Findings

Research objectives of the study are to study the factors contributing to brand building in corporate hospitals in National Capital Region, the emergence and growth of corporate hospitals in National Capital Region, to study the brand strategies and challenges of corporate hospitals in National Capital Region and to study and suggest the branding strategies for a modern corporate hospital in National Capital Region. Although the management, doctors and the para- medical staff were not open about discussing the brand strategies of their hospitals due to constraints of corporate secrecy and medical ethics, the study resulted in the following findings based both on the observations and research of the study and also the brand perceptions derived from the survey of patients in both the hospitals Fortis and Max Healthcare. Generally speaking, there are five key brand strategies to establish to create a strong brand. These are developing the brand vision, establishing the brand position, communicating the brand position, fulfilling the brand contract and measuring return on brand investment. Analyzing on these lines, Fortis has made huge strides within a decade of its commencement in terms of providing quality services. It has created an image for itself for providing quality at an affordable price. Quality has been their healthcare focus which is a key differentiator for them. Fortis brand strategy is to make its brand presence felt through aggressive pursuit for quality accreditation and certifications. Fortis works with the QCI (Quality council of India) to generate quality standards and an accreditation system (NABH) which is practical and affordable. Fortis, with its brand image and a large network, is focusing on academics and on partnering with educational institutes and research centres to tap into its pool of talent. Fortis actively explores the opportunities in medical education facilities to ensure the availability of qualified and trained manpower for all prevailing and future needs. Fortis brand strategy is to rightly offer unbeatable medical value propositions already catering to international patients providing quality healthcare services at attractive value propositions.

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Healthy employees add health and happiness to a business. The healthcare delivery services at Fortis are catered to employee needs. All patient records are accessible at all its hospitals across the country so that its employees have the convenience of choosing the centre most convenient to them for accessing their healthcare records. Fortis healthcare has built a tele-medical network, which connects its facilities providing continuous expert healthcare. Fortis has also tied up with both public and private partners in the Indian healthcare industry to provide specialty and quality healthcare facilities. The Fortis group is empanelled with many top corporates, public sector undertakings, multinational companies and insurance companies. The employees of these empanelled companies are given special offers on health check up programmes and medical management services. Fortis has created a physical evidence of its expert and specialized services by advertising and communicating their achievements in medical care thus reposing the customer confidence in their services. Fortis healthcare is committed to providing the healthcare services backed by state-of-the-art technology and trained technicians. Another brand strategy which Fortis employs deliberately is its short stay surgery programmes which make the stay in the hospital as short as possible enabling the patient to walk out of surgery in just a couple of days through advances in medical technology and adequate skilled staff. When compared to its competition, Fortis maintains a stable price policy and there is a very marginal difference when it comes to the amount charged thus becoming a price- quality leader in the healthcare segment. Analysing the Fortis healthcare services the price for visits for patients is reasonable as compared to other corporate hospitals according to the perception of the respondents .The price of major medical treatments is also subsidized according to the income groups. Fortis also comes up with special healthcare programmers for senior citizens and also discounts for its female patients over forty years of age. Fortis also has many free clinics for the poor and also in the rural areas in the National capital region. - 37 -

Another brand strategy Fortis employs is tying up with many companies and offices and providing them with the health cards to its employees to be treated on No cash basis. By this strategy Fortis made a huge amount of customer base and in the process retained many a customer. Fortis has opened many free health camps and free health check-up days in their hospitals to increase the customer base. They celebrate special days as World Cancer day and World Osteoporosis day in order to bring awareness among their patients .During these days they give discounts on the services provided and thus adding on their already existing promotions. Fortis also sets up blood donation camps in different colleges and NGOs and through this, they are able to get into the eyes of the general public and the young blood of India. They also organize road shows to create awareness and put in some very attractive hoardings sending messages. Fortis brand strategy is to adopt best corporate governance practices. They have a strong board of independent directors advising and guiding policies and proposals made by their operating management. Max healthcare consists of eight hospitals that have advanced facilities and each hospital concentrates on several specializations which address the patients needs. Max Healthcare is the choice for medical tourism in India because it houses world renowned specialized doctors. Max Healthcare hospitals have become the first in North India to receive the prestigious National Accreditation from the NABH. The hospital provides the highest level of professional expertise and world class care in all major medical disciplines and support specialties. The hospital has a team of well trained and highly experienced consultants, surgeons in various specialties providing the highest standards of medical and patient care with a focus on service excellence. The hospital uses the state-of-art-technology to provide excellence in delivery of its services.

