Why Indian healthcare needs to move beyond hospitals: understanding home healthcare

By Gaurav Thukral 

Due to an increase in the geriatric population and lifestyle diseases, there has been a significant increase in the diseases burden in India, causing a strain on the existing conventional healthcare delivery system of hospitals to provide quality inpatient and outpatient services. This strain has caused our healthcare system, which currently comprises mainly hospitals and clinics to reach a breaking point, as the country continues to struggle with a huge shortage of medical and clinical staff in hospitals and healthcare units. The healthcare crisis is further triggered by the fact that there has been a rise in the number of nuclear families, rendering several people unable to manage the health of their loved ones.

Understanding home healthcare

In order to ease this pressure both on the hospitals and patients is the innovative approach of home healthcare, which has not been able to establish solid ground in India due to several misconceptions about the system amongst both traditional healthcare providers and patients as well.

Many hospitals do not support collaboration with the home healthcare industry as they feel threatened by this model, whereas, in reality, home healthcare providers are valuable partners for hospitals in providing step down healthcare delivery. In fact, having a collaborative relationship between the two can benefit both the home healthcare provider and the hospital.

For instance, often patients have to stay in Intensive Care Units (ICU) for a longer time as there is a constant shortage of beds in hospitals, which increases pressure on the emergency department to manage new critical patients. Hospitals can prevent overcrowding and its associated perils such as hospital-acquired infections by partnering with home healthcare experts. Several postoperative cases can be moved under the guidance of home healthcare experts making sure beds are available for critical patients in the ICU.

Additionally, patients who have been very sick and gone through strenuous operations need holistic high quality medical even after discharge and a partnership between home healthcare providers and hospitals will also ensure the continuum of expert medical care. Additionally, this can be provided in the comfort of a patient’s home, thereby, ensuring a faster recovery for the patient.

Home healthcare vs nursing care

A major misconception about home health care and this continuum is that it is often viewed as an extension of nursing care, whereby, a patient merely has an attendant to care for them. However, home healthcare providers actually use highly sophisticated apparatus, devices and algorithms, digital documentation along with a solid care plan and exceptionally well-trained nursing and paramedical staff to provide high-quality ICU step down care in oncology, immunology, amongst others.

From providing patients with intravenous drip, tracheostomy care, urinary catheterization to highly sophisticated vital and heart monitoring through sophisticated ICU apparatus, home healthcare providers ensure all of this can be done at home. Using remote monitoring equipment, wearable devices and algorithms real-time data is fed constantly to medical specialists in hospitals to ensure round the clock expert care and supervision.

Home health care providers often develop close relationships with patients and their families, which can be used to provide feedback to hospitals to improve their services. In the recent past, there has been a general mistrust and negativity in the relationship between hospitals and patients, and home healthcare providers can help improve this bond by providing continuing services and the right feedback.

Financial benefits

Often hospital owners believe that healthcare providers are financial threats and would hamper their revenue streams, however, this is hardly the case. In fact, home healthcare providers help clear out ICU beds for critical cases which is critical to hospitals as ICU beds usually generate the highest revenue in the first week, lesser in the second and much less third week onwards. If a patient stays on the hospital bed beyond a week, it leads to low average revenue per operational bed (AROB). However, if a home health care provider steps in at this stage to provide the same level of care but in the comfort of patient’s home, then the hospital gains by assigning that bed to a new more patient. Even patients can avail ICU level healthcare at home at almost a fifth at the price of care at the hospital.

Innovation is the need of the hour

Home healthcare systems are very important in ensuring holistic are that is profitable for hospitals while also being beneficial and economical for patients. Without compromising on quality, home healthcare solutions can be up to 40% more economical as compared to hospitals as they utilize available capacity in patient homes. Apart from financial gain, shifting back home provides mental respite to the patient and their loved ones, which also translates into a faster recovery.

This partnership between hospitals and home healthcare providers is the innovative solution needed to solve the massive shortage of hospital beds in India. India has a huge network of government centres which are supplemented by super and multi-speciality hospitals in all metros and some smaller cities. However, in all tier II and III cities and town there is a major lack of adequate healthcare and patients living further from a tertiary care centre often drop treatments due to the cost and inconvenience of travelling the distance.

While one solution is that the government increases the capacity and infrastructure of the existing centres or builds new ones in these towns and cities, it is a very costly and long-term endeavour which would require years to be executed. On another hand, a much more feasible and durable solution would be to develop a network of home healthcare facilities.

Not only do home healthcare providers provide step down ICU care but they are instrumental in providing palliative care, and help in managing and reducing burden of chronic diseases like diabetes and obesity. Home health care services play an important role in physiotherapy, antenatal pregnancy care, post-delivery care and much more.

Additionally, with the rise in the geriatric population and the nuclear family system, the elderly often struggle with loneliness and depression. Home -healthcare steps in to bridge this gap and provide the necessary support to the elderly and their family by providing holistic compassionate care which involves medicine and transport support, companionship, individual care support, and compassionate counselling.

Healthcare of a nation is of utmost importance and it should be prioritized, personalized and delivered with utmost care using the right combination of technology and compassion. This will only be possible with the collaborative efforts of hospitals, home healthcare providers, patients and government in streamlining home health care into the medical system of the country.

Dr Gaurav Thukral is the Chief Operating Officer of HealthCare at HOME.