1. LISTENING TO YOUR PATIENTS
A survey of patient behaviour in Jaipur, India
August, 2010
This note has been prepared by Kanvic for the exclusive purpose of our Clients.. The material contained herein cannot be copied, used, circulated for any other purpose.
All rights reserved Kanvic Consulting Private Limited.

2. Contents
A. Objectives and methodology 3
B. Key findings 8
C. Detailed findings 10
D. Contact 25
2

3. A. Objectives and methodology
This note has been prepared by Kanvic for the exclusive purpose of our Clients.. The material contained herein cannot be copied, used, circulated for any other purpose.
All rights reserved Kanvic Consulting Private Limited.

4. In view of changing healthcare landscape in Jaipur, we conducted a patient
behaviour survey
Location of Jaipur in Rajasthan state
Healthcare sector has been witnessing
a very rapid change in India with the
entry of corporate hospitals, emergence of
lifestyle diseases and evolving needs of
Haryana population for healthcare services.
Jaipur is a major city in North Western
part of India and is a capital of the state
Uttar
of Rajasthan.
Pradesh
Healthcare landscape has changed
Jaipur drastically with patients demanding better
Rajasthan services and hospitals willing to offer them.
The competition is also increasing with
entry of new hospitals which have raised
the bar for others.
In view of changing market situation,
Kanvic conducted a patient behaviour
survey from July - August 2010.
Madhya This report provides detailed findings of
Gujarat patient profile and behaviour for
Pradesh
healthcare services in Jaipur.
Area of survey 4

5. The survey had four main objectives
1 Map profile of patients visiting hospitals in Jaipur
2 Quantify disease incidence in Jaipur market
Identify key criteria in choosing and judging a
3 hospital by patients
4 Understand patient’s satisfaction with the quality
of care and services provided by a hospital
5

6. We interviewed 113 patients from 8 hospitals with a structured questionnaire
660 hospitals and
nursing homes in
Jaipur
113 Number of patients
interviewed for the survey
8 Number of hospitals which
participated in the study
A cross-section of hospitals
14 hospitals
Sample including private, public and
trust catering both single
speciality and multi-speciality
selected based on
their size, ownership
pattern and speciality
Face to face interview with
Tool the patients with a structured
questionnaire
6

7. Patients had a diverse profile including men and women from various
occupations and age groups
Age distribution, years, % Gender, % Occupation,%
1%
19% 12% 13%
7%
34%
16%
45% 34%
66%
27% 20%
5%
0 to 6 7 to 19 Male Government servant Business person
20 to 40 41 to 60 Female Private sector employee Housewife
60+ Student NA
45% respondents are 66% respondents are male and 34% respondents are from
between 20 to 40 34% is female business.
years old.
Note: Percentages are percent of total number of respondents
Source: Kanvic Patient Survey 2010 7

8. B. Key findings
This note has been prepared by Kanvic for the exclusive purpose of our Clients.. The material contained herein cannot be copied, used, circulated for any other purpose.
All rights reserved Kanvic Consulting Private Limited.

9. We found seven aspects of patient behaviour which are relevant for a
hospital’s decision making
Key findings from patient behaviour survey
1 Jaipur hospitals receive almost half the patients from other parts of Rajasthan outside
Jaipur.
The top five specialities in terms of patient volume are Orthopedics, General medicine,
2 Oncology, Gastroenterology and Cardiology.
A doctor’s goodwill is the most important criterion for patients to choose a hospital.
3 It is followed by hospital’s reputation and specialisation.
4 One third patients stay for over 7 days in a hospital.
While care received from Doctors is rated highly, hospitals need to make efforts to
5 improve their infrastructure and reception services. There is also a room for
improvement in care provided by nurses.
6 A vast majority of patients are happy to recommend their hospital to other people.
While doctor’s reputation is top 5 criteria in judging a hospital after patients have
experienced the services, quality of doctors, quality of treatment and quality of facilities
7 carry more weight in judging a hospital.
9

10. C. Detailed findings
This note has been prepared by Kanvic for the exclusive purpose of our Clients.. The material contained herein cannot be copied, used, circulated for any other purpose.
All rights reserved Kanvic Consulting Private Limited.

