The National Health Policy 2017 envisions to add 1.8 million hospital beds to reach the global median by 2025, creating significant opportunity for manufacturers to establish and expand in the country.

A hospital bed can make a huge difference when it comes to quick recovery of the patient. Comfort, better positioning, improved blood circulation, safety features, and ease of care are some commonly sought features.There are several undergoing technological advancements in hospital beds to further increase the comfort and safety of a patient. One such advancement is smart beds that have a remote monitoring system to keep track of the patient.

The growing focus on patient experience and optimal care, rapid technology developments, and growing competition for healthcare services are forcing hospitals to invest in new generation smart and intelligent beds with advanced features such as remote monitoring, integrated sensors that track and monitor patient physiological parameters, and electronic controls that simplify nursing care.

Since patients spend a large amount of time on the bed, it is imperative for hospitals to monitor their condition regularly. In recent years, advances in technology have helped vendors develop automated hospital beds that can be controlled and operated with minimal human effort. The preference for advanced features, such as hydraulic adjustability, AC-powered, and powered patient rotation beds, among healthcare service providers is increasing as compared with manual or semi-automated beds.

Indian Market Dynamics

In 2016, the Indian hospital beds market is estimated at 650 crore with sales at 100,000 units. The market may be segmented as high-end motorized beds, which are long-term care beds with 2–4 motors and priced at above 100,000; mid-end beds, which are semielectric and for critical care, at an average unit price range of 50,000–75,000; and low-end ones which require manual labor through the use of a crank system to adjust the bed's posturing and height and are for acute care. The low-end segment with 50,000 units constitutes 50 percent of the total market, in volume terms.

An estimated, 30,000 beds of the mid-end segment were sold, valued at 225 crore. The market is dominated by Midmark, ArjoHuntleigh, Paramount, and Godrej. Some other brands present are VISCO, Mediline, Meditek, Bharat Surgicals, and Geeta Surgicals.

The market for the high-end segment in 2016 is estimated at 20,000 beds. This market is dominated by Midmark. Other brands with aggressive presence are ArjoHuntleigh, Stryker, Paramount, and Hill Rom.

The quality of healthcare in a country can be gauged from the adequacy of healthcare infrastructure and personnel in that country which, in turn, can be assessed from the bed density (bed count per 10,000 of population) and the availability of physicians and nurses. For India, that is where the concern begins. For a country accounting for the second highest world population, India's overall bed density stands at 9 in 2016, as per the Organization of Pharmaceutical Producers of India (OPPI). There is a yawning gap with regard to the global median of 30 beds; the situation indicates a shortfall of nearly 1.8 million beds vis--vis the current global median for which the country needs to nearly quadruple its bed capacity. The problem remains last-mile reach, particularly for the rural population.

The Government of India has implemented Pradhan Mantri Swasthya Suraksha Yojana (PMSSY) with the primary objective of correcting the imbalances in availability of affordable/reliable tertiary level healthcare in the country in general. Government Medical Colleges/Institutes (GMCIs) and six AIIMS have been set up, and existing GMCIs are being upgraded under the scheme. Two more branches of AIIMS in Gujarat and Jharkhand have been recently announced. 492 maternal and child health (MCH) wings with bed capacity of more than 30,000 have been approved under the National Health Mission (NHM). Recently, the governmenthas approved a proposal for creation of a super specialty block in Institute of Medical Sciences, BHU at a cost of 200 crore.

In addition, NHM has allocated a 26,690 crore budget to revitalize rural and urban health sectors. Moreover, the Ministry of Health and Family Welfare has identified 58 districts in 20 states/UT under a centrally sponsored scheme for establishment of new medical colleges attached with existing district/referral hospitals. The total cost of establishment of one medical college under the scheme is 189 crore. As on July 2017, 55 new medical colleges had been approved. Funds to the tune of 4357.42 crore have been released to the state governments/UT administrations. A part of these funds will be allocated for hospital beds.

