Growing hospitalisation costs, rising elderly population and a need for personalised medical attention have fuelled a rapid increase in India's home healthcare services sector, which is set to grow manifold in the coming years, say stakeholders.

"The home healthcare sector in India is burgeoning and is expected to reach $6 billion (Rs 40,000 crore) by 2020 from a $2 billion market opportunity in 2014," said Nightingales Home Health Services Chief Executive Officer Narasimha Jayakumar. Echoing him, Alok Roy, Chairman, Medica Group of Hospitals, which recently launched homecare services, said the Indian market had a significant potential though it was now at a nascent stage.

"The Indian market is currently estimated at over $3 billion per annum and is growing at over 20 percent annually. "Home healthcare market In India is witnessing tremendous growth due to the rise in the aging population. The market for home healthcare services in India is set to double in the coming years," said Roy.

According to Vivek Srivastava , Co-Founder and CEO of Healthcare at Home, the overall homecare market is growing at a compound annual growth rate (CAGR) of 40 per cent over the past three-four years. Cost competitiveness for in-home health services has been a major driver of their demand.

"Homecare as a concept is gaining ground in India and the reasons are clinical and societal... it definitely works out cheaper to the extent of 30 per cent as compared to the hospital cost as there is no infrastructure and other overheads. This apart, the cost of a family member needing to stay off from work is an additional saving," said Apollo Homecare CEO Mahesh Joshi.

Roy said patients end up saving 20-50 per cent cost as compared to regular hospital treatment depending upon the services taken. "For instance, ICU services are 40-50 per cent cheaper than those provided in hospitals," he said. Again, oncology care at home would also be cheaper by 20 per cent compared to similar hospital facilities, said Srivastava.

Homecare service providers also said improved affordability, need for a personalised care for chronic and lifestyle-based diseases, changes in the traditional family system and rise of nuclear families contributory factors in market growth. The operators are providing an array of services, but the most sough-after include COPD management, stroke rehabilitation, ICU, dentistry, oncology, baby care, attention to post transplant patients and geriatric population.

However, non-availability of comprehensive insurance coverage for these services is seen as the "most important piece missing in the entire ecosystem", Joshi said, adding an insurance facility will be a game changer for the industry going forward. "Although home healthcare services are gaining considerable traction in India, they are currently not comprehensively covered by health insurance companies. We expect these policies to change in the coming years as these services prove to be an indispensable treatment option for many," Jayakumar said.

According to Joshi, the organised players in home healthcare are in discussions with leading insurance providers and hoping a couple of them would take this up as a value added service for their clients. While home healthcare services have several "clear advantages" for a section of patients over treatment in a traditional hospital, choosing in-home care for one's elderly parents or other loved ones is "not without risk", People for Better Treatment President Kunal Saha said.

"In a developing country like India, where corruption has riddled through virtually all aspects of public services, with hardly any checks and balances even for the qualified doctors... the new field of home healthcare services is likely to attract unscrupulous people in this lucrative business." This could pose "serious threats to the lives of the suffering elderly citizens who may become more vulnerable in the secrecy of individualised medical care by unqualified caregivers", said Saha in an e-mailed response.

In the US and other developed countries, more and more people have been opting for home healthcare services for elderly and debilitated patients for more than two decades. Saha, HIV/AIDS Specialist, Adjunct Professor and Consultant, Columbus State Community College, Ohio, said the Indian government should lay down a "strict and transparent mechanism and licensing system" to regulate the businesses of home health services before they are allowed to operate.