1.

Executive summery Indian Tourism

Tourism is the largest service industry in India, with a contribution of 6.23% to the national GDP and 8.78% of the total employment in India. India witnesses more than 5 million annual foreign tourist arrivals and 562 million domestic tourism visits. The tourism industry in India generated about US$100 billion in 2008 and that is expected to increase to US$275.5 billion by 2018 at a 9.4% annual growth rate. The Ministry of Tourism is the nodal agency for the development and promotion of tourism in India and maintains the "Incredible India" campaign.

Medical Tourism in India

Medical tourism in India has emerged as the fastest growing segment of tourism industry despite the global economic downturn. High cost of treatments in the developed countries, particularly the USA and UK, has been forcing patients from such regions to look for alternative and cost-effective destinations to get their treatments done. The Indian medical tourism industry is presently at a nascent stage, but has an enormous potential for future growth and development.

Medical Tourism in Gujarat

During the last decade, the State of Gujarat has witnessed enormous growth of high quality health care delivery facilities in the State. Gujarats Healthcare sector has made impressive strides in recent years and is surging ahead with new facilities and technology. Gujarat has the State-of -the- art technology and the skilled super specialists. This, coupled with excellent

infrastructure and professional management, nurses and paramedical staff, can take on international competition for providing a range of services and treatments at a fraction of prevailing costs in international markets with comparable success rates and services levels directly in proportion to the high value system and natural caring that comes with its unique cultural heritage. Exploiting the religious, cultural and wild life tourism potential of the State and collaboration with the tourism industry can complement the growth of medical tourism.

Satisfaction Level of the Patients

The survey of the patients who came from outside the India are mostly from the United States of America, Africa and United Kingdom. The major purpose to come in India are social gathering, treatment and tourism. The findings suggest that patients are coming majorly for the cardiac diseases, orthopedic diseases and for gastro intestinal diseases. Most of the patients select the Hospital or Doctors on the bases of the advice of their relatives or friends and from web sites. The major attraction for the patients are doctors specialization and low treatment charges. Patients gave their first priority to the treatment, followed by financial expenses, hospitality and accommodation. Most of the patients are satisfied with the treatment and facilities available in the hospital. Majority of the patients show their eagerness to visit the same hospital again in the future if there will be any need arise.

2. Research Design:
An explorative study will be carried out to meet the research objective. Initially the study will be done on the different hospitals and services provided by them. Descriptive - To gauge the mind set and view points of the patients pertaining to their preference.

The length of the questionnaire would be 11 and the sample size will be around 100 respondents.

3. Research Methodology
3.1 Research Objectives
Macro Objectives: To find out the satisfaction level of the patients in the multi-specialty hospitals. To find out the factors, why NRIs are attracted towards taking medical treatments in India. To find out which kind of medical treatment is mostly preferred by the NRIs to take in India.

Micro Objectives: To make aware the administration department of the particular hospitals regarding acceptance of facilities and services provided by them to the patients.

3.2 Scope of the study

Collecting data from the existing multispecialty and super specialty hospitals, medical centres and polyclinics in Vadodara and Ahmedabad city.

Study the satisfaction level of the NRI patients who already took and are taking treatment in the hospitals.

3.3 Nature of Research

Research will be descriptive and explorative in nature. Research will be done mainly to understand the satisfaction level of the patients and by this way can understands the competition and also need gaps so that better services can be develop.

4. Sampling Design Process:

Sample Unit: Foreign Patients who have used health care facilities at Ahmedabad and Vadodara.

Target Population: Non residents Indians who came India for treatments.

Sample Size: 100

Method: Convenient Judgement sampling

Data Collection: from various major multispecialty hospitals, super specialty hospitals, medical centres and polyclinics of Ahmedabad and Vadodara.

5. Data Sources:
The data would be collected in the form of Primary data through a survey in Ahmedabad and Vadodara with the help of Personal Interviews. Field Work

The Research Project work is limited to Gujarat especially Ahmedabad and Vadodara.

Fieldwork would include the following work. Taking the prior appointment from the respondents (The hospital Management) Personnel interview of Administration department of particular hospital/Medical Practitioner

Personal interview/telephonic interview/email interview of patients Primary Data Questionnaire Secondary Data Marketing Research Text books, Internet and News papers

6. Tourism in India
6.1 History and Development
Tourism development in India has passed through many phases. At Government level the development of tourist facilities was taken up in a planned manner in 1956 coinciding with the Second Five Year Plan. The approach has evolved from isolated planning of single unit facilities in the Second and Third Five Year Plans. The Sixth Plan marked the beginning of a new era when tourism began to be considered a major instrument for social integration and economic development.

But it was only after the 80s that tourism activity gained momentum. The Government took several significant steps. A National Policy on tourism was announced in 1982. Later in 1988, the National Committee on Tourism formulated a comprehensive plan for achieving a sustainable growth in tourism. In July 1991, tourism was also declared as a priority sector for foreign investment. In 1992, a National Action Plan was prepared and in 1996 the National Strategy for Promotion of Tourism was drafted. The other major development that took place were the setting up of the India Tourism Development Corporation in 1966 to promote India as a tourist destination and the Tourism Finance Corporation in 1989 to finance tourism projects. Altogether, 21 Government-run Hotel Management and Catering Technology Institutes and 14 Food Craft Institutes were also established for imparting specialized training in hoteliering and catering.

6.2 Current Scenario in Indian Tourism

Tourism is the largest service industry in India, with a contribution of 6.23% to the national GDP and 8.78% of the total employment in India. India witnesses more than 5 million annual foreign tourist arrivals and 562 million domestic tourism visits. The tourism industry in India generated about US$100 billion in 2008 and that is expected to increase to US$275.5 billion by 2018 at a 9.4% annual growth rate. The Ministry of Tourism is the nodal agency for the development and promotion of tourism in India and maintains the "Incredible India" campaign.

According to World Travel and Tourism Council, India will be a tourism hotspot from 20092018, having the highest 10-year growth potential. The Travel & Tourism Competitiveness Report 2007 ranked tourism in India 6th in terms of price competitiveness and 39th in terms of safety and security. Despite short- and medium-term setbacks, such as shortage of hotel rooms, tourism revenues are expected to surge by 42% from 2007 to 2017. India has a growing medical tourism sector. The 2010 Commonwealth Games in Delhi are expected to significantly boost tourism in India.

Wild Life in India

India is home to several well known large mammals including the Asian Elephant, Bengal Tiger, Asiatic Lion, Leopard and Indian Rhinoceros, often engrained culturally and religiously often being associated with deities. Other well known large Indian mammals include ungulates such as the domestic Asian Water buffalo, wild Asian Water buffalo, Nilgai, Gaur and several species of deer and antelope. Some members of the dog family such as the Indian Wolf, Bengal Fox, Golden Jackal and the Dhole or Wild Dogs are also widely distributed. It is also home to the Striped Hyaena, Macaques, Langurs and Mongoose species. India also has a large variety of protected wildlife. The country's protected wilderness consists of 75 National parks of India and 421 Sanctuaries, of which 19 fall under the purview of Project Tiger. Its climatic and geographic diversity makes it the home of over 350 mammals and 1200 bird species, many of which are unique to the subcontinent. Some well known national wildlife sanctuaries include Bharatpur, Corbett, Kanha, Kaziranga, Periyar, Ranthambore and Sariska. The world's largest mangrove forest Sundarbans is located in southern West Bengal. The Sundarbans is UNESCO World Heritage Site.

Hill Stations
Several hill stations served as summer capitals of Indian provinces, princely states, or, in the case of Shimla, of British India itself. Since Indian Independence, the role of these hill stations as summer capitals has largely ended, but many hill stations remain popular summer resorts. Most famous hill stations are:

Pachmarhi, Madhya Pradesh - It is also known as The Queen of Satpura. Araku, Andhra Pradesh Gulmarg, Srinagar and Laddakh in Jammu and Kashmir Darjeeling in West Bengal Munnar in Kerala Ooty and Kodaikanal in Tamil Nadu Shillong in Meghalaya Shimla, Kullu in Himachal Pradesh Nainital in Uttarakhand Gangtok in Sikkim Mussoorie in Uttarakhand

In addition to the bustling hill stations and summer capitals of yore, there are several serene and peaceful nature retreats and places of interest to visit for a nature lover. These range from the stunning moonscapes of Leh and Ladhak, to small, exclusive nature retreats such as Dunagiri, Binsar, Mukteshwar in the Himalayas, to rolling vistas of Western Ghats to numerous private retreats in the rolling hills of Kerala.

