DIFFERENT HEALTH CARE STANDARDS

FOLLOWED IN INDIA

SUBMITTED BY : -
RAJESH RANJAN
1815991071
INTODUCTION
IPHS are a set of uniform standards envisaged to
improve the quality of health care delivery in the
country. The IPHS documents have been revised
keeping in view the changing protocols of the existing
programmes and introduction of new programmes
especially for Non-Communicable Diseases.
HEALTHCARE IN INDIA
India has a universal multi-payer health care model that is paid
for by a combination of public and private health insurance
funds along with the element of almost entirely tax-funded
public hospitals. The public hospital system is essentially free
for all Indian residents except for small, often symbolic co-
payments in some services.  At the federal level, a national
publicly funded health insurance program was launched in
2018 by the Government of India, called Ayushman Bharat.
This aimed to cover the bottom 50% (500 million people) of
the country's population working in the unorganized
sector (enterprises having less than 10 employees) and offers
them free treatment at both public and private hospitals.
 For people working in the organized sector (enterprises with more
than 10 employees) and earning a monthly salary of up to ₹21,000
are covered by the social insurance scheme of Employees state
Insurance . which entirely funds their healthcare (along with
unemployment benefits), both in public and private
hospitals. People earning more than that amount are provided
health insurance coverage by their employers through either one of
the four main public health insurance funds which are the National
Insurance Company , The Oriental Insurance Company , United
India Insurance Company  and New India assurance  or a private
insurance provider. As of 2020, 300 million Indians are covered by
insurance bought from one of the public or private insurance
companies by their employers as group or individual plans.
Indian nationals and expatriates who work in the public
sector are eligible for a comprehensive package of benefits
including, both public and private health, preventive,
diagnostic, and curative services and pharmaceuticals with
very few exclusions and no cost sharing. Most services
including state of the art cardio-vascular procedures, organ
transplants, and cancer treatments (including bone
marrow transplants) are covered. Employers are
responsible for paying for an extensive package of services
for private sector expatriates (through one of the public or
private funds) unless they are eligible for the Employees'
State Insurance.
The health systems in India
1. Central
2. State
3. Local peripheral
At the central level
The minister of health and family
welfare.
The directorate general of health
services.
The central council of health and
family.
Directorate general of health services
Directorate general of health services
Director general of health services
 Additional director general of health services
Deputy director general of health services
 Administrative staff.
Function of directorate general of
health services.
To provide technical support to the Department of
Health and Family Welfare for achieving Universal
Health Care accessible to all citizens and to prioritize
special groups.. To facilitate transparency and
maintenance of standar GHS is headed by Director
General of Health Services (DGHS), an officer of
Central Health Services, who renders technical advice
on all medical and public health matters to Ministry of
Health and Family Welfare in Counselling for medical
education
Additional director general of health
services.
 The Directorate co-ordinates with the Health
Directorates of all States/UTs for implementation of
various National Health Programmes through its
Regional Offices of Health and Family Welfare. The
Dte.GHS oversees the functioning of Central
Government Hospitals and their management. It also
addresses health concerns of the people through its
Subordinate Offices/Institutes spread all over the
country.
Central council of health
Union Health Minister Chairperson
 State Health Minister ( Members)
Union health minister
A health minister is the member of a
country's government typically responsible for
protecting and promoting public health and
providing welfare and other Social security services.
Some governments have separate Ministers for Mental
health
State level
At the State level the Health Care Delivery System is
under the State Department of Health and Family
Welfare, headed by a Minister and with a Secretariat
under the charge of Secretary/ Commissioner (Health
and Family Welfare). It consists of political head,
administrative head & technical head.
The four level of healthcare system
Primary Care.
Secondary Care.
Tertiary Care.
Quaternary Care.
Primary healthcare services
Most people are very familiar with primary care. This office is
your first stop for most of your symptoms and medical concerns.
You might seek primary care for the following:

