Docstoc

TRENDS AND ISSUES IN MED SURG

Document Sample
TRENDS AND ISSUES IN MED SURG Powered By Docstoc
					Who were..


THE FIRST
‘NURSES’?
 PRE      HISTORIC PERIOD
        GOD,EVIL ,SIN CAUSE DISEASE
        MAKING HOLES IN BODY TO WARD OFF
         DISEASE

   MIDDLE AGE
       care was provided primarily by religious
    orders , mainly by nun sisters
NURSING AS A PROFESSION

Emerged in late 19th century
Credit is given to Florence
 Nightingale
IN INDIA
 KING ASHOKA, CHARAKA,SUSRUTHA
  ARE IMPORTANT PERSONS
 EAST INDIA COMPANY INTRODUCED
  NURSING
 JAMSHETJEEJEE JEEBHOY WAS THE
  FIRST TRAINED NURSE
 TOP CAUSE OF DEATH IN INDIA

CAUSE                      DEATH/ 1OOO
IHD                        15

LRTI                       11
CEREBRO VASCULAR DISEASE   106

COPD                       88

TUBERCULOSIS               36

DIARRHOEAL DISEASE         65

HIV/AIDS                   46
                           W H O(2008)
 DISEASE WISE POPULATION IN INDIA
DISEASE           POPULATION

COPD & ASTHMA     4.6 MILLION

DIABETIC          3.5 MILLION

HIV POSITIVE      2-3 MILLION

EPILEPTIC         0.5 MILLION

CANCER            1 MILLION

CARDIO VASCULAR   3.3 MILLION

MENTAL HEALTH     7.5 MILLION

TUBERCULOSIS      1.8 MILLION

BLINDNESS         16 MILLION    (11TH FIVE YEAR PLAN )
 MEDICAL AND NURSING STUDIES CONDUCTED IN INDIA
NO OF   CNS   COPD   CVD   CANCER   Tb    DM       HIV      PSYCH
RESEAR                                                      IATRY
CH
STUDIES




591     51    10     149   166      14    115      40       46




                                         (CLINICALTRIAL.GOV 2008)
          HEALTHCARE INDIA
• Beds                  = 0.7/1000 people
• Extra Beds needed     = 75000 beds / per year

• Expected spend on     = Rs.2000 billion by 2012
  Healthcare
  % of GDP             =0.9% to grow
                            up to 8.5% of GDP
  Govt. Spend expected = up 6% by 2010

GDP- sum of the income generated by production in the
  country in a period
   TECHNOLOGY - TRENDS(Healthcare will be the
      largest user of technology and the largest Employer)`

• Micro-processor based implantable in patients.
• CPU-driven technology supported by artificial
  intelligence.
• Robotics in OTs
• Robotics in Path-labs / Research.
• Laser Technology in surgery
• Instrumentation in medical and surgical practices.
• Biotechnology, Genomics, Molecular Biology and Stem
  cell research.
            ReMeDi Telemedicine solution
                                                Video conferencing over very low
                                               bandwidth: Video + audio + data
                                               transmission at 28 Kbps

                                                Equipment taking rural conditions
                                               into account: completely battery
ReMeDi: Remote Medical Diagnostics             operated, reengineering of probes,
                                               wireless connectivity with the PC
   Medical equipment
      12 channel ECG, Blood pressure,
                                                Breaking of the cost barrier while
      Heart sounds, Pulse rate,                maintaining the quality: entire
      Temperature, Pulseoximeter, Image        telemedicine solution at affordable
      capture,                                 prices
      Video and audio conferencing,
      Data presentation and display,            No additional software or
      Electronic patient records               hardware needed other than PC,
                                               web cam, internet connectivity
      accessible at any time, print facility
 Tele-medicine cluster for villages
                               Internet
                                 Kiosk                                               Internet
                               Village A                                               Kiosk
                                                     Telemed                         Village B
                                                     Solution
   Healthcare                  Connectivity
    Provider
   (Consultation-                                      Connectivity
Pri/Sec; Delivery of
    Medicines,)
                                                                                     Telemed
                                    SERVER at                                        Solution
                                      Central                                        Internet
                                     Location                                          Kiosk
                                                                      Connectivity
              Connectivity                                                           Village C

                                      Connectivity


                                                       Telemed
                                                       Solution                          Telemed
                                                                                         Solution
                                Internet
                                  Kiosk




               Healthcare can reach every village with Tele-medicine
                                                   16


      Limits to Modern Medicine
Spectacular    Nutrition, Immunization,
Advances –     Antibiotics, Aseptic
Low            surgery, Maternal and
  Cost         child care, Healthy life
               styles
Grey Areas –   Degenerative diseases,
High Cost      Autoimmune diseases,
               Malignancies
Dark Areas     Idiopathic, Iatrogenic,
               Hospital Infections,
               Progressive, irreversible
               disorders
                                           Lok Satta
                                                    17



    Hospitalization – Financial Stress

   Only 10% Indians have some form of health
    insurance, mostly inadequate
   Hospitalized Indians spend 58% of their total
    annual expenditure on health care
   Over 25% of hospitalized Indians fall below
    poverty line because of hospital expenses




                                            Lok Satta
                                              18
Percent of Hospitalized Indians falling into
                 Poverty




                                      Lok Satta
                                                                                             19
         Differentials in Health Status (States)
  Sector      Populatio    IMR/ Per    <5Mortality   Weight For    MMR /     Leprosy      Malaria
              n BPL (%)    1000 Livr    per 1000     Age - % of     Lakh    cases per       +ve
                             Births     (NFHS II)     Children    (Annual     10000       Cases in
                            (1999 –                   Under 3      Report   population   year 2000
                             SRS)                      years       2000)                    (in
                                                       (,2SD)                            thousand
                                                                                             s)