Beaches
Elephants and camels rides are common on Indian beaches. Shown here is Havelock Island, part of the Andaman and Nicobar Islands India offers a wide range of tropical beaches with silver/golden sand to coral beaches of Lakshadweep. States like Kerala and Goa have exploited the potential of beaches to the fullest. However, there are a lot many unexploited beaches in the states of Andhra Pradesh, Gujarat, Maharastra, Tamil Nadu and Karnataka. These states have very high potential to be develop them as future destinations for prospective tourists. Some of the famous tourist beaches are:

Beaches of Vizag, Andhra Pradesh Beaches of Puri, Orissa Beaches of Digha, West Bengal Beaches of Goa Kovalam Beach, Kerala Marina Beach, Chennai Beaches of Mahabalipuram Beaches in Mumbai Beaches of Diu Beaches of Midnapore, West Bengal Andaman and Nicobar Islands Lakshadweep Islands

Adventure Tourism

Skiing in Manali, Himachal Pradesh

River rafting and kayaking in Himalayas Mountain climbing in Himalayas Rock climbing in Madhya Pradesh Skiing in Gulmarg or Auli Boat racing in Bhopal Paragliding in Maharashtra

A Country Forever... A Story Forever

With Tourism being one of the foremost avenues to put India on the global map, it is heartening to see that the Travel and Tourism Competitiveness Report of 2009 from the World Economic Forum, has ranked India as 11th in the Asia Pacific region and 62nd overall, moving up three places on the list of the worlds most attractive destinations. It also ranked 14th best tourist destination for its natural resources and 24th for its cultural resources, owing to many World Heritage sites, rich flora and fauna, and strong creative industry. The Indian

tourism industry ranked 5th in long-term growth and the report also expects it to become the second largest employer in the world by the year 2019. The Tourism Ministry has claimed that tourism in India has already started showing signs of early recovery from the impact of global economic meltdown and in December 2009 tourists arrivals grew substantially by 21% registering a growth of over 8% over the arrivals in December 2007 which was actually a year of high growth. In spite of the global economic recession in 2008 and 2009, the Indian economy has continued to have good growth. Indias GDP in 2008-09 grew by 6.7%. During April-September, 2009 Indias GDP has seen a growth of 7%, whereas the global economy is estimated to have a negative growth in 2009. The quantum jump in Foreign Direct Investment (FDI) in the Hotel & Tourism sector in the year 2008 and 2009 is also indicative of the positive scenario. Indicating a turnaround, foreign tourist arrivals into the country grew by 21 percent in December 2009, over the corresponding month in 2008. However, it had fallen by 3% for the entire year of 2009 due to the meltdown, H1N1 scare and the Mumbai terror attacks.

Foreign Tourist Arrivals 2009

Estimates of foreign tourists arrivals (FTAs) and foreign exchange earnings (FEEs) are important indicators of the tourism sectors. FEEs in USD terms during the month of November 2009 were USD 1.2 billion as compared to USD 1 billion in November 2008. FTAs during 2009 were 5.11 million with a growth rate of (-) 3.3% as compared to the FTAs of 5.28 million and growth rate of 4% during 2008.

Though the growth rate for 2009 is (-) 3.3%, it is better than UNWTOs projected growth rate of (-) 6% to (-) 4% for the world.

FTAs during the Month of December 2009 were 6.46 lakh as compared to FTAs of 5.34 lakh in December 2008 and 5.97 lakh in December 2007.

Foreign Exchange Earnings 2009

FEEs in Rupee terms during 2009 were Rs. 54960 crore as compared to Rs. 50730 crore in 2008. The growth rate in FEEs in Rupee terms during 2009 was 8.3% as compared to 2008, and 14.4% during 2008 as compared to 2007. In spite of the negative growth rate of 3.3% in FTAs, FEEs in rupee terms observed a positive growth rate of about 8% during 2009. FEEs during 2009 were USD 11.39 billion as compared to USD 11.75 billion during 2008. The growth rate in FEEs in USD terms during 2009 was (-) 3% as compared to 2008, and 9.5% during 2008 as compared to 2007.

FTAs in January 2010

FTAs during the month of January 2010 were 4.91 lakh as compared to FTAs of 4.22 lakh during the month of January 2009 and 5.12 lakh in January 2008. There has been a growth of 16.4% in January 2010 over January 2009 as compared to a negative growth of 17.6% registered in January 2009 over January 2008.

FEEs in January 2010

FEEs during the month of January 2010 were Rs. 5593 crore as compared to Rs. 4598 crore in January 2009 and Rs. 5438 crore in January 2008. The growth rate in FEEs in Rupee terms in January 2010 over January 2009 were 21.6% as compared to (-) 15.4% in January 2009 over January 2008.

Government Initiatives
Realising that the true potential of tourism lies in responsible practices on both the demand and supply sides of the tourism chain, the Ministry of Tourism has adopted the sustainable tourism route and incorporated it into the innovative Rural Tourism Project.

Projects and Sanctioned Budgets

Development of tourism is primarily undertaken by the State Governments/Union Territory Administrations and the Ministry of Tourism provides financial assistance for tourism projects based on the proposals received from them subject to availability of funds and priority. The Tourism Ministry had sanctioned numerous projects across the nation for enhancing the tourism infrastructure; many of them were sanctioned during the year 2009.

Future Potential
The World Travel and Tourism Council (WTTC) along with its strategic partner Oxford Economics conducted the Tourism Satellite Accounting (TSA) research in March 2009. In

accordance with this latest released research, the future of Indian Tourism has some bright prospects. The demand for tourism in India is expected to grow by 8.2% between 2010 and 2019 which will place India at the third position in the world. Indian tourism is expected to employ over 40 million people by 2019. Capital investment in Indias travel and tourism sector is expected to grow at 8.8% between 2010 and 2019. The research report forecasts India to get capital investment worth USD 94.5 billion in the travel and tourism sector by 2019.

6.3 The various segments (structures) within tourism are:

Medical Tourism
It is one of the fastest growing segments in India. India has been able to leverage on certain advantages it has over other countries like highly skilled doctors, cost effective treatment,

improved quality of private healthcare etc. Some of the common treatments for which overseas patients to come to India are heart surgery, knee transplant, cosmetic surgery and dental care. India's traditional rejuvenation therapy like yoga and ayurvedic therapy are also becoming popular.

Eco Tourism
It is relatively new segment in India. It involves visiting natural areas without disturbing the fragile ecosystem. Eco tourism generates wealth for the local people, who in turn take measures to conserve and protect the environment and natural resources. India with its natural diversity is one of the pristine places in the world for eco tourism. The Himalayan region, Kerala, Northeast, Andaman and Nicobar Islands and Lakshadweep islands the Western and Eastern Ghats are some of the hot spots for eco tourism in India. India has some of the best wildlife reserves in the world, rich in flora and fauna.

Heritage Tourism
Heritage tourism is a very lucrative segment in India. It is widely believed it would emerge as the most important segment within tourism in terms of revenue generation by 2010.India has a rich cultural history and reflection of its glorious past is still visible in its numerous forts, monuments, palaces, places of worship etc. Heritage tourism itself can be further classified as colonial heritage, urban renewal, religious tourism, industrial heritage and ethnicity. The Indian government must show keen interest in preserving the heritage sites from a tourism perspective.

Adventure Tourism

India's varied geographical and climatic conditions offer excellent opportunity for adventure sports. In recent times the popularity of adventure tourism has increased. Adventure sports like river rafting, rock climbing, mountaineering, trekking, skiing, snow climbing, scuba diving and angling can be undertaken in the country and the country offers multiple locations to choose from. The trans Himalayan region, the Garhwal and Kumaon mountains, the Western Ghats, deserts of Rajasthan, Andaman and Lakshadweep islands are some of the most popular destination for adventure tourism.

7. Industry Players
7.1 Thomas Cook India Ltd.

Company Information
Thomas Cook (India) Ltd. is the largest integrated Travel and Travel related Financial Services Company in the country offering a broad spectrum of services that include Foreign Exchange, Corporate Travel, Leisure Travel, and Insurance. The Company launched its Indian operations in 1881 and is celebrating its 127 years of world-class service in India. Thomas Cook (India) operates in the following areas of business, namely: Leisure Travel, Corporate Travel Management, MICE, Foreign Exchange, SWIFT Network, Travel Insurance, Credit Cards, Pre-Paid Cards, Life Insurance and E-Business. Post March 31st 2008, Thomas Cook (India) Limited (TCIL) is a part of Thomas Cook Group plc UK (TCG). On March 7th 2008, TCG announced its decision to acquire TCIL from Dubai Investment Group. Thomas Cook Group plc is one of the largest travel groups in the world with a market capitalization of approximately US$6 Billion. In June 2006, Thomas Cook (India) acquired LKP Forex Limited and Travel Corporation (India) Pvt. Ltd. (TCI).