11. We covered three stages of a patient’s experience with hospital services to
map their profile and understand behaviour
Key issues covered in survey
3 1
Criteria for Source market
Post Pre
judgement Disease incidence
admission
Recommendation discharge Selection criteria
Repeat patient (loyalty)
2
During
admission
Average length of
stay (ALOS)
Medical care
Services
Source: Kanvic 11

12. Almost half the patients come from other cities in Rajasthan
1
Source markets for patients coming to hospitals in
Jaipur, percent of respondents, n=113
3
10 An overwhelming 48%
patients come from cities
other than Jaipur in
Rajasthan.
48 Other states also
contribute a significant 10
100 percent.
These findings have
implications for
hospitals to develop
referral network with
39
primary health centres
and doctors in their source
market.
Jaipur Other cities of Outside
No reply Total
Rajasthan Rajasthan
Source: Kanvic Patient Survey 2010 12

13. Orthopedics has maximum number of patients for treatment
1
Patients seeking treatment in each speciality,
percent of respondents, n=113
Orthopedics 17.7%
Orthopedics is the highest
General medicine 14.2%
volume speciality with over
17 percent patients seeking
Oncology 13.3%
treatment in this area.
Gastroenterology 12.4%
Combined with General
medicine and Oncology,
Cardiology 8.8%
they cover almost half the
patients in Jaipur.
Neurosurgery 7.0%
Obstetrics & 6.0% Cardiology is at number five
Gynaecology with 8.8 percent patients
4.0%
coming for treatment for
Nephrology heart related diseases.
3.5%
Neurology
Other specialities like
3.5% Neurology and Urology also
Urology figure in top 10.
9.6%
Other
Source: Kanvic Patient Survey 2010 13

14. Doctor’s goodwill is the most important factor for a patient to choose a
hospital
1
Criteria for choosing a hospital, percent, n=113
Doctor’s goodwill 27.4% Over 27 percent patients
choose a hospital based on
Hospital’s reputation 16.8% doctor’s goodwill.
Hospital’s
10.6%
specialisation
Hospital’s reputation and its
Referrals 10.6% specialisation are other
important factors finding
Close to home 7.9%
favour with 16.8% and
Quality of Facilities 6.2% 10.6% patients respectively.
Referred by another
hospital 4.4% While clinical factors are the
key reasons for a patient to
Quality of Treatment 3.5%
make a choice, non-clinical
Affordability 3.5% factors such as close to home
and quality of facilities are
Quality of Services 3.5% also important to some extent.
Employer’s choice 3.5%
Affordability is also part of
Previous experience 3.5% decision making but not a
critical factor while choosing a
Quality of Staff 2.6% hospital.
Note: Percentages add up to more than 100 because of multiple responses
Source: Kanvic Patient Survey 2010 14

15. Over 40 percent patients had visited the same hospital earlier
1
Repeat patients visiting a hospital, percent
of respondents
NO
42%
YES
58%
Source: Kanvic Patient Survey 2010 15

16. One third inpatients stay for over seven days in a hospital
2
Segmentation of patients, percent Average length of stay (ALOS) for
of respondents, n=113 inpatients, percent of respondents, n=61
Outpatients
46% Inpatients
54% 48%
33%
20%
Less than 3 Between 3
Over 7 days
days and 7 days
Source: Kanvic Patient Survey 2010 16

17. Hospitals’ performance on key service indicators is a mixed bag with some
hospitals showing consistent results
2
Patients rating hospital services “Excellent”, percent of
respondents, n=113
Hospital Reception Care from Doctor Care from Nurse Infrastructure
13%
A 13% 13% 0%
80% 100% 60% 80%
B
C 75% 87%
75% 75%
NR
D 12% 24% 24%
90%
E 80% 100% NR
30%
F 50% 60% 30%
87%
G 47% 60% 78%
H 49% 74% 60% 66%
NR - No Response
Source: Kanvic Patient Survey 2010 17

18. While some hospitals have been rated excellent by 80 percent patients for
reception services, the rating is as poor as 12-13 percent for others
2
Rating reception services, percent of respondents, n=113
Hospital
A 13% 87% Reception services play an
important role in patient
satisfaction.
B 80% 20%
While not as important as
C 75% 25% clinical services, they can
create a negative perception
even if the clinical services
D 12% 53% 35% are excellent.
E 80% 20% While some hospitals have
been rated highly for quality
of reception services, there
F 50% 40% 10% are others who have not done
well.
G 47% 13% 33% 7%
In two hospitals, 7-9 percent
patients rate quality of
H 49% 20% 22% 9% reception services as bad.
Excellent Good Acceptable Bad
Source: Kanvic Patient Survey 2010 18

19. We found two hospitals exceptionally good in patients’ satisfaction with care
received from doctors
2
Rating care received from doctors, percent of
respondents, n=113
Hospital
A 13% 87%
B 100% Care from Doctors is a key
factor in determining
C satisfaction level of patients.
87% 13%
Two hospitals have been
D 24% 65% 11% rated excellent by 100
percent of their patients for
quality of care received from
E 100% Doctors.
F 60% 40% At the same time, there are
two hospitals where quality
of care from Doctors is either
G 80% 20% acceptable or poor.
H 74% 23% 3%
Excellent Good Acceptable Bad
Source: Kanvic Patient Survey 2010 19

