labels: healthcare, finance - general, investment - general, insurance
Homely healthcarenews
Anil Kumar Chillimuntha
03 May 2003

Surat: Indian hospitals have a long history but the pace of growth is minimal. Where we lack and where we stand is just an insignificant thought. A thorough study of our hospitals and its management is only a longstanding wish.

If we do not correct ourselves and grow to excel, a day will come when a majority of our hospitals will be considered inefficient. We are bugged with many traditional styles while the world is revolutionising. The priority of this article is to debug by incorporating the latest techniques used in the West, such as the concept 'home healthcare.'

'Home care' is a simple phrase that encompasses a wide range of health and social services. These services are delivered at home to the recovering, disabled, chronically or terminally ill persons in need of medical, nursing, social, or therapeutic treatment and/or assistance with the essential activities of daily living.

The history of home care is very old but it still did not take shape into India. Nursing services have been and probably will continue to be the major component of home healthcare. The history of home healthcare is therefore reflected in the history of home nursing services.

Deeper roots
Home healthcare can be traced to the Boston Dispensary, which in 1796 provided the sick poor the dignity to be cared for at home rather than in the hospital. At that time hospitals were still considered to be pest houses, where the poor went to die. In 1877 the women's Branch of the New York City mission was the first establishment in the United States to hire a graduate nurse to provide nursing care for the sick in their homes.

In 1885, the first voluntary agency specifically organised to provide home nursing care was founded in Buffalo, New York. Other voluntary agencies, alter to become Visiting Nurse Association, opened their doors in Boston and Philadelphia in 1886. Gradually it grew up to thousands of home care providers.

Whose services are required for home care? The services of a doctor, nurse, social worker, physical therapist, respiratory therapist, nutritionist, followed by speech and occupational therapies, homemaker (home health aides), and finally a variety of others. Home healthcare is multidisciplinary and should be coordinated. Referral from one member of the health services team to another can mobilise other services to aid the client.

There are many psychological benefits to the client who receives healthcare services at home. In comparison with an institution, the home offers the client more privacy and more control of the environment. The client is free to maintain customary daily habits and stay up all night and sleep all day if desired. Most often, there is a friendly and interested emotional support system close at home.

Professionals treating clients on an ongoing basis in the home can note signs of deterioration and quickly take steps to remedy the situation. If blood tests or X-rays are needed for diagnosis, they can be taken in the client's home using portable machines.

The economic aspect
From a financial viewpoint, frequently cited advantages of home healthcare are that it reduces the length of hospitalisation by making early discharge possible. It diminishes the need for readmission to hospitals, provides a more economical alternative to institutional care, and decreases capital construction costs by releasing hospital and institutional beds.

The most important value of comprehensive home healthcare is that it fosters independence. An exception, of course, is care of the terminally ill, but even in that situation home care is familiar and comforting surrounding makes it possible for people to die less stressfully and with a greater control over their situation.

Financing home care is not difficult. We've all heard the old adage, 'If you have got your health you have got everything,' and that's true as far as it goes but it does not go far enough. Unfortunately in today's medical marketplace you need something more, something that may hold the key to your continued good health or the solution to curing whatever might be ailing you, that something is being a clientele to a good well managed hospital.

Ask any patient and they uniformly agree that healthcare costs money, lots and lots of money. A major illness requires a couple of weeks in the hospital and is enough to flush the lives savings right down the drain and into the hands of the doctors, hospitals, drug companies, and diagnostic services.

This being so, there are only two things keeping most of us from bankruptcy court: the good fortune of not becoming ill or injured and second, use of home healthcare that costs less than hospitalisation. Thus, home healthcare may be the most important need most of us face, since sooner or later we or a loved one are bound to need the services of a physician and/or a stay in the hospital. So the effects of the extension of healthcare facilities to home are a boost to the nation's progress.

The need to invest more
In the US, life insurance companies saw the benefit of home nursing care, and they also became involved in the home-nursing field. Metropolitan Life Insurance Company was the first to offer home visiting nurse services to some of its policyholders in 1909. The idea spread to other insurance companies, such as John Hancock Insurance Company.

In the late 1940s hospitals began to enter the home healthcare field. The most well-known hospital-based programme was and still is the Montefiore Hospital Home Care in New York City, which began in 1947. With the liberalisation of the insurance sector (and the emergence of many Indian insurance companies with joint ventures with foreign insurance companies) there's a great scope for financing home care in India.

There's a need to drive the healthcare sector to pay attention to economic imperatives and how to improve the dwindling revenues of the hospitals and reducing the healthcare cost. It is quite important to note that, to run a hospital it needs lots of innovation, dedication, and hard work for the uplift of our hospitals in India. Home care, if started by the hospital as a department, can show a brighter spectrum to the dwindling revenues of the hospital.

Chillimuntha, who has an MBA and a doctorate degree in hospital administration, is the administration manager at Adventist College and Hospital, Surat. He can be contacted at

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