THE ARAVIND EYE
HOSPITAL, MADURAI, INDIA
: IN SERVICE FOR SIGHT
BLINDNESS PROBLEM IN INDIA
1992
30 MILLION PEOPLE ALL OVER THE WORLD
12 MILLION PEOPLE IN INDIA
95% DUE TO CATARACT RELATED
2000
18.7 MILLION BLIND PEOPLE
9.7 MILLION ARE RELATED TO CATARACT
2010-2020
24.1 MILLION BY 2010
31.6 MILLION BY 2020
ARVIND EYE HOSPITAL
FOUNDED BY DR.G.VENKATASWAMY IN 1976
20 BED HOSPITALS AND 3 DOCTORS
70 BEDS IN 1978
250 BEDS IN 1981
1992
240 HOSPITAL STAFFS, 30 DOCTORS, 120 NURSES, 60 ADMIN
PERSONNEL, 30 OTHERS
Service Sequence at Arvind Eye
Hospital
Registration
Vision
Recording
Preliminary
Examinatio
n
Refraction
Test
Tear Duct
function
Testing of
Tension
Final
Examination
600 Beds
Madurai
400 Beds
T-veni
100 Beds
Thoni
400 Beds
Coimbatore
TILL 1992, 3.65 MILLION PATIENTS AND 335000 CATARACT OPERATIONS ARE DONE
90% OF FUNDS ARE SELF GENERATED AND REST COMES FROM RCSB(U.K) AND SEVA
(USA)
INTRAOCULAR LENS
$30 PER PIECE WHILE IMPORTING
NOW `200 WHICH WILL REDUCE TO ` 100 LATER
AURO LAB: 60000 LENS/YEAR
PROBLEM
o MORE THAN FULL CAPACITY ON MONDAY, TUESDAY AND WEDNESDAY
o SLACK ON THURSDAY AND FRIDAY
Main Hospital
Independent functioning
ICCE surgery cost Rs 500 to Rs 1000
ECCE surgery cost Rs 1500 to Rs 2500
Expenses include surgery, stay, medicines etc
Patients guided at each step by several support staf
Dr. Venkataswamy also involved in guiding and support
Experienced doctors and support staf
Hassle free check ups, diagnosis and surgery
Free Hospital
Completely free
Mostly ICCE surgeries
ECCE if medically recommended
Dealt with more patients
Doctors and staf experienced and compassionate
Patients, post-surgery, provided aphakic glasses
Complications, if any, monitored carefully
People from same communities placed together
Eye Camp
Multiple camps organized in several areas in Tamil Nadu
Conducted with help of local community along with a local
sponsor
Sponsor pays for publicity, food and transportation of
patients
Hospital pays for tests, surgery and medicines
Support staf included hospital employees, college students
and other volunteers
Constraints in Turning up for examination
Causes for Not Turning
Up
Percentage
Remedies being used
Still have vision, however
diminished
26
Camps at peoples reach
Cannot aford food and
transportation
25
Camp sponsored
Cannot leave family
13
Patients transported in Groups
supported by volunteers
Fear of surgery
11
No one to accompany
10
Family opposition
How to scale up the Model
Use operations management techniques
to spread out traffic to the whole day
rather than through the morning only
Manage the 3 most busy days, use
token/prior-appointment system. Manage
the slack
Only critical tasks should be done by
senior surgeons, routine tasks can be
done by junior residents. Bring down the
time per surgery from 10 minutes to 5-8
minutes per surgery.
Deeper Analysis into the
Aravind Model
Economies of scale bring cost
advantages
Model can be replicated wherever
minimum customization is required and
standardization of processes is possible
Recruit some nurses out of nursing
colleges to save on training costs and
get ready-to-go nurses
Use avenues other than eye camps to
generate revenue streams
Doctors work 60 hours a week instead of
30
KEY SUCCESS DETERMINANTS
OPTIMUM USE OF SURGEONS TIME
EFFICIENT SURGEONS
EFFICIENT RECRUITMENT AND TRAINING OF
NURSING STAFF
MAINTAINING HIGH QUALITY STANDARDS
ORGANIZING RURAL CAMPS TO ATTRACT VOLUMES
OF PATIENTS
IN HOUSE MANUFACTURE OF IOL
Recommendations
Scale up AuroLab and manufacture IOLs and sell
them to competing eye hospitals like LV Prasad
in Hyderabad.
Increase community out reach, use NGO
networks as well
Increase the fee on paid services to cover a
larger base of the free service hospital
Generate an eye Bank on full scale
Use donations like LVP and make it a central part
of your cash flows
Franchise Aravind Hospitals
The revenue model must first ensure that
the cost of capital at least must be
recovered
Franchisee rights may be provided through
competitive bidding to interested parties in
neighbouring states
Franchisees financial ability must be
assessed to gauge his ability to support a
free hospital. Ideals must match too.
New hospitals must be mentored by senior
ophthalmologists to ensure quality in
services provided.
