Food Quality and Hygiene Standards

Food hygiene in hospital poses peculiar problems, particularly given the presence of patients who could be more vulnerable than healthy subjects to microbiological and nutritional risks. Moreover, in nosocomial outbreaks of infectious intestinal disease, the mortality risk has been proved to be significantly higher than the community outbreaks and highest for food borne outbreaks. On the other hand, the common involvement in the role of food handlers of nurses or domestic staff, not specifically trained about food hygiene and HACCP, may represent a further cause of concern.

Earlier, HACCP certification was only limited to Hotel and restaurant industry but now Hospitals are also showing interest in it. As NABH certification is going on some hospitals trying to upgrade their Food Quality Standards. May be in future it would be Government norms to get HACCP kind of certification for Food quality and Hygiene Standards. In India P. D Hinduja hospital is the first hospital to get HACCP certification. Hospitals are realising that these kind of certification is important for Patient care and for fast recovery also with medical care. Also, HACCP plays a role in marketing of hospitals. The certification from HACCP is one among the others where the hospital has been at the vanguard of many such quality initiatives including NABH, CAP, ISO 27001 for IT safety and Six Sigma to name a few Let’s learn about HACCP Certification.

What is HACCP?

HACCP stands for - Hazard Analysis Critical Control Point

In short, HACCP system which includes a series of procedures to control the process and sensitive points in the food chain, with the ultimate goal of consumer foods used in the state and in a way that is safe for his health.

 HACCP - the system from the seventies of the twentieth century became recognized as an international standard for safe food production.Also, the World Health Organization (WHO) has adopted it as the most effective means for controlling foodborne diseases.

Seven Principles of HACCP

1. The implementation of hazard analysis / risk, identify hazards / risks that may arise in the process of food production.

2. Determination of critical control points (CCP). For each identified risk must exist at least one appropriate and critical control point whose existence enables high-quality identification of possible risks.

3. Determination of critical limits, maximal and / or minimum value, by which the biological, chemical and physical hazards are controlled in order of prevention. If so, critical limits are adjusted to the requirements of regulations or law.

4. Determination of procedures / processes for monitoring the CCP, with which to ensure that the CCP remains in critical limits. Monitoring of critical limits, is the answers to the questions: what, how, how often and by whom.

5. Determination of corrective measures if monitoring shows that the CCP is not within critical limits. Corrective measures to ensure that the cause of the problem is identified and eliminated.

6. Establishing procedures / processes for verification and certification procedures and the HACCP system is effective and works well. The authorized persons employed in manufacturing, HACCP team and the inspection of the facility should be also included in the verification activities.

7. The establishment and effective management of records and documents, and documenting evidence that the HACCP system is working well.

Benefit of HACCP (some of them)

·     Improved food safety in Hospitals.

·     Increased awareness of food risks among the staffs.

·     Reduce the cost.

·     Increased patient confidence.

·     Consistency in inspection criteria.

·     Promotion of Hospital.

·     Compliance with food law.

·     Reduction in complaints.

·     Reduced risk of negative publicity about food quality and Hygiene.

·     Improved responsiveness to problems through devised corrective action.

Medical Tourism – Patient beyond borders

Traveling abroad to receive medical care is becoming an increasingly popular trend and is a phenomenon that is rapidly developing into a thriving healthcare industry. Patients are more than ever availing themselves of high quality, affordable and easily accessible health related services found outside of their home country. Both patient and destinations are benefiting from this.  Medical tourism can be broadly defined as provision of Cost effective private medical care in collaboration with the tourism industry, for patients needing surgical and other form of specialized treatment.

Medical Tourism in Asia to reach $8.5 billion by 2013

Medical tourism has bright future and Asia is the Hotspot for this Industry. Thailand and India are the key dominating players; but other Asian country also turning up the competition with government backed medical tourism program. Asia is one of the first regions in the World to promote medical tourism and has created a brand name for itself for having affordable and high quality healthcare. Asian medical tourist number of arrivals is expected to cross the figure of 10 million numbers by 2015. Thailand, India and Singapore are expected to control more than 80% market share in 2015. From 2009-2011 the number of medical tourist in India has grown by 30%. South Korea is a fast growing medial tourism destination. It is estimated that by 2015 South Korea will attract more than 300 thousand medical tourists.

Some Insurance companies like WellPoint and Health net announced a program that will allow employees of a Wisconsin printing company to get coverage for non-emergency surgical in India. Medical tourism helps insurance companies to lower down the burden.  

Top 10 destinations for Medical Tourism

India, Thailand, Singapore, Malaysia, Taiwan, Brazil, Korea, Cost Rica, Turkey, Mexico. 