Illness: You may see your primary care doctor when you notice a

new symptom or when you come down with a cold, the flu, or
some other infection.
Injury: You may also seek primary care for a broken bone, a sore
muscle, a skin rash, or any other acute medical problem.
Referral: Also, primary care is typically responsible for
coordinating your care among specialists and other levels of care.
primary care for the following:
Secondary healthcare services.
Secondary care is when your primary care provider
refers you to a specialist. Secondary care means your
doctor has transferred your care to someone who has
more specific expertise in whatever health issue you
are experiencing.
Cardiologists focus on the heart and blood vessels.
Endocrinologists focus on hormone systems,
including diseases like diabetes and thyroid disease.
Oncologists specialize in treating cancers, and many
focus on a specific type of cancer.
Tertiary healthcare services.
If you are hospitalized and require a higher level of specialty
care, your doctor may refer you to tertiary care. Tertiary care
requires highly specialized equipment and expertise.
At this level, you will find procedures such as:
Coronary artery bypass surgery
Dialysis
Plastic surgeries
Neurosurgeries
Severe burn treatments
Complex treatments or procedures
Quaternary healthcare services.
Quaternary care is considered an extension of tertiary
care. However, it is even more specialized and highly
unusual.
Because it is so specific, not every hospital or medical
centre offers quaternary care. Some may only provide
quaternary care for particular medical conditions or
systems of the body.
The types of quaternary care include:
Experimental medicine and procedures
Uncommon and specialized surgeries
Community healthcare centre
A healthcare centre, health centre, or community health
centre is one of a network of clinics staffed by a group of General
practitioners and nurses providing healthcare services to people in
a certain area. Typical services covered are family practice and
dental care, but some clinics have expanded greatly and can
include internal medicine, pediatric, women’s care, family
planning, pharmacy, optometry, laboratory testing, and more. In
countries with universal healthcare, most people use the
healthcare centres. In countries without universal healthcare, the
clients include the uninsured, underinsured, low-income or those
living in areas where little access to primary health care is
available. In the Central and East Europe, bigger health centres are
commonly called policlinics (not to be confused with polyclinics
In addition to medical services, functions of CHCs also
include making provisions for safe drinking water
and basic sanitation, prevention and control of
endemic diseases, collection of vital statistics of the
area, health and nutrition , education and training of
various health personnel working under the CHC area.
Unlike Sub-centre and PHCs, CHCs have been
envisaged as only one type and will act both as Block
level health administrative unit and gatekeeper for
referrals to higher level of facilities. The revised IPHS
(CHC) has considered the services, infrastructure,
manpower, equipment and drugs in two categories of
Essential (minimum assured services) and Desirable
(the ideal level services which the states and UT shall
try to achieve).
All essential services as envisaged in the CHC should be
made available, whichroutine and emergency care in
Surgery, Medicine, Obstetrics and Gynaecology, Paediatrics,
Dental and AYUSH in addition to all the National Health
Programmes. Standards of services under existing
programmes were updated and standards added for newly
developed non communicable disease programmes based
on the inputs from various programme divisions. Standards
for Newborn stabilization unit, MTP facilities for second
trimester pregnancy (desirable), The Integrated Counselling
and Testing Centre (ICTC), Blood storage and link Anti
Retroviral Therapy centre have been added. includes
Service Delivery in CHCs
OPD Services and IPD Services: General, Medicine,
Surgery, Obstetrics & Gynaecology, Paediatrics, Dental
and AYUSH services.
Eye Specialist services (at one for every 5 CHCs).
Emergency Services.
 Laboratory Services.
 National Health Programmes.
Service Delivery in CHCs
Every CHC has to provide the following services which
have been indicated as Essential and Desirable. All
States/UTs must ensure the availability of all Essential
services and aspire to achieve Desiable services which
are the ideal that should be available.
Healthcare standards for US.
Health care facilities are largely owned and operated by
private sector businesses. 58% of community hospitals in
the United States are non-profit, 21% are governmentowned,
and 21% are for-profit.
 According to the World Health Organization (WHO), the
United States spent $9,403 on health care per capita, and
17.9% on health care as percentage of its GDP in 2014.
Healthcare coverage is provided through a combination of
private health insurance and public health coverage (e.g.,
Medicare, Medicaid).
 The United States does not have a universal healthcare
program, unlike most other developed countries
Facilities
The non-profit hospitals share of total hospital capacity has remained relatively
stable (about 70%) for decades. There are also privately owned for-profit hospitals as
well as government hospitals in some locations, mainly owned by county and city
governments.
 The Hill-Burton Act was passed in 1946, which provided federal funding for
hospitals in exchange for treating poor patients.
 The largest hospital system in 2016 by revenue was HCA Healthcare; in 2019,
Dignity Health and Catholic Health Initiatives merged into CommonSpirit Health to
create the largest by revenue, spanning 21 states.
 Integrated delivery systems, where the provider and the insurer share the risk in an
attempt to provide value-based healthcare, have grown in popularity. Regional areas
have separate healthcare markets, and in some markets competition is limited as the
demand from the local population cannot support multiple hospitals.
 About two-thirds of doctors practice in small offices with less than seven
physicians, with over 80% owned by physicians; these sometimes join groups such
as independent practice associations to increase bargaining power.
Hospice services for the terminally ill who are expected to live six months or less
are most commonly subsidized by charities and government. Prenatal, family
planning, and dysplasia clinics are governmentfunded obstetric and gynecologic
specialty clinics respectively, and are usually staffed by nurse practitioners.
 Services, particularly urgent-care services, may also be delivered remotely via
telemedicine by providers such as Teladoc.
 Besides government and private health care facilities, there are also 355
registered free clinics in the United States that provide limited medical services.
They are considered to be part of the social safety net for those who lack health
insurance. Their services may range from more acute care (i.e. STDs, injuries,
respiratory diseases) to long term care (i.e. dentistry, counseling).
 Another component of the healthcare safety net would be federally funded
community health centers. Other health care facilities include long-term
housing facilities which as of 2019, there were 15,600 nursing homes across the
United States. With only a large portion of that number being for-profit (69.3%)
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