TCIL presently operates in over 72 cities across over 180 locations. The company has overseas operations in Sri Lanka which is a branch of TCIL and Mauritius which is a subsidiary of Thomas Cook (India). The Company employs over 2,200 resources and is listed on both the Bombay Stock Exchange as well as the National Stock Exchange. Thomas Cook (India), over the years has received several prestigious awards such as the Golden Peacock Award for excellence in Corporate Governance and the Pacific Asia Travel Association (PATA) Golden Award for Best Travel. Recently, the Company won the Best Tour Operator at the CNBC Awaaz Travel Awards 2008 and was also accredited the P1 rating which is the highest financial rating given by Crisil. Founded in 2007 Headquarters in Peterborough, England, UK Key people are Thomas Middlehoff (Chairman), Michael Beckett (Deputy Chairman), Manny Fontenla-Novoa (CEO) IT is a travel industry Its products are Package Holidays Employees are 31000

7.2 SOTC - India's Leading Tour operator

SOTC is Kuoni India's key outbound travel brand. SOTC, Indias largest outbound tour operator was acquired by Kuoni Travels - World's leading premium Tour Operator in the year 1996 and is a leader in all segments, namely Escorted Tours, Free Individual Travel, Special Interest Tours and Domestic Holidays amongst others. Till date, SOTC has escorted over 4 lakh passengers across the globe to various destinations including Europe, USA, Australia, New Zealand, Far East, Africa and many more. They have served travelers for years and won their smiles and hearts. SOTCs vast array of holiday services is taking holidaying to an entirely new level. SOTC has been voted "Best Outbound Tour Operator" five times in a row by the Galileo Express Travel & Tourism Awards Committee. The company has not only fully utilized the existing market potential but has also created new markets through innovative packages namely BhramanMandal brand which is dedicated for the Marathi speaking population and 'Gurjar Vishwadarshan' brand that is dedicated for the Gujarati speaking population. SOTC Corporate (MICE) tours offer the following services to customers: Research and development of complete program Identification and reservation of location Venue and accommodation selection Planning, organisation and equipping of location area Contracting and negotiation of services Organisation of pre and post tour programs, spouse programs, social programs and arrangements for accompanying guests

Specialized exclusive theme dinners Audiovisual recording of the event Shows and special entertainments Special evening venues Transportation - meet and greet services during all arrivals Security Visa application services

SOTC Trade Fair Tours SOTC Trade Fair Tours is a division that caters exclusively to the needs and requirements of the keen businessman visiting or exhibiting in International trade fairs. Increase in the number of Indian participants & visitors to various International exhibitions to compete at a global level confirm huge potential for Group Outbound Travel. In the past few years SOTC Trade Fair Tours has successfully organised delegations to various International trade fairs, which has helped in creating awareness and earning a reputation in the market. The efforts and strength in offering the best quality services have been recognized by the 'Indo German Chamber of Commerce', Industry Associations and International Exhibition Organizers, etc by appointing SOTC Trade Fair Tours as their exclusive official agent in India. SOTC Trade Fair Tours has given a new dimension to the trade fair visitors by providing value added services such as confirmed accommodation during the fair period, Indian meals, option to pay in easy monthly installments, factory visits etc - all this and more at extremely attractive and competitive prices.

8. Medical Tourism as an Industry

Medical tourism is actually thousands of years old. In ancient Greece, pilgrims and patients came from all over the Mediterranean to the sanctuary of the healing god, Asklepios, at Epidaurus. In Roman Britain, patients took the waters at a shrine at Bath, a practice that continued for 2,000 years. From the 18th century wealthy Europeans travelled to spas from Germany to the Nile. In the 21st century, relatively low-cost jet travel has taken the industry beyond the wealthy and desperate. The reasons patients travel for treatment vary. Many medical tourists from the United States are seeking treatment at a quarter or sometimes even a 10th of the cost at home. From Canada, it is often people who are frustrated by long waiting times. From Great Britain, the patient can't wait for treatment by the National Health Service but also can't afford to see a physician in private practice. For others, becoming a medical tourist is a chance to combine a tropical vacation with elective or plastic surgery. And more patients are coming from poorer countries such as Bangladesh where treatment may not be available. Countries that actively promote medical tourism include Cuba, Costa Rica, Hungary, India, Israel, Jordan, Lithuania, Malaysia and Thailand. Belgium, Poland and Singapore are now entering the field. South Africa specializes in medical safaris-visit the country for a safari, with a stopover for plastic surgery, a nose job and a chance to see lions and elephants.

9. Medical Tourism in India

Medical Tourism (also known as Health Tourism, Medical Travel) is about travelling to a foreign country for medical treatment. It involves the benefit of cost effective treatment, private medical care in collaboration with the tourism industry. The concept of Medical Tourism is fast catching-up in India where people from any part of the world travel to the country for the purpose of medical treatment and get the dual benefit of travelling and sightseeing to various parts of India. Medical Tourism is a growing concept in India because of various reasons. Much of it depends upon factors those are:

Low cost surgeries and medical treatments such as complex Bone Marrow transplant, liver transplant, kidney transplant, specialized cardiac/heart surgery, surgeries for hip joint replacement, knee joint replacement, dental surgery, and cosmetic surgeries, to mention a few. All these surgical procedures are carried out by expert doctors.

India has various state-of-the-art medical institutes and hospitals of international standards.

People all around the world are eager to see the diversity and unity of India. So, when they get the advantage of medical treatment along with a dual advantage of getting to travel India, they choose India over others.

Comparatively the cost of surgery in India is estimated to be one-tenth of that in the United States or Western Europe, and sometimes even less. A heart-valve replacement that would cost $200,000 or more in the US, for example, goes for $10,000 in India--and that includes round-trip airfare and a brief vacation package. Similarly there are other such surgical procedures that cost less in India.

Chennai (formerly known as Madras), the capital city of the Indian state of Tamil Nadu, has been declared India's Health Capital, as it nets in 48% of health tourists from abroad and 37-41% of domestic health tourists.

9.1 Booming Medical Tourism in India

Medical tourism in India has emerged as the fastest growing segment of tourism industry despite the global economic downturn. High cost of treatments in the developed countries, particularly the USA and UK, has been forcing patients from such regions to look for alternative and cost-effective destinations to get their treatments done. The Indian medical tourism industry is presently at a nascent stage, but has an enormous potential for future growth and development.

We have also found that India represents the most potential medical tourism market in the world. Factors such as low cost, scale and range of treatments provided by India differentiate it from other medical tourism destinations. Moreover, the growth in Indias medical tourism market will be a boon for several associated industries, including hospital industry, medical equipments industry and pharmaceutical industry. In addition to the existence of modern medicine, indigenous or traditional medical practitioners are providing their services across the country. There are over 3,000 hospitals and around 726,000 registered practitioners catering to the needs of traditional Indian healthcare. Indian hotels are also entering the wellness services market by tying up with professional organizations in a range of wellness fields and offering spas and Ayurvedic massages.

Our comprehensive report also provides a deep insight into the Indian medical tourism market and evaluates the past, present and future scenario of the medical tourism market. It

discusses the key factors which are making India an attractive medical tourism destination. Both statistics and trends about market size, tourist arrivals, infrastructure, accreditations, drivers and restraints have been thoroughly discussed in the report.

9.2 Emerging Trends of Medical Tourism in India

Medical tourism was a silver lining for those millions of Uninsured, underinsured and those who were forced to postpone treatments due to long waiting lists. What seemed like a boon to patients from Western countries like US, UK and Canada is now a twilight of hope for those countries who are deemed as Medical Tourism hubs. In popular medical tourism destinations like India, Singapore and Thailand, Medical Tourism is a fast growing industry where millions of dollars are being pumped in rigorously. In order to cope with the growing demand for medical care, hospitals, medical practitioners and even governments have taken measures to promote health care in India. When it comes to health care, safety is the foremost concern. The hospitals in India are well equipped with the latest technology and houses highly qualified and experienced staff who can provide timely and quality medical treatment to patients. As a move in promoting medical tourism, many hospitals are deemed as corporate hospitals that specially cater to the needs of medical tourists in India. Apart from offering world class treatments, they offer

various services that make medical tourists stay in India hassle free. Many hospitals in India have international accreditations that certify the quality of health care service. Indian Government has acknowledged the growth of medical tourism in India and is now offering Medical Visas. The initial period for a medical visa may be up to a period of one year or the period of treatment whichever less, which can be extended for a further period up to one year be the State Government/ FRROs on the production of medical certificate/ advice from the reputed/ recognized/ specialized hospitals in the country. Any further extension will be granted by the Ministry of Home Affairs only on the recommendations of the State Government/ FRROs supported by appropriate Medical documents. Such visa will be valid for maximum three entries during one year. India is a big player in the medical tourism industry. In fact, it has been ranked the most popular medical tourism destination by many. Apart from the contribution of government and hospitals in improving the health care service in India, what truly gives that edge to India over other medical tourism destinations is the innumerable rejuvenation options it offers and the easiness of stay in India. India is the birth place of Yoga, which is one of the most popular forms of exercise and rejuvenation today. There are almost an infinite number of Spa and rejuvenation centers in India that could uplift the mood and enhance health of medical tourists. India is a tourists paradise and when in India for medical treatment, tourism comes as a co-benefit of medical tourism. Unlike other exotic destinations in the world, it is surprisingly easy to commute, stay and converse in India. People in India are extremely warm and have a sound command over English. All these factors make India the sought after destinations for medical tourism and India is now equipped to cater to the fast growing demand for health care in India.

