As home care needs rise, insurance gaps widen, Pg2

Key Highlights:

• India's health insurance system largely overlooks home-based care, despite rising demand from an aging population and increasing disease burden.
• Life expectancy in India has risen to 72 years in 2024, with the senior citizen population projected to reach 347 million by 2050.
• The Indian home healthcare market is expected to grow from $16.3 billion in 2025 to $74.57 billion by 2034.
• Families face significant out-of-pocket expenses, often ₹30,000 to ₹1 lakh monthly, for post-hospitalization home care.
• Existing domiciliary hospitalization provisions are narrow, restrictive, and often excluded by insurers due to verification challenges.
• There is a critical shortage of qualified and trained home healthcare professionals, leading to unregulated and often substandard services.

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Detailed Insights:

• The current healthcare system primarily focuses on acute care and hospitalizations, neglecting long-term chronic conditions and rehabilitation needs at home.
• Lack of home care coverage leads to compromised recovery, avoidable complications, and increased hospital readmissions, paradoxically spiking overall healthcare costs.
• Many families are forced to give up jobs to care for relatives, causing immense socio-economic and psychological stress.
• Experts advocate for expanding insurance policies to cover home-based care, drawing parallels with long-term care insurance models in countries like Japan and Germany.
• The National Accreditation Board for Hospitals and Healthcare (NABH) accreditation for home care organizations is suggested to standardize and improve service quality.
• Kerala has initiated a government-approved six-month Caregiver Certificate Course to professionalize home nursing care and provide dignified employment.
• NGOs like Self Employed Women’s Association (SEWA), in collaboration with Pallium India, are training women for professional palliative and nursing care.
• Policy recommendations include training workers, ensuring wage guarantees, setting safety rules, providing financial aid for family caregivers, and establishing respite care provisions.

Key Concepts Involved:

• Domiciliary Hospitalization: A specific, narrow health insurance provision for short-term home care, requiring a doctor's certification.
• National Accreditation Board for Hospitals and Healthcare (NABH): An autonomous body under the Quality Council of India that accredits healthcare organizations.
• Caregiver Certificate Course: A vocational training program aimed at professionalizing home-based nursing and palliative care services.
• Self Employed Women’s Association (SEWA): A trade union of poor, self-employed women workers in India, often involved in social welfare initiatives.