INTRODUCTION

INTRODUCTION
Healthcare industry is a wide and intensive form of services which are related to well being of human beings. Health care is the social sector and it is provided at State level with the help of Central Government. Health care industry covers hospitals, health insurances, medical software, health equipments and pharmacy in it.

Right from the time of Ramayana and Mahabharata, health care was there but with time, Health care sector has changed substantially. With improvement in Medical Science and technology it has gone through considerable change and improved a lot.

Health care service is the combination of tangible and intangible aspect with the intangible aspect dominating the intangible aspect. In fact it can be said to be completely intangible, in that, the services (consultancy) offered by the doctor are completely intangible. The tangible things could include the bed, the dcor, etc. Efforts made by hospitals to tangibles the service offering would be discussed in details in the unique characteristics part of the report.

OBJECTIVE OF THE RESEARCH

Objectives of the Research

The research objectives for the project undertaken can be defined as follows: To determine the demographic variables of the patients of different hospitals Examine the patients perception about the hospitals. To judge the satisfaction level of hospitals of different administration like governmental, private and missionary The research tracks responses at following two layers

1. Services availability 2. Cost effectiveness To analyze the psychographic variables of the customers of different types of hospitals.

SCOPE OF THE STUDY

Scope of the study

It is aimed to study the hospitals at Sitapur and types of services available, availability of specialized doctors and patients behavior regarding various hospitals. The project is analyzed the demographic, psychographic and economic characteristics of the patients in taking medication. It includes the detailed study of patients focusing on the various parameters that lead to identifying and understanding the perception of the patients.

EXECUTIVE SUMMARY

Executive Summary
HEALTHCARE AND HOSPITAL INDUSTRY
Healthcare industry is a wide and intensive form of services which are related to well being of human beings. Health care is the social sector and it is provided at State level with the help of Central Government. Health care industry covers hospitals, health insurances, medical software, health equipments and pharmacy in it. Health care sector has changed substantially. With improvement in Medical Science and technology it has gone through considerable change and improved a lot.

The major inputs of health care industries are as listed below: I. II III. IV. Hospitals Medical insurance Medical software Health equipments

Health care service is the combination of tangible and intangible aspect with the intangible aspect dominating the tangible aspect. In fact it can be said to be completely intangible, in that, the services (consultancy) offered by the doctor are completely intangible. The tangible things could include the bed, the dcor, etc. Efforts made by hospitals to tangibles the service offering would be discussed in details in the unique characteristics part of the report.

Different types of health care services available in India

Hospitals Pathology Clinics Blood Banks Meditation Centers Emergency services like Ambulances, etc. Online Medical Services Telemedicine Naturopathy Yoga Centre Fitness Centre Laughter Clubs Health Spas In the Constitution of India, health is a state subject. Central govts intervention to assist the state govt is needed in the areas of control and eradication of major communicable & non- communicable diseases, policy formulation, international health, medical & Para-medical education along with regulatory measures, drug control and prevention of food adulteration, besides activities concerning the containment of population growth including safe motherhood, child survival and immunization Program. The plan outlay for central sector health programme in the Annual Plans 1997-98 is Rs.920.20 crore including a foreign aid component of Rs.400 Crore. A major portion of

outlay is for the control and eradication of diseases like malaria, , blindness being implemented under Centrally sponsored schemes. Another major component of the central sector health programme is purely Central schemes through which financial assistance is given to institutions engaged in various health related activities. These institutions are responsible for contribution in the field of control of communicable & non-communicable diseases, medical education, training, research and parent -care. In our project our focus has been the hospital sector which is the major component of the healthcare industry.

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OVERVIEW

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Overview
The Hospital Industry
Some Facts

Indias healthcare industry is currently worth Rs 73,000 crore which is roughly 4 percent of the GDP. The industry is expected to grow at the rate of 13 percent for the next six years which amounts to an addition of Rs 9,000 crores each year.

The national average of proportion of households in the middle and higher middle income group has increased from 14% in 1990 to 20 % in 1999.

The population to bed ratio in India is 1 bed per 1000, in relation to the WHO norm of 1 bed per 300.

In India, there exists space for 75000 to 100000 hospital beds. Private insurance will drive the healthcare revenues. Considering the rising middle and higher middle income group we get a conservative estimate of 200 million insurable lives

Over the last five years, there has been an attitudinal change amongst a section of Indians who are spending more on healthcare.

Corporate hospitals mushroomed in the late eighties. The boom remained short lived and out of the 22 listed hospitals scrips, most are being trading below par. An increasingly fragmented market, lack of statistics, capital intensive operations and a long gestation period are all wise reasons to shy away from investing in the healthcare industry.

