RM

A STUDY ON EMERGING TREND IN HEALTHCARE SECTOR 1

CHAPTER 1

INTRODUCTION

Healthcare sector is considered one of the largest sector in terms of both revenue and

workforce employment. The estimated valuation of the sector was close to USD 74 billion as

at financial year 2011-12.

A large and growing population, a booming economy, rapid urbanization which has

expanded the middle class, rising diseases and increased awareness level has enable the

sector to grow at much higher rate.

The sector is dominated by private players capturing about 70% of the total market delivery

in India. Leading from the front is the Hospital industry which is estimated to be around USD

54.7 billion by 2012 and contributes around 82% of the total revenue generated by healthcare

industry as a whole. However, there remains a significant gap in terms of number of beds or

number of doctors available which is far below the World Health Organizations (WHO)

requirement of 1:250. Apart from this the sector is currently surrounded with multiple issues

in regards to infrastructure, availability of adequate investment, skilled human resources.

Although the government has taken several steps in eliminating healthcare related issues but

it still remains insufficient and a lot is needed to be done. Giving due importance to the sector

the share of healthcare in 12th five year plan allocation of total funds is increased to 2.5% of

the GDP. The current plan is a step ahead in the journey towards quality healthcare for all.


OBJECTIVES OF THE STUDY:

To find out the various new trend in healthcare sector.

To find out the satisfaction level of the customers with their respective hospital.

To understand the needs and importance healthcare in ones life.

To get knowledge of various diseases prevailing in the area.

HYPOTHESIS

: There was no growth in healthcare sector in past few years.

: There was growth in healthcare sector in past few years.

: There is no use of modern machine in hospitals.

: There is use of modern machine in hospitals.

: Most of individuals have no health insurance for any uncertainty.

: Most of individuals have health insurance for any uncertainty.

LIMITATIONS

The project has some limitations because it is totally based on efforts of individuals. Peoples

may be careless and may not give correct answer to the questions, because of so many

reasons.

It is totally based on personal efforts of individuals.

Some of the consumers are unable to understand the questionnaire.

Language is one of the worst problem, some of the consumers are unable to understand

English.

Some consumers are not interested in filling questionnaire.


CHAPTER SCHEME

Chapter 1

Introduction

Healthcare

Objective of study

Rationale behind the study

Research problem

Research methodology

Chapter 2

Review of literature

Chapter 3

Indian Healthcare Sector

Segments in Health Sector

Key Trends and Drivers in Healthcare Sector

Health Cities: The Evolving Concept of Healthcare in India

Healthcare Fights for Mindshare, Market share & Margins

Emerging Trends in Indian Healthcare Sector

Questionnaire

Bibliography


RESEARCH METHODOLOGY

To make a comprehensive study on Emerging Trends in Healthcare Sector and know the

various diseases prevailing in the area.

Type of research

Descriptive type research has used to complete the project.

DATA COLLECTION:

1- Primary Data

Keeping in view the nature of this study, questionnaire method was found to be most

effective. The questionnaire is structured i.e. it is presented having form question in

sequence, and non-disguised

2- Secondary Data

Secondary Data which are used for research to know the history of Healthcare sector are

collected from already available resources like internet and other sources like magazines and

journals printed by top cooperates.

SAMPLE SIZE

30 respondents has selected as sample size for research.


CHAPTER 2

REVIEW OF LITERATURE

As the research work on healthcare sector is large which is usually by top cooperates and as

their reviews are given below

Emerging Trends: Indian Healthcare Industry, by Onicra Credit Rating Agency of

India Ltd., December 2012.

SMEs can concentrate only in few cities and towns as they lack the infrastructure & funds for

registering themselves at national level. Healthcare industry requires high initial investment

and the entrepreneurs are unable to arrange such amount of capital investment hence this

sector is not growing at a fast pace. Due to limited capacity restriction these SMEs cannot

operate beyond a certain level. Changing economic scenario is putting pressure on investors

as sophisticated machinery needs to be imported and rupee devaluation is digging deeper

hole in the pocket of investors. Lack of information on market segmentation and demand

makes SMEs handicapped in terms of planning and targeting the profitable market. Lack of

skilled human resources is one of the major challenges faced by SMEs as the skilled

resources are hired by big corporate at a lucrative pay package and the SMEs are left with no

other option than compromising on quality. The Public Private Partnership (PPP) model is

lacking in the SME sector, if PPP model is implemented intensively it can enhance the

quality of health care services as funds required for improving the infrastructure will be

provided by government and management skill can be given by the SME unit. This initiative

will make healthcare facilities affordable for the middle and lower strata of the society. One


of the major challenges which the industry as whole is facing is paucity of bed. India

currently has 1 bed per 1050 people as compared to 1 bed per 250 people. Due to lack of

infrastructure and investment the SMEs are unable to bridge this gap.

