August 13, 2008

Hospitals Now Have Standards to Match

By Nirmala M Nagaraj

Bangalore: Hospitals coming under audit for quality, service and fee structure? Well, that might be long in coming, but there's some good news for those who haven't had the best of experience during hospitalization .

The National Accreditation Board for Hospitals (NABH) - established by the Quality Council of India in 2006 - has accredited 19 hospitals across India, including five from Karnataka , on key parameters such as patient care and safety . Fee structure, the crux of several bitter experiences, has not been covered, though.

Why is the audit exercise so important? Aren't there government checks on the mushrooming of private hospitals? The answer is both yes and no. No, because there's no control on the setting up or functioning of the hospitals in India. Yes, because the Clinical Establishment Bill, drawn up last year to ensure uniform standard of facilities and services, is yet to be tabled in Parliament . Only four states - Arunachal Pradesh, Himachal Pradesh, Mizoram and Sikkim - are keen on implementing the Bill, once passed.

The Central Health Intelligence Bureau says India has 9,923 government hospitals with 4,80,306 beds. Karnataka has nearly 10% of it, with 868 government hospitals and community health centres.

Shocking, there's no catalogue of private medical establishments in the country. In the absence of licensing or registration policy, starting a hospital, nursing home or a clinic is, well, kid's play.

The question is less about proliferation of hospitals and more about basic infrastructure . Quality is the buzzword. That's where the accreditation exercise kicks in.

NABH consultant Dr Kishore Murthy explains: "The hospital (submitting itself to the NABH accreditation ) will have to justify the procedure recommended to patients. Indirectly, we're monitoring fee structures, and the accreditation has to be upgraded every three years. The NABH is a member of International Society for Quality in Health Care."

Accreditation plays a key role in medical tourism. Dr Murthy says: "Some insurance companies consider only NABH-accredited hospitals for reimbursement."

Apart from assessing hospitals and blood banks, the NABH will soon size up nursing homes and clinics as well.

India has hit the quality healthcare path almost a century after the US did. The US started accrediting hospitals in 1910 and set up a joint commission on accreditation of hospitals in 1951. Other quality votaries are the UK and South Africa.



Access to and continuity of care

Patient rights and education

Management of medication

Infection control in hospital

Facility-management , safety

HR, information-management systems


54 hospitals have applied for NABH accreditation

Annual accreditation fee hinges on the number of hospital beds

Up to 100 beds, it's Rs 1 lakh; 101 to 301, Rs 1.5 lakh; over 301, Rs 2.1 lakh

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