Privately funded quality health care in India: a sustainable and equitablemodel

Objective. As the cost and degree of training necessary to provide state of the art health care has increased throughout the world, the present challe nge in health care is to establish institutions that are financially sound and responsive to the dynamic needs of the communities in which they exist. As public funds have diminished, the role of the private sector in establi shing innovative health care institutions has increased. Setting and study participants. This paper reviews the case of the LV Prasa d Eye Institute (LVPEI), an ophthalmologic institute in Hyderabad, India, t hat is financially sound and medically vital. With an annual budget of US$3 Million, 180 000 patients are seen and 23 000 surgeries are performed at t he Institute and its satellites each year. Main Measures. The Institute provides patient care at a ratio of 1:1 non-pa ying to paying patients through fee cross-subsidization. The Institute uses a combination of financial modalities, including donations, grants and fee s to administer its non-patient care programs. Non-clinical programs of the Institute include a paramedical training program and a fellowship in ophth almology, an internationally accredited eye bank for the preservation of co rneal tissues, a rural out-reach and education program, a basic science and epidemiology program that directs health policy activities of the Institut e and a rehabilitation program for patients with incurable visual deficits. To evaluate its effectiveness, LVPEI uses quality improvement measures, in cluding patient surveys, post-operative outcomes studies and service utiliz ation reviews. Conclusion. This case report of a privately-funded medical institution desc ribes a successful model through which high-quality, equitable health care can be provided in a developing country. The LVPEI's active program of qual ity management, its academic commitment and programmatic relevance to the n eeds of its community should be modularized and replicated to establish equ itable, efficient and effective health care institutions in the developing world.