Listening To Your Patients

LISTENING TO YOUR PATIENTS
A survey of patient behaviour in Jaipur, India

August, 2010
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All rights reserved Kanvic Consulting Private Limited.
Contents
A. Objectives and methodology 3
B. Key findings 8
C. Detailed findings 10
D. Contact 25
2
A. Objectives and methodology
In view of changing healthcare landscape in Jaipur, we conducted a patient
behaviour survey
Location of Jaipur in Rajasthan state
Healthcare sector has been witnessing

a very rapid change in India with the
entry of corporate hospitals, emergence of
lifestyle diseases and evolving needs of
Haryana population for healthcare services.
Jaipur is a major city in North Western

part of India and is a capital of the state
Uttar
of Rajasthan.
Pradesh
Healthcare landscape has changed
Jaipur drastically with patients demanding better
Rajasthan services and hospitals willing to offer them.
The competition is also increasing with
entry of new hospitals which have raised
the bar for others.
In view of changing market situation,

Kanvic conducted a patient behaviour
survey from July - August 2010.
Madhya This report provides detailed findings of

Gujarat patient profile and behaviour for
Pradesh
healthcare services in Jaipur.
Area of survey 4
The survey had four main objectives
1 Map profile of patients visiting hospitals in Jaipur
2 Quantify disease incidence in Jaipur market
Identify key criteria in choosing and judging a

3 hospital by patients
4 Understand patient’s satisfaction with the quality

of care and services provided by a hospital
5
We interviewed 113 patients from 8 hospitals with a structured questionnaire
660 hospitals and

nursing homes in
Jaipur
113 Number of patients
interviewed for the survey
8 Number of hospitals which

participated in the study
A cross-section of hospitals
14 hospitals
Sample including private, public and
trust catering both single
speciality and multi-speciality
selected based on
their size, ownership
pattern and speciality
Face to face interview with
Tool the patients with a structured
questionnaire
6
Patients had a diverse profile including men and women from various
occupations and age groups
Age distribution, years, % Gender, % Occupation,%
1%
19% 12% 13%
7%
34%
16%
45% 34%
66%
27% 20%
5%
0 to 6 7 to 19 Male Government servant Business person

20 to 40 41 to 60 Female Private sector employee Housewife
60+ Student NA
45% respondents are 66% respondents are male and 34% respondents are from
between 20 to 40 34% is female business.
years old.
Note: Percentages are percent of total number of respondents

Source: Kanvic Patient Survey 2010 7
B. Key findings
We found seven aspects of patient behaviour which are relevant for a
hospital’s decision making
Key findings from patient behaviour survey
1 Jaipur hospitals receive almost half the patients from other parts of Rajasthan outside
Jaipur.
The top five specialities in terms of patient volume are Orthopedics, General medicine,
2 Oncology, Gastroenterology and Cardiology.
A doctor’s goodwill is the most important criterion for patients to choose a hospital.
3 It is followed by hospital’s reputation and specialisation.
4 One third patients stay for over 7 days in a hospital.
While care received from Doctors is rated highly, hospitals need to make efforts to
5 improve their infrastructure and reception services. There is also a room for
improvement in care provided by nurses.
6 A vast majority of patients are happy to recommend their hospital to other people.
While doctor’s reputation is top 5 criteria in judging a hospital after patients have
experienced the services, quality of doctors, quality of treatment and quality of facilities
7 carry more weight in judging a hospital.
9
C. Detailed findings
We covered three stages of a patient’s experience with hospital services to
map their profile and understand behaviour
Key issues covered in survey
3 1
Criteria for Source market
Post Pre
judgement Disease incidence
admission
Recommendation discharge Selection criteria
Repeat patient (loyalty)
2
During
admission
Average length of
stay (ALOS)
Medical care
Services
Source: Kanvic 11
Almost half the patients come from other cities in Rajasthan
Source markets for patients coming to hospitals in

Jaipur, percent of respondents, n=113
3
10 An overwhelming 48%
patients come from cities
other than Jaipur in
Rajasthan.
48 Other states also

contribute a significant 10
100 percent.
These findings have

implications for
hospitals to develop
referral network with
39
primary health centres
and doctors in their source
market.
Jaipur Other cities of Outside

No reply Total
Rajasthan Rajasthan

Orthopedics has maximum number of patients for treatment
Patients seeking treatment in each speciality,

percent of respondents, n=113
Orthopedics 17.7%
Orthopedics is the highest

General medicine 14.2%
volume speciality with over
17 percent patients seeking
Oncology 13.3%
treatment in this area.
Gastroenterology 12.4%
Combined with General
medicine and Oncology,
Cardiology 8.8%
they cover almost half the
patients in Jaipur.
Neurosurgery 7.0%
Obstetrics & 6.0% Cardiology is at number five

Gynaecology with 8.8 percent patients
4.0%
coming for treatment for
Nephrology heart related diseases.
3.5%
Neurology
Other specialities like
3.5% Neurology and Urology also
Urology figure in top 10.
9.6%
Other