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Strategy 1 based on perception1

The respondents were asked to rate the two hospitals on various parameters. On the question of service quality, majority of the respondents agreed that Fortis hospital provides them with best service. Further the patients from Max healthcare also agreed that they are provided with good quality service. The service quality plays an important part in the satisfaction of the patients. Also as the people prefer to visit a known and trusted hospital more, hence it makes all the business sense for the hospitals to provide good quality of service.

Strategy 2 based on perception2

Technology plays an important part in the treatment of patients in the current medical practice. A number of sophisticated and advance instruments assist the doctors in identifying the cause and providing the suitable cure. In addition the medical labs are also using high end technology these days. Majority of the respondents from Fortis hospital agreed that the hospital provides the latest technology treatment to the patients. Further the patients from Max Healthcare also agreed that the hospital is technologically advanced in providing treatment.

Strategy 3 based on perception3

At times it happens in the hospital that a lot of time is spent in billing and other formalities while the patient is moving out of the hospital. This becomes an irritant for the patients and their attendants as they are asked to complete a lot of formalities. However in case of Fortis, this is not the case as pointed out by the respondents. According to the survey majority of the patients from Fortis agreed that the waiting time is quite less. On the other hand in case of Max Healthcare, the patients had to wait a long time for completing the formalities while getting discharged. This is one of the important factors which impact the brand perception for the patients as pointed out by them.

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Strategy4 based on perception4

With the new age hospitals, the accommodation has also become an area of concern for the patients. The patients and their attendants prefer clean and well lit up rooms as the charges are more in the corporate hospitals. Fortis has good quality accommodation for the patients as pointed out by the respondents. Further Max is also at a good position in terms of the accommodation as pointed out by majority of the participants in the survey.

Strategy 5 based on perception5

Nurses are the ones who mainly take care of the medication of patient. As such having sufficient staff of nurses is an important factor for any hospital. Both Fortis and Max are believed to have sufficient number of nurses for serving patients, as pointed out by majority of the respondents in the survey.

Strategy 6 based on perception6

Hospital charges have been rising continuously over the past few years and with the corporatisation of the hospitals the charges have changed totally. A number of hospitals overcharge the patient or in case of medical insurance they try to fleece the company by giving inflated bills for a medication. The reason for this is apparently that the insurance companies do not pay the full amount of the bills to the hospitals and have certain fixed compensation packages for certain medical or surgical conditions. In case of Fortis the patients believe that the hospital charges are in accordance with the service provided and economical as against the other hospitals. The same is however not true for Max. Majority of the respondents felt that the charges are higher than that of other hospitals. The charges taken by a hospital play a lot of role in the brand image of the hospital. If the customers perceive that a hospital overcharges then it destroys the brand image of the hospital.

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Strategy 7 based on perception7

The number of doctors that a hospital has impacts the time that a doctor can give to every patient. The more the number of doctors, the more is the time for patients. On this aspect both Max and Fortis were rated well by a large number of the respondents in the survey. This implies that the two hospitals have good number of doctors.

Strategy 8 based on perception8

Further the two hospitals also have sufficient number of rooms for the patients, according to the responses of the participants in the survey.

Strategy 9 based on perception9

In certain hospitals the medicines prescribed by the doctor are not available in the hospital and the same has to be sourced from outside by the patient or his/her attendants. This becomes an irritating factor for them. In case of Fortis the patients pointed out that the hospital has sufficient availability of medicines. The same was also said by the respondents from Max hospital.

Strategy 10 based on perception10

The patients do not like to wait too long when visiting the hospital OPD. This is one of the irritant factors which makes the patients to change the hospitals also and spoils their brand image. On this aspect Max Healthcare was not given a healthy rating and the patients found out that they had to wait long for consulting with the doctor in the OPD. On the other hand the patients visiting Fortis responded that the waiting time in OPD was within limit and reasonable. This had a lot of positive impact on the brand image of Fortis.