A new report, "Booming Medical Tourism in India, provides an insight into the Indian medical tourism market. It evaluates the past, present and future scenario of the Indian medical tourism market and discusses the key factors that are making India a favorable medical tourism destination. Both statistics and trends regarding market size, tourist arrivals, infrastructure, accreditations, drivers and restraints have been thoroughly discussed in the report. The research suggests that India represents the most potential medical tourism market in the world. Factors such as low cost, scale and range of treatments provided by India differentiate it from other medical tourism destinations. The growth in Indias medical tourism market is expected to serve as a boon for several associated industries including hotels, medical equipment and pharmaceuticals.

9.3 Government Plans for Attracting Medical Tourism to India

To promote growth in the Indian medical travel industry, the Indian government has plans to improve health infrastructure. The government is currently in the process of increasing the number of hospitals, clinics, and clinical laboratories in urban as well as rural parts of the country. Incentives and tax holidays are being offered to hospitals and dispensaries providing health travel facilities. The Indian medical travel and health care sector offers plenty of opportunities for businessmen, medical equipment manufacturers, healthcare service providers, and tourist agencies, and the government is encouraging them to invest in therapeutic and preventive health services so as to increase medical travel to India. The government has published analytical reports on the available opportunities in the Indian health care industry so corporate houses can make informed decisions regarding the Indian medical tourism sector.

9.4 Expansion of Medical Tourism in India

There are several characteristics that make India an appealing destination for visitors seeking health services. These include its well-trained health practitioners; a large populace of good English speaking doctors, guides and medical staff; availability of super-specialty centres that excel in cardiology and cardio-thoracic surgery, joint replacements, transplants, cosmetic treatments, dental care, orthopaedic surgery and more; hospitals that provide the full gamut of health services which include full body pathology, comprehensive physical and gynaecological examinations, echo Doppler, high strength MRI etc. using latest, technologically advanced diagnostic equipments; and finally, and more importantly the availability of these premium services at prices that are extremely reasonable for the foreign tourist. In fact, the competitive cost of medical treatment in India has been the main catalyst for the growth of medical tourism in the country. The costs of comparable treatment in India are on average one eighth to one fifth of those in the West. For instance, a cardiac procedure costs anywhere between US$ 40,000 - 60,000 in the United States, US$ 30,000 in Singapore, US$

12,000 - 15,000 in Thailand and only US$ 3,000 - 6,000 in India. Likewise, the associated costs of surgery are also low. India also has the potential to emerge as a hub for preventive health screening in view of the availability of low-cost diagnostic tests. At a private clinic in London a health check-up for men that includes blood tests, electro-cardiogram tests, chest X-Rays, lung tests and abdominal ultrasound costs around 350. In comparison, a comparable check-up at a clinic operated by Delhi-based healthcare company Max Healthcare costs US$ 84. A Magnetic Resonance Imaging (MRI) scan costs US$ 60 at Escorts Hospital in Delhi, compared with roughly US$ 700 in New York. A study done by the India Brand Equity Foundation (IBEF) in 2004 showed that India is more cost-competitive as compared to other leading medical tourism destination like Thailand. Thailand has a cost advantage over India in only two categories: plastic surgery and breast augmentation. India is cheaper than Thailand across a whole range of otherand more serious surgery categories as the following chart indicates. Surgery Bone Marrow Transplant Liver Transplant Open Heart Surgery (CABG) Hip Replacement Knee Surgery Hysterectomy Gall Bladder removal * cost in US$ Thailand US$ 62500 US$ 75000 US$ 14250 US$ 6900 US$ 7000 US$ 2012 US$ 1755 India US$ 30000 US$ 40000 US$ 4400 US$ 4500 US$ 4500 US$ 511 US$ 555

The health services in India have the additional advantage of providing a good mix of allopathic and alternative systems of medicine. For instance, while New Delhi has emerged as a prime destination for cardiac care; Chennai has established a niche for quality eye care; Kerala and Karnataka have emerged as hubs for state-of-the-art ayurvedic healing. The scope for profit in this sector has encouraged several large corporations, such as

pharmaceuticals and industrial companies, and several non-resident Indians (NRIs) to invest money in setting up super-specialty hospitals such as Apollo, Medinova, CDR, Mediciti in Hyderabad; Hindujas and Wockhardt in Mumbai; Max, Escorts, Apollo in Delhi etc.8 These facilities now dominate the upper end of the private sector and cater predominantly to medical tourists and affluent sections of the society. These establishments have created a niche job market for health professionals predominantly trained in public sector institutes. Even the Government of India has responded promptly to tap the potential of this sector. In its effort to capitalize on this opportunity the Government has untaken measures to promote India as a global health destination. The National Health Policy 2002 strongly encourages medical facilities to provide services to users from overseas. It states that providers of such services to patients from overseas will be encouraged by extending to their foreign exchange, all fiscal incentives, including the status of deemed exports, which are available to other exporters of goods and services. The Indian Ministry of Tourism has started a new category of visas for the medical tourists. These visas called the M or medical-visas are valid for one year but can be extended up to three years and are issued for a patient along with a companion. Efforts have also been undertaken to improve the airport infrastructure to ensure smooth arrival and departure of the health tourists. A brochure of the ministry predicts a phenomenal expansion of the Indian health-care industry in the coming years. These factors have favored the recent spurt of growth of medical tourism in India. Official figures indicate that medical tourists from 55 different countries come to India for treatment. While most of these patients are from developed countries, India is also seeing a surge of patients from countries in Africa and South and West Asia that lack adequate healthcare infrastructure. Among others, foreign health travelers to India comprise of a large number of

non-resident Indians (NRIs). If the present trend continues trade in health and health-services will become one of the biggest sectors in India. However, there are several challenges that could impede the growth of medical tourism in India, more importantly the growth of this sector poses a threat to the already crippled public health system in India.

Kerala Medical Tourism

Kerala is not only a beautiful destination in Southern India known for its scenic beaches and serene backwaters. Of late Kerala has gained international attention for Medical Tourism and is becoming a popular international medical tourism destination. Kerala is famous for its alternative medical therapies such as Ayurveda, which help to rejuvenate and revitalize the body. What many tourists have now discovered is that Kerala has a pool of trained doctors and nurses and an excellent network of hospitals that offer international standard treatments at very affordable prices. Previously Indians working abroad, such as residents of Kerala working in the Persian Gulf countries, would return to India for medical treatment. Now International patients too have realized the advantages of traveling to Kerala and the medical tourism industry has begun to take off in a big way. Faced with exorbitant fees for procedures such as cardiac surgery, dentistry and cosmetic surgery in their home countries, patients from the West and the Middle East have begun looking at India and Kerala in particular. Indian doctors have established themselves as highly skilled and conscientious caregivers worldwide. Many doctors who have trained or worked abroad have returned to India to work here. Their reputation has led to the growth of the Medical Tourism industry in Kerala. Kerala Travel Tourism offers tour packages that combine medical treatment with a restful

holiday in Kerala India. The world-class hospital facilities, pre and post-operative care and pleasant climate make your medical treatment and recovery in Kerala a positive experience. Some Medical Tourism options in Kerala are given below.

10. Medical Tourism Companies

HelloMD.com Advent Medical Services group is a leading medical service provider based in India with accomplished and distinguished physicians and surgeons with a vast experience in variety of disciplines including cardiothoracic surgery cosmetic and plastic surgery, laparoscopic surgery, endoscopic surgery, microsurgery, joint replacements and highly advanced form of ophthalmic and ear surgery. web site url : http://www.hellomd.com Indicure Indicure is a limited company in New Delhi, India founded by a group of medical and management professionals with an objective to provide customised patient care management services in India for medical tourism, health care tourism and home health care services. web site url : http://www.indicure.com/ JD Healthcare Located in British Columbia on the west coast of Canada, JD Healthcare and its partners have been providing healthcare to patients worldwide for over two years. With strong ties to the global pharmaceutical industry, Company the pleasure of assisting countless thousands around the world who can barely afford to put food on the table, let alone pay hundreds of dollars in medical bills every month. web site url : http://www.jdhealthcare.com

Medical Tourism in India - Erco Travels Erco Travels provides Dental Care Packages, Eye ( Refractive ) Care Packages, Heart Care Packages, Heart Surgery Packages, Cosmetic Treatment Packages, Orthopaedic Surgery Packages and Health Check Up along with other tourism packages. web site url : http://www.medicaltourismindia.com Med In India Med In India provides professional, caring and comprehensive services to Medical Tourists looking for medical treatments (and tourist package) in India. Its services help you choose a treatments which are scheduled at your convenience and that too at an affordable cost. It

11. Gujarat:

A Global Health Destination Promoting Medical Tourism in Gujarat

As part of its Navratri Celebrations Vibrant Gujarat 2006, the Government of Gujarat took the opportunity to promote its world-class medical facilities and medical expertise making Gujarat as a destination for medical tourism for Non Resident Indians. Concept of Medical Tourism includes combining Healthcare with tourism potential and offering the Best of the East and the West under one roof. Indias emergence as the preferred Global Healthcare destination has attracted patients from the globe to come to India particularly Gujarat for treatment which is estimated to contribute 25-31 % of the industry earnings of one hundred thousand crores. The Gujarati community comprises of 32% of the total 20.1 million people of Indian origin worldwide. According to a study by Confederation of Indian Industry (CII), India has a competitive edge especially its cost advantage. The Cost of Medical treatment in India is less than 1/3rd of that in many European and US Hospitals. Gujarats medical expertise and the strength of its facilities are better than those of some of the south-east Asian nations and Gujarat hospitals are trying to do lot harder selling abroad.

