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Table 3 - Surgical outcomes of Apollo, Spire and the NHS
Measure Apollo Spire NHS average
3 year revision rate - hip replacements 1.17% 0.8% 1.3%
3 year revision rate - knee replacements 0.0% 1.0% 1.3%
Mortality rate - hip replacements 0.0% 3.2% 6.4%
Mortality rate - knee replacements 0.0% 3.6% 6.3%
C. difficile rate (per 1,000 bed days) Nil 0.02 1.56
Wound infection rate - hip replacements 0.6% 0.3% 0.9%
Wound infection rate - knee replacements 0.42% 0.04% 0.5%
Both Apollo and Spire hospitals are regulated by external bodies, ensuring standards are
maintained. In both the UK and India, patients were satisfied with the treatment received.
UK citizens receiving treatment in India are prepared to recommend treatment at Apollo.
However, the follow-up care currently provided by Apollo does not meet the guidelines
recommended by the British Orthopaedic Association (BOA).
Patient satisfaction (including cultural issues)
Interviews with patients revealed that patients sought treatment in India due to the low cost,
high level of expertise in India, previous experience of difficulties within the NHS and long
waiting lists in the NHS. Apollo was specifically chosen by the patients due to the hospital’s
reputation and efficiency with regards to dealing with patients’ needs.
The patients interviewed stated that prior to travelling to Apollo their expectations were
higher than what they initially experienced stating that they were slightly nervous when they
arrived. This was due to the chaotic nature of the hospital when they arrived at 3am. However,
they went on to state that their expectations were met when they had settled in to their private
ward. All staff exceeded their expectations in the service they delivered.
Cultural barriers were not reported at Apollo, there were no language barriers due to the
English speaking policy within the hospital and services such as catering were tailored to the
patient, with a wide range of choices available. When asked if they would advise others to
travel to India they responded positively
As interviews were not possible with patients who have had treatment at Spire, information
from the Independent Advisory Services was used. SIHA who showed that in private
hospitals in Scotland 98% of patients would recommend the hospital to others (Independent
Healthcare Advisory Services, 2008). The WIHA found that the average was closer to 88%
(Independent Healthcare Advisory Services, 2008), whereas the IHAS found that 97% of
people would recommend the hospital that provided their care (Independent Healthcare
Advisory Services, 2008).
Discussion
The survey conducted confirmed that cost was the most common identifiable reason for
influencing discretionary health spending. Although it was theorised that due to the highly
price sensitive nature of health insurance, people willing to pay the least for insurance would
be the most likely to accept treatment abroad due to cost implications, the survey indicated