Strategy 11 based on perception11

The helpful and courteous nature of the staff at the hospital plays a very important role. As the patient is already suffering, hence if the staff of the hospital is not helpful and courteous then it can make the patient quite irritated. Fortis has courteous and helpful staff as pointed out by the respondents in the survey. Further the patients from

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Max also said that the staff in the hospital was quite helpful and extended courtesy in all respects.

Strategy 12 based on perception12

Training is quite significant in the hospital sector as the hospital industry is quite specialized and the staff needs to be well trained to handle the patients and their queries. In case of Fortis it was found out that the staff had the requisite training, as pointed out by the respondents in the survey. Further Max was also rated to be satisfactory in terms of the training of staff, by a large number of participants.

Strategy 13 based on perception13

As the patients are suffering from some or the other problem, therefore the kind and compassionate nature of the nurses helps a lot in reducing their suffering. As the nurses are the ones who are always around and if they are not kind then the patients feel irritated and do not prefer to stay in that hospital. In case of both Max and Fortis, majority of the patients agreed that the nurses are kind and compassionate.

Strategy 14 based on perception14

Further if the doctors do not understand the problem the patient is going through and do not take interest in what the patient is saying then it makes the patient feel irritated and he or she does not prefer to take medication from that doctor. If the doctors empathise with the patient then a psychological relief is provided to the patient immediately. On this aspect majority of the respondents agreed that both Max and Fortis have empathetic nature of the doctors.

Strategy 15 based on perception15

Once the patient moves out, he or she comes back for check up or as per directions of doctor. However in most of the cases there is no follow up from the hospital for taking feedback of the customer or to remind the next visit. The same is true with Max, with majority of respondents stating that the hospital did not follow up after discharge. However in case of Fortis, the patients said that there was follow up from

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the hospital side. This is an important brand building exercise and plays a role in the perception of the customers. On the whole the survey provided a lot of important information regarding the brand perception of the hospitals in the National Capital Region of Delhi and how the corporatization has changed the brand images. The two hospitals Max Healthcare and Fortis are quite well known and have a corporate outlook. According to the survey the respondents rated Fortis above Max in terms of brand perception on a number of factors. The main aspects which impact brand perception include the charges levied by the hospital with regards to the treatment provided, the time that the patient has to spend while getting discharged, the time that the patient has to spend while waiting for consultation in OPD and the follow up that the hospital does with the patients after they are discharged from the hospital. On the whole the respondents rated Fortis hospital as having a better brand image in comparison to Max Healthcare.

4.1Descriptive statistics:
The table given in Appendix II, shows that we have taken equal 50 percentage of patients from two hospitals Max HealthCare and Fortis each. From the table given in Appendix II, distribution of age researcher observes that 98% of the individuals in our sample are of age from 18 to 60 years+ while only 2% are of age less than 18 years. This is shown graphically in pie chart.

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From the table given in Appendix II, distribution of gender researcher observes that 66% of the individuals in our sample are males while only 34% are females. This is shown graphically in pie chart.

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From the table given in Appendix II, distribution of occupation researcher observes that 30% of the individuals in our sample are business persons, 24% are housewife and 20% self-employed while only 15%, 9% and 2% are service workers, unemployed and students respectively. This is shown graphically in pie chart.

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From the table given in Appendix II, distribution of educational qualifications researcher observes that 80% of the individuals in our sample are either graduates or post graduates while only 13% and 7% are 10 th and 12th class students. This is shown graphically in pie chart.

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From the table given in Appendix II, distribution of income researcher observes that 84% of the individuals in our sample are of income group either 6,00,001- 9,00,000 INR or 9,00,001-12,00,000 INR while only 2% are of income greater than 12,00,000INR income and 14% are of income less than 6,00,000 INR. This is shown graphically in pie chart.

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From the table given in Appendix II, distribution of concern about going to same hospital researcher observes that 79% are concerned about going to the same hospital while 21% are not concerned about going to the same hospital. This is shown graphically in pie chart.

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From the table given in Appendix II, distribution of going for regular checkups researcher observes that 68% are concerned about going for regular checkups while 32% are not concerned about going for regular checkups. This is shown graphically in pie chart.

