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1. NARAYANA HRUDAYALAYA HEART HOSPITAL:
CARDIAC CARE FOR THE POOR
manigarg21@gmail.com
 MANEESH GARG
GROUP 1
Case Analysis

2. The Indian Health Landscape
2003:
 Indian Government spent approx 1% of its GDP on public health care
 Overall expenditure on health – 5% of GDP (Asian average: 6.3%)
 85% of the Indian population and 47% of children under 3 years of age didn’t
receive enough nourishment – National Nutrition Monitoring Bureau
 15,000 hospitals and 6,00,000 physicians – well equipped health care system
 Number of physicians per 1,000 population: 0.5
 70% of doctors only in urban areas
 Government hospitals were underequipped and understaffed

3. The Indian Health Landscape
2003:
 Less than 14% of the population was supported by health insurance
 Medical Tourism
 1,50,000 foreign patients
 OHS would cost only $ 3,000 - $ 10,000 at the best Indian hospital as compared
to $1,50,000 in the U.S and $70,000 in UK
 2.4 million people needed heart surgery every year
 Only 60,000 surgeries were performed each year
 Approx 25% of heart attacks occurred among the under 40 population
 Around 2,24,000 newborns in India were affected by heart disease every
year

4. Present Scenario in Indian Health
Care Industry
 The Indian healthcare sector is expected to reach US$ 100 billion by 2015 from the
current US$ 65 billion, growing at around 20 per cent a year, according to rating agency
Fitch
 Government is proposing an increase in public spending by half a percentage point to
make it 1.58% for the coming five years (2012-17) under the 12th Plan
 Major factors driving the growth in the sector include :
 increasing population
 growing lifestyle related health issues
 Cheaper costs for treatment
 trust in medical tourism
 improving health insurance penetration
 increasing disposable income
 government initiatives
 Focus on Public Private Partnership (PPP) models

5. Present Scenario in Indian Health
Care Industry
 According to the Planning Commission's draft, the country's government-run healthcare
system is short of the target by a jaw-dropping 76%
 There are 53% fewer nurses, specialist doctors are short by 88%
 Radiographers are short by 85% and laboratory technicians are short by 80%
 According to union budget 2012-13, healthcare spending to be increased from Rs.26,897 cr
to Rs. 30,702 cr an increase of 14%
 There are 12,760 Govt. hospitals having 5,76,793 beds in the country
 6,795 hospitals are in rural area with 1,49,690 beds and 3,748 hospital are in Urban area
with 3,99,195 beds
 India has a total of 1,45,894 sub centers 23,391 PHCs and 4,510 CHCs
 There is an 18% shortfall in PHCs, and an alarming 34% shortfall in CHCs

6. Present Scenario in Indian Health
Care Industry
 According to the government's formula, we're
supposed to
 one sub-centre for every 5,000 people (3,000 in
hilly areas)
 one primary health centre for every 30,000 people
(20,000 in hilly areas)
 one community health center for every 120,000
people (80,000 in hilly areas)
 According to the Global Atlas on cardiovascular disease
prevention and control 2011, death rate due to ischemic
heart disease (a condition which is characterized by
reduced blood supply of the heart muscle) in India is 165.8
per 100,000. Around 116.4 per 100, 000 people in India
die due to cerebrovascular diseases

7. About the Hospital

God’s Compassionate Home

Situated in Bangalore, Karnataka

Founded in 2001, by Dr. Devi Shetty

Aims at providing medical treatment to the
poor

Vision : “Affordable Quality Healthcare for
the Masses Worldwide”

Mission : “A dream to making quality
healthcare accessible to the masses
worldwide”

Around 40% of all treatments were pediatric

8. Wal-Martization of health care

Focused on volumes

Performed 19 OHS & 25 catherization procedures
everyday, almost 8 times the average at other Indian
Hospitals

500 blood tests on a machine everyday, as compared to
other hospitals which run 2 tests on a machine

Negotiate better deals with suppliers- no long term
contracts

Took machines on monthly rent and paid for reagents
used to run the machine

9. Wal-Martization of health care

Management software which helped maintain
minimum inventory & quicker processing of tests

Used generic drugs which were 80% cheaper than
the market rate for similar medication

Spent only 22% of its revenue on staff salaries

Doctors got fixed salary and not % of the revenue

Monitored funds on a daily basis- helped in
planning

10. Wal-Martization of health care

Break even price for an Open Heart Surgery:

Rs.90,000 – adults

Rs. 1,30,000- children

Basic package including surgery & hospitalization charges: Rs. 1, 10,000 – cheapest in the country

Treatment and care same irrespective of general or private ward

Karuna Hrudaya: Financially constrained patients could pay Rs. 65, 000 for OHS and the rest will
be paid by NH

Narayana Hrudayalaya Trust: For patients who couldn’t afford to pay anything, this trust would
help them in getting funds via donations
“ Never turn away a patient for lack of
funds ”

