SERVICE MARKETING MIX OF INDIAN HOSPITALS

Healthcare in India is one of the largest service sectors, with more than 4
million people engaged. The hospital services market represents one of the
most lucrative segments of the Indian healthcare industry. The Indian hospital
industry is worth USD 280 billion in 2020 as against USD 44 billion in 2010.
Various factors such as increasing prevalence of diseases, improving
affordability and rising penetration of health insurance continue to fuel
growth in the Indian hospital industry. One of the most important elements in
human life is achieving the appropriate health care on time and this growing
need of sound health has not only increased the number of hospitals and also
has shaped competitive hospital industry but still there is a shortage of 4,477
primary healthcare centers and 2,337 community healthcare centers *.
According to “Indian Hospital Services Market Outlook” by RNCOS Industry
Research Solutions, the country needs to cover the cumulative deficit of
around 3 million hospital beds to match up with the global average of 3 beds
per 1000 population**. This scenario has given rise to Hospital service
marketing which is a specialized field that deals with connecting patients,
physicians, and hospitals in mutual relationships.

Service Marketing Mix

The essence of any marketing activity is its marketing mix which has
been defined as the set of marketing tools the firm uses to pursue its
marketing objective. The components of traditional marketing mix are
Product, Price, Place and Promotion but while talking about hospital sector it
is better to apply Service Marketing Mix which has three additional elements
viz. People, Physical Evidence & Process. Having the right marketing mix to
market the services of the hospital industry is very important. Using the right
balance of marketing elements, hospital service marketers can ensure that
their marketing efforts fetch them expected result.
 1. Product
The product is the central component of any marketing mix which can be
defined as a set of attributes offered to consumer. Most products of the
hospitals are services which can be classified as line services, supportive
services and auxiliary services. Line services which are also called core
services include indoor & outpatient services, emergency services i.e. ICU &
operation theater. Services offered by medical & Para-medical staff come
under supportive services which directly determine the quality of medical
services. At last auxiliary services include ambulatory services, dietary
services, indoor & outdoor patient registration services, engineering &
maintenance services which all help in making hospital services effective.

Hospitals are facing several threats like increasing competition, rising costs,
and image problems that can threaten their existence and to face it its
suggested to make continues innovations in product. Product differentiation is
the key to marketing success & in hospitals this can be easily done by the
mixing & matching of the same set of available elements. The strong product
create a different brand image of hospital and establishes positive relationship
between hospital brand image & patient loyalty.
Sustainability as a business approach is becoming widely adopted by
health care companies and organizations around the world, and the easy way
for all kind of hospital to become sustainable is making their product
effective,
2. Price
Price is actual charge made by a hospital and Dobson, Vanzo, Doherty,
& Tanamor (2005) Studied charge setting practices of 238 private & public
hospitals. They found that hospitals in large urban areas, and usually teaching
hospitals, are more likely to consider cost information in their charge setting
than their rural and non-teaching counterparts, they also identified a huge gap
between charges of public & private hospitals. It was suggested hospital
marketers to adopt transparent pricing strategy which ultimately lead to higher
patient satisfaction,. They found that price acceptance is directly influenced
by satisfaction judgments and loyalty. In addition, price fairness influences
price acceptance indirectly through customer satisfaction and loyalty. They
suggested keeping price transparency and reliability when prices are
increased.
Monetary & non monetary cost has significant impact on patient
satisfaction & loyalty towards hospital and hospital’s costs are highly affected
with the supply chain practices adopted by the hospitals, so hospital marketer
should always try to purchases from manufacturer directly or take advantage
of distributor schemes.

