Dissociate healthcare from affluence

22 Mar

Poor Country, Top Doctors
A hospital in India shows how to separate a nation’s wealth from the quality of its health care.
BENGALURU, India—”Surgery happens in three phases,” says Dr. Devi Prasad Shetty. First in a surgeon’s mind prior to the operation, then on the operating table, and then again in the mind postsurgery, when the doctor evaluates how performance could be further improved. “For other surgeons, the next opportunity for improvement is after a few months, but in our case, because of the numbers involved, it is the next day.”

The 16 cardiac surgeons at Narayana Institute of Cardiac Sciences each conduct at least one to two surgeries a day and 400 to 600 per year, compared with the 100 to 200 that is the norm for U.S. cardiac surgeons. Through such economies of scale, as well as administrative innovations and the embrace of new technology, the network of hospitals Shetty founded in 2002, Narayana Hrudayalaya, can offer surgeries at a small fraction of their cost in the U.S.—without compromising quality of care. Here, in a country with one of the lowest concentrations of doctors and hospital beds, Narayana Health City—the hospital where NICS resides—is one of only 10 medical centers in the world that offer one of the most difficult heart surgeries, the pulmonary thromboendarterectomy, with infection and mortality rates comparable to those in U.S. hospitals.

“I believe that India can become the first country in the world to dissociate healthcare from affluence,” Shetty says. “We can prove that the wealth of the nation has nothing to do with the quality of health care.”


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