20. On the other hand, there is a room for improvement in care provided by the
nurses with one hospital doing bad
2
Rating of care received from nurses, percent of
respondents, n=113
Hospital
A 13% 25% 35% 25% While Doctors visit patients
once or twice in a day, nurses
are available 24x7.
B 60% 40%
As a result, the expectation
C 75% 25% level from nurses is high.
There is a room for
D NR improvement in quality of
care provided by nurses.
E NR
No hospital has achieved
100% excellent rating in this
F 30% 70% case.
On the contrary, there is one
G 78% 22%
hospital which has been
rated bad by as high as
60% 20% 20% 25% patients.
H
Excellent Good Acceptable Bad
NR - No Response
Source: Kanvic Patient Survey 2010 20

21. Infrastructure is also an issue with a couple of hospitals
2
Quality of infrastructure (rooms, facilities etc.), percent
of respondents, n=113
Hospital
A 75% 13% 12%
B 80% 20%
Quality of infrastructure
also needs improvement.
C 75% 25%
While half the hospitals have
been rated excellent by over
D 24% 59% 17% 75 percent patients for
infrastructure, the other half
lags behind by a large
E 90% 10%
difference.
F 30% 60% 10% On infrastructure also, two
hospitals have been rated
poor by their patients.
G 87% 13%
H 66% 26% 8%
Excellent Good Acceptable Bad
Source: Kanvic Patient Survey 2010 21

22. In spite of hiccups in non clinical services, a majority of patients are willing to
recommend the hospital
3
Willingness to recommend hospital to other patients, percent of respondents, n=113
Hospital
A 100%
B 100%
C 100%
D 94% 6%
E 90% 10%
F 100%
G 100%
H 91% 9%
Yes No
Source: Kanvic Patient Survey 2010 22

23. Quality of doctors is also the most important criteria in judging a hospital
3
Criteria for judging a hospital, percent of
respondents, n=113
Quality of doctors 42.5%
Quality of doctors,
Quality of treatment 23.9% treatment and facilities are
the three most important
23.0%
criteria in judging a hospital
Quality of facilities
with an overwhelming 42.5
Doctor’s reputation percent patients judging a
20.3%
hospital based on quality of
doctors.
Quality of staff 15.9%
Quality of infrastructure Other factors which patients
11.5%
choose to judge a hospital are
quality of staff, infrastructure
Quality of services 10.6%
and services.
Affordability 4.4%
While patients consider
Hospital’s reputation affordability, quality of
3.5%
reception and proximity to
home in their decision
Quality of reception 3.5%
making, they are not rated
very high in importance.
Close to home 0.8%
Note: Percentages add up to more than 100 because of multiple responses
Source: Kanvic Patient Survey 2010 23

24. Mapping the criteria for choosing and judging a hospital throws some
important insights about a patient’s behaviour
3
A map of patients’ criteria for choosing
and judging a hospital
Doctor’s reputation has clearly
emerged as the most important
High
Quality of
Importance for judging a hospital
doctors
Quality of criterion in choosing and judging
treatment
Quality of
a hospital.
facilities
Doctor’s
Quality of reputation
While quality of doctor,
staff Quality of treatment, and facilities are
services
important for judging the
hospital, they are not highly rated
Medium
for choosing a hospital. This is
perhaps due to rating of
judgement given by patients after
experiencing healthcare services
at the hospital.
Affordability
Hospital’s
Close to reputation The difference in criteria are
Low
home important for hospitals to align
themselves with new and repeat
patients differently.
Low Medium High
Importance for choosing a hospital
Source: Kanvic Patient Survey 2010, Kanvic analysis 24

25. D. Contact
This note has been prepared by Kanvic for the exclusive purpose of our Clients.. The material contained herein cannot be copied, used, circulated for any other purpose.
All rights reserved Kanvic Consulting Private Limited.

26. Authors of the study
Deepak Sharma
Director
M: +91 99283 77800
E: deepak@kanvic.com
Maxime Assedo
Junior Consultant
M: +91 76655 96165
E: maxime@kanvic.com
Abhishek Taragi
Junior Consultant
M: +91 94147 96338
E: abhishek@kanvic.com
26

27. About Kanvic
Kanvic is a management consulting firm helping businesses develop winning strategies, drive
profitable growth and achieve operational excellence to reap long lasting rewards in fast
growing Indian economy. We work with C-level executives to develop innovative solutions for
business challenges of 21st century India by bringing in leading edge management thinking
informed by in-depth research and sound analysis.
Contact
Jaipur Bangalore London
Deepak Sharma Ravindra Beleyur Bharat Vagadia
M: +91 99283 77800 M: +91 94481 46963 M: +44 7711 898089
E: deepak@kanvic.com E: ravi@kanvic.com E: bharat@kanvic.com
www.kanvic.com
27