Emerging Trends in Healthcare, by KPMG in India, 17 February 2012.

Healthcare is at an influx of paradigm shifts in terms of changing disease patterns, increasing

dual disease burden for both rural and urban India. On the supply side there has been uneven

distribution of healthcare infrastructure and resources posing various challenges to the sector.

A multi-pronged approach from key stake holders is necessary to address the issue. Both the

public and private sector need to work in tandem to make healthcare available, accessible and

affordable. India would need various solutions towards this end. The government plans to

undertake building 6 super speciality tertiary care hospitals with research and education

centres across the country. These would cater to the weaker sections making high end clinical

care available to the masses. Encouraging current initiatives on pubic private partnerships,

for both the care provider and education sectors, should continue. The government should

continue flagship programmes such as such as Rashtriya Swastha Bima Yojana (RSBY) and

State level Insurance schemes like the Arogyashri, Chiranjeevi etc.


CHAPTER 3

INDIAN HEALTHCARE SECTOR

The Indian healthcare delivery market is estimated at US$ 18.7 billion and employs over four

million people, making it one of the largest service sectors in the economy today. Total

national healthcare spending reached 5.2% of GDP, or US $34.9 billion in 2004 and is

expected to rise to 5.5% of GDP or US $60.9 billion by 2009. This includes the

pharmaceuticals market, government and private spending. Private segment constitutes bulk

and growing rapidly, to reach $38 billion by 2012. There are various gaps in the Indian

healthcare market, which also present a vast opportunity. Good healthcare in India is in

extreme short supply. Hospitals in India are running at 80-90 per cent occupancy. With the

demand for healthcare far exceeding supply, Indias healthcare industry is expected to grow

by around 15 per cent a year for the next six years.

There are some economic factors which make India such an exciting market. Since

healthcare is dependent on the people served, Indias huge population of a billion people

represents a big opportunity. The middle income group in this vast base is also a large 300

million. India spends only 1% of its GDP on health, translating into $35 per capita. France

spends 10.4% and Japan 8%. A significant portion of the population receives inadequate or

no health care, specifically 25.7% living below the poverty line and those who have only the

public health system to rely on. National Family Health Survey for 2005-06 estimates 453

deaths per 100,000 women; higher than Cambodia, Bolivia and Botswana. India accounts for

20% of the world's maternal deaths, with a woman dying every five minutes. 20% of deaths

of children worldwide under the age of 5 occur in India. The private healthcare sector in


India accounts for over 75 per cent of total healthcare expenditure in the country and is one

of the largest in the world. Indias healthcare sector, however, falls well below international

benchmarks for physical infrastructure and manpower, and even falls below the standards

existing in comparable developing countries.

Given the growing demand, the emergence of reputed private players, and the huge

investment needs in the healthcare sector, in recent years, there has been growing interest

among foreign players and non-resident Indians to enter the Indian healthcare market. There

is also growing interest among domestic and international financial institutions, private

equity funds, venture capitalists, and banks to explore investment opportunities across a wide

range of segments. This study examines the status and the major brands in the key segments

of the healthcare sector, i.e., in hospitals. It also analyses the implications for the overall

healthcare system.


SEGMENTS IN HEALTH SECTOR

It comprises of many segments like: - Medical infrastructure, Medical equipment, Health

insurance, Training and education, Telemedicine, Clinical trials etc. The industry has grown

at about 13 per cent annually in recent years and is expected to grow at 15 per cent per year

over the next four to five years.

How the healthcare Pie will evolve:-

2006

100%=$34.2bn

2012

100%=$78.6bn

14% Infrastructure 14%

5% Medical Equipment 5%

35% Bed Revenues 36%

18% Pharmaceuticals 16%

2% Health Insurance 5%

1% Medical Value Travel 2%

11% Health Outsourcing 9%

3% Independent Path Laboratories 3%

1% Clinical Trials 1%

3% Training and Education 3%

1% Medical Textiles 1%

6% Medical Consumables 5%

Source: The Business World, Ernst & Young Survey; June 2012

Share of tertiary care in the total healthcare market is around 15-20%. Market for tertiary

care expected to grow at a faster rate, due to rise in complex in-patient ailments such as heart

diseases and cancer.