Some of the major planned investments in hospitals for enhancing capacity, of which hospital beds will also be a part are:

  • Telangana state government is planning to acquire land for construction of four 750-bed super-specialty hospitals in Greater Hyderabad at a total cost of 2400 crore.
  • The Odisha government will construct one specialty hospital and five secondary-care hospitals with a total of 800 beds through the public–private partnership model that will invest 424 crore in the project.
  • The Government of West Bengal plans to set up budget hospitals across the state, which would be equipped with facilities like private cabins with ACs and TVs, single, double, and four-bedded cabins, and ICUs.
  • The Maharashtra government is working on a policy to promote the setting up of cooperative hospitals in all districts of the state to reduce the burden on public-run institutions.
  • A National Cancer Institute is planned in Jhajjar, Haryana and Kolkata. Also, state cancer institutes (SCI) and tertiary care cancer centers (TCCC) are being set up in different parts of the country under the Tertiary Care for Cancer scheme.
  • The 100-bed ESI hospital at Udaipur, Rajasthan is planned to be constructed with a project cost of 77.79 crore and dedicated OT, modern path laboratories, and diagnostic facilities. Two 100-bed ESI hospitals will come up at Bikaner and Neemrana. Three existing 50-bed ESI hospitals located at Kota, Jodhpur, and Bhilwara will be upgraded to 100 beds.
  • AIIMS has signed three Memorandum of Understandings (MoUs) with a cumulative net worth of 7670 crore to expand infrastructure and other facilities.
  • Safdarjung Hospital, New Delhi has planned an infrastructure revamp in three phases, wherein the bed strength will be increased from 1531 to 2500.
  • Apollo Hospitals has planned an addition of 1045 beds by 2019 involving an investment of over 100,500 crore. They have earmarked their first investment in Punjab, with the launch of Apollo Cradle and Apollo Clinic in Amritsar.
  • Fortis Hospitals group has announced its plan to add six hospitals through the operations and management strategy by the end of 2018.
  • Wenlock Hospital has received a grant for restoration and upgradation. The hospital will build a new 176-bed three-storied super-specialty block; and a 350-bed surgical complex with Kasturba Medical College.
  • ONGC Limited has signed a Memorandum of Agreement with Dr Babasaheb Ambedkar Vaidyakiya Pratishthan (BAVP) for setting up a multispecialty hospitality in Assam, costing 312.34 crore.
  • Aster DM Healthcare has entered into an agreement with Rashtreeya Sikshana Samithi Trust (RSST) to launch a 200-bed Aster RV super-specialty hospital.
  • Westminster Healthcare is expected to invest 125 crore in setting up a state-of-the-art center in Nungambakkam, Chennai that will have world-renowned doctors and some of the best technologies.

Global Market

The global hospital beds market is estimated at USD 5710 million in 2016 and is expected to reach USD 7482 million by 2022, growing at a CAGR of 4.6 percent, predicts Research and Markets. Increasing number of hospitalization cases, technological advancements in the field, and improving healthcare infrastructure in emerging economies are important factors positively influencing the market.

The hospital beds industry based on treatment has made huge growth in the recent years. The growing acceptance of acute care beds, critical care beds, and long-term beds have increased demand. Among the various treatments, the acute care bed segment accounted for the highest share, while among the various types, the general bed segment dominated. In developing countries, where price is key, manual and semi-electrical beds are preferred, as compared to electric beds. Europe is expected to remain the most lucrative regional market over the next six years, which is a reflection of increasing expenditure in Europe's medical industry and healthcare organizations. North America forms the second most profitable region due to robust healthcare infrastructure, whereas Asia-Pacific is projected for most robust growth rate, owing to the vast population base and improving healthcare infrastructure in the emerging economies.

The market is highly competitive and is characterized by the presence of a large number of vendors. Paramount Bed Co. Ltd., Getinge Group, LINET spol. s r.o., ArjoHuntleigh, Stryker, Hill-Rom Holdings Inc., Invacare Corporation, and Medline Industries Inc. are some of the key players currently operational in the global market. Most of these companies have sub-divisional production units in order to meet the demand coming from medical establishments that are replacing their outdated hospital beds with advanced ones.

Technology Trends

A hospital bed is not a simple bed, but a specialized type that is designed to meet all the needs the hospital environment has. Many new innovative solutions have emerged as hospital centers and physician groups strive to deliver services. New technologies are focused on making it easier for patients to receive better care. The beds are now well equipped with features that allow patients to adjust the height, as well as the head and foot sections of the bed, for better positioning, improved blood circulation, ease of transfer, and safety in case of patients, who are at a risk of falling out of the beds.

Electric and semi-electric beds. Most popular models require electricity to run the adjustment mechanisms as well as control panels. An electric hospital bed features electric motor controls, which raise the head and foot, as well as the bed frame with a single button push. As the positions are changed fast and easily, most hospitals give preference to these models.

Smart beds. They offer an effective solution for healthcare providers to constantly monitor patients and provide better care. These beds contain sensors to monitor body temperature, heartbeat, blood, oxygen, and pressure sensors, among others, all of which are required and necessary for the doctors to monitor the health of the patient. In addition, smart beds are instrumental for healthcare providers to predict, detect, and prevent unscheduled bed exits.