They are seeking to achieve this by measures such as: Creating centre of excellences in the respective fields Quality stamp through accreditation from global certification agencies such as JCI Developing a network Customised Packaged are available

There was a one mega event organized during the nine days of Navratri; an exhibition on medical tourism where leading hospitals of the state had an opportunity to show their facilities and service packages. The Exhibition: The Governor, H/E Navalkishor Sharma, inaugurated the exhibition. The exhibition was from 23rd September to 1st October. The hospitals such as Apollo, Sterling Hospital, Bankers Heart Hospital, J. S. Ayurvedic Hospital, G.E. Health Care, Fortis Hospital, Rajasthan hospital, and the Cardiology, Kidney and Cancer institutes from the Civil Hospital campus participated in the exhibition enthusiastically. The exhibition also promoted Indian Systems of Medicine specifically, Ayurveda, Naturopathy and Yoga. The focus areas for medical tourism have been derived from the fact that there are waiting lists in various specialties for both inpatients and outpatients, anything between three weeks to one year in hospitals in UK and USA. Many hospitals in Gujarat have experience in providing services to the NRGs and according to them the potential areas for Gujarat would be: Cardiology Renal transplantation

Carcinoma Dental care Cataract Restructuring plastic surgery Wellness and screening Programme In Vitro Fertilization Holistic care through Indian Systems of Medicine.

Planning for medical tourism ahead. The Government of Gujarat sees this occasion as a beginning for making Gujarat a Global Health Destination. The long-term plans include: Establishing a Medical tourism council M.O.Us with private hospitals for provision of high quality health care. Introduction of Nursing Home Act Accreditation of service providers so that quality services are assured. Medi City Opportunities for private participation in public hospitals Investments in Capacity Building Schools of Public Health and Hospital Management

12. Major Hospitals in Ahmedabad and Vadodara 12.1 Apollo Hospital

The Story of Apollo Hospitals is intrinsically tied to the story of Dr. Prathap C. Reddy, the founding Chairman. His wondrous journey from rural Andhra Pradesh to architecting modern healthcare in India is synonymous with Apollos sweeping achievements in making India a global healthcare hub. He had settled down to a flourishing practice in USA, when the pangs of an unfinished dream started. These pangs continued to gain ground, strong and silent until that one day, when Dr. Reddy realized that he was consumed by the overwhelming need to lay the foundation for his vision. He moved back to India and started the uphill task of making Apollo Hospitals a reality. Today, Apollo Hospitals group is the largest healthcare service provider in Asia and the third largest in the world. As a group, Apollo has touched and enriched over 20 million lives. Apollo Hospitals started as a 150 bedded hospital in Chennai in 1983. India, in the early 80's, was not the easiest place for private enterprise. Moreover, private healthcare institutions were unknown and they were not doing cutting edge work. 27 years later it is an amazing story of success, achievement and most importantly, dreams realized. As Apollo Hospitals has made colossal strides to reach where it is, more and more facets of the founding vision have turned to reality. Today, Apollo group is not just one of the country's premier healthcare providers but has also played a pioneering role in helping India become the centre-of-excellence in global healthcare.

The Apollo Hospitals group today includes over 8065 beds across 46 hospitals in India and overseas, neighborhood diagnostic clinics, an extensive chain of Apollo Pharmacies, medical BPO, health insurance services and clinical research divisions that are working on the cutting edge of medical science. However, the largest achievement of the Apollo group has been to take quality healthcare to across the length and breadth of India. Of touching 10 million lives and giving hope to an entire segment of the Indian population who did not have an option beyond limited medical infrastructure. Apollo has succeeded in being more than just a quality healthcare provider. It has been a major player in scripting the medical landscape of the nation. This is primarily because the group has continuously been at the helm of several game-changing innovations in Indian healthcare. By the start of the new millennium, Apollo Hospitals group had become an integrated healthcare organization with owned and managed hospitals, diagnostic clinics, dispensing pharmacies and consultancy services. In addition, the group's service offerings include healthcare at the patient's doorstep, clinical & diagnostic services, medical business process outsourcing, third party administration services and heath insurance. To enhance performance and service to customers, the company also makes available the services to support the business of healthcare, telemedicine services, education & training programs, research services and a host of non profit projects.

About Apollo Ahmedabad

Today Apollo Hospitals group is recognized as the "Architect of Healthcare" in India. Apollo group has a long history of accomplishments with its unique ability of resource management. Apollo Hospitals, Ahmedabad opened in May 2003. A multi-specialty quaternary care hospital further strengthens the healthcare infrastructure in Gujarat, setting new benchmarks in quality standards in healthcare delivery. Keeping with the tradition of delivering healthcare at par with the best in the world, Apollo relies a great deal on innovation, introspection and improvement to render tender loving care to patients. Apollo Hospitals, Ahmedabad provides holistic healthcare that includes prevention, treatment, rehabilitation and health education for patients, their families and clients by touching their lives.

International Patients
Apollo Hospitals, Ahmedabad, a 400 bedded quaternary care hospital, has an overall success rate of 98%. Located just 5 Kms from the Ahmedabad International Airport, the hospital not only offers world class healthcare facilities but also has a wonderful serene nature surrounding it. Built over 10 acres of land, the hospital has 65 ICU beds and is the largest corporate hospital in Gujarat offering world class diagnostic, medical and surgical facilities. Medical Tourism in India has witnessed an enormous growth and has opened a plenty of opportunities in the private and voluntary sector. Leading the race in attracting medical

tourists to India is Apollo Hospitals, the healthcare powerhouse of India. Traveling from all around the world, medical tourists seek essential healthcare services. Apollo Hospitals, Ahmedabad offers superlative services in line with international patient care standards and has therefore carved a niche in the health tourism sector. Arrival at Airport On arrival, patients will be received at the Apollo Medical Centre, a unit of Apollo Hospitals, Ahmedabad, by their representative and taken to main Apollo Hospital as per the admission plan. They Specialised in: Coronary Angiography & Angioplasty Open Heart Surgery Stem Cell Transplantation Knee Replacement Kidney Transplantation Cosmetic Surgery Paediatric Cardiology Radiation & Surgical Oncology Medical Health Checks

1. 2. 3. 4. 5. 6. 7. 8. 9.

Special Facilities Available

Transport services including Airport pickup Foreign exchange support Accommodation for relatives and attendants Communication Center Locker facility International conferencing facility Postage & Couriers Travel Desk Cyber Caf Library Places of Worship Bank ATM

Telemedicine Facility:
Apollos vision is to provide a successful working model of Telemedicine which selfpropagates across India and abroad. It will provide a channel for continuous access to the most sophisticated medical support systems at all times. Apollo aims at extending superspeciality services to remote countries across the globe by proactively using technological developments and imaging techniques to create benchmark standards in the field of medicine and health. They have a state of the art telemedicine centre, to cater for needs of all international patients.

12.2 Shalby Hospital, Ahmedabad.

Shalby Hospitals is amongst the league of few hospitals to have received NABH (National Accreditation Board of Hospitals) certificate in a short span of time. Shalbys NABH journey started in July 2009 as Shalby family organized itself into small teams of healthcare professionals taking the daunting task to set systems and process documentations in place. From infrastructure & facility management to services & medical management, all teams were aligned with only one focus in mind ensuring Better Patient Care & Improved Patient Safety through improvement in quality services offered by the hospital. Shalby Hospital: In pursuit of Quality Health Service Shalby Hospitals provide world class facility and offer a holistic range of medical services to patients from across the globe. Shalbys compassionate approach to medical care is patient centric, with multidisciplinary teams of highly skilled medical professionals working together to improve the quality of life for patients. Although a multi specialty health care provider, Shalby is particularly renowned for its high volumes in joint replacement surgeries with more than 16000 Total Knee Replacement surgeries conducted till date a world record of sorts. At Shalby, they believe it is more important, in these days of patient choice, to listen carefully to the views of their patients so that they are able to respond to their needs. They strive to continually improve the quality of patient care, monitoring and measuring the treatments their patients receive and evaluating performances against their own as well as industry standards. Shalby is committed to providing highest quality healthcare through innovative use of technology across the offered medical specialties, this not only ensures

minimizing infection rate but also ensures they offer the worlds best services to their patients. Shalby Hospitals is a modern, state of the art 230 bed quaternary care healthcare centre centrally located in Ahmedabad. The hospital transcends the best of the service standards practiced anywhere in the world and has to its credit the honor of being one of the preferred destinations for Total Knee Replacement surgeries. Under the able guidance and leadership of Dr. Vikram Shah who has successfully performed over 16000 Knee Replacement surgeries (till March 2009). Its world class infrastructure includes:

9 Operation Theatres 3 Class 100 Operation Theatres for Joint Replacement

2 Class 10000 Operation Theatres for Cardiac Surgery 3 General Operation Theatres

1 Dedicated Operation Theatre for Laproscopy and Endoscopy Macquet Operative tables All Operation Theatres have Laminar Airflow to minimize infections Surgeons use space suits as a measure to isolate air-exhaust A-Dec Dental Chairs Root ZX & X Smart for painless Root Canal Therapy Carl-Ziess Optio Surgical Microscope for neurosurgery Dedicated level for International Patients Choice of cuisines Prayer room In-house Travel Desk for air / rail bookings

Shalby Hospitals also offers world class services in the following medical disciplines: Joint Replacement Surgeries Endoscopic & Laproscopic Surgery Urology

(Knee & Hip) Dentistry & Dental Implantology

Intervention Cardiology Neuro Sciences (Medical Surgical) Ophthalmology Bariatric Surgery Reconstructive Surgery Burns & Plastic Surgery Cosmetic & Aesthetic Surgery

&

Nephrology Oncoloy (Medical & Surgical) Endocinology (Medical & Surgical) Paediatrics (Medical & Surgical) Trauma & Orthopedic Surgery Intervention Radiology Pain Management

Shalby Hospitals treasures its skilled and efficient manpower in all walks of hospital services from administration to paramedics to consultants. It is this very force which has further advanced their growth as a prominent quaternary care hospital in the region serving not only Indian patients but also extending its healing touch to patients from UAE, Qatar, Oman, Syria, Yemen, Uganda, Tanzania, Kenya etc.

12.3 Sterling Hospital

STERLING ADDLIFE INDIA LIMITED came into existence with effect from 29.12.2000 as a Limited Company registered with the office of the Registrar of Companies; Gujarat. Sterling Addlife India Ltd. is a dominant player and premier healthcare service provider in Gujarat. It has become one of the leading regional healthcare companies in India. The philosophy of the company remains to be patient centric, follower of ethical medical practices, and a provider of world class healthcare to global clientele.

Sterling Hospital, owned and managed by Sterling AddLife India Ltd., is the leading hospital chain in Gujarat. It is engaged in providing high quality medical and surgical care in a host of critical specialties such as Cardiology and CVTS surgeries, Neurology and Neurosurgeries, Nephrology and Kidney Transplant, GI Medicine and Surgeries, Hematology, Oncology and Onco-surgery, Critical and Emergency Care, Trauma and Orthopedic, Neonatology as well as General Medicine and Surgeries. Sterling has two multi-speciality tertiary care hospitals, one each at Ahmedabad and Vadodara and three satellite centers, one each at Kalol, Mehsana and Himmatnagar. The company has STERLING HOSPITAL, a multi-super speciality hospital in Ahmedabad with 310 beds, 7 major operation theatres and 84 ICU beds. The company has also taken over Sterling Hospital, Vadodara which is having all multi-super-specialty facilities. Sterling's high quality services attract patients from Gujarat, Rajasthan, Madhya Pradesh, Maharashtra and even from outside the country. Sterling proposes to cross the 1000-bed mark with additional state-of-the art hospitals planned at Rajkot, Surat and Bhavnagar by 2010. Sterling is also focused on clinical research and medical education through DNB programs. As a part of Sterling's ambitious growth plans, Actis, the well-known Private Equity Firm, has recently acquired a significant equity stake in Sterling AddLife India Ltd. Sterling has taken up 2 green field projects at Rajkot and Bhavnagar. The estimated cost of Rajkot project for setting up a 160 bed hospitals is kept at Rs. 75 Crores. The company has acquired a piece of commercial land at Bhavnagar for setting up a medium sized 120 beds capacity (expandable upto 130 beds) hospital with estimated cost of project of Rs. 46 Crores.

Corporate

At Sterling Hospitals they understand that healthy employees contribute to a healthy business. Their healthcare delivery systems are specially designed to suit every employee needs. From wellness and preventive care, to the treatment of illness and rehabilitation, they have been pioneers in every link of the healthcare chain. For their employees and their dependents, this means easy access to the most sophisticated medical facilities.

Doctors
Sterling Hospitals has managed to create a world-class healthcare system by integrating internationally benchmarked medical practices with cutting-edge technology and above all 'Patient Care'. The institute has brought the sharpest, the brightest and the most diligent resources to work together and to deliver finest care to its patients. All those health professionals who visualize a synergy with the institute's core values of 'Service to mankind, Compassion for fellow human beings and utmost Integrity in all actions', are welcome to be a part of the -Team Sterling.

Patients
Sterling Hospital, has emerged as a preferred destination for quality medical treatment attracting patients worldwide. Given this advantage, Sterling Hospitals has focused its efforts towards being a world-class hospital that exceeds the expectations of its patients. With highly advanced medical infrastructure, broad knowledge base, medical expertise and extensive integration, Sterling Hospital makes an ideal partner for patients seeking a more

affordable treatment. The hospital offers globally benchmarked healthcare services administered by surgeons and physicians trained in international medical practices. These services include advanced cardiology and cardiovascular surgery, orthopaedics and joint replacement surgery & Minimally Invasive Surgery, Cosmetology, Oncology and Neurology amongst others.

International patients
Medical Tourism in India has witnessed strong growth in past few years. India is emerging as a preferred destination for international patients due to availability of best in class treatment at fraction of a cost compared to treatment cost in US or Europe. Sterling hospitals has focussed its efforts towards being a world-class hospital that exceeds the expectations of its international patients on all counts, be it quality of healthcare or other support services such as travel and stay. Sterling hospitals renders superlative services in the lines of International Patient Care, and has therefore carved a niche in the Medical Tourism sector.

Various medical specialties offered to International patients are:

Cardiology Cardio Thoracic & Vascular Surgery Internal medicine Infectious disease management Orthopaedics Orthopaedic Surgery (Total Hip/Knee Replacements, Joint Replacements)

Plastic Surgery Cosmetic Surgery Bariatric Surgery (Gastric By Pass Surgery, Gastric Banding etc) Gynaecology & Obstetrics General Surgery Minimal Invasive Surgery Neurology & Neuro Surgery Nephrology (Dialysis) Paediatrics & Paediatric Surgery Pulmonology Renal Sciences (Renal Transplantation) ENT

Centres
Sterling Hospital is 310 beds multi-superspecialty hospital, situated in the heart of Ahmedabad and Sterling acquired a 110 bed tertiary care hospital in Baroda. STERLING HOSPITALS are a part of an integrated world-class healthcare facility. They endeavour to go beyond the expected and deliver the most positive experience to each of their patients. In this endeavour of their, they are backed by cutting-edge technology and

internationally trained, highly qualified medical professionals, who administer the bestavailable medical services across all major disciplines of medicine and surgery.

Highlights
1. 2.

The pathology department ranked 3rd in India and 10th in world (2006- 07) Sterling Hospital has been ranked Best Hospital ( 2007) by IMRB an The Week magazine

Core specialities include:

Cardiac Science Gastroenterology Neuro Science Orthopaedics Critical Care Nephrology Oncology.

Services
24 x 7 Emergency services Specialized services like Pain clinic, Stroke clinic, Diabetes clinic, Wellness clinic, etc. Basic services like Health Check up & its packages that suit your requirements

12.4 Bhailal Amin General Hospital, Vadodara

Established in 1964, BAGH - an ISO 9001:2000 Institute is a 160 bedded premier MultiSpecialty & Tertiary Care Hospital of Gujarat & has been at the forefront of ushering in a revolution in health care. From a highly qualified team of doctors, state-of-the-art medical facilities, to following internationally acclaimed practices, everything at BAGH is aimed at

offering the best in health-care. Our warm and sensitive staff, coupled with the green environs, makes your stay at BAGH, a pleasant & comfortable one. It is a Multi-Specialty & Tertiary Care hospital with 6 Operation Theatres & 4 Intensive Care Units with 24 hours service in Accidents & Emergency, Heart Command Center, Radiology including CT Scan, Pathology Lab with 'Home Collection Service', Blood Bank including Component Separation facility, ICUs, Pharmacy, Mobile ICU, Ambulance, Mortuary service, Medico-Legal cases & Partial Pathological Postmortem. Bhailal Amin General Hospital is truly a "home away from home", where "Patient Care" is "Beyond Compare" BAGH has a tie up with International Health Care Service providers like:

INTERNATIONAL SOS OCEANIC HEALTH PLUS

12.5 Centre for Knee & Hip Surgery, Vadodara

Centre for Knee & Hip Surgery (CKHS), at Baroda is probably the only unit in India, which addresses the entire range of knee-related problems and offers patients need-based solutions. It has the complete range of treatment facilities for knee & Hip problems starting from non-operative solutions to the minimally invasive arthroscopic surgical technique

extending up to complex procedures like knee and hip replacement surgery and Revision knee & hip replacement surgery. This clinic is perhaps the only one of its kind in the entire country to focus just on the knee and hip joint. The benefits of having such a clinic are plenty. Some of them are:

Under a single roof, a comprehensive range of state-of-the-art infrastructure is available for anything and everything to do with knee and hip related problems. The Centre is able to invest in the best and the latest possible electronic instrumentation systems for knee & hip surgery which are available in the world, as it just focuses on these joints . It would otherwise be very difficult, if not impossible, to keep on pumping money for updating every area of orthopaedics.