KEY TRENDS AND DRIVERS IN HEALTHCARE SECTOR

Shift to lifestyle-related diseases to drive higher healthcare spends

While rising incomes and growing literacy are likely to drive higher per capita expenditures

on healthcare, the shift in disease profiles from infectious to lifestyle-related diseases are

expected to raise expenditures per treatment. Lifestyle-related diseases are typically more

expensive to treat than infectious ones. In 2001, the average inpatient cost for lifestyle-

related diseases (cardiac problems, digestive issues etc.) was US$ 658 compared to US$ 91

for infectious diseases.

Indias disease profile is expected to follow the same pattern as in developed economies.

Based on demographic trends and disease profiles, lifestyle diseases - cardiovascular, asthma

and cancer have become the most important segments, and in-patient spending is expected to

represent nearly 50 per cent of total healthcare expenditure. In the inpatient market, the share

of infectious diseases is expected to decline from 19 per cent in 2004 to 16 per cent in 2008.

The number of cardiac-disease-related treatments in India is expected to grow from 1.5

million to 1.9 million per year over 2004-08, which would constitute 5.1 per cent of all

treatments, The spend share of inpatient cardiac treatment is estimated to grow to 19 per cent

of the total in 2008 from 16 per cent in 2004. This would drive a 13.4 per cent CAGR in the

inpatient cardiac care market from US$ 1.2 billion in 2004 to US$ 2.04 billion in 2008. The

average realisation per inpatient for cardiac related treatment is much higher than for other

disease segments.


Source: Ernst & Young Analysis, Business Line: 2012

Growing Middle Class and Patient Preference

There is favourable increase in percentage of working class population from 32% in 2006 to

36% in year 2016. General awareness, literacy rates and patient preferences in healthcare

decisions is growing. National Health Policy, 2002 has laid strong emphasis on the policy

goal of better engaging patients in their healthcare decisions.

Awareness towards Preventive healthcare

Increasing health consciousness among common people has created avenues for preventive

healthcare. Hospitals have started witnessing a number of patients who visit for health check-

ups as a preventive measure. The various health check-up packages offered include a

combination of CBC, blood sugar, cholesterol, urine, stool, digital chest X-Ray, ECG,

Cardic 6%

Oncology 4% Diabetic

3% Orthopedic

3% Gynaecological

5%

Neurology 3%

Urology 4%

Gastro Intestinal 12%

Accidents 9%

Fever 8%

Others 43%

2012


general examination, blood group, blood sugar, liver profile, proteins, lipid profile,

cholesterol, and renal profile. Around 70 per cent of treatment decisions in the country are

based on lab results. This trend has further led to newer avenues for companies involved in

carrying out diagnostic tests.

Increased life expectancy and an ageing population

In the domestic market, health spending will be sustained by two demographic trends:

increased life expectancy and an ageing population. Life expectancy, which averaged 63.3

years in 2000-04, is expected to increase to 65.1 years in 2005-09 and to 66 years in 2006-10.

The proportion of the population aged 65 years and over is also on the rise, and will increase

from 4.7 per cent in 2000 to 5.3 per cent in 2005 and 5.8 per cent in 2010. Although the rate

of ageing in India is slower than the developed world, the large population makes any

increase significant in terms of absolute numbers, and therefore also in terms of market

potential.

Overburdened health infrastructure & high costs in the West

The healthcare systems in Europe and the United States are under severe pressure;

particularly the National Health Service (NHS) in the UK, which has a long list of patients

waiting for over a year for surgery. In the US the healthcare crisis has a different dimension.

Around 50 million citizens are uninsured, with even the insured having to pay dearly for

treatment. Further, the shortage of paramedical professionals such as nurses has aggravated

the situation. Patients from the US are now regularly beating a path to India, as many of their

insurance companies have entered into tie-ups with private Indian hospital chains.


