If ease of doing business in India is something the Government wants to achieve, then India’s last but one ranking on a global transparency index on healthcare systems should be some cause for concern.

India ranks 31 of the 32 countries assessed by consultant KPMG International in its global “Through the looking glass” report. Only China features lower than India, among the countries assessed, in terms of opaqueness on information and data, though they may fare well in terms of physical infrastructure.

Nevertheless, the report’s India perspective makes a case for greater transparency in India on the public reporting on specific health parameters even as care is taken to protect critical sensitive patient-related detail.

The intent of the study is not to show how high or low a country ranks but to showcase good healthcare systems that keep the patient at the centre, explains Nilaya Varma, Partner and Chief Operating Officer (Infrastructure, Government and Healthcare) with KPMG in India. The Government needs to create a system where more health related information is gathered and put out in public domain by hospitals in a format that makes sense for patients looking at it, he says.

The study mapped 27 indicators across six dimensions of transparency to provide an individual transparency scorecard for countries representing developed, middle and low income populations. And the dimensions included patient experience, governance (rights and responsibilities) and personal healthcare data (access and safeguarding of patient data), for example.

Taking publically available data, the study looked at things like does a hospital give the success rate on a procedure, for example, information that can help a patient to decide, Varma told Business Line. Hospital re-admission, for example, is an important parameter in the Western world, because it reflects the quality of care. And a simple thing like knowing whether a hospital has more babies delivered naturally or through c-sections, for instance, can reveal much to a prospective parent, he points out.

Patients have no idea what they have paid for, he says, a disconcerting situation that was revealed recently involving cardiac stents and the margins that distributors and hospitals got.

Unintended repercussions

Interestingly, the report cautions a high ranking on the index may not always be a good thing, in that it could have unintended repercussions, Varma points out. If a hospital is seen handling too many people with one type of disease, it may get unnecessarily stereo-typed, he says. Also, he agrees, hospitals in the need to push good outcomes may refuse a critical patient. Privacy is the other concern, and the voluntary system of public disclosure should ensure that sensitive patient information is protected and not shared, he says.

Nevertheless, India has got some features right in terms of the Right to Information and voluntary accreditation of hospitals, he says. Interestingly, the Index seems to take an ambivalent view on the United States. Explaining this, Varma said, different states had significant sometimes even different regulations and aggregating them could have become misleading.