The Centre for Knee & Hip Surgery has established itself as a prime centre for medical tourism in India. They have patients coming from U.K., U.S.A., Kenya, Tanzania, Uganda, Zambia, Australia, New Zealand, Panama Canal, Mauritius, Fiji Islands & the Middle East countries. These patients include foreigners and not just Non Resident Indians.

Facilities Provided to International Patients:

Pick - up and drop-off at the airport. Assisting them in planning their travel. Regular and prompt responses to their queries on phone and e-mails.

Arranging for nearby hotel accommodation at special discounted rates for patients and relatives in 3, 4 or 5 star hotels.

12.6 Baroda Heart Institute and Research Centre, Vadodara

Founded on the 11th of March, 2001 the institute is unique by the fact that it is poised to become the best cardiac care centre in Gujarat and the neighbouring states. We were born out of the dream concept of providing Single Centre Management of cardiac ailments.

BHIRC offers the highest standards of comprehensive cardiac care from basic facilities in preventive cardiology to the most sophisticated curative technology, supported by thorough professionals, clinicians and administrators. The technological advances made in the 20th century have brought scientific marvels into our hospitals, these in turn have made an unprecedented demand on hospitals' medical services, particularly in areas such as Surgery, Clinical Laboratories and Radiological as well as Cardiac rehabilitation services. Over and above, visibility of state-of-the-art technology has been made by means of appropriate lighting, colour, furnishing, noise level, aroma (absence of hospital smell), visitor accommodation and staff accommodation, maintenance of high-tech. equipments and high-touch humanity.

Facilities Interventional Cardiology

The Fully Digital Cardiac Catheterisation Lab from Philips is the heart of this

department and is manned by an expert team of DM qualified Interventional Cardiologists.

The Integris H5000 is suspended from the ceiling to provide fro better

manoeuvrability and is equipped with digital subtraction angiography which helps in cardiac and vascular interventions and uses digital.

technology to store and retrieve images, archives all the angiographic data,

has a dedicated work station with off line QCA facilities which automatically makes self programmed CDs which can be reviewed later.

The combination of these technologies and expertise makes this one of the

most sophisticated and research oriented laboratory in the country. Non Invasive Cardiology (NIC)

The Non Invasive Cardiology (NIC) department is equipped with the latest

high resolution ultra vision 5500 echo Colour Doppler machine from HP.

The facility includes Colour Doppler echo cardiology, multi plane trans-

oesophageal echocardiography, and dobutamine stress echocardiography.

We are also the first to have myocardial contrast echocardiography in India.

Added to that, acoustic quantification and colour kinesis help to overcome many limitations and add to the accuracy of diagnosis. Bedside intra operative echo colour Doppler and TEE are also available.

We also possess a computerized cardiac stress test machine from Space Labs

with advanced touch screen technology which is used to perform accurate and reproducible exercises testing for patients with coronary artery disease.

In addition to this, the department is also equipped with the sophisticated

Zymed Holter monitoring system which is used for diagnosis of all kinds of cardiac arrhythmias.

Intensive Coronary Care Unit (I.C.C.U.)

Did you know that 30% of patients die following a Heart Attack? This can be

avoided by having life support systems and other facilities to prevent any emergency following a heart attack.

BHIRC now has a 12-bedded Coronary Care Unit equipped with the latest

monitoring system networked on the Central Monitoring System and manned round the clock by medical officers and fully trained and dedicated nursing staff.

The I.C.C.U. at BHIRC has established a reputation for excellence in cardiac

care in the region. Cardiac Surgery

The surgeries performed here are not only restricted to conventional adult and

paediatric surgery. Some of the most advanced and pioneering procedures like Beating Heart surgery, minimally invasive or key hole surgery and total arterial revascularisation are undertaken here.

A high standard of care is maintained with the help of dedicated cardiac

surgeons, cardiac anaesthetists, per fusionists and of course high quality nursing care.

This is reflected in excellent surgical results obtained at this centre. The

department also has a top of the line cardiac surgery theatre equipped with the latest monitoring system, ventilators, defibrillators, heart lung machine, cold lighting system and electronically controlled operation table. Paediatric Cardiac Care

A total of 150,000 children are born every year with congenital heart disease

and yet less than 2000 manage to be treated.

The Surgical department of Baroda Heart Institute & Research Centre aims to

close down the gap.

The paediatric cardiac care department at BHIRC is one of the few centers in

the country offering advanced diagnostic and treatment facilities for children with heart diseases.

The department is fully geared to perform diagnostic procedures like

paediatric echo-colour Doppler studies, TEE, cardiac catheterizations and paediatric interventions like balloon valvuloplasty, balloon angioplasty, closing defects in the heart using a variety of devices and life saving procedures like atrial septostomies.

All this is backed by the specialized paediatric cardiac care surgical team who

are masters in various congenital heart diseases. Cardiac Electrophysiology

Cardiac electrophysiology is a procedure which studies the electrical

properties of the heart and evaluates the cause of irregular cardiac rhythm. Curative procedures like radiofrequency ablation and implantation of AICD are also available at this premier institute. Interventional Radiology

The department has high resolution ultrasonography and X-Ray machines,

and provides top of the line interventional radiology services starting from duplex vascular Doppler studies, digital substraction angiography to various therapeutic vascular interventions like angioplasty, stenting and implantation of IVC filters.

Clinical Pathology & Microbiology

To provide round the clock clinical pathology and microbiological services to

out patients and indoor patients of the hospital, there is a top class pathology lab with fully automated bio-chemistry and haematology equipments.

The department keeps an eye to ensure that the hospital environment is

infection free at all times. Pharmacy

A fully equipped round the clock pharmacy is situated at the hospital which is

more than adequate to cater to all the needs of the patients. Cardiac Nursing

The nurses at the institute are well qualified and go through vigorous reviewal

training to handle cardiac patients, both adult and paediatric, in all aspects of pre & post operative care, regardless of the whether the patient is stable or in a critical condition.

13.Analysis of The Primary Data

1.

From which country you are coming from/ What is your Nationality?

o United States of America o United Kingdom o Africa o Australia o Others

As mention in the Chart, 45 patients came from United States of America, 17 patients from United Kingdom, 20 patients from different parts of Africa, 8 from Australia and 10 patients from different countries like New-Zealand, Canada, Mauritius, Fiji Islands & the Middle East countries.

By doing survey of 100 patients, we find that maximum number of patients came from United States of America. Another two leading countries are Africa and United Kingdom. Here, we find that Americans are more attracted towards India because they find their relatives and friends in India. We also find that number of Gujarati people who settled abroad is more to come in India for the medical treatment.

2.

For what purpose you are coming to India? o Treatment with Tourism o Treatment with Shopping o Treatment with Social Gathering

As mention in the above charts, the question is regarding purpose to come India, 60% of the patients mention the purpose of treatment with tourism in India. By doing survey of 100 patients, 34% patients came for treatment along with social gatherings. There are only 6% of the patients who came for the purpose of treatment with shopping.

3. For which treatment you have come? o Orthopaedic o Ophthalmic o Cosmetic o Cardiac o Neurological o Gastro intestinal o Respiratory system related o Urological o Gynaecological/Obstetrical o Dental o Paediatric o Psychiatric

As mention in the chart, most of the patients came to India for the treatment of Cardiac diseases. Another very common disease is of Gastro Intestinal and of Orthopaedic. The diseases of Respiratory System and Dental diseases are also can be seen among the patients.

There were many patients who took treatment for diseases of multiple system. 19 patients were taking orthopaedic treatments which include majorly knee and hip replacement surgery. There were 22 Cardiac patients majorly came for Bypass surgery and Angioplasty. Gastro intestinal diseases also can be seen in more number of patients. There were 21 patients who were suffering from Gastro Intestinal disorders which majorly include Laparoscopic Surgery. Respiratory diseases also can be seen in 15 patients. In India Dental surgery is also appreciated by the NRIs. Here we can see there are 12 patients who came for the Dental surgery. As mention above in the charts, we find very few patients of other system related treatment.

4.