Indias value proposition goes far beyond cost; quality second to none

Cost is not the only factor weighing in Indias favour. Escorts Hospital, for instance, is one of

the only handful treatment facilities worldwide that specialise in robotic surgery. The death

rate of coronary bypass patients at Escorts is 0.8 per cent. By contrast, the 1999 death rate for

the same procedure at New York-Presbyterian Hospital was 2.35 per cent, according to a

2002 study by the New York State Health Department. The overall success rate of cardiac

bypasses is 98.7 per cent in India, as opposed to only 97.5 per cent in the United States.

Healthcare Players Now Targeting Smaller Cities

Increasing focus on unexplored regions of India in terms of healthcare.

Growing need for improved healthcare infrastructure in small cities.

Better access owing to development of new national/international airports e.g.

Visakhapatnam, Nagpur


EMERGING TRENDS IN INDIAN HEALTHCARE SECTOR

Rise in lifestyle related diseases

As discussed earlier in the report though the country has been able to control diseases like

polio, leprosy and tetanus but it has to now face a new breed of lifestyle related diseases like

diabetes, obesity and cardiovascular ailments has cropped up. The present generation which

is accustomed to sedentary work, alcohol consumption and smoking are more prone to such

lifestyle related diseases. According to World Health Statistics 2012 about 61.3 million

people in India are diabetic amongst whom about 11% of the male population (adult) and

10.8% of the female population have shown a significant rise in blood glucose. Similarly, as

per National Family Health Survey (NFHS) about 13% of the women population and 11% of

the men population in India is obese.

Demand of good quality and specialty healthcare facility in Top cities

There is a significant demand for specialty healthcare facilities like oncology, nephrology

and ophthalmology in smaller cities. Some of the major healthcare facilitators are entering

top cities in India.

Growth in medical tourism

One of the main external factors which are contributing to the growth of Indian Healthcare

sector is the rise in medical tourism. According to a leading research agency the medical

tourism market is expected to expand at a CAGR of 27% to reach USD3.9 billion in 2014


from USD1.9 billion in 2011. India as a well-educated, English speaking nation offering

quality private hospitals and medical facilities at a relatively lower cost is able to attract

foreigners. According to industry estimates, in some of the cases India provides best in class

treatment at one tenth of the cost incurred in the United States of America.

Increased demand of Health Insurance

There is a limited exposure of health care insurance in India however; an increased

awareness level among the people about its need has increased the demand. According to

Insurance Regulatory and Development Authority (IRDA) the insurance premium received

over the period of 2006 to 2010 has shown a CAGR of 39%.

Government Initiatives: Still Insufficient

The five year plan adopted an inclusive approach towards health care which includes

equitable and comprehensive individual health care, improved sanitation, clean drinking

water, nutritious food, hygiene, good feeding practices and development of delivery systems

responsive to the needs of people. Some of the main goals set by the five year plan are given

below

Reducing Infant Mortality Rate (IMR) to 28 per 1000 live births.

Reducing Maternal Mortality Ratio (MMR) to one per 1000 live births.

Reducing Total Fertility Rate (TFR) to 2.1.

Reducing malnutrition among children of age group 03 to half its present level.

Reducing anaemia among women and girls by 50 per cent.

Raising the sex ratio for age group 06 to 935 by 201112 and 950 by 201617.


Providing clean drinking water for all by 2009 and ensuring no slip-backs.

An analysis of 11th five year plan depicts that although there is a significant progress made

in the area of MMR, IMR and TFR, however, the improvement in child sex ratio is not good

enough. MMR which calculates the number of deaths caused due to maternity reduced by

5.8%, IMR which calculate the number of deaths of infant per thousand live births fell by

5%. Similarly, TFR which calculates the number of children born to a woman during her

entire reproductive period fell by 2.8%. However, the same cannot be said in the case of

child sex ratio. Most of the states except a few showed a decline in child sex ratio.

Looking at the current 11th five year plan the Planning Commission of India has increased

the expenditure on healthcare by three folds in the 12th five year plan. The total allocation of

funds stands at USD 55 billion under the plan, as a result the share of healthcare allocation to

total plan allocation increased to 2.5% of the GDP as against 1% during the current plan. The

12th five year plan will look for a greater public-private partnership in the sector and will

focus on providing a sound regulatory environment, promote research and development

initiatives, improve infrastructural facility and provision of a universal healthcare.


HEALTHCARE FIGHTS FOR MINDSHARE, MARKETSHARE & MARGINS

Healthcare leaders embrace three trends: retail healthcare, the convergence of care

management and customer service, and a new focus on compliance and operational

excellence. As the velocity of change in healthcare continues to accelerate, we are seeing

three big trends emerging: healthcare retail transformation, the convergence of care

management and customer service, and compliance and operational excellence.