Doctor’s goodwill is the most important factor for a patient to choose a
hospital
1
Criteria for choosing a hospital, percent, n=113
Doctor’s goodwill 27.4% Over 27 percent patients

choose a hospital based on
Hospital’s reputation 16.8% doctor’s goodwill.
Hospital’s
10.6%
specialisation
Hospital’s reputation and its
Referrals 10.6% specialisation are other
important factors finding
Close to home 7.9%
favour with 16.8% and
Quality of Facilities 6.2% 10.6% patients respectively.
Referred by another
hospital 4.4% While clinical factors are the
key reasons for a patient to
Quality of Treatment 3.5%
make a choice, non-clinical
Affordability 3.5% factors such as close to home
and quality of facilities are
Quality of Services 3.5% also important to some extent.
Employer’s choice 3.5%
Affordability is also part of
Previous experience 3.5% decision making but not a
critical factor while choosing a
Quality of Staff 2.6% hospital.
Note: Percentages add up to more than 100 because of multiple responses

Over 40 percent patients had visited the same hospital earlier
Repeat patients visiting a hospital, percent

of respondents
NO
42%
YES
58%

One third inpatients stay for over seven days in a hospital
Segmentation of patients, percent Average length of stay (ALOS) for

of respondents, n=113 inpatients, percent of respondents, n=61
Outpatients
46% Inpatients
54% 48%
33%
20%
Less than 3 Between 3

Over 7 days
days and 7 days

Hospitals’ performance on key service indicators is a mixed bag with some
hospitals showing consistent results
2
Patients rating hospital services “Excellent”, percent of

respondents, n=113
Hospital Reception Care from Doctor Care from Nurse Infrastructure
13%
A 13% 13% 0%
80% 100% 60% 80%

B
C 75% 87%
75% 75%
NR
D 12% 24% 24%
90%
E 80% 100% NR
30%
F 50% 60% 30%
87%
G 47% 60% 78%
H 49% 74% 60% 66%
NR - No Response
While some hospitals have been rated excellent by 80 percent patients for
reception services, the rating is as poor as 12-13 percent for others
2
Rating reception services, percent of respondents, n=113
Hospital
A 13% 87% Reception services play an

important role in patient
satisfaction.
B 80% 20%
While not as important as

C 75% 25% clinical services, they can
create a negative perception
even if the clinical services
D 12% 53% 35% are excellent.
E 80% 20% While some hospitals have

been rated highly for quality
of reception services, there
F 50% 40% 10% are others who have not done
well.
G 47% 13% 33% 7%
In two hospitals, 7-9 percent
patients rate quality of
H 49% 20% 22% 9% reception services as bad.
Excellent Good Acceptable Bad

We found two hospitals exceptionally good in patients’ satisfaction with care
received from doctors
2
Rating care received from doctors, percent of

respondents, n=113
Hospital
A 13% 87%
B 100% Care from Doctors is a key

factor in determining
C satisfaction level of patients.
87% 13%
Two hospitals have been

D 24% 65% 11% rated excellent by 100
percent of their patients for
quality of care received from
E 100% Doctors.
F 60% 40% At the same time, there are

two hospitals where quality
of care from Doctors is either
G 80% 20% acceptable or poor.
H 74% 23% 3%

On the other hand, there is a room for improvement in care provided by the
nurses with one hospital doing bad
2
Rating of care received from nurses, percent of

respondents, n=113
Hospital
A 13% 25% 35% 25% While Doctors visit patients

once or twice in a day, nurses
are available 24x7.
B 60% 40%
As a result, the expectation

C 75% 25% level from nurses is high.
There is a room for

D NR improvement in quality of
care provided by nurses.
E NR
No hospital has achieved
100% excellent rating in this
F 30% 70% case.
On the contrary, there is one

G 78% 22%
hospital which has been
rated bad by as high as
60% 20% 20% 25% patients.
H
NR - No Response
Infrastructure is also an issue with a couple of hospitals
Quality of infrastructure (rooms, facilities etc.), percent

of respondents, n=113
Hospital
A 75% 13% 12%
B 80% 20%
Quality of infrastructure
also needs improvement.
C 75% 25%
While half the hospitals have
been rated excellent by over
D 24% 59% 17% 75 percent patients for
infrastructure, the other half
lags behind by a large
E 90% 10%
difference.
F 30% 60% 10% On infrastructure also, two

hospitals have been rated
poor by their patients.
G 87% 13%
H 66% 26% 8%

In spite of hiccups in non clinical services, a majority of patients are willing to
recommend the hospital
3
Willingness to recommend hospital to other patients, percent of respondents, n=113
Hospital
A 100%
B 100%
C 100%
D 94% 6%
E 90% 10%
F 100%
G 100%
H 91% 9%
Yes No

Quality of doctors is also the most important criteria in judging a hospital
Criteria for judging a hospital, percent of

respondents, n=113
Quality of doctors 42.5%

Quality of doctors,
Quality of treatment 23.9% treatment and facilities are
the three most important
23.0%
criteria in judging a hospital
Quality of facilities
with an overwhelming 42.5
Doctor’s reputation percent patients judging a
20.3%
hospital based on quality of
doctors.
Quality of staff 15.9%
Quality of infrastructure Other factors which patients