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Government and trust hospitals dominate the scene. Many of the trust hospitals suffer from poor management. Good corporate hospitals are still too few to amount to a critical mass. Corporate hospitals failed a decade ago because they emerged in isolation and werent part of a larger phenomenon. However, now, there are the insurance companies, the hospital hardware and the software companies that have come together to create the boom.

Factors Attracting Corporate In the Healthcare Sector

Recognition as an industry: In the mid 80s, the healthcare sector was recognized as an industry. Hence it became possible to get long term funding from the Financial Institutions. The government also reduced the import duty on medical equipments and technology, thus opening up the sector. Since the National Health Policy (the policys main objective was Health For All by the Year 2000) was approved in 1983, little has been done to update or amend the policy even as the country changes and the new health problems arise from ecological degradation. The focus has been on epidemiological profile of the medical care and not on comprehensive healthcare. Socio-Economic Changes: The rise of literacy rate , higher levels of income and increasing awareness through deep penetration of media channels, contributed to greater attention being paid to health. With the rise in the system of nuclear families, it became

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necessary for regular health check-ups and increase in health expenses for the bread-earner of the family. Brand Development: Many family run business houses have set-up charity hospitals. By lending their name to the hospital, they develop a good image in the markets which further improves the brand image of products from their other businesses. Extension To Related Business: Some pharmaceutical companies like Wockhardt and Max India, have ventured into this sector as it is a direct extension to their line of business. Opening Of The Insurance Sector: In India, approx. 60% of the total health expenditure comes from self paid category as against governments contribution of 25-30 %. A majority of private hospitals are expensive for a normal middle class family. The opening up of the insurance sector to private players is expected to give a shot in the arms of the healthcare industry. Health Insurance will make healthcare affordable to a large number of people. Currently, in India only 2 million people ( 0.2 % of total population of 1 billion), are covered under Mediclaim, whereas in developed nations like USA about 75 % of the total population are covered under some insurance scheme. General Insurance Company has never aggressively marketed health insurance. Moreover, GIC takes up to 6 months to process a claim and reimburses customers after they have paid for treatment out of their own pockets. This will give a great advantage to private players like Cigna which is planning to launch Smart Cards that can be used in hospitals, patient guidance facilities, travel insurance, etc.

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The Consultants, Financiers and Insurance Agencies are to benefit from this boom. The insurers will use PPOs, that will grow into HMOs, to assume insurance risks on clients behalf. Medical Equipments, Medical Software and Hospitals will see the biggest boom.

THE SERVICE MARKETING TRIANGLE:

HOSPITAL

DOCTOR Company: Here, the hospital is the company

PATIENT that dreams up an idea of

service offering (treatment), which will satisfy the customers (patients) expectations (of getting cured).

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 Customer: The patient who seeks to get cured is the customer for the hospital as he is the one who avails the service and pays for it. Provider: Doctor, the inseparable part of the hospital is the provider, as he is the one who comes in direct contact with the patient. The reputation of the hospital is directly in the hands of the doctor. A satisfied patient is a very important source of word of mouth promotion for the organization.

Classification of Hospitals

HOSPITALS Objective Ownership Path Allopath Size District

TeachingcumResearch

Government

Semi-Govt General Voluntary Agencies

Ayurved

Taluk

Homeo

Special

Primary Health Centre

Unani Private Charitable Others Teaching

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7 Ps of marketing for hospitals

Product:
The service product is an offering of commercial intent having features of both intangible and tangible, seeking to satisfy the new wants and demands of the consumer. Hospital industry is action oriented and there is a lot of interaction with the customers (patients). The service product of the hospitals normally have the following features: o Quality Level: When we talk about marketing hospitals, it is natural that we are very particular about managing our services in the right fashion.

Supportive services play an important role in improving the quality of medicare. These services which include laboratory, blood-banks, catering, radiology and laundry, in a true sense determine the quality of services made available by medical and para-medical personnel. They get a strong base for treatment since the diagnostic aspect determines a direction. To get the best result from OT, it is natural that equipments are properly sterlised. In addition, the dresses and clothes are also required to be made bacteria free. The patients are required to wear disinfected linen which should be made available. The radiology department should have hi-tech facilities keeping in view the pressure of work. Of late, we find sophisticated equipments and unless hospitals make the same services available the same, the quality of services cannot be improved.

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o Accessories: This is a very good way of segmenting customers. Many hospitals provide additional services such as catering, laundry, yoga sessions, cafeterias, etc. for the customers (patients)who are willing to pay extra. Hospitals have different wards General and Special. Certain

hospitals provide services for the family members of the patients (when they are not from the same city) accommodation and catering.

o Packaging: It is the bundling of many services into the core service. Eg: Apollo hospital offers a full health check-up to the patients. Similarly other hospitals also offer package deals for health check-ups. For example if a person has to undergo a bypass surgery, he can pay a lump sum amount during admission, say rupees 1 lakh for all procedures, tests, stay, etc, at once.

o Product line: hospitals through their services offer many choices to the patients and cover a wide range of customer needs. For example: Apollo hospital has dental department, cardiology department, etc. and within the dental department it has dental surgery, root canal, etc.

