Indian healthcare value chain status quo not a sustainable solution

Abstract

Purpose: Indian healthcare system, especially in rural regions, faces several problems that prevent it from achieving universal and sustainable healthcare coverage. The purpose of this paper is to capture such problems through expert opinions and provide solution concepts that are derived from other similar scenarios. Design/methodology/approach: Delphi study has been conducted with 38 experts from diverse areas related to the Indian healthcare sector. Nineteen theses were formulated based on the discussion with experts and were reconfirmed through intensive desktop research. Finally, theses were subjected to expert panel member’s evaluation. Findings: The pool of arguments provided by the participating experts included 415 written statements explaining the (dis-)agreement with the theses. The experts achieved consensus in six theses with interquartile ranges smaller or equal to 20. The written arguments provided by experts were summarized into five different categories, namely interrelations/dependencies in healthcare, inequalities in healthcare, lack of proactive measures, importance of healthcare personnel and role of government in healthcare. Finally, a framework is proposed mapping the issues identified at different stages of the healthcare value chain. Problem-based cost allocation and hub-and-spoke model are discussed as potential solutions for the issues identified. Research limitations/implications: Lack of empirical and statistical data on the effective cost arising from the present issues suggests future research to determine these expenses and therefore examine the feasibility of applying the problem-based cost allocation framework discussed in this study. Practical implications: Results show that merely targeting the supply side of healthcare falls short of the mark, especially in a country, such as India, with large socio-economic differentials. Healthcare system, hence, should be viewed from a market perspective, taking both forces of supply and demand into consideration. Originality/value: This study intends to allow for a comprehensive approach to identify the issues in Indian healthcare system by reviewing the existing key studies in literature and validating it through empirical inputs from experts in the domain. Based on the validation, a framework is proposed mapping the issues identified at different stages of the healthcare value chain.