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Need and Location Identification of Dialysis Units in Delhi Under PPP Framework

  • Neha Garg
  • Agency : Dialysis Unit, PPP Framework, Dialysis Patients
  • Objective : The aim of the study was to assess the need and location identification for setting up of dialysis units in Delhi under PPP framework. The study was both quantitative and qualitative for finding the number and location of dialysis units. The data was collected through primary interactions with doctors, suppliers and government hospitals.
  • Background : Delhi is the healthcare hub for a geographically large and populated catchment area comprising of J&K, Punjab, Haryana, UP, Bihar, MP and Rajasthan. Given the state’s current population it is estimated that 3,000 patients are diagnosed with ESRD every year. Also the expenditure of a dialysis patient in private facilities is significantly high i.e Rs.20000 per month and there is inadequate facility in government centres. Thereby this issue need to be addressed and PPP framework has been found the most suitable option for the same.
  • Methodology : Primary data collection was done through detailed questionnaire. Hence the demand supply study was done by collecting both secondary and primary data. After finding a significant demand the methodology for the referral and satellite centers was formulated by visiting different Delhi government hospitals and getting information of services provided there. Private center’s dialysis prices and volumes were found and thereby provision to charge nominal fee was designed so that maximum people can afford the services. This project helped to understand patient behavior by primaries with various doctors.
  • Findings : It was found that here are only 500 machines in Delhi with only 24 in government setup. If machines in centrally funded hospitals and centres operated by quasi-government organisations also include then also it accounts for only 60-70 machines. This means only the high income category can afford treatment in private centres while a large section of the middle and low income population does not have the access to avail dialysis services. Thus there is a gap of around 600 machines facilities should be provided at least for sec A, B and C population strata for which around 750 – 900 machines are required. Thereby in the 1st phase government should look at the provision of around 250 more machines. 25 government hospitals were visited and were segmented based on presence of critical care and dialysis facility. Based on this segmentation 13 – 19 hospitals were identified where machines can be placed and also 3 clusters were formed to address the issue of transportation which is significant for a dialysis patient as he has to come 3 times a week for dialysis sessions. 3 – 4 hospitals were identified in each cluster out of which one or two can be developed as referral centres and in the rest of centres relatively fewer machines can be placed.
  • Recommendations : It is recommended that there is need for setting up more machines in Delhi and the government should look at the provision of 250 to 300 additional dialysis beds to augment existing supply of services.  
the study was to assess the need and location identification for setting up of dialysis units in Delhi under PPP framework