Healthcare retail transformation

For many moons, the health insurance model in the US was almost pure business-to-business

(B2B). Health plans sold their programs directly to employers, and the human resources

departments within those employers served as the ambassadors of plan benefits for the

employees. Now, the industry model is quickly transitioning from B2B to B2C (business-to-

consumer). That's adding increased levels of operational complexity.

"Retail" means dealing with all the HealthCare.gov implications, an aging population, new

consumer demands for multi-channel retail experiences, and so on. In response, health plans

are investing time, effort, and money to explore ways to better educate their current and

potential members on their offerings, on a much larger scale. Operating in a B2C

environment has opened health plans to a customer base that includes the traditional B2B

clientele, but also individual consumers, each with his or her own specific circumstances and

needs. As a result, some health plans are creating new content, opening retail storefronts,

launching awareness campaigns, and implementing numerous other initiatives to create retail


engagement -- all with mixed results. It's truly radical change, an incredibly disruptive

challenge, but it is also a phenomenal opportunity.

In the midst of all this turmoil, we see innovative healthcare organizations really gaining

traction. The organizations taking control are doing so by focusing on the customer

experience and creating unique, customized, member-centric initiatives that deliver efficient

and highly automated interactions to make the product explanation and management, sales,

enrolment, and on-boarding of the member easy, convenient, and seamless. These types of

integrated programs, with the correct application of technology, are catching the attention of

member populations and driving the kind of customer loyalty previously reserved for

consumer brands. This kind of stickiness can only be good for reducing costs and creating the

kind of collaborative healthcare that can drive up the quality of health while driving down

costs.

Customer service and care management

To me, care management is the cornerstone of healthcare transformation. It is the intersection

of clinical care and customer care, and a properly designed and managed care management

program simultaneously reduces clinical and administrative costs, improves health outcomes,

and creates loyal members. How awesome is that? To that point, it's exciting to see that many

leading healthcare organizations are recognizing that care management is, indeed, a real

sweet spot for the true "value-added" aspects of engaging with their members. Fully

integrated disease, case, utilization, and wellness programs on a unified platform that is also

connected to the customer service system offer a truly seamless and meaningful experience

for members.


Care managers engaging members (and providers) are the supreme ambassadors of "MY"

health plan. Every interaction they have is a "moment of truth" that creates a lasting

impression of how well the health plan is treating them. Care teams help members with a

wide variety of needs to manage their care plans, select services and providers, figure the

cost implications of different choices, and even deal with appointments and prescription refill

reminders. They are often the central point for optimizing the collaboration among the plan,

the members, and the providers. Training care managers in customer service, not just clinical

service, and fusing the two together on a deployable platform, offers incredible opportunities

for innovation, happy members, and great outcomes.

Compliance and operational excellence

The quest for operational excellence has long been a focus for healthcare organizations

seeking to maximize productivity while simultaneously reducing costs. With the new

Medical Loss Ratio rules, this has become an even more urgent initiative. It is really

interesting how "compliance" has become such a dominating force as well, and is now a key

metric in almost every department's operational excellence report card.

Healthcare reform has created new legislation and new transparency where compliance

performance can quickly translate into everything from jaw-dropping penalties (bad) to

demonstrating great quality scores (very positive). These two examples can have significant

impacts on the top and bottom lines. For example, the halo effect of great quality scores

(especially in the B2C model) often results in better member retention and even revenue

premiums, whereas costly penalties are well, costly.


What can a healthcare organization do to optimize operational excellence and improve

compliance? Knowing the requirements is key, but having the processes, systems, and

workflows that expose and dynamically track the activities as they relate to the specific

measures at all times ensures that complex requirements are being consistently followed. Just

as important, when a requirement (like a service level agreement) is in jeopardy of being

missed, an automated alert system escalates the issue to a supervisor or manager to address

and correct the issue before it becomes a compliance problem. Organizations need to have a

nimble system that can be quickly modified, tested, and re-deployed to keep ahead of rapidly

changing state and federal regulations. Often, the challenge includes multiple state

regulations changing simultaneously. This "speed-to-value" is proving to be the critical path

for winning in this new post-reform economy. Compliance, adherence, and agility are critical

aspects of today's healthcare solutions.

