Health camps a tool for private hospitals to hike occupancy

The practice of private hospitals organising medical camps to get more inpatients has come into focus with the death of four patients in Ahmedabad following angioplasty which was deemed unnecessary. Often labelled as charitable or CSR activity, in reality, camps are marketing activities for private hospitals, including large corporate hospitals that are constantly trying to push up occupancy say industry insiders.
The average occupancy in most hospital groups is about 60-70%. The footfalls in camps are closely monitored by marketing departments with calculations of what percentage of camp attendance gets converted to inpatients. There are quarterly plans for how many camps or outreach clinics have to be organised in which locations and of what specialties.
These camps are not only organised within the regions where the hospitals are located but also in other states, especially states seen as promising “catchment areas” such as West Bengal and the North East. While some tie up with local health facilities or diagnostic set ups to provide logistical support, others have their own agents who make the local arrangements.
“Multiple hospitals chains organise camps in the Andamans every week, despite the population being small. Most of these hospitals fly in superspecialists who do consultations and then refer patients back to the main hospitals for procedures. They aggressively target patients with heart, and bone and joint issues. A lot of valve replacement, stenting and knee replacements are being advised. Neurology and urology camps are also popular,” said a doctor who did not want to be identified.
In the Andamans, the ads for medical camps in local newspapers are from Chennai-based groups. Delhi-based groups seem to be more active in the NCR and the north.
In places with inadequate tertiary care facilities, the camps are advertised as an opportunity for consultation with “eminent doctors” who are “flying in” to provide “world-class healthcare” by conducting comprehensive health evaluation to provide personalised treatment plans.
The bait is often free health check-up, a few free medicines or free consultations. In some camps consultation charges have to be paid while registration is free. Tests that cost a few hundred rupees like blood sugar, haemoglobin and blood pressure check, ECG, weight and BMI measurement are done in the name of detecting health problems early and many are referred for “specialised treatment or surgery”, which could cost several thousands to a few lakh rupees, to the main hospital. “There is no external audit of these procedures being recommended, on whether the procedures were necessary or appropriate,” said a doctor working for a corporate hospital.
The marketing departments have access to the database of patients who attended the camp and their diagnosis to follow up with reminders via emails, messages and calls. They have the responsibility of modifying the offer if the patients seem unsure and to throw in free priority appointments with senior doctors, or offer pick-up and drop facility if distance is an issue or offer discounts on procedures and/or investigations. The focus is on how to increase extraction from camps, and even a 15-20% conversion to inpatients is considered decent.
“There is very little continuity of care post-surgery or procedure for patients being drawn from camps in places that are thousands of kilometres away. Most of them cannot afford to make frequent trips and there have been complaints of poor follow-up,” said a doctor in the marketing division of a hospital.
“They are using the health camps to reach communities who wouldn’t otherwise step into their hospitals. It is definitely about building business but in the guise of expanding tertiary care services to underserved areas, the hospitals are exploiting an untapped market which also happens to be vulnerable. Private sector is also leveraging the gap in public provisioning via models where they can operate unrestrained and without any oversight,” said Malini Aisola of the Campaign for Dignified and Affordable Healthcare, a patient advocacy group.