Achieving Better Integration in Trauma Care Delivery in India: Insights from a Patient Survey

Interdependencies among health care providers result in complex health care supply chains with fragmented health care processes characterized by coordination failure and incentive misalignment. In developing countries where resources are scarce such coordination failures can have potentially severe impact on patient health. But, there is limited understanding about how coordination takes place across and within the different health care service providers and how this influence hospital transfer time and length of stay. This article addresses this gap in literature by studying trauma care delivery in India using a patient survey (n=104). The Indian healthcare system is particularly interesting as India has to provide low cost care to large populations living in geographically big areas, at the same time when the health care infrastructure is struggling to meet increasing demands. The findings suggest mechanisms to better integrate the processes from the accident site to the hospital which include setting-up referral processes, 24 hour ambulance services, using third party coordinators and process improvement within the hospital following lean principles, thereby pointing towards health policy implications.