The Indian home healthcare sector, which has grown to a $5.4 billion market, needs to have strong accreditation and standardisation processes to ensure the quality of services, a report from India on the fledgling segment has stressed.
Home healthcare largely refers to the treatment of diseases or palliative or even critical care within the comfort of the patients’ homes and sometimes assistance with daily living for senior citizens or people with several chronic ailments.
The report, prepared by Nathealth, a network of private players in India’s healthcare ecosystem, with inputs from Niti Aayog and the health ministry, says that the segment is growing at a 19 percent CAGR.
Titled Indian Home Healthcare: Redefining the Modern Care Continuum, the report says the segment is expected to grow at a $19.9 billion market by 2025, and the market has the potential to grow an additional $5 billion with the ‘right impetus’.
The expansion of home healthcare service, said Dr Harsh Mahajan, president of Nathealth during its annual summit on March 29, is particularly significant in a country like India with a low bed-to-population ratio.
In addition, the service is crucial for those with a variety of healthcare issues.
In a study conducted by Apollo Home Care, on the execution of a standardised care plan at home under the supervision of a medical expert for post-discharge patients – in a cohort of 3,374 patients- the re-hospitalisation rate decreased from 36 per 1,000 patients to 15 per 1,000 patients within a year, says the report.
The segment, however, remains largely -- up to 99 percent -- unorganised, according to Dr Mahesh Joshi, president and chief executive at Apollo Home Healthcare Limited. He is also the vice-president of the Home Healthcare Association.
Largely senior care but rapidly expanding
India has several home healthcare players providing services across preventive, promotive, chronic, acute rehabilitative, and palliative care in the comfort of the patient’s home.
During the beginning of COVID-19, a large number of critical clinical cases of patients with prostate cancer, hypertension, deep vein thrombosis, chronic kidney disease, dementia and sepsis were provided care at home.
In addition, patients with central pontine myelinolysis (a serious neurological disorder), lower respiratory tract infection, pneumonia, acute kidney injury, decompensated chronic liver disease, portal hypertension, and certain categories of coronary artery disease have also availed of home healthcare services.
How does it work?
Home healthcare has mainly two components- medical and non-medical. Under the first component, the skilled care of a medical professional, like a physician, registered nurse, or physical therapist, is provided, as prescribed by a doctor.
Sometimes, in addition to medical care or in isolation, unskilled or non-medical care is provided. It includes assistance with daily activities such as bathing, dressing, meal preparation, transportation to and from physician’s appointments, running errands, shopping and housekeeping.
The latest report has endorsed that homecare workers and professionals should be recognised as an allied and healthcare professional category under the National Commission for Allied and Healthcare Professions Act, 2021.
Also, according to experts, training is very critical, and, therefore the industry needs to invest in it to deliver quality in the sector.
Addressing pandemic challenges
The report said that Apollo Home Care addressed the needs of over 25,000 COVID-19 patients at home from over 120 locations across India – 10,000 in the first wave over five months and 15,000 in the second wave over six weeks.
Likewise, another service provider, Portea, deployed a 10-day COVID-19 home isolation programme, focusing on the holistic care of asymptomatic and mildly symptomatic patients from the first wave, which continued through the third or the Omicron wave.
Over 4 lakh patients were managed remotely across multiple locations in India, including tier 2,3, and 4 cities, highlighted the report.
Critical Care Unified, on the other hand, served a critical COVID-19 patient with respiratory failure, CKD, shortness of breath, atrial fibrillation, pneumonia, and sepsis with septic shock and a history of cancer.
‘Many players with no standards’
Dr Mahajan conceded that there may be a large number of fly-by-night operators with no standard, a fact that was also endorsed by Vivek Srivastava, co-founder, and chief executive of Healthcare at Home.
“We believe that it is very important to have accreditation and standardisation in this sector. Else, this sector would not have the quality which is required,” he told Moneycontrol.
“There are so many players who are claiming to provide homecare but have no standards and hence the quality delivered is poor and could be dangerous,” he said.
All this will not only give a bad name to the sector but also drive away customers as well, he said.
‘Standardisation must to win patient confidence’
Registration and licensing for home care providers akin to hospitals under the Clinical Establishments Act, 2010, may be able to drive confidence among customers and service providers.
Dr Joshi said that regulating the industry will ensure a certain minimum standard of care and also bring in the right expectation setting for customers. The standards have been defined by the home healthcare association along with the Quality Council of India.
Industry insiders also said that accreditation may be required for insurance, public reimbursement, and empanelment under government schemes.“Currently homecare is not covered by insurance and by government schemes,” said Srivastava, adding that if the issue is addressed, it could save a lot of money for the customers.