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What is the Future of Home Healthcare in India?

Market Trends

What is the Future of Home Healthcare in India?

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.

Niti Aayog reports that 65% of hospital beds in India cater to 50% of the population, while the other half is dependent on the remaining 35% of hospital beds. This is brought on by pronounced regional disparities in India’s healthcare system(1) There are stark differences in healthcare infrastructure development between urban and rural areas, as well as between different states. According to the Human Development Index 2020, India has merely 5 hospital beds and 8.6 physicians per 10,000 people. The country ranks only 155th on the Global Health Index (2) With a population of more than 1.38 billion, India’s healthcare infrastructure is woefully inadequate.
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.

What is Home Healthcare?

Home healthcare is an umbrella term referring to the medical services and assistance
offered to healthcare seekers at their homes. This includes:

Home healthcare services such as home medical and nursing assistance and lab services
● Home healthcare devices that cover all health screening, monitoring, and self-
diagnostic devices
Home healthcare solutions such as telemedicine and telehealth services

COVID-19: The spark plug for growth of home healthcare in India

Home healthcare services were previously available in India, but they truly expanded their reach during the height of the infection and lockdown and proved that they could close the enormous gap between demand and supply. During the lockdown, healthcare seekers had access to respiratory therapy, lab tests, health monitoring equipment, and teleconsultation services from the comfort of their homes. Around 21.5 million COVID patients received home-based care, and 93% of patients recovered from COVID-19 through home healthcare(3).

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).

Growth Catalysts

  • Ageing Indian population

WHO reports that by 2025, India’s elderly population is projected to increase to 158.7 million, thus making up 11.1% of the country’s overall population (7). According to ‘The National Commission on Population’, India’s elderly population will reach 193.8 million by 2031(8). The 75th NSS survey found that 21% of India’s elderly suffer from at least one chronic disease, with hypertension and diabetes accounting for 68% of them(7). This implies that in the future, there will be a significantly growing demand for home healthcare services such as telemedicine, medical assistance, at-home laboratory services, and personal monitoring devices.

  • The increasing burden of chronic diseases

By 2030, it is projected that lifestyle diseases will account for a staggering 74% of all fatalities (up from 56% in 2008) in India, with the bulk of cases being related to cardiovascular disease, cancer, and diabetes. As a result, home care facilities would experience a huge increase in demand. 

  • Cost of treatment

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).

  • Changing family structure

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.

Market value

The global home healthcare market value was estimated to be $320.6 billion in 2021 and is expected to grow at a projected CAGR of 7.9% from 2022 to 2030(11). The Indian market in particular was valued at $7.4 billion and is anticipated to increase at a CAGR of 19.27% from 2022 to 2030(3).

What can India learn from the successful home healthcare models of other countries?

India’s home healthcare expenditure accounts for only about 3.6% of all healthcare expenditure, compared to 8.3% in developed nations. Countries such as the US, Japan, Canada, Denmark, Iceland, Sweden, and Norway have successful models of home healthcare.

Country Home Healthcare Programm
USA
    • Triple Aim: By providing post-acute care at home, Medicare expenditure was reduced by 39% per patient
    • Hospital at Home: Johns Hopkins’ initiative for the delivery of acute care at home resulted in a 32% reduction in expenditures and a 33.33% reduction in the duration of hospital stay
    • Advanced Care at Home:  This initiative by Mayo Clinic resulted in faster recovery of patients with a 30% reduction in cost for the patient as well as hospital
Japan 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
Canada Recognising home care as an essential component of the Canadian healthcare system resulted in a 100% increase in home care beneficiaries within a decade, as well as an 82% decrease in the number of hospital bed days
Denmark Telehealth projects helped in the delivery of care and monitoring of COPD patients at home. Municipalities were in charge of providing care and services
Iceland 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
Sweden 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
Norway Integrated technology to create a dementia-friendly society

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.

Home healthcare providers in India

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:

● Nightingales: With over 1100 employees and 28 different services in Bangalore, Hyderabad, Mumbai, and Chennai, ‘Nightingales’ has served over 1 lakh customers over the past 22 years

● Portea: With tie-ups to over 70 hospitals, Portea operates in 16 cities and has served over 5 lakh patients so far
● Care24: Care24 operates in 9+ Indian cities and has more than 1.3 million patient visits

● Apollo Homecare: Apollo Homecare operates in 11 cities and has an annual patient flow of 2 lak

The future ahead for the Indian home healthcare sector

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

  • Establishing a standardised registration process for home care service providers
  • Ensuring quality accreditation specific to home care
  • Creating a formal process for employee training, certification, compensation, and verification
  • Implementing staff safety guidelines and regulations 
  • Defining virtual care delivery standards, integration, and adoption guidelines 
  • Guaranteeing insurance coverage for all home healthcare services and products

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”

Conclusion

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.

References

1.https://www.niti.gov.in/sites/default/files/2022-02/AIM-NITI-IPE-whitepaper-on-Blended-Financing.pdf.  Accessed on 1st August 2022.

2. https://hdr.undp.org/system/files/documents//hdr2020pdf.pdf Accessed on 1st August 2022.

3. https://www.nathealthindia.org/pdf/wp/june/Home_healthcare_whitepaper.pdf. Accessed on 1st August 2022.

4. https://www2.deloitte.com/content/dam/Deloitte/in/Documents/life-sciences-health-care/in-lshc-Deloitte_HealthcareConsumerSurvey-new-noexp.pdf Accessed on 1st August 2022.

5. https://www.niti.gov.in/sites/default/files/2021-03/InvestmentOpportunities_HealthcareSector_0.pdf Accessed on 3rd August 2022.

6. https://www.financialexpress.com/healthcare/diagnostic/india-witnesses-rise-in-popularity-of-home-diagnostic-tests-experts-say-trend-to-continue/2499455/ Accessed on 1st August 2022.

7. Jana A, Chattopadhyay A. Prevalence and potential determinants of chronic disease among elderly in India: Rural-urban perspectives. Plos one. 2022 Mar 11;17(3):e0264937

8. https://www.mospi.gov.in/documents/213904/301563/Elderly%20in%20India%2020211  Accessed on 1st August 2022.

9. https://www.grandviewresearch.com/industry-analysis/india-home-healthcare-market Accessed on 1st August 2022.

10. https://www.niti.gov.in/sites/default/files/2021-10/HealthInsurance-forIndiasMissingMiddle_28-10-2021.pdf Accessed on 1st August 2022.

11. https://www.grandviewresearch.com/industry-analysis/home-healthcare-industry# Accessed on 3rd August 2022.

12. https://www.statista.com/statistics/792074/india-internet-penetration-rate/#:~:text=Internet%20penetration%20rate%20in%20India%20went%20up%2    Accessed on 10th August 2022.

Post Tags :

Digital Healthcare, Teleconsultation

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