In all the excitement and confusion that the market is experiencing, we see several great

opportunities emerging where, with the proper focus, healthcare organizations can establish

their leadership while improving both the customer experience and their company's

performance.


HEALTH CITIES: THE EVOLVING CONCEPT OF HEALTHCARE IN INDIA

Major corporate hospital groups in India are making significant investments in

setting up state-of-the-art Health Cities in major Indian cities. Around 15-20 Health Cities

are expected to come up in India in the next 5 years. Health Cities are looking at catering to

larger populations by offering facilities such as hotels, residential facilities, and recreational

facilities of spa, gym and even golf courses. Greater emphasis is on education, research and

development.

Health City No of Beds Area(acre) Investment(US$ Million)

Dr Naresh Trehans MediCity,

Gurgaon

1,600 93 293

Fortis MediCity, Gurgaon 600-800 - 293

Fortis MediCity, Lucknow 800 52 122-195

Apollo Health City,

Hyderabad

700 33 243

Nagpur Health City, Nagpur 2,000 100 N.A.

Chennai Health City, (Global

Group)

1,000 46 245

Bangal Health city, Durgapur 50,000 800 487

Narayana Health City,

Bangalore

5,000 100 488

Other Health City Plans in the Pipeline

MIOT hospitals, Chennai have plans to set up a multispecialty medical city

Reliance ADAG has expressed interest in building a 60 acre health city in Kolkata

CMCH, Ludhiana has initiated a US$ 12.2 million Medi-City project in Ludhiana


Questionnaire

This is the questionnaire that deals with health care and your involvement in health care.

Please take a few minutes to express your opinions about the availability and quality of

health care in your community. Your answers are important for the success of this study.

Name:

1. What is your age?

20-25 25-30 30 and above

2. Sex: M / F

3. How many hospitals/Clinics are there in area of 2 kms?

3 and less 3-6 6 and more

4. Is there a difference in performance between the available hospitals in this area and other

areas?

Yes No

5. Is there a wide difference in the cost of the different hospitals in this area than other

areas?

Yes No

6. Do you generally receive care from the same hospital?

Yes No

7. How satisfied are you with the skill and competency of the staff?

Very dissatisfied Somewhat dissatisfied Neutral Somewhat satisfied

Very satisfied

8. Does the hospital have equipment for modern diagnosis and treatment?

Yes No

9. Does the hospital have modern operating room facilities?

Yes No


10. How satisfied are you with Friendliness and courtesy of the hospital staff?


Very satisfied

11. How satisfied are you with the Cost associated to hospitals?


Very satisfied

12. What kind of medical insurance coverage do you have?

None Private Employer sponsored

13. How many kind of diseases you or your friends have come across recently?

2 and less 3-5 5 and more

14. How many times have you and any member of your family been to your doctor in the last

year?

0 1 2 3 4 5 and more

15. How many times have you visited a friend or loved one in the hospital in the last year?

1-2 3-4 5-6 7 and more

16. How many times have you and other members of your family been a patient in a hospital

in the last 3 years?

0 1 2 3 4 5 and more

17. From your experience in the past, when you or a member of your family needs hospital cares, who decides on the hospital?

You usually decide

You decide based on information from your physician

You and your physician decide together

Your physician decides based on information you provide

Your physician decides

Depends on the situation

18. What was your total household income (from all sources) for the year?

Rs.1,00,000 and less

Rs. 1,00,000 Rs. 3,00,000

Rs. 3,00,000 Rs. 5,00,000

Rs. 5,00,000 and above


BIBLIOGRAPHY

Books

Healthcare Informatics and Analytics: Emerging Issues and Trends - Madjid Tavana

The Future of Healthcare: Global Trends Worth Watching - Andrew N. Garman PsyD

15 Surprising Trends Changing Healthcare - Rohit Bhargava

Webilography

http://www.kpmg.com/in/en/industry/pages/healthcare.aspx

http://www.deloitte.com/assets/DcomIndia/Local%20Assets/Documents/Thoughtware/AI

MAJune2013.pdf

http://www.kpmg.com/IN/en/IssuesAndInsights/ThoughtLeadership/Emrging_trends_in_

healthcare.pdf

https://www.pwc.com/en_GX/gx/healthcare/pdf/emerging-market-report-hc-in-india.pdf

https://www.imf.org/external/pubs/ft/books/2012/health/healthcare.pdf

RM

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