What are the bases for selecting this Hospital/Doctor?

o Relatives/Friends o Web sites

o Magazines o News papers o Television

As mention in the above charts, there are many bases to get information regarding particular Hospital or Doctor. As mention in the charts 75% patients get information from their relatives or friends. Patients who dont have any relatives or friends in India could get information from web sites. There are 17% of the patients who get information from the web sites. There are very few patients got information from various magazines, News Papers and Television which are 3%, 4% and 2% respectively. Here we found that Positive Word of Mouth can grape more number of customers. Which facilities have attracted you to come here?

5.

o Doctors specialisation

o Treatment charges o Infrastructures o Accommodation o Hospital administration o Hospitality

As mention in the chart, most of the patients attracted towards the Doctors specialisation and Treatment Charges. There are 46% of the patients who are attracted towards the specialisation of the Doctors and 35% are attracted towards the low cost of treatment. 11% are attracted towards the Infrastructure of the hospital and 3% are happy with the Accommodation facilities of the hospital and 3% with Hospital Administration. There are only 2% of the patients who attracted towards the Hospitality of the Hospital. Give the ranks to following matters. 1 leads to most important for you.

6.

o Treatment o Financial expenses o Hospitality o accommodation

Here as mention in the chart, 68% of the patients gave their first priority to Treatment, 52% patients gave their second priority to Financial Expenses, 54% patients gave third priority to Hospitality and 53% patients gave their last priority to Accommodation.

Here as mention in the above charts, we can see the majority of the patients gave first priority to Treatment followed by Financial Expenses, Hospitality and Accommodation.

7.

Are you satisfied with the treatment given here?

o Highly Satisfied o Satisfied o Neither satisfied nor dissatisfied o Dissatisfied o Highly dissatisfied

We have given numbers to find out Mean. Highly Satisfied-1, Satisfied-2, Neutral-3, Dissatisfied-4, Highly Dissatisfied-5 Calculation: Mean = [25(1) + 56(2) + 11(3) + 7(4) + 1(5)] / 100

= 203/100 = 2.03 Here, Mean is 2.03, which indicates the most of the patients are satisfied. As mention in the chart, 56 out of 100 patients are satisfied with the treatment taken in India. 25 patients are Highly Satisfied, 11 patients are not in stage of deciding their satisfaction level. They are neither satisfied nor dissatisfied. 7 patients are not happy with the treatment given by the hospital. So they are dissatisfied and there is only one patient who is highly dissatisfied with the treatment.

8.

How much you are satisfied with the facilities available in this hospital?

o Highly Satisfied o Satisfied o Neither satisfied nor dissatisfied o Dissatisfied o Highly dissatisfied

We have given the numbers to find out the Mean. Highly Satisfied-1, Satisfied-2, Neutral-3, Dissatisfied-4, Highly Dissatisfied-5 Calculation:

Mean = [30(1) + 48(2) + 16(3) + 6(4) + 0(5)] / 100 = 198/100 = 1.98 Here, Mean is 1.98 which is towards 2 which indicates most of the patients are satisfied with the Facilities given by the hospitals. Here as mention in the above chart, 48 patients are satisfied with the facilities available in the hospital. 30 patients are Highly Satisfied. There are 16 patients who are not in the stage to decide their satisfaction level regarding facilities available in the hospital. So they are neither satisfied nor dissatisfied. There are 6 patients who are Dissatisfied with the facilities available in the hospital.

9.

Would you come again here in future if you need any treatment?

o Yes o No o Cant say

Here as mention in the above chart, 84 patients show their eagerness to come again in the same hospital in future if any need will arise. 10 patients replied negatively and 6 patients are in the dilemma whether they should visit again the same hospital or not if need arise in the future.

14. Findings

The survey of the 100 patients who came from outside the India in different Multispecialty and super specialty hospitals of Ahmedabad and Vadodara are mostly from the United States of America, Africa and United Kingdom.

The major purpose to come in India are Treatment, Tourism and Social Gathering. The findings suggest that patients are coming majorly for the cardiac diseases, orthopedic diseases and for gastro intestinal diseases.

Patients are also attracted towards the alternative therapy like Ayurveda, Yunani and Yoga.

Most of the patients select the Hospital or Doctors on the bases of the advice of their relatives or friends and from the web sites.

The major attractions for the patients are doctors specialization and low treatment charges.

Patients gave their first priority to the treatment, followed by financial expenses, hospitality and accommodation.

Most of the patients are satisfied with the treatment and facilities available in the hospital.

Majority of the patients show their eagerness to visit the same hospital again in the future if there will be any need arise.

There are many suggestions from the patients side for the hospitals are, focusing on advertisements as well as establish Yoga and Rehabilitation centers along with the major clinical department.

15. Recommendations
1.

Here majority of the patients are from US, UK and Africa. So hospital should try to capture the number of patients from other than these country.

2.

The majority of the patients are coming for the Cardiac, Orthopaedic and Gastro Enterological diseases, so our hospitals should develop super specialty ward and department to capture more number of patients.

3.

Our hospitals should develop alternative therapy ward or department like Ayurveda, Yunani, Spa and Yoga along with the rehabilitation centres.

4. 5.

To increase the Advertisement of the Hospitals by using different media. As most of the patients are satisfied with the Treatment and Facilities provided by the hospitals, so hospitals should maintain them.

6.

For patients who are dissatisfied with the treatment and facilities, hospitals should try to know the reasons behind the dissatisfaction.

7. 8.

Hospital should reduced the Professional Attitude towards the NRIs patients. Increase travel facility for the foreign tourists

9. 10. 11.

visa-on-arrival facility for tourists from selected countries. Improve and modernize airport infrastructure and services. Make more and more advertisement by using different medias to capture more market shares.

12.

Create public awareness about economic and social benefits of tourism.

13.

16.
1.

Opportunities
India offers vast range of medical treatments from simple dental procedures to

the complex cardiac surgeries. 2. in India. 3. Wellness tourism, spa, yoga and Ayurveda, has a very bright future in India as Patients can save 60%-95% of their treatment costs by undergoing treatment

foreigners are increasingly flocking to India to seek physical and mental healing. 4. In 2007, around 272,000 medical tourists visited India for medical tourism

and brought US$ 656 Million in revenues. 5. Lack of proper hospital accreditation system and inefficient laws against

malpractice will be the biggest factor limiting the growth of Indias medical tourism Industry. 6. India enjoys a considerable superiority over both Singapore and Thailand as

preferred medical destination.

7.

The Indian economys steady growth rate is also being reflected in the Indian

healthcare and medical travel industry. Healthcare and medical health travel are priority areas for India, and the government has increased its budgetary outlay for medical travel and foreign investment. Customs duties on the import of medical equipment have been slashed, and special incentives are being offered for future private healthcare facilities.

17. Glossary
Orthopaedic Orthopaedic surgery or orthopedics (also spelled

orthopaedics) is the branch of surgery concerned with conditions involving the musculoskeletal system. Orthopaedic surgeons use both surgical and non-surgical means to treat musculoskeletal trauma, sports injuries, degenerative diseases, infections, tumours, and congenital disorders.

Ophthalmic Ophthalmology is a branch of medicine which deals with the

diseases and surgery of the visual pathways, including the eye, hairs, and areas surrounding the eye, such as the lacrimal system and eyelids. The term ophthalmologist is an eye specialist for medical and surgical problems. Since ophthalmologists perform operations on eyes, they are considered to be both a surgical and medical specialty.

Neurological Neurology is a medical specialty dealing with disorders of

the nervous system. Specifically, it deals with the diagnosis and treatment of all

categories of disease involving the central, peripheral, and autonomic nervous systems, including their coverings, blood vessels, and all effecter tissue, such as muscle. The corresponding surgical specialty is neurosurgery. A neurologist is a physician who specializes in neurology, and is trained to investigate, or diagnose and treat neurological disorders. Paediatric neurologists treat neurological disease in children.

Gastro Intestinal Gastroenterology is the branch of medicine whereby the

digestive system and its disorders are studied. Diseases affecting the gastrointestinal tract, which includes the organs from mouth to anus, along the alimentary canal, are the focus of this specialty. Physicians practicing in this field of medicine are called gastroenterologists.

Urological Urology is the surgical specialty that focuses on the urinary

tracts of males and females, and on the reproductive system of males. Medical professionals specializing in the field of urology are called urologists and are trained to diagnose, treat, and manage patients with urological disorders. The organs covered by urology include the kidneys, ureters, urinary bladder, urethra, and the male reproductive organs.

Gynaecology/obstetrics - Gynaecology or gynecology is the medical practice

dealing with the health of the female reproductive system (uterus, vagina, and

ovaries). Literally, outside medicine, it means "the science of women". Almost all modern gynaecologists are also obstetricians.

Paediatrics Paediatrics is the branch of medicine that deals with the

medical care of infants, children, and adolescents. The upper age limit of such patients ranges from age 12 to 21. A medical practitioner who specializes in this area is known as a paediatrician. The word paediatrics and its cognates mean healer of children.

18. Bibliography Naresh

Malhotra. (2009):Marketing Research an Applied Orientation, 5th

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