Which private hospital is best for you? New grading system will help patients decide on treatment options

The Quality Council of India (QCI) plans to grade private hospitals on key patient-centric performance indicators and quality medical service parameters for the first time, top officials said. The hospitals will be graded A+++, A++ or A+.

The QCI and the National Accreditation Board for Hospitals & Healthcare Providers (NABH) are preparing a report on the grading exercise and plan to release it next month, said Dr. Alexander Thomas, chairperson of the QCI’s technical committee on grading of hospitals.

“The introduction of a new grading system is designed to set benchmarks that foster healthy competition among institutions, thereby instilling greater patient confidence in the quality of care. Once implemented, hospitals accredited by NABH, Joint Commission International (JCI), Australian Commission on Safety and Quality in Health Care and other reputable agencies will be eligible to apply for grading," Dr. Thomas said. 

 

The move to build a grading system follows a QCI decision in March 2023 identifying the need to grade healthcare organizations after they are granted accreditation. QCI is a non-profit organization established by the government which assesses the quality of products, services and processes.

Thomas noted that patients often relied on personal recommendations, online searches, or media rankings when selecting healthcare providers. He also highlighted the demand from the medical tourism and insurance sectors for more comprehensive performance metrics.

Voluntary grading

Only accredited hospitals will be eligible to apply for grading standards, which is voluntary and involves a one-time fee.

“It is going to be a universal thing, not only for local patients but also for international patients. It also helps the hospitals in improving so that there is transparency," Dr. Naresh Trehan, chairman and managing director of Medanta, said.

Pilot studies to confirm the proposed system’s practicality and benefits were conducted in seven multispecialty hospitals in the north, east, west, south and central zones last year. Indraprastha Apollo Hospitals in New Delhi, Christian Medical College Vellore, Hinduja Hospital in Mumbai, Amrita Hospital in Faridabad, Down Town Hospital in Guwahati, and Bombay Hospital in Indore were among the hospitals that participated in the study.

"Customer feedback was obtained from select hospitals before finalizing the standards, which focus on patient safety, experience and satisfaction as well as other factors like sustainable, climate-resilient healthcare practices," Thomas said, adding that the initiative is planned for launch next month.

In the later phase, QCI will start preparing grading standards for small healthcare organizations, dental centres and clinics and the third phase will include developing standards primary healthcare centres in rural areas.

 

According to Dr. Eesha Arora Narang, deputy director at the QCI, this policy initiative came about after realizing that there were no grading standards when it came to choosing between two accredited hospitals.

“We have been working on this project for the last two years and tentatively, we will be releasing the standards next month," Narang said. She added that A+++ would be the highest grade, followed by A++ and A+.

Dr. Ashutosh Raghuvanshi, MD & CEO of Fortis Healthcare, which already has NABH accreditation, said grading hospitals is important for multiple reasons. 

"NABH accreditation ensures hospitals meet essential standards, but grading offers a more detailed and transparent comparison across various quality metrics such as clinical outcomes, patient experiences, and operational efficiency. This initiative will allow patients to make more informed choices by understanding not just if a hospital meets standards, but how well it performs in specific areas. This transparent, patient-centric approach not only fosters healthy competition among hospitals but also drives continuous improvement, ensuring better access to high-quality medical care, improving patient safety, and enhancing overall trust in healthcare services," Dr. Raghuvanshi said.

The new standards will comprise 10 sections including structure, process & outcome, patient experience, use of technology, innovation, staff experience, academics and research. Action points have been included to remove subjectivity and make the standards objective.

Narang of QCI said that in the study, more than 700 patients were interviewed to understand on what basis they chose hospitals. The patients were also asked about the grading of hospitals and how it would benefit them.

“There was a request from the ministry of tourism and the insurance industry because they want differential pricing for different graded hospitals," Narang said.

Scientific basis

Experts said the grading of hospitals will improve the quality of healthcare.

"This is necessary for the people to know what facilities are available and what grading a hospital has," Trehan said. “So, the grading would be done on the very scientific basis. If a hospital has to improve its grading, they have to improve their services and results. Their outcomes and service excellence would be judged in terms of quality, procedure, equipment, services, success and mortality rate, manpower, and outcomes."

In India, the NABH accredits hospitals based on compliance with certain standards. There are more than 30,000 private hospitals in India. However, only 10,000 are NABH-accredited.

There are no immediate plans to implement a grading system for government hospitals. However, the central government has initiated National Quality Assurance Standards for state-run hospitals to ensure quality, which is similar to NABH-accreditation in the private sector.