Why these ten designations?  There are varieties of factors including followings-

 Government and private sector investment in healthcare infrastructure

Broad commitment to international accreditation, quality assurance, and transparency of outcomes

International patient flow

Potential for cost savings

Political transparency and stability

Ease of access to tourism infrastructure

Sustained reputation for specialty excellence

History of healthcare innovation and achievement

Successful adoption of best practices and cutting-edge medical technology

Availability of internationally-trained, experienced medical staff

                                                                                  

Followings are the top specialties for Medical Travelers

Cosmetic Surgery

Cardiology

Oncology

Spine Surgery

Ophthalmology

Dentistry, Orthopedics

Reproductive/IVF

Weight Loss Surgery

Health Screenings

How much money one can save on Cost on Surgeries?

India : 65%-80%

Brazil: 25%-40%

Costa Rica: 40%-65%

Korea: 30%-45%

Malaysia: 65%-80%

Mexico: 40%-65%

Singapore: 30%-45%

Taiwan: 40-55%

Thailand: 50%-70%

Turkey: 50%-65%

People prefer medical tourism for numbers of reason. For many western countries cost is main reason, for other countries accessibility and availability are motivation factors. A survey conducted has been by the medical tourism company to find out the “Why are patients deciding to travel abroad for treatment?”   Following are the result of the survey.

88% - People says Affordability (Costly in Home Country)

66%- Waiting period is high

57% -Quality

46%- Availability

38%-Better care

36%- Tourism factors

30%-Privacy

28%- Additional Benefit

26%-Adaptability (treatment is not acceptable in Home country (e.g- Foetal  sex determination )

13 %- other reasons

Comparison of the surgery cost

Surgery	USA	Colombia	Costa Rica	India	Jordan	Korea	Mexico	Singapore	Thailand
Heart Bypass	$144,000	$14,630	$25,000	$8,500	$10,000	$24,000	$20,000	$13,500	$24,000
Angioplasty	$57,000	$7,106	$13,000	$8,500	$5,000	$19,600	$16,000	$7,500	$7,000
Heart Valve Replacement	$170,000	$10,450	$30,000	$1,200	$12,000	$36,000	$30,000	$13,500	$22,000
Hip Replacement	$50,000	$8,360	$12,500	$8,000	$8,000	$16,450	$13,125	$11,100	$14,000
Hip Resurfacing	$50,000	$10,500	$12,000	$8,000	$8,000	$20,900	$12,800	$12,100	$16,000
Knee Replacement	$50,000	$7,106	$11,500	$7,000	$7,000	$17,800	$10,650	$10,800	$12,000
Spinal Fusion	$100,000	$14,500	$15,000	$12,000	$10,000	$17,350	$7,000	$18,300	$11,000
Dental Implant	$2,000-10,000	$1,672	$1,000	$700	$500	$3,400	$910	$2,900	$3,000
Lap Band	$30,000	$6,500	$8,500	$7,500	$5,000	$9,500	$8,430	$12,000	$12,000
Breast Implants	$10,000	$2,600	$3,500	$4,500	$3,000	$11,000	$8,000	$5,400	$3,700
Rhinoplasty	$8,000	$1,677	$5,500	$3,500	$2,500	$4,000	$4,165	$2,700	$3,400
Face Lift	$15,000	$3,305	$5,900	$7,000	$3,000	$3,000	$7,200	$4,000	$6,600
Hysterectomy	$15,000	$1,845	$5,500	$5,500	$2,500	$9,000	$6,675	$4,000	$5,000

Issues related to Medical Tourism Growth

Assessing reliable information.

Too many new comer jumping on medical tourism bandwagon, not experienced or understanding of the industry.

Lack of pre and post-operative care arrangement.

Complicated intra-county laws and legal procedures.

Lack of support system by Gov. Bodies.

Patients not being properly informed about pro and cons.

Language difficulties and other communication problem.

Cross cultural misunderstandings.

Challenge for hospital and providers in maintaining internationally acceptable standards.

Lack of willingness to travel abroad for medical treatment.

Some Disadvantage of Medical Tourism

Cost is usually the primary reason for opting for treatment abroad, so what are you sacrificing to save a few bucks?  How much are you willing to concede to get the treatment you can afford?

Will you be traveling alone or bringing some family members or friends with you?  This will of course add to your cost, but would you like to be recuperating in a foreign country on your own?  Would your family be prepared to let you?  It is likely that you will be advised not to fly in the immediate aftermath of the procedure, so be prepared to spend numerous days and nights tied up.

Getting treatment abroad – no matter the reputation of the hospital – is always a flight into the unknown.  You may be talking to doctors who can’t articulate the details of the procedure to your understanding.  You might wonder are these hospitals regulated and managed to the same standards and practices as your local hospitals.  Is there a reason why your local hospital is quoting such an extraordinarily high price in comparison?  Maybe the procedure just is that complicated?

Will you be covered by your insurance company?  There may be a small chance that your premium may not cover procedures which are carried out overseas, so obviously, this should be checked out in advance.  You would imagine they would encourage this type of cost effectiveness, but they must also take into consideration the chances of malpractice or error on behalf of the hospital involved.  Some hospitals may have a tenuous reputation when it comes to libelous malpractice claims.