No one anticipated that the novel coronavirus, first reported in China in December 2019,
would become a global pandemic and alter the way our world works, forever. In India, the
outbreak of SARS-CoV-2 blatantly exposed the vulnerabilities of our healthcare system, with the scarcity of hospital beds being a major concern during the first two waves of the viral infection.
Due to a severe shortage of hospital beds, as well as to ease overcrowding in hospitals, many patients were advised to use homecare services during the peak infection period of COVID-19. Thus, our country’s healthcare crisis opened up a number of previously untapped and unexplored avenues, which have since developed significantly.
The ‘contact-free’ nature of telemedicine services made them immensely popular during the pandemic period. According to a survey, telemedicine users nearly doubled during the lockdown, from only 21% of consumers in the pre-lockdown period to 44% at that time. Additionally, 73% of those who have never used telemedicine services before are indicating a readiness to do so now(4). The telemedicine market in India, valued at $830 million in 2019, is projected to grow at a CAGR of 31% and touch $5.5 billion by 2025(5).
Similarly, home diagnostic testing also saw a significant increase in popularity during the lockdown, due to its prompt and practical results. In FY-2021, the Indian diagnostics lab market was estimated to be worth $12319.32 million. It is expected to grow at a CAGR of 12.25% by FY2027(6).
There was also a significant increase in the at-home collection of samples for laboratory tests. A survey showed that almost 74% of respondents preferred sample collection at home rather than going to a hospital or lab. Patients also preferred receiving their postoperative care and therapy at home due to lower chances of infection, greater comfort, and lower costs(5). There was an impetus in the popularity of home diagnostic and health monitoring devices as well during the same period. Besides convenience and comfort, patients prefer home health care for its lower cost. By using home healthcare services, patients can reduce their overall medical treatment expenditures by up to 25%(9).
The 2011 Census reported that 52.1% of Indian households were nuclear families. With a greater shift to this type of family structure coupled with the increased participation of women in the workforce, people are hard-pressed to dedicate their time and attention to their aged parents, especially in urban India. This contributes to an increased dependency on home healthcare facilities to bridge the gap.
The Long-Term Care Insurance system resulted in an 82% increase in the use of home healthcare facilities within 2 years and created nearly 2 million jobs within the first 10 years
An interconnected health information exchange system was established in which patients’ lifestyle changes are updated on mobile apps. This allowed doctors to track and manage medications and other aspects of care more effectively
Citizens can track their heart rhythm using wearable devices or smartphones and monitor their health status. This allows patients to effectively monitor their health condition
In most European countries, home healthcare is under the organized control of the government and municipality. Such a system does not exist in India, and the majority of the home healthcare market falls into the unorganized sector. However, as a result of the current catalyzed growth, organized home healthcare players are expected to lead market growth from 1.1% by 2020 to 2.4% by 2025(3).
Currently, the greatest challenges to making high-quality healthcare accessible to everyone are the high population burden and poor economic background of the majority of citizens. India can overcome this by leveraging its vast human resources. With the introduction of ‘Digital India’, the Indian government has boosted the penetration of internet facilities throughout the country. The percentage of people using the internet increased to 47% in 2021(12). The integration of digitization in the industry can increase the regulation of home healthcare facilities and make them more accessible to patients.
Hospitals, as well as stand-alone players, are involved in the home healthcare market in India. Some of the notable home healthcare providers in India include:
Besides the greater quality and reach of healthcare facilities, home health care is also creating significant job opportunities and is expected to generate up to 3.1 million jobs by 2025. A growing organised home healthcare industry will lead to better quality services and safer working conditions.
The Indian government launched its national telemedicine platform, called e-Sanjeevani, in April 2020. In June 2022, the government integrated e-Sanjeevani with the Ayushman Bharat Digital Mission (ABDM) to allow easier storage of medical records and their transactions with healthcare providers.Such digitalization initiatives further promote the accessibility of home healthcare in India.
Due to its increasing demand, many private insurance companies are expanding their coverage to include home healthcare services. Senior citizens with Max Bupa Health Insurance are covered for home care services recommended by their doctors under domiciliary therapy. Religare Health Insurance pays about 10% of the insured amount for at-home care(9).
The Healthcare Federation(3). of India released its whitepaper with recommendations for the government to further improve home healthcare. It calls for greater involvement of the government in the management of the home healthcare system in India. Some of the actions expected of the government include
The Healthcare Federation of India recommends that home healthcare may be guided by the principle that “what can be done at home MUST be done at home”
Home healthcare may provide long-term answers to the problems that continue to plague the world, including changing disease profiles, a changing demographic pyramid, changing family structures, and rising healthcare costs. The growing need for home-based care and experiences from the COVID-19 pandemic point to a greater requirement for investment in home healthcare, as this would drastically improve access and continuity of care when resources are limited. Additionally, this could create employment opportunities for millions. Most notably, the quality of home healthcare can be greatly improved in India if the government steps up to introduce regulations for the standardisation of this sector.