Ahmedabad: Medical care in India has seen a profusion of private institutions and corporate hospitals, and the trend is likely to continue. So says the latest study conducted by INGRES (ICRA Information, Grading and Research Service), which concludes that the current scenario of demand exceeding supply is likely to continue at least over the next decade.

According to the report, the role of the private sector is going to increase in view of the government being constrained by its fiscal position and also the increasing preference among a burgeoning middleclass for private medical care.

The inadequacy of resources in government-run medical care infrastructure has also shifted the demand towards private concerns. Besides, the emergence of private insurers and increasing spread of medical insurance is also giving a fillip to private medical care.

The key trends that are likely to alter the demand for medical care services, as highlighted by ICRA, include a changing demographic profile (towards a higher proportion of the aged), epidemiological transition towards non-communicable diseases and increasing concerns about the quality of care among users. On the supply side, quite a few investor-owned hospitals have come up, while the number of foreign alliances has increased.

Even though the future of the private sector is bright, there remains an urgent need to build more patient trust towards private establishments. "The necessity, appropriateness and efficiency of care delivered by medical care facilities are increasingly under question. There is a widespread belief that most facilities overcharge by way of unnecessary diagnostic tests and by stretching the patient''s length of stay. The problem is exacerbated by lack of regulation and institutional pressure to lower ''cost per illness episode''," the study notes.

The ICRA analysis also points towards the need for some form of quality-checking mechanism, either by way of licensing or by accreditation. There has been increasing interest in the latter with a number of bodies having announced plans for developing an accreditation service. Further, there are indications that the government, both at the centre and at the state levels, is in the process of developing suitable legislation to ensure standards.

The study further notes that while considerable progress has been made in improving the health of the Indian population, the current status still compares poorly with that of many other developing countries. This is ironical, considering that India spends a comparatively large share of its gross domestic product on health. India''s policy towards health has traditionally identified provision of primary healthcare as the state''s responsibility.

The role of the central government has been limited to family welfare and disease control programmes. The policy has traditionally remained silent on the role of the private sector in the provision of medical care. Notwithstanding this, the private and voluntary medical care sectors have developed to meet the increasing demand for medical care services.

The study also reviews the current health status of the Indian population, the size of the Indian healthcare spending, the government''s approach and policies towards the sector and the size and types of medical care infrastructure in India.