Orthopaedic practice in Indian secondary care - Exploring the notion of ‘integrated care’ from the perspectives of healthcare professionals and patients, with strategies for implementation

Abstract

For the duration of my medical elective, I was placed in a government hospital by the name of Loknayak Jai Prakash Narayan Hospital. It specialises in trauma and orthopaedics, and is one of four government hospitals in Patna- the state capital of Bihar. My supervisor subspecialises in the hip and knee joint. Most patients belong to the lower socioeconomic classes and therefore rely on free delivery of care. During this essay I will reflect upon my firsthand experiences, as well as explore the existing literature, to highlight the importance of integrated care. Orthopaedics is a speciality that brings together many diverse groups of healthcare professionals. The NHS has always placed a strong emphasis on continuity of care by designing standardised frameworks. Coming from an alternative perspective, I seek to observe whether patients and healthcare professionals in Bihar also understand the concept of integrated care. Using examples I will look back to see how various teams work together within the Indian secondary care context.