Remote monitoring system. They are located in the hospital beds and transfer all patient signals to the supervisor, especially in those cases that require intense care. This critical information is sent to the central system of the hospital and enables health supervisors to instantaneously review and monitor patient's vitals. In addition, this system sends alert messages, or signals, to the supervisors in case of any sudden change in the status of the patient during that period of time.

Warning systems. Modern beds are capable of sensing the patient's position, alerting the clinicians regarding any issues, and transmitting the data to the hospital's electronic medical record (EMR). New technologies, such as anti-fall warning lights and sounds to help protect high-risk patients monitor local bed status and alert clinicians if preset parameters are compromised. Alerts can either be transmitted through the EMR or sent directly to nurses' mobile devices.

Automatic patient turning. Bedsores are the third in order after cancer and cardiovascular diseases in terms of cost, according to a study published in the International Journal of Research in Medical Sciences (2015). Recent hospital beds are capable of automatically turning patients every few hours. The beds can move in all directions, be tilted at different angles, and extended for tall patients. They can also weigh patients and perform vibration and percussion massages.

Power mattresses. Hospital beds with power mattresses for uninterrupted pressure redistribution with fitted electric motor, improve blood circulation and help in preventing the formation of bed sores.

Floating bed. Various manufacturers are introducing floating beds for specialized wound care.They are geared toward patients with burns or skin grafts from a surgical procedure. Technology involves use of silica beads that heat up and get excited and create a frictionless surface to accelerate wound healing and reduce complications, which helps to improve outcomes for patients with flaps/grafts, stage 3 to 4 pressure injuries, and deep-tissue injuries. Yet another technology introduced is to use a system that redistributes pressure by simulating the effects of a body immersed in fluid. It automatically measures the characteristics of patients when they are on the support surface and then creates a personalized immersion profile.

Way Forward

The smart hospital beds market in India is expected to grow at a significant rate over the next 5–10 years, owing to the increasing privatization of hospitals. Private players today account for nearly 60 percent of all in-patient care, contributing to more than 70 percent of the bed capacity expansion in the last decade. Hospitals and other healthcare emergency centers are taking increased precautions and providing required facilities to address medical emergencies.

In the coming years, hospital beds will continue to become more efficient with advanced monitoring features, latest technological advances for lighter designs, and patient's safety. The National Health Policy 2017 envisions to add 1.8 million new hospital beds to ensure availability of 2 beds per 1000 population by the end of 2025, offering immense growth opportunities for manufactures over the next few years. Exemption of healthcare in the 2017 GST regime indicates the government's vision for making healthcare affordable and available to all.

Sumeet Aggarwal
Industry Speak
Trends and Future

With a vast population, India has large patient pool existing in various urban, semiurban, and rural areas. At present, the country has 1.3 hospital beds per thousand of the population as compared to a global average of 3, which indicates a dismal availability of healthcare delivery in India.

India's medical bed market is slated to grow at a robust pace owing to the presence of a large patient pool consisting of the elderly, growth in population suffering from chronic and noncommunicable diseases, and supported by government's new health policy. Improving healthcare infrastructure along with growing number of government and private hospitals will drive industry growth.

As the practice of medicine and technology evolved over the last few decades, hospital beds have turned into more sophisticated medical devices, especially from comfort and safety standpoints. The last decade has seen significant innovations in medical devices design. Hospital beds have become lighter and stronger with use of polymer, superior synthetic castors, emergency positions like CPR and advanced features like lateral tilt, weight monitoring, and the like. IEC upgraded and enforced the hospital bed standard during 2013 to further enhance patient safety and essential performance.

Challenges and Opportunities

Access and affordability of healthcare are the two major challenges in India. Healthcare delivery in India is spread unevenly with scarcity of such large facilities in tier-II and tier-III cities across India. Hospital chains have an opportunity to expand in tier-II and tier-III cities. The number of PE transactions in the healthcare space is expected to grow. The new National Health Policy envisions significant growth in bed density, which in turn is expected to fuel demand.

Outlook

In the coming years, hospital beds will continue to become more efficient. With advances in technology, the incorporation of embedded control panels, nurse alarms, weighing scales, etc. is more becoming a norm. Beds will become smarter with IOT-enabled applications. The touchless solutions will analyze and transform big data into information, helping staff easily detect anomalies and assess overall wellness.

Sumeet Aggarwal
Managing Director,
Midmark India


 

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