11. Company Background
In 1989, Dr. Shetty
joined the Birla
Heart Research
Foundation,
Calcutta
Realized, India has
a lot of wellequipped
hospitals, but
unaffordable by
the poor
#. Co-founded Asia
Heart Foundation (AHF)
#. Later promoted
Rabindranath Tagore
Institute (RTI) of
Cardiac Sciences- 150
bed heart hospital, with
3 OTs & a 22 bed
intensive therapy unit
#. Personal Cardiac
surgeon of Mother
Teresa
#. In 2001, with the
help of his father in
law (SNC), Dr.
Shetty founded NH

12. Fact Sheet
2012
 25 acre area
 2 storey housing
 Beds: 280
 Operation Theatres: 5
2004
2001
 Beds: 500
 Operation Theatres: 10
 Catherization Labs: 2
 Open heart surgeries: 11,228
(half were pediatric)
 Surgeries: 4,276 (1,467 on children)
 Catherization procedures: 5,430
 Cardiac surgeons & cardiologists: 90
 Beds: 1,000
 Operation Theatres: 24
 Infrastructure to perform 50 heart
surgeries daily
 Treat patients from 73 countries
 NH Group has 12 hospitals, 2 care
centers and 5 upcoming hospitals

13. Heart Disease
 Occurs when supply of blood to the heart stops
 Happens when coronary arteries get clogged due to fat & cholesterol
Methods to cure coronary heart disease:
Angioplasty
A balloon catheter is
inserted in/near the
blockage and
inflated , thus
opening the blocked
vessel
Finally, arteries
open up and
adequate blood
flows to the heart
CABG
Creates a bypass
along the blocked
part of the coronary
artery
Recommended over
Angioplasty

14. Telemedicine
In telemedicine a surgeon or a specialist instruct
another doctor who is operating the patient. It is
basically used when a specialist is not able to reach
and operate. When a general practitioner feels
that a heart patient need for immediate
treatment, s/he may use telemedicine
The state government planned to sponsor 29 more
CCUs. Between 2001 and July 2004, the NH facility
performed 9,591 tele-consultations and the CCUs
had 4,077 inpatients
Both NH and RTI started outreach campus for
cardiac diagnosis and care. Each weekend, two
buses were sent out to rural areas, up to 800
kilometers in order to give best possible help
onsite

15. Yeshasvini
NH started 19 postgraduate courses. In 2005, collaborate with Indira Gandhi National Open
University (IGNOU) and scheduled to offer India’s first diploma in cardiology.
Dr. Shetty developed an insurance program “Yeshasvini”. The team of NH set up an insurance
scheme or 1.7 million farmers and their families in Karnataka

16. According to Dr. Shetty, they managed to reduce the cost of bone marrow
transplant from Rs. 1.2 million (USD 27,000) to Rs. 400,000 (USD 8,900), this time they
used the blood which can’t be used for cardiac surgery after 10 days but can be used for
transplant up to 26 days.
According to Dr. Shetty our three line of business:
 Heart hospital and associated activities
 Yeshasvini insurance scheme
 Finally Health City

17. Updates
 NH group of hospital have following hospitals:
NH Institute of Cardiac Sciences, Bangalore, RTIICS NH, Kolkata, NH
Multispecialty Hospital, Bangalore, Brahmananda NH, Jamshedpur, Mazumdar Shaw
Cancer Center, Bangalore, NH Hospital, Hyderabad, MS Ramaiah NH, Bangalore, Narayana
Hrudayalaya, Jaipur, Chinmaya NH, Bangalore, Rotary Narayana Hrudayalaya, Kolkata, SDM
NH, Dharwad, NH Devraj Urs Hospital, Kolar
 NH hospital comes in o10 best hospitals of Bangalore city
 The telemedicine network of the hospital connects to countries like Malaysia,
Mauritius and Pakistan
 Narayana Hrudayalaya Dental Chain Started in 2008, NHDC has expanded to 25 dental
clinics, 19 in Bengaluru and 6 in Kolkata
 Bangalore-based Narayan Hrudayalaya Hospitals (NHH) which is setting up Rs 600 cr.
health City

18. Updates
 Soon they will implement the 300-bed health
care facility in eastern part of the city
 Multispecialty hospital and cancer center
 Proposed health city, Ahmadabad
 They are planning to build low-cost heart
hospitals across India with collective capacity of
30,000 beds in the next 5-7 years’ time
Source: http://www.business-standard.com/india/news/narayan-hrudayalaya-plans-low-cost-heart-hospitals/164176/on)
http://www.narayanahospitals.com/

19. S
Strength
S
High volume of surgery
Affordable
New technology
Collaborations
Insurance scheme
Limited approach
Poor technology
infrastructure
W
Internal
factor
W
NH
Opportunity
O
Weakness
O
Expansion
Steady sectorial growth
Air ambulance
T
Threat
Competitors can follow the
same
Attrition rate
External
factor
T
Positive
Negative