial protection for their healthcare needs.
• About 70% of India’s healthcare infrastructure is in the top 20 cities.

The number of hospitals accredited to the National Accreditation Board for Hospitals & Healthcare Providers (NABH) has increased from five in 2012 to over 150 in 2016.

The report was released in the presence of Faggan Singh Kulaste, Minister of State for Health & Family Welfare, Government of India.

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