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From the table given in Appendix II, distribution of number of checkups in a year researcher observes that 74% are concerned for every six months checkups, 16% are concerned for monthly checkups while 10% are concerned for once in a year checkups. This is shown graphically in pie chart.

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4.3 Statistical Analysis:

The researcher will apply the independent sample t-test to know whether there are differences in the perceptions of the two hospitals. As our scale of measurement of perception is scale with five categories from strongly disagree to strongly agree so high value of mean indicates a good perception of the perception of that hospital. From the following table researcher observes that for both the Fortis and Max HealthCare the distribution of perceptions is non-normal but as our samples are of size 100 for each of the hospitals so the independent sample t-test is robust against the normality assumption and hence may apply independent sample t-test.

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Perceptions 1-5:
From the Levenes tests of equality of variances researcher observes that the distribution of perceptions from 1-5 have equal variances for both the hospitals which is the requirement for the independent sample t-test. Researcher observes that 1) The mean perception about the hospital service quality is not significantly different between the Max and Fortis hospitals as t(198)=1.33, p=0.185>0.05. From table of group statistics researcher observes that the mean perception of Max and Fortis hospitals service quality are 4.49 and 4.33 respectively. So we conclude that although the average service quality is not different in Max and Fortis hospitals, there is a good perception amongst the customers about the service quality of both the hospitals. 2) The mean perception about the hospital latest technology treatment is not significantly different between the Max and Fortis hospitals as t(198)=1.838, p=0.068>0.05. From table of group statistics researcher observes that the mean perception of Max and Fortis hospitals latest technology treatment are 4.31 and 4.11 respectively. So we conclude that although the average latest technology treatment is not different in Max and Fortis hospitals, there is a good perception amongst the customers about the latest technology treatment of both the hospitals. 3) The mean perception about the hospital has reduced waiting time for out-patient is significantly different between the Max and Fortis hospitals as t(198)=-22.914, p<0.001. From table of group statistics researcher observes that the mean perception of Max and Fortis hospitals about reduced waiting time for out-patient are 1.90 and 4.24 respectively. So we conclude that not only the average waiting time for out-patient is significantly different in Max and Fortis hospitals, but also there is a good perception amongst the customers that Fortis has reduced waiting time for out-patient as compared to Max.

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4) The mean perception about the Hospital accommodation is not significantly different between the Max and Fortis hospitals as t(198)=0.795, p=0.428>0.05. From table of group statistics researcher observes that the mean perception of Max and Fortis Hospital accommodation are 4.18 and 4.09 respectively. So we conclude that although the average perception about accommodation is not different in Max and Fortis hospitals, there is a good perception amongst the customers that both the Hospital provides the best accommodation. 5) The mean perception about the number of nurses in the hospital is not significantly different between the Max and Fortis hospitals as t(198)=-1.295, p=0.209>0.05. From table of group statistics researcher observes that the mean perception of Max and Fortis number of nurses in the hospital are 3.93 and 4.11 respectively. So we conclude that although the average perception that the hospitals have enough number of nurses is not different in Max and Fortis hospitals, there is a good perception amongst the customers that both the hospitals have enough number of nurses.

Perceptions6-10:
From the Levenes tests of equality of variances researcher observes that the distribution of perceptions from 6-10, except perception-8, have equal variances for both the hospitals which is the requirement for the independent sample t-test. Also here as the sample size is quit large so the assumption violation has a little effect. Researcher observes that 6) The mean perception about the hospital charge is significantly different between the Max and Fortis hospitals as t (198)=-16.22, p<0.001. From table of group statistics researcher observes that the mean perception of Max and Fortis hospitals charge are 1.83 and 4.09 respectively. So we conclude that not only the average perception about the hospital charge is different in Max and Fortis hospitals, but also on the average customers feel that Fortis hospital charges reasonable fees for treatment compared to the Max hospitals