India            26.1          70         94.9          47         408         3.7         2200
Rural           27.09          75        103.7          49.6         -          -            -
Urban           23.62          44         63.1          38.4         -          -            -
Better Performing States
Kerala           12.72         14         18.8          27          87         0.9          5.1
Maharashtra      25.02         48         58.1          50         135         3.1         138
Tamil Nadu       21.12         52         63.3          37          79         4.1          56
Low Performing States
Orissa           47.15         97        104.4          54         498         7.05        483
Bihar            42.60         63        105.1          54         707        11.83        132
Rajasthan        15.28         81        114.9          51         607         0.8          53
UP               31.15         84        122.5          52         707         4.3          99
MP               37.43         90        137.6          55         498         3.83        528
                                                                                    Lok Satta
Source: National Health Policy, 2002
     Over the past years, we had set a bold aspiration
                for health in India
India was a signatory to the Alma-Ata
     declaration 1978, to attain the
           global objective of

      “Health for All by year 2000”

                              now

    “Health for all by the year 2020”
  Escorts Heart Institute & Research Centre Ltd, New Delhi, INDIA
                                           But we are far from achieving that vision

                                 Beds                      Physicians                Nurses
                                 Per ’000 population,      Per ’000 population,      Per ’000 population,
                                  2001*                      2001*                      2001*
                                                             0.5**

   India                          1.5                              1.2                 0.9



   Other low income
                                   1.5                            1.0                    1.6
    countries (e.g., sub-
    Saharan Africa)
   Middle income countries
    (e.g., China, Brazil                  4.3                           1.8               1.9
    Thailand, South Africa,
    Korea)
   High income countries
    (e.g., US, Western                           7.4                    1.8                            7.5
    Europe, Japan)


   World average                   3.3                          1.5                          3.3



            Escorts Heart Institute & Research Centre Ltd, New Delhi, INDIA
Demographic Facts: Longevity
   Life Expectancy (years)
 Year        AGE
1941-50      32.1
1951-60      41.2
1991-95      60.3
1996-2001    62.88
2001-2006    64.77
2006-2011    66.43
                     NATIONAL SAMPLE SURVEY
     INDIAN HEALTHCARE CAPABILITY

 Over 60,000 cardiac surgeries done
  per year with out comes at par with
  international standards

 Multi organ transplants like Renal,
  Liver, Heart, Bone Marrow
  Transplants, are successfully
  performed at one tenth the cost.

 Patients from over 55 countries
  treated at Indian Hospitals.
INDIAN HOSPITALS CAN OFFER MEDICAL SERVICES AT A
      FRACTION OF THE US / EUROPEAN COST


 PROCEDURE                      COST (US$)
                      US       THAILAND    INDIA     UK


 Heart Surgery      40,000       7,500     6,000    23,000


 Bone Marrow        2,50,000     -------   26,000   1,50,000

 Transplant         3,00,000     -------   69,000   2,00,000

 Liver Transplant   20,000       8,000     6,000    12,000

 Knee Replacement   20,000       3,500     2,000    10,000

 Cosmetic Surgery
                                   India has the opportunity to provide the best of the
                                                Western & Eastern healthcare systems


                                                                      India’s Gift to the World
 Ayurveda         recognized  as an
   official     healthcare system in
   Hungary.                                                               Ayurveda

 Doctors     in  the    west  are                                        Yoga
   increasingly prescribing Indian
   Systems of Medicine                                                    Siddha

 More than 70% of the American
   population         prefer      a       natural
   approach               to               health

      Americans are said to spend
       around $ 25bn on non-
       traditional medical therapies
       and products *



  Source : Los Angeles Times
  * Economic times dated 25th July 2003



              Escorts Heart Institute & Research Centre Ltd, New Delhi, INDIA
•       The Gamma Knife® isn't really a knife at all,
  but radio surgery - a non-invasive neurosurgical
  procedure that uses powerful doses of radiation to
  target and treat diseased brain tissue while leaving
  surrounding tissue intact.
• Gamma Knife surgery represents one of the most
  advanced means available to manage brain
  tumours , arteriovenous malformations , pain or
  movement disorders.
• The procedure is unique because, with the
  Gamma Knife, no surgical incision is performed to
  expose the target.
                                                        31


          Challenges of the Future
   Immunization coverage ( TB: 68%, Measles:
    50%, DPT: 70%, overall : 33%)
   Four major infectious diseases: Malaria, TB,
    HIV/AIDS, RHD
   Preventable blindness
   Population control – large northern state
   Alternative systems – integration
   Mounting cost of hospital care
   Health manpower training – inadequacies
                                                Lok Satta
Healthcare Infrastructure…..
    In Summation

     India needs at least 750,000 extra beds to meet
      the demand for inpatient treatment by 2012-
      opportunity in tertiary healthcare facilities.
     India needs at least 1 million more qualified
      nurses and 500,000 more doctors by 2012 as
      compared to existing number.- opportunity in
      medical education.

     Government and international agencies will
      only be able to gear up US$ 7 billion and the
      rest of investment has to come from private
      sector.
“Politics encircles us today like the coil
of a snake from which one cannot get
out, no matter how much one tries ”


                       - Mahatma Gandhi
                                     33

				
DOCUMENT INFO
Shared By:
Categories:
Tags:
Stats:
views:13
posted:12/23/2010
language:English
pages:33