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o Brand name: The hospitals, to differentiate themselves, and their services from others use a brand name. The intangibility factor of the service makes it all the more important for the hospitals to do so.

Place
Under hospital marketing, distribution of Medicare services plays a crucial role. This focuses on the instrumentality of almost all who are found involved in making services available to the ultimate users. In case of hospitals the location of hospital plays a very important role. The kind of services a hospital is rendering is also very important for determining the location of the hospital. Eg. Tata memorial hospital specializes in cancer treatment and is located at a centre place unlike other normal hospitals, which you can find all over other places. It can be unambiguously accepted that the medical personnel need a fair blending of two important properties i.e. they should be professionally sound and should have in-depth knowledge at psychology. A particular doctor might be famous for his case handling records but he may not be made available for all the patients because of the place factor. Now in this case the service provided, that is the doctor may be a visiting doctor for different hospitals at different locations to beat the place factors. Unlike other service industries, under hospital marketing all efforts should be for making available to the society the best possible medical aid.

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In a country like India, which is geographically vast and where majority of the population lives in the rural areas, place factor for the hospitals play a very crucial role. A typical small village / town may be having small dispensaries but they will not have super speciality hospitals. For that they will have to be dependent on the hospitals in the urban areas.

People Under hospital marketing the marketing mix variable people includes all the different people involved in the service providing process (internal customers of the hospitals) which includes doctors, nurses, supporting staff etc. The earliest and the best way of having control on the quality of people will be by approving professionally sound doctors and other staff. Hospital is a place where small activity undertaken can be a matter of life and death, so the people factor is very important. One of the major classifications of hospitals is private and government. In the government hospital the people factor has to be specially taken care of. In Indian government hospitals except a few almost all the hospitals and their personnel hardly find the behavioural dimensions significant. It is against this background that even if the users get the quality medical aid they are found dissatisfied with the rough and indecent behaviour of the doctors. Under hospital marketing a right person for the right job has to be appointed and they should be adaptable and possess versatility. The patients in the hospitals are already

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suffering from trauma, which has to be understood by the doctors and other staff. The people of the hospital should be constantly motivated to give the best of their effort.

Process
Process generally forms the different tasks that are performed by the hospital. The process factor is mainly dependent on the size of the hospital and kind of service it is offering. A typical process involved in a medium sized hospital can be as follows.

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Apart from this flow there are other allied activities like record keeping administration at services etc which fall under the process factor. These stages do not exist separately but are interlinked. The most important elements are lines of communication within the setup. The experience of the patient depends on the final interplay of all these factors.

Physical evidence
It does play an important role in health care services, as the core benefit a customer seeks is proper diagnosis and cure of the problem. For a local small time dispensary or hospital physical evidence may not be of much help. In recent days some major super speciality hospitals are using physical evidence for distinguishing itself as something unique.

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Physical evidence can be in the form of smart buildings, logos, mascots etc. a smart building infrastructure indicates that the hospital can take care of all the needs of the patient.

Promotion:

Hospitals for promotion use either advertisement or PR or

both after taking into

consideration the target customers, media type, budget and the sales promotion. Since a few years the prime times in T.V. are reserved for advertising social issues like family planning, use of different types of contraceptives, care for the girl child and so on. These commercials use the common man approach for reference group appeal. In case of health care products and services use for common man appeal is widely prevalent. The use of celebrities is not as effective as that of a common man. An ordinary person thinks that if it works well for people like him, it will also work equally well for him. The identification with the common man is easy and quick. Besides TV, other media of promotion are to be used innovatively. Unlike the urban area, in rural areas newspapers and magazines do not have the same impact in conveying messages. In villages, hoardings and wall writings near the markets and recreation centers attract the attention of villagers. This market consists of 180 million strong middle income group and a small income group. This group has a large discretionary income. These discerning consumers are very careful in choosing health

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care services. The last decade has witnessed a health, appearance and nutrition conscious population. The health care field has become very competitive. Although around one-fourth of our population stays in urban India, three fourths of the total doctors have engaged themselves in this part. Many of these doctors visit the contiguous rural areas, but they may operate from the urban area. The patients of upper middle and upper income group have a wide choice to make from a number of clinics and hospitals. Therefore, many hospitals have abandoned traditions and adopted marketing strategies to woo more and more patients to their clinics. Word-of-mouth plays a very important role in promotion of hospitals. A person in need of a health care service does not know for sure where to search for relevant information. He consults his family members, relations and friends first. The patients who come to a hospital generally have the old patients of that hospital as referrals. Word-of-mouth plays an important role during information acquisition stage of the customers as there are no objective performance measures to judge the various alternatives available to them. Therefore, satisfied past patients of a hospital can bring more number of patients to that hospital than a number of advertisements. In a competitive market place, the images of the firms swill affect their competitive standing. One factor that is likely to have a significant impact on the health care scene is the growth of hospital chains such as Apollo Hospitals, Birla Health Centres ,etc. Artificial heart transplants and other complex operations although are few in number and generate a small portion of the total revenue, they help in generating word-of-

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mouth which health care providers are actually interested. Many of these companies are spending a lot in corporate advertising for Image building.

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Marketing hospitals

Marketing in Hospitals Marketing is unethical was the frequent refrain in the eighties, when very few hospitals realized that it was necessary to incorporate marketing as an integral function in the hospital operations. But the major argument at that time lay in understanding whether this professional orientation was really required for its viability, profitability and sustainability. This argument however became favorable in the late nineties as corporate companies like Wockhardt and Max India started venturing into the hospital industry, apart from the ongoing mergers and acquisitions that were already taking place at that time. Even the TPAs started building tie-ups with corporate clients and there was already an abysmal utilization of resources in the existing hospitals. In addition to the above a major factor that contributed to the acceptance of marketing in hospitals was an increase in the delivery of services. Perception of patients was another important consideration for hospitals, as they felt that the patients would take them as profit oriented organization rather than service oriented organization. Ultimately, marketing was accepted only by a few while the others discarded the concept. Hospitals who accepted marketing also carried out their functioned by concentrating around corporate clients. Lately it has been felt that many Indian hospitals have a dilemma regarding the functions of marketing. In an era where hospitals are experiencing a major shift in their clientele, they are worried more about the patients perception of hospitals and therefore the concept of brand restructuring and brand engineering is vital.

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As hospitals spend millions of rupees in technology and infrastructure, it becomes necessary, that they attract patients and generate funds. In order, to do the same, the hospitals follow various marketing and brand building exercises. Some of them are listed below:

Many hospitals have eminent personalities from the industry in their Board of trustees. This indirectly leads to increase in, inflow of patients, working in the companies of these Trustees. Besides the presence of eminent personalities creates a sense of confidence in the minds of people.

Private hospitals can attract their shareholders by offering discounts. For example, a special discount of 20 % on all preventive health checks is offered to all shareholders of Apollo Hospitals Limited.

Hospitals have long-term understanding with PPOs (Preferred Provider Organization), which further have understanding with corporate. Any case of sickness found in the employees of these corporate refer them to the PPOs , which further sends them to the hospital for check-ups and treatment.

The success rate of crucial operations and surgeries, reflect the technological and knowledge- based edge of the hospital over the competitors. Such successes are discussed in health magazines and newspapers, which becomes a natural advantage for the hospital.

Some hospitals by means of their past track record have created a niche market for themselves. For example, Hinduja Hospital is known for its high-quality healthcare at reasonable rates, whereas Lilavati Hospital is known for its five-star services.

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Hospitals hold seminars and conferences relating to specific diseases, where they invite the doctors from all round the country, for detailed discussion. This makes the hospital well known amongst the doctors, who could in future refer complicated cases to the hospital.

Hospitals can also promote medical colleges. This helps them to generate extra resources in form of fees, using the same infrastructure.

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HOSPITAL AT SITAPUR

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Hospitals at Sitapur
On basis of administration hospitals can be widely categorized into three types: Government Hospitals Private Hospitals Missionary Hospitals

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Government Hospitals at Sitapur

There are two government hospitals at Sitapur i.e. District Hospital & Female Government Hospital.

District Hospital

This hospital is directly governed by Government of Uttar Pradesh and all the Doctors, Administrative Staff, Nurses and Ward Boys are the employee of Government of Uttar Pradesh.

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Departments at Government Hospital

Department Administration General Physician (General Ward) Department of Surgery Department of Cardiology Department of Skin & Venereal Diseases Department of ENT (Ear, Nose, Throat) Emergency Department of Pediatrics Department of Tuberculosis & Chest Department of Orthopedics Department of Dental Specialist Dr. Vijay Kumar Singh (M.B.B.S) Dr. Awdhesh Chandra (M.B.B.S) Dr. H.K.Fuloria (M.S) Dr. Shekhar Bharaddwaj (M.S) Dr. B.R.Jaiswal (M.B.B.S , Dip (card.) Vacant Dr. Yashwant Singh (D.L.O) Dr. Sharad Chandra (M.B.B.S) Dr. S.P. Singh (M.D (Ped.) Dr. A.K.Arya (D.T.C.D) Dr. S.P.Ojha M.D (Ortho) Dr. D.K.Gangwar M.D (Ortho) Dr. Sunita Ambust (B.D.S)

Fee Structure
Patient form of has to taken from outdoor of Re. 1 for any department which is valid for 1 week. Basic medicine is for free. Prescribed medicine can be taken from any medical store.

Other Facilities Available

X- Ray:- Rs. 55 per X-ray Pathology Normal Surgery Oxygen
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 Ambulance Milk for Kids DOTS (free Medicine for Tuberculosis) AIDS Diagnosis (Free) Wards for Admitting Patients (No of Total Beds 207) General Ward:- Rs. 10 daily per bed Private Ward :-Rs. 30 Daily per bed Emergency:- Totally Free

Female Government Hospital

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This hospital was basically developed for birth operations, normal deliveries, various vaccinations in kids and new born baby.

Basic medications available

Delivery Surgery Vaccination Adolescence gynecological problems General gynecological problems

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Departments at Government Hospital

Department Administration

Specialist
Chief Medical Officer Dr. Suman Mishra D.G.O Dr. Suvidha Singh D.G.O

O.P.D

Department of Pediatrics

Dr. Sushma Karanwal M.B.B.S Dr. Madhur Singha

Department of Gynecology

M.B.B.S Dr. Richa Pandey D.G.O

Fee Structure
Patient form of has to taken from outdoor of Re. 1 for any department which is valid for 1 week. Basic medicine is for free. Prescribed medicine can be taken from any medical store.

Other Facilities Available

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Normal Surgery Oxygen Ambulance Milk for Kids Wards for Admitting Patients Emergency Totally Free

Private Hospitals
There are many private hospitals and nursing homes in Sitapur. Some are detailed below:

1. Saksham Nursing Home

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Dr. Kanika Agarwal D.G.O (Gayane)

Dr. Sameer Agarwal M.S, Ortho

2. Pragati Nursing Home

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 Dr. Anand Jaiswal M.S (Ortho) Dr. Neera Jaiswal M.S

3. Vinod Nursing Home

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Dr. P.K. Rastogi B.A.M.S

Dr. P.K.Dhawan M.D (Consultant on Call)

4. Amrit Nursing Home

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Dr. G.P. Gupta M.S

Dr. Sikha Gupta Gayane

5. Ishwar Mother & Child Care Nursing Home

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Dr, Sunil Vaish M.D (Pediatrician)

Dr. Chitra Vaish M.S (D.G.O)

6. Sethi Nursing Home

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Dr. Gagan Sethi M.S (Ortho)

Dr. Seema Sethi D.G.O

Dr. Manish Sethi DCH (Pediatrician)

Dr. Shilpi Sethi M.D (Anesthesia)

Missionary Hospital
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B.C.M hospital is the only one missionary hospital at dist. Sitapur, Situated at Khairabad, nearly six kilometers from the city heart. BCM hospital, was established by Fr. Gerard at Khairabad for serving people.

Departments at BCM Hospital

Department

Specialist
Dr. Sr, Mary Rose Chief Administrator

Administration

Dr. Manish Rastogi M.D, Physician

Assistant administrative Dr. Sr. Leena

Department of Gynecology

D.G.O Dr. Alka M.B.B.S Dr. Reena M.B.B.S Dr. Sushma

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M.B.B.S Dr. Nancy M.B.B.S Dr. Mamta

M.B.B.S Dr. Vishal Bhatnagar

General Physician

M.D Dr. Rajeev M.B.B.S Dr. A.P Gupta M.B.B.S Dr. Shailendra Shukla M.B.B.S

Special Facilities
Ophthalmology, General Surgery, Orthopedic, Psychiatrist, 44

Pediatrics, X-ray, Ultrasound, Pharmacy Skin Care.

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RESEARCH METHODOLOGY

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Methodology of Project

A survey process consists of stages or steps that guide the project from its conception through the final analysis, recommendations and ultimate actions. The research process provides a systematic, planned approach to the research project and ensures that all aspects of the research project are consistent with each other.

SURVEY PROCESS
<

The research process has four distinct yet interrelated steps for research analysis It has a logical and hierarchical ordering: Determination of information research problem. Development of appropriate research design. Execution of research design. Communication of results. Each step is viewed as a separate process that includes a combination of task , step and specific procedure. The steps undertake are logical, objective, systematic, reliable, valid, impersonal and ongoing.

EXPLORATORY RESEARCH
The method used for exploratory research is Primary Data Secondary data 47

PRIMARY DATA

Data which is collected for the first time is called primary data or we can say that new data which is collected for the first time to solve the problem is known as primary data. Qualitative or quantitative data that are newly collected in the course of research, Consists of original information that comes from people and includes information gathered from surveys, focus groups, independent observations and test results Primary data is basically collected by getting questionnaire filled by the respondents.

SECONDARY DATA

Information that already exists somewhere, and have been collected to solve research problem is known as secondary data. Sources include census reports, trade publications, and subscription services. Data that have already been collected and published for another research project .There are two types of secondary data: internal and external secondary data. Information compiled inside or outside the organization for some purpose other than the current investigation. Research information which has already been published. Market information compiled for purposes other than the current research effort; it can be internal data, such as existing sales-tracking information, or it can be research conducted by someone else, such as a market research company or the U.S. government Secondary source of data used consists of books and websites

DESCRIPTIVE RESEARCH
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STEPS in the descriptive research: Statement of the problem Identification of information needed to solve the problem Selection or development of instruments for gathering the information Identification of target population and determination of sampling Plan. Design of procedure for information collection Collection of information Analysis of information Generalizations and/or predictions

DATA COLLECTION

Data collection took place with the help of filling of questionnaires.. The common factor in all varieties of the questionnaire method is this reliance on verbal responses to questions, written or oral. The questionnaire was designed in such a way so that it can be understood by all the respondents. It was also important as researcher to respect the samples time and energy hence the questionnaire was designed in such a way, that its administration would not exceed 4-5 mins. These questionnaires were personally administered.

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The first hand information was collected by people who filled the questionnaires. The primary data collected by directly interacting with the people. The respondents were contacted at hospitals and market. The data was collected by interacting with 100 respondents who filled the questionnaires and gave the necessary information. The respondents consist of house wives, students, business men, professionals etc. the required information was collected by directly interacting with these respondents.

DETERMINATION THE SAMPLE PLAN AND SAMPLE SIZE

TARGET POPULATION

Target population to be served by project includes key demographic information (i.e.; age, sex etc.). The target population is the population on which study of the research is based upon and on which conclusion is to be made. In an ideal situation, the sampling frames to matches the target population. The respondents consist of house wives, students, business men, professionals etc. the required information was collected by directly interacting with these respondents. I have selected the sample trough Simple random Sampling

SAMPLE SIZE:

This involves figuring out how many samples are required to conduct research. The numbers of samples research need are affected by the following factors: Project goals

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How you plan to analyze your data How variable your data are or are likely to be How precisely you want to measure change or trend The number of years over which you want to detect a trend How many times a year you will sample each point How much money and manpower you have

SAMPLE SIZE

I have targeted 100 people in the age group above 21 years for the purpose of the research. The sample size is influenced by the target population. The target population represents the Sitapur regions. . The people are from different professional backgrounds. The details of our sample are explained in chapter named primary research where the divisions are explained in demographics section.

SAMPLING TECHNIQUE

Simple random sampling technique has been used to select the sample A simple random sample is a group of subjects (a sample) chosen from a larger group (a population). Each subject from the population is chosen randomly and entirely by chance, such that each subject has the same probability of being chosen at any stage during the sampling process. This process and technique is known as Simple Random Sampling, and should not be confused with Random Sampling.

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ERRORS IN THE STUDY

Interviewer error There is interviewer bias in the questionnaire method. Open-ended questions can be biased by the interviewers views or probing, as interviewers are guiding the respondent while the questionnaire is being filled out. The attitudes the interviewer revels to the respondent during the interview can greatly affect their level of interest and willingness to answer openly. As interviewers probing and clarifications, maximize respondent understanding and yield complete answers, these advantages are offset by the problems of prestige seeking, social desirability and courtesy biases. Questionnaire error The questionnaire designing has to careful so that only required data is concisely reveled and there is no redundant data generated. The questions have to be worded carefully so that the questions are not loaded and does not lead to a bias in the respondents mind Respondent error The respondents selected to be interviewed were not always available and willing to co operate also in most cases the respondents were found that they have no knowledge, opinion, attitudes or facts required additionally uninformed response errors and response styles also led to survey error. Sampling error

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In the research study sample size of 100 is taken, which cannot determine the buying behavior of the total population.

Research Design

Research design is a conceptual structure within which research is conducted. A research design is the detailed blueprint used to guide a research study towards its objective. It is a series of advanced decision taken together comprising a master plan or a model for conducting the research in consonance with the research objectives. Research design is needed because it facilitates the smooth sailing of the various research operations, thereby making research as efficient as possible yielding maximum information with the minimum effort, time and money.

RESEARCHD ESIGN

EX RATORY PLO RESEARCH D ESIGN

CO CLU E N SIV RESEARCH D ESIGN

D ESCRIPTIV E RESEARCH

CAU SAL RESEARCH

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DATA ANALYSIS AND INTERPRETATION

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Data analysis and interpretation

1. Have you been diagnosed for any disease?

Yes 89%

No 11%

11%

Yes No

89%

Interpretation
89% of the respondent said that they were diagnosed for one or the other disease while 11% of the respondent said they were never diagnosed for disease.

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2. For Medication which hospital did you choose? Government Hospital Private Hospital Missionary Hospital 65 % 25 % 10 %

10% Government Hospital 25% Private Hospital 65%

Interpretation
65% of the respondent said that they preferred Government hospital, 25% preferred Private hospital and 10% of the respondent preferred Missionary Hospital.

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3. Please look at the list of specialists below and tick those who have been involved in your care. General Practitioner Neurologist Physiotherapist Dietitian Psychologist / counselor GP Practice nurse Occupational therapist Rehabilitation consultant Optician Continence adviser Benefits agency adviser Speech therapist 80 % 8% 6% 1% 2% 26% 35% 12% 5% 26% 6% 10% 0%

0% 3%5% 12% 2% 6% 16% 12% 36%

4% 3% 1% 0%

General Practitioner Neurologist Physiotherapist Dietitian Psychologist / counselor GP Practice nurse Occupational therapist Rehabilitation consultant Optician Continence adviser Benefits agency adviser Speech therapist

Interpretation
80% of the respondent visited general practitioner, 85 visited neurologist, 1% dieticians, 2% psychologist, 26% GP, 35% practice nurse, 12% therapist, 5% consultant, 26% optician, 6% to advisors .

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5. For Medication which hospital did you find more effective? Government Hospital Private Hospital Missionary Hospital 20% 25% 55%

20% Government Hospital Private Hospital 55% 25% Missionary Hospital

Interpretation
20% of the respondent find government hospital more effective while 25% of the respondent find private hospital effective in curing patients while rest 55% preferred and find missionary hospitals effective

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6. Which of the following reasons affects your choice of the hospital for medication? a. Fee Structure

Yes 75%

No 25%

25%

Yes No

75%

Interpretation
75% of the respondent said that fees matters while getting medication while 25% did not bothered about fees.

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b. Services Available

Yes 75%

No 25%

25%

Yes No

75%

Interpretation
75% of the respondent said that service matters while getting medication while 25% did not bothered about services.

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c. Non-Hygienic Condition of Hospital

Yes 68 % No 32 %

32% Yes No 68%

Interpretation
68% of the respondent said that non hygienic condition of the hospital effects their choice of preference while 32% of the respondent said that it does not effects them.

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d. Non Availability of Specialists

Yes 46%

No 54%

Yes No

Interpretation
46% of the respondent said that unavailability of specialist in hospital effects their choice of preference while 32% of the respondent said that it does not effects them.

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FINDINGS

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Findings & Suggestion

The general perception that large hospitals, with high bed-occupancy rate, are profitable is misleading. Global experience shows that hospital with more than 250 beds dont do well. Many Indian hospitals are following the US healthcare industry, by decreasing the average length of stay of patients and increasing patient turnover. US research shows that 80% of the revenues form a patient comes in the first 72 hours post- admission. Hospitals generate a lot of revenues from General Inspection, because the patient turnover is very high.

A large percent of revenues come from specialized services like operations and surgeries. It is because of these reasons that many corporate are planning for a small 100 beds specialized hospitals, which caters to specific diseases like cardiac, cosmetic surgery, neurology etc. Research shows that there exist a lot of space for super-specialized hospitals with 100-150 beds, which generate revenues equivalent to large 500 bed general hospital. Typically large hospitals with approximately 500 bed capacity takes about 9-10 years to break even whereas super-specialty hospitals with about 100 beds take about 6-7 years to break even. Therefore, going in for super-specialty hospitals seems to be a more viable option today.

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 Hospitals could also generate revenues from medicines if they are supplying them in-house. Some hospitals make it mandatory for the patients to buy medicines from the hospitals chemist shop. A margin of 15-20 % can be charged for such medicinal supplies. Though many hospitals run by Trusts do not earn this way, but new entrants or corporate for whom private healthcare sector is a direct extension of their line of business ( eg. Parma companies), can generate good returns from medicine supply.

Health Plan packages can be provided by hospitals to family and corporate. For example Family Health Plan Services (FHP), a subsidiary of Apollo Hospitals does health management of employees of its clients. With a wide net work of Hospitals and Healthcare providers countrywide, and a tie -up with General Insurance Corporation of India, FHP offers a range of services to employees and dependants, such as Preventive Healthcare, Corporate Counseling, welfare Programmes, Claims Administration, Patient-care Coordination and so on. So FHP's healthcare packages, optimize the benefits while keeping the cost under control.

