High volume, low cost healthcare: The case of the Aravind Eye Care System

11 April 2013

Most countries suffer from a simple mismatch: both the need and the demand for healthcare services are rising at a much faster rate than the supply of healthcare professionals. Though rich countries are not immune, in developing countries such as India the problem is further compounded by the numbing fact that 313 million people live on less than $1.25 a day.

The World Health Organisation recommends 2.5 doctors, nurses and midwives for every 1,000 people. America and Britain have more than 12 while India has just 1.6. As the world grows older and as the disease profile leans more towards chronic conditions, competition for healthcare workers will only intensify. To make a bad situation worse, we all know that healthcare is notorious for its inefficiencies.

Faced with so many constraints, it’s not surprising that most of the innovations in healthcare were born in the developing world. In India, with so few doctors and a large underserved population, many innovations revolve around making the doctor more efficient.

India is home to 12 million of the world’s 37 million blind people. Recognizing an unmet need, a retired ophthalmologist, Dr Govindappa Venkataswamy, founded a specialised eye care clinic in 1976 with just 11 beds. Today, the Aravind Eye Care System (AECS) is the world’s largest provider of eye care services focused on the mission of “eliminating needless blindness”.

At the AECS, a well-trained paramedical force takes care of the most of the routine tests and clinical workup, allowing the doctor to focus on the most critical tasks – diagnosis and surgery. In the operating rooms, an efficient system cuts down time between surgeries to a mere two to three minutes without compromising on quality or patient safety. As a result, a surgeon at Aravind performs 2,000 surgeries a year, against a national average of less than 400. On a typical day, Aravind performs 10,000 patient examinations and 1,500 sight restoring surgeries, 50 per cent of it being done for free or at a steeply subsidized rate. Standards are set for patients’ waiting time, and the staff monitors this real time to ensure smooth patient flow. Every step is calibrated for efficiency and cost effectiveness.

Through ten eye hospitals (secondary and tertiary) and a network of 40 primary eye care centres across the state of Tamilnadu, Aravind provides about 4 per cent of the eye care in India with less than 1 per cent of the manpower. And yet, the unmet need in the country is a staggering 200 million. In a move uncommon in the world of healthcare, Aravind works with hospitals across the country and beyond, proactively sharing its model and helping hospitals become more efficient and effective while maintaining financial self sustainability.

Blog following a Reform roundtable seminar on “High volume, low cost healthcare: The case of the Aravind Eye Care System”, on 11 April, led by Sanil Joseph, Hospital Management Consultant.

Sanil Joseph joined Aravind in 2005 as faculty associate focusing initially on training activities. Currently his areas of focus include designing various training programmes, teaching in training courses, leading consultancy for capacity building projects in India and abroad and leading and coordinating the research activities at LAICO. Sanil holds a Masters in Hospital Administration (MHA) from Mahatma Gandhi University, Kerala.



Gre Morors

19 January, 2015

Great and a very useful blog for me. Thanks a lot for sharing.