NEW DELHI: Need admission in a hospital? Chances are that you might not get a bed, however, unwell you are. Here is an example: the waiting time for a private ward under the neuro-surgery department at premiere All India Institute of Medical Sciences (AIIMS) is between four and six months. However, if a patient needs to be admitted in a general bed at AIIMS for the same surgery, the lag time is more than a year. The Planning Commission attributes this to India's acute shortage of hospital beds.
The Commission's high-level expert group (HLEG) on health says when it comes to secondary and tertiary care, India lags behind most other countries in number of hospital beds per 1,000 population. The nation, though, has a higher absolute number of hospital beds than other countries.
The World Health Statistics says India ranks among the lowest on this count globally: 0.9 beds per 1,000 population, which is far below the global average of 2.9 beds.
The National Health Profile 2010 says India has a public sector availability of one bed per 2,012 population in 12,760 government hospitals - around 0.5 beds per 1,000 population.
Sri Lanka, on the other hand, has 3.1 beds per 1,000 population, China (3), Thailand (2.2), Brazil (2.4), USA (3.1) and the UK (3.9).
Dr Shakti Gupta, who heads hospital administration at the AIIMS, said "It was recommended in 1948 by the Bhore committee that there should be one bed per 1,000 population. We still haven't been able to reach that target. India has around 0.7 beds per 1,000 population."
Dr Gupta added, "There was no extension of healthcare facilities for a better part of these 63 years. There was also no private sector at that time. Things will change because the thrust is more on day care centres. The concept is that patients should be investigated at day care and once found fit for surgery should be admitted. The average stay of a patient should be around three to four days. Earlier, we would admit a patient, waste seven-10 days on diagnosing the problem and then take h/him for surgery."
The Commission has recommended expansion of functional capacity to two beds per 1,000 population by 2022. In its latest report on universal health coverage, it has said "Given a population of 1,353 million by 2022, the HLEG estimates that 27.05 lakh beds will be required to achieve two beds per 1,000 population. Based on the population norms, the size and spread of India's population will require a physical infrastructure of 3,14,547 sub health centres, 50,591 primary health centres, 12,648 community health centres, 4,561 sub district hospitals and 642 district hospitals."
A recent Technopak study indicates that developments in hi-tech diagnostics and interventions will drive a shift in healthcare delivery from predominantly inpatient to outpatient settings. The study, which finds extensive mention in the Commission's report, predicts that 75% of all surgical procedures in India in 2020 will be conducted in outpatient ambulatory surgery centres. This will also cost 47% less than inpatient services.
An alternative analysis undertaken by the Healthcare Management and Consultancy (HOSMAC) said the availability of public hospital beds in rural India varies widely: from just one bed per 4,471 population in central India to one bed per 1,650 population in southern India. It said on an average, urban India has one private sector hospital bed per 422 population. Although the inadequacy of beds in rural India forces people to travel to the nearest urban center for healthcare, almost 805 of patients seeking treatment across the country in private institutions belonged to middle and low-income groups, with 50% of all patients in northern and central India belonging to the lower income category. Central India has the fewest private sector hospital beds in the country.