11.5%
choose to judge a hospital are
quality of staff, infrastructure
Quality of services 10.6%
and services.
Affordability 4.4%
While patients consider
Hospital’s reputation affordability, quality of
3.5%
reception and proximity to
home in their decision
Quality of reception 3.5%
making, they are not rated
very high in importance.
Close to home 0.8%
Note: Percentages add up to more than 100 because of multiple responses

Mapping the criteria for choosing and judging a hospital throws some
important insights about a patient’s behaviour
3
A map of patients’ criteria for choosing

and judging a hospital
Doctor’s reputation has clearly

emerged as the most important
High
Quality of
Importance for judging a hospital
doctors
Quality of criterion in choosing and judging
treatment
Quality of
a hospital.
facilities
Doctor’s
Quality of reputation
While quality of doctor,
staff Quality of treatment, and facilities are
services
important for judging the
hospital, they are not highly rated
Medium
for choosing a hospital. This is

perhaps due to rating of
judgement given by patients after
experiencing healthcare services
at the hospital.
Affordability
Hospital’s
Close to reputation The difference in criteria are
Low
home important for hospitals to align

themselves with new and repeat
patients differently.
Low Medium High
Importance for choosing a hospital
Source: Kanvic Patient Survey 2010, Kanvic analysis 24

D. Contact
Authors of the study
Deepak Sharma
Director
M: +91 99283 77800
E: deepak@kanvic.com
Maxime Assedo
Junior Consultant
M: +91 76655 96165
E: maxime@kanvic.com
Abhishek Taragi
Junior Consultant
M: +91 94147 96338
E: abhishek@kanvic.com
26
About Kanvic
Kanvic is a management consulting firm helping businesses develop winning strategies, drive
profitable growth and achieve operational excellence to reap long lasting rewards in fast
growing Indian economy. We work with C-level executives to develop innovative solutions for
business challenges of 21st century India by bringing in leading edge management thinking
informed by in-depth research and sound analysis.
Contact
Jaipur Bangalore London
Deepak Sharma Ravindra Beleyur Bharat Vagadia
M: +91 99283 77800 M: +91 94481 46963 M: +44 7711 898089

E: deepak@kanvic.com E: ravi@kanvic.com E: bharat@kanvic.com
www.kanvic.com
27

Listening To Your Patients - A Survey of Patient Behaviour in Jaipur India

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A survey of patient behaviour in Jaipur, India

A. Objectives and methodology 3

Location of Jaipur in Rajasthan state

Healthcare sector has been witnessing

Jaipur is a major city in North Western

In view of changing market situation,

Madhya This report provides detailed findings of

1 Map profile of patients visiting hospitals in Jaipur

2 Quantify disease incidence in Jaipur market

Identify key criteria in choosing and judging a

4 Understand patient’s satisfaction with the quality

660 hospitals and

8 Number of hospitals which

Age distribution, years, % Gender, % Occupation,%

0 to 6 7 to 19 Male Government servant Business person

Note: Percentages are percent of total number of respondents

Key findings from patient behaviour survey

4 One third patients stay for over 7 days in a hospital.

Key issues covered in survey

Source markets for patients coming to hospitals in

48 Other states also

These findings have

Jaipur Other cities of Outside

Source: Kanvic Patient Survey 2010 12

Patients seeking treatment in each speciality,

Orthopedics is the highest

Obstetrics & 6.0% Cardiology is at number five

Source: Kanvic Patient Survey 2010 13

Criteria for choosing a hospital, percent, n=113

Doctor’s goodwill 27.4% Over 27 percent patients

Note: Percentages add up to more than 100 because of multiple responses

Repeat patients visiting a hospital, percent

Source: Kanvic Patient Survey 2010 15

Segmentation of patients, percent Average length of stay (ALOS) for

Less than 3 Between 3

Source: Kanvic Patient Survey 2010 16

Patients rating hospital services “Excellent”, percent of

Hospital Reception Care from Doctor Care from Nurse Infrastructure

80% 100% 60% 80%

H 49% 74% 60% 66%

Rating reception services, percent of respondents, n=113

A 13% 87% Reception services play an

While not as important as

E 80% 20% While some hospitals have

Excellent Good Acceptable Bad

Source: Kanvic Patient Survey 2010 18

Rating care received from doctors, percent of

B 100% Care from Doctors is a key

Two hospitals have been

F 60% 40% At the same time, there are

Excellent Good Acceptable Bad

Source: Kanvic Patient Survey 2010 19

Rating of care received from nurses, percent of

A 13% 25% 35% 25% While Doctors visit patients

As a result, the expectation

There is a room for

On the contrary, there is one

Excellent Good Acceptable Bad

Quality of infrastructure (rooms, facilities etc.), percent

A 75% 13% 12%

F 30% 60% 10% On infrastructure also, two

Excellent Good Acceptable Bad