Aravind eye care system does not run like the typical hospital. It can be more likened to a production facility. But, make no mistake, the care and quality of eye care provided is world class.
To start with, the most crucial aspect of Aravind is that they treat both paying and non-paying patients. Funds from the paying patients along with donations pay for more than 60% of the non-paying patients.
Hub and spoke model
Aravind also strongly believes that all the patients needing eye care do not necessarily come to the main hospitals. Patients are screened through numerous eye camps, patients who require spectacles or other small treatments are provided with the same, on the same day at the camp. Patients who require surgeries or other treatments are taken to the base hospitals by Aravind (Free transport); they are operated on the next day and are discharged in a day or two.
We can use Simon Morfit's concept of integrating market days and healthcare. http://bit.ly/kDrplR People can come to the markets but can just drop by to have their eyes checked. People needing further treatment can be sent to the base hospitals if needed.
The concept of free transport is very crucial. There is a financial implication for the patient seeking eye care far away from their villages. He/she has to spend on transport, miscellaneous expenses like food, etc and then loss due to lost wages. This problem is amplified as the patient needs to be accompanied by a family member through the process. Aravind estimates that a patient is subjected to a cost of INR 350 in seeking eye care. But, when these expenses are met by Aravind, it works out to be much cheaper, thereby saving about INR 220 for the patient.
Doctors are employed as residents. As they perform only specific tasks like surgeries, they do more of what they do best. Each doctor performs 2600 surgeries a year.
Nurses are the lifeline of the system. They are recruited from nearby villages and trained in house. 900 of them are trained every year and 99% of the trained nurses stay within the system.
Ophthalmic assistants are the people who perform the skill based but routine tasks, for which doctors are not required. These assistants are also trained in house.
Since Aravind only focuses on eye care, they are specialised. They buy the best equipments and since they perform specific tasks, they are run continuously to minimise down time. This ultimately helps Aravind achieve economies of scale.