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7) The mean perception about the enough number of doctors in the hospitals is not significantly different between the Max and Fortis hospitals as t(198)=-0.88, p=0.376>0.05. From table of group statistics researcher observes that the mean perception of Max and Fortis hospitals having enough number of doctors are 4.17 and 4.29 respectively. So we conclude that although the average perception about the hospital having enough number of doctors is not different in Max and Fortis hospitals, but on the average customers feel that both the hospitals have enough number of doctors to treat the patients. 8) The mean perception about the enough number of rooms in the hospitals is not significantly different between the Max and Fortis hospitals as t(198)=0.15, p=0.881>0.05. From table of group statistics researcher observes that the mean perception of Max and Fortis hospitals having enough number of rooms are 4.10 and 4.08 respectively. So we conclude that although the average perception about the hospital having enough number of rooms is not different in Max and Fortis hospitals, but on the average customers feel that both the hospitals have enough number of rooms for the patients. 9) The mean perception about the enough number of medicines available in the hospitals is not significantly different between the Max and Fortis hospitals as t(198)=-0.655, p=0.513>0.05. From table of group statistics researcher observes that the mean perception of Max and Fortis hospitals having enough number of medicines available are 3.90 and 4.00 respectively. So we conclude that although the average perception about the hospital having enough number of medicines available is not different in Max and Fortis hospitals, but on the average customers feel that both the hospitals have enough number of medicines available for the patients. 10) The mean perception about the waiting time in OPD in the hospitals is significantly different between the Max and Fortis hospitals as t(198)=-13.285, p<0.001. From table of group statistics researcher observes that the mean perception of Max and Fortis hospitals having waiting time in OPD are 1.94 and 3.93 respectively. So we conclude that not only the average perception about the - 54 -

hospital waiting time in OPD is different in Max and Fortis hospitals, but on the average customers feel that waiting time in OPS is in limit in Fortis only and out of limit in Max.

Perceptions11-15:
From the Levenes tests of equality of variances researcher observes that the distribution of perceptions from 11-15, except perception-14, have equal variances for both the hospitals which is the requirement for the independent sample t-test. Also here as the sample size is quite large so the assumption violation has a little effect. Researcher observes that 11) The mean perception about the hospital staff courteous and helpful behavior is significantly different between the Max and Fortis hospitals as t(198)=-2.311, p=0.02<0.05. From table of group statistics researcher observes that the mean perception of Max and Fortis hospital staff courteous and helpful behavior are 3.84 and 4.18 respectively. So we conclude that although the average perception about hospital staff courteous and helpful behavior is different in Max and Fortis hospitals, but also on the average customers feel that both hospitals staff have a good courteous and helpful behavior although Fortis staff is slightly more courteous. 12) The mean perception about the hospital staff training is not significantly different between the Max and Fortis hospitals as t(198)=0.881, p=0.379>0.05. From table of group statistics researcher observes that the mean perception of Max and Fortis hospital staff training are 3.83 and 3.67 respectively. So we conclude that not only the average perception about hospital staff training is different in Max and Fortis hospitals, but also on the average customers feel that both hospitals staff training is good. 13) The mean perception about the hospital staff nurses in the ward are kind and compassionate is not significantly different between the Max and Fortis hospitals as t(198)=0.672, p=0.502>0.05. From table of group statistics researcher observes that the mean perception of Max and Fortis hospital staff nurses in the ward are - 55 -

kind and compassionate are 3.80 and 3.69 respectively. So we conclude that although the average perception about hospital staff nurses in the ward are kind and compassionate is not different in Max and Fortis hospitals, but on the average customers feel that both hospitals staff nurses in the ward are kind and compassionate. 14) The mean perception about the hospital doctors are empathetic is not significantly different between the Max and Fortis hospitals as t(198)=1.721, p=0.087>0.05. From table of group statistics researcher observes that the mean perception of Max and Fortis hospital doctors are empathetic are 4.04 and 3.77 respectively. So we conclude that although the average perception about hospital doctors are empathetic is not different in Max and Fortis hospitals, but on the average customers feel that both hospitals doctors are empathetic. 15) The mean perception about follow up calls from the hospital is significantly

different between the Max and Fortis hospitals as t(198)=-13.608, p<0.001. From table of group statistics researcher observes that the mean perception of Max and Fortis hospital follow up calls from the hospital are 1.87 and 3.92 respectively. So we conclude that not only the average perception about follow up calls from the hospital is different in Max and Fortis hospitals, but on the average customers feel that follow up calls from the hospital from Max hospital are not happening whereas Fortis is better position in this case and provide follow up calls

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