3. Place
Place refers to the contact point between health service provider &
patient. This element of marketing mix leads to the identification of suitable
location. For effective distribution of Medicare services it is essential that the
hospitals should be able to provide
basic medical services at different parts of residential areas and also to rural
areas in particular, furthermore Hospital should be located somewhere which
is easily accessible by patients and transport services are also available for
them easily
While selecting location for any clinic or hospital spatial analysis of GIS
method should be adopted, on the other hand Lin, Lee and Chen (2010)
pointed out that an appropriate medical region must be selected before
establishing a new hospital so recommended data envelopment analysis
(DEA) method to establish the effective indicators, and to identify medical
areas lacking medical resources and where there is relatively less competition
Miller (2010) said that in past, a hospital could rely on its location for a
stable client base but practically there are limitations to the degree of physical
changes which can be made to an existing building so according to hospitals
can moderate the effect of location by investing more extensively in clinical
technologies tend to be better performance.

4. Promotion
Promotion activities of a hospital helps in communicating the existence
of services offered to present, past & future customers. Generally promotion
includes advertising, sales promotion, personal selling & publicity, but
instead of undertaking aggressive promotion, hospitals rely lot on WOM &
social marketing Hence hospital advertisements should contain a relatively
high level of information and should be advertised as comfort zones for
human ailments
Positioning is effective marketing strategic tools that can help a hospital
compete for market share and revenues more effectively. In developing
strategies, a hospital must first assess a community's health needs, establish
the hospital's current and desired positions on its segments' perceptual maps,
and finally, choose and implement appropriate positioning strategies. So
instead of doing hospital promotion, marketer should focus on health
education which can position the image of hospital in the mind of patients and
in turn increase its market share.

5. People
Hospital industry is a knowledge based industry, so people play key role
in hospitals which include doctors, nursing staff, paramedical staff,
supporting staff & front office executives. Proper management of human
resources is critical in providing a high quality of health care as ‘doctor
concern’ and nurse-client interaction are the most important factor affecting
customer satisfaction. Following factors should be considered as part of the
recruitment process of medical staff:
a) Emotionally stable individuals having inclination for good service
b)Caring nature
Unavailability of doctors and nurses, as well as their negative attitudes
and behaviors, are major barriers to the utilization of public and private
hospitals. Winsted (2000) supported the notion that Patients want doctors to
demonstrate concern and competence, be congenial, communicate with them,
be courteous, and be civil. Successful implementation of these behaviors by
service personnel could be a very useful tool for medical providers to ensure
customer satisfaction and retention.
6. Physical Evidence
Physical evidence of a hospital includes all the physical or tangible
commodities which provide a tangible aspect to the intangible services. It is
necessary for a hospital to be well organized and Special care should be taken
to maintain hygienic, cleanliness and whole hospital must be well lit Physical
evidence particularly plays an important role in the hospital where the patients
are already depressed or traumatized and a good atmosphere could make all
the difference. While designing a hospital facility it should be engineered
properly as Holder (2008) concluded that physical evidence is an important
dimension in the perception of service quality for patients in health sector.
Review has identified following important aspects of physical evidence:
1.Physical design of the hospital
2.Amenities, signs, symbol, and artifacts
3.Ambient conditions (Pollack, 2009)
4.General condition of equipment and neat appearance of staff members
5.Energy Efficiency and Indoor Air Quality
7. Process
Process is defined as an operational flow of activities which are taken
place at hospital for the efficient delivery of services. Following attributes of
process leads to patient satisfaction:
1.Least difference between perceived waiting times and expected waiting time
2.Choice of physician
3.Appropriate use of patient safety measures & patient education
The transition from hospital to home is a vulnerable period of
discontinuity and potential adverse events. Hospitalists and other inpatient
providers should not view discharge as an end to their obligation to patients
but rather should attempt to promote a safe and efficient transition of care.
Narang (2010) concluded that health care delivery is statistically significant in
impacting the perception of respondents, so it should be improved continually.

Conclusion
Service Marketing Mix is of great importance in today’s Hospital
Industry and is the best tool to be innovative in the industry. With the growing
importance of service marketing mix, hospital administrators are becoming
increasingly marketing oriented. All the above service marketing mix
elements revolve around customers. In hospital service price transparency,
placing hospital services at convenient location of patients, behavior of
medical staff, tangibility and process through technology plays important role
in differentiating services from competitors.