Cooperating for better care.

Padinhare P. Mohanan

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Healthcare lessons from India


Parasurama  commanding Varuna (the Hindu God of water) to part the seas and reveal Kerala.

This NEJM Catalyst presents four lessons from India in making healthcare more efficient.

It lists four problems and strategies to address them. (The full article, of course, gives much more elaboration. ) The authors are Mark D. Huffman, M.D., of Northwestern University’s Feinberg School of Medicine, and Padinhare P. Mohanan, M.D., director of the Department of Cardiology at the Westford-HiTech Hospital, in Thrissur, Kerala, India.

“Problem 1: High Patient Volumes”

“Strategy: Limit blood-pressure measurement to only systolic blood pressure (BP).”

“Problem 2: Unaffordable Services”

“Strategy: Post pricing information.”

“Problem 3: Limited Supply of Clinicians”

“Strategy: Use more nonphysician health workers.”

“Problem 4: Low Treatment Rates”

“Strategy: Explore fixed-dose, combination-therapy options.”

The authors conclude:

“Strategies for efficient healthcare exist in many low- and middle-income countries, often driven by necessity. Some of these strategies can be applied, to varying degrees, in high-income countries such as the United States, thereby driving improvements in efficiency without compromising quality of care. Much in medicine is done as a reflexive habit, but new ideas from other parts of the world can challenge the status quo with the goal of improving care.  What’s happening in India might give us some ideas for how to act differently.”


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