CHAPTER I

INTRODUCTION AND RESEARCH DESIGN

1.1 Introduction

There is nothing in our life that is more treasured than good health. Health is

more valuable than money, as the latter can never buy healthiness and happiness.

Hence, to stay healthy is not an option but a necessity to live a happy life, because

health is the biggest gift of God. This is the reason why almost all the people agree

and guide Ralph Waldo Emerson.

Health can be defined as a state of complete physical, mental, social and

spiritual well-being, which consists in maintaining the body as much as possible, by

following daily advice and preventive measures to reduce the possibility of disease. In

simple words, health is a state when the body is free from any diseases or injury, and

the mind is free of worry and anxiety.

Health is the most important thing not only for our life but also our society.

Health plays an important role in human life. It helps a person to achieve anything, a

person wants in life, making the person to feel happy and enabling to fight disease.

Moreover, good health is a basic need to make a positive family and community life.

It enables people to participate in and contribute to the society in different ways,

which leads to eradicating extreme poverty and promoting economic growth.

Health is closely related to our life style and environment. Unhygienic,

polluted environment and frequent life style changes are major factors affecting our
 health. We can improve our health, by making some life style changes, such as

adequate sleep, balanced diet and regular exercise. But, with people travelling in

phased life flow, it is a matter of concern that they do not find time to

maintain the health. Thus, some people fail to focus on their health and the service of

health sector becomes an essential one to safeguard the health of the community.

Healthcare has become one of the most important service sectors in India, in

terms of revenue and employment. Healthcare comprises of hospitals, medical

devices, clinical trials, outsourcing, telemedicine, medical tourism, health insurance

and medical equipment. Hospitals are the very nucleus part of health care system. The

first and foremost function and responsibility of a hospital is to give proper care to the

sick and injured without any social, economic or racial discrimination.

The growing Indian health care sector is categorized into two major

components namely public and private. Both the components provide same kind of

services to society. However, the private sector is large and plays an important role in

healthcare service. It provides more than 70 per cent of health services in India1. The

private hospital is further expanding beyond the public hospital, for a variety of

reasons, such as attractive infrastructure, clean and healthy environment, quality and

easy access to service, kind hospitality etc.

The Corona epidemic, which is said to be started in China and gradually

spread to neighbouring countries and paralyzed world life, did not spare the livelihood

of the Indian nation. The deadly Corona, which spread in India, consumed many lives

and wreaked Havoc. The virus not only increased the rate of infection, but also the

mortality rate day by day and destabilized the Indian economy and medical sector. In

such a dire situation, the Government of India had to face great challenges.

1
Siddhartha Bhattacharya, Role of private sector towards universal health coverage in India, The Times of India,
May 6, 2020.
 On the one hand, the lack of infrastructure to trace the sick and on the other

hand, the inability to provide adequate remedial measures, to solve the problem of

people who are struggling to buy food, commodities in curfew, to punish those who

violate the curfew and to arrange in time, essential goods to reach the people without

any restrictions. Here, the private medical sector has given a helping hand to the

government. They halved the burden on the health sector, through immediate corona

testing, proper medical care, maintaining/sanitizing wards, 24 hours assistance etc.

Moreover, the private hospitals have the following advantages

Better equipped to offer personalized care

Shorter wait time

Adequate doctor- to - patient ratios

Updated amenities

Faster access to the best medical specialists

Get one to one nursing

Choice to who will carry out treatment

Greater individualized attention

Despite of having aforesaid benefits, people who used private medical services

were facing many difficulties such as high fees, unnecessary testing, and the like.

However, in the medical field, choosing a hospital by patients depends upon the

beliefs of the people. The belief, feeling and behaviour of the people differ from

person to person and also every person does not continue to stick to his/her beliefs,

feeling and behaviour constantly, because these can be changed due to situations.

Attitude comprises of the aforesaid three components. The attitude of the people in

the early days absolutely differed from the attitude of the present. Attitude is nothing

but a like or dislike of something or some object/services. In the early days, all the
ailments were cured by hand remedies. It was a habit not to go to the hospital, even

for childbirth. Later a progressive attitude developed and people felt the need to seek

the help of the hospital in a few essential and emergency situations.

But now, even for minor ailments in the body, people tend to resort to

hospital. It is the belief of the people that, it is mandatory to have a medical

generation has gone one step further and has become accustomed to taking their

children to the hospital, even when they refuse to eat.

While comparing Public hospital with Private hospital the fees are at a upper

side, then, people still rely on the private health care. The following two cases are the

best examples of credibility of private hospitals among general public. In current

scenario, the Corona Vaccine is offered in both Public and Private Hospitals, but

some people feel that the vaccine given in the private hospitals is the most reliable.

On the other hand, most of the private hospitals charge fee for vaccination, Corona

treatment fixed by government and also for the test relevant to the disease, but most of

the people are more inclined to seek private health care services.

1.2 Statement of the Problem

From early times to the present day, it is a common fact that, every person

experiences some kind of health hazard in his/her daily life. But, in the ancient days,

the people healed their physical ailments in homemade proprietary medicines. Later

they started going to the physician and then to the next level to a hospital. But all the

diseases we have presently are a challenge to the medical field. The COVID-19,

which has been around the world for the past more than two years and the subsequent

Black Fungus in eyes and Omicron in the third wave are prime examples of this.

Despite numerous articles claiming that the spread of such diseases is due to the
global biological war and the consumption of infected meat, it is an undeniable fact

that people do not have adequate immunity. This is due to the modern life style,

particularly due to environmental pollution, high intake of fast food, adulterated food,

unhygienic water, excessive use of electronic devise and the like. In such a situation,

people are forced to go to the hospital to maintain their health. As a result, increase in

the number of patients, the medical field is growing exponentially. The health sector