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CONCLUSION

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Conclusion
The conditions of hospitals at Sitapur is not very good, lack of services, mismanagement, lack of doctors, unavailability of various apparatus can be easily diagnosed. The blood bank is not available in the city for blood either relative have to donate blood or they have to buy it from Lucknow. Many specialists such as Neurosurgeon, cardiologist, open heart surgery, plastic surgery etc., is not yet available. For these services patients are referred either to K.G.M.U or P.G.I, Lucknow. Government hospitals are less costly but many basic facilities are unavailable. Oxygen, ambulance and surgical equipments are not available in emergency. Comparatively Private hospitals have good facilities but very costly and above reach of common man.

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 No private hospital in Sitapur has the entire physician under its roof. Each has only one or two departments. Missionary Hospital (B.C.M) has all the facilities available at good rates. Its major drawback is, it is out of the main city and unavailability of transport so every man cannot reach there.

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RECOMANDATION AND SUGGESTION

RECOMANDATION AND SUGGESTION

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 Apart from preventive healthcare, stress management programs could be provided. For example Effective Stress Management Programme offered by Wockhardt Hospital. This programme provides a medical perspective of stress and is conducted by a medical professional. The programme includes a series of one-to-one sessions, with a clinical Psychologist highlighting the factors responsible for inducing stress, and the methodologies, which can be adopted to cope with this phenomenon practically Hospitals can become integrated healthcare systems i.e. when medicines, food services, laundry and linen etc will become "purchased" services. These third-party operations will increase the profit margins. Mergers could be used for synergy of skills - i.e. to help the merged organizations benefit from one another's individual strengths by applying them across the board. It also helps them to make joint investments in branding or information technology and also to react effectively to the changed market forces. Hospitals could also generate revenues from medicines if they are supplying them in-house. Some hospitals make it mandatory for the patients to buy medicines from the hospitals chemist shop. A margin of 15-20 % can be charged for such medicinal supplies. Though many hospitals run by Trusts do not earn this way, but new entrants or corporate for whom private healthcare sector is a direct extension of their line of business ( eg. Parma companies), can generate good returns from medicine supply. Health Plan packages can be provided by hospitals to family and corporate. For example Family Health Plan Services (FHP), a subsidiary of Apollo Hospitals does

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health management of employees of its clients. With a wide net work of Hospitals and Healthcare providers countrywide, and a tie -up with General Insurance Corporation of India, FHP offers a range of services to employees and dependants, such as Preventive Healthcare, Corporate Counseling, welfare Programmes, Claims Administration, Patien

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LIMITATION

72

LIMITATIONS

For analysis we took the sample of 100 customers.so, perhaps the findings of this may not be accurate. Most of the customer was not ready to fill the questionnaire.

As the universe was single (lucknow) . So the right type of knowledge has not been collected. Some customers gave very limited answers.

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BIBLIOGRAPHY

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BIBLIOGRAPHY

BOOKS Kothari Philip, Marketing Management, Prentice Hall India, New Delhi. Kothari C.R, Research Methodology, Wishwa Prakashan, New Delhi.

NEWSPAPERS The Times of India Business Times Economic Times

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ANNEXURE

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Patient questionnaire
Name............................................................................................ Date of birth........................ ...................................................................................................... 1. Have you been diagnosed for any disease? Yes No

2. For Medication which hospital did you choose? Government Hospital Private Hospital Missionary Hospital

3. Please look at the list of specialists below and tick those who have been involved in your care. Neurologist Physiotherapist Dietitian Psychologist/counsellor GP Practice nurse Occupational therapist Rehabilitation consultant Optician Continence adviser Benefits agency adviser Speech therapist

Any other specialists you have come into contact with who are not listed above: .................................................................................................................................................... .................................................................................................................................................... 5. For Medication which hospital did you find more effective? Government Hospital Private Hospital Missionary Hospital Why?

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.................................................................................................................................................... 6. Which of the following reasons affects your choice of the hospital for medication? a. Fee Structure Yes b. Services Available Yes c. Non-Hygienic Condition of Hospital Yes d. Non Availability of Specialists Yes No No No No

Any others ?

7. Problems faced at Government Hospital a. Costly Medication Fee Yes b. Unavailability of Services Yes c. Non-Hygienic Condition of Hospital Yes d. Unavailability of Specialists Yes e. Over Rush Yes f. Ignorance of Doctor Yes No No No No No No

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8. Problems faced at Private Hospitals a. Costly Medication Fee Yes b. Unavailability of Services Yes c. Non-Hygienic Condition of Hospital Yes d. Unavailability of Specialists Yes e. Over Rush Yes f. Ignorance of Doctor Yes No No No No No No

9. Problems faced at Missionary Hospital a. Costly Medication Fee Yes b. Unavailability of Services Yes c. Non-Hygienic Condition of Hospital Yes d. Unavailability of Specialists Yes e. Over Rush Yes f. Ignorance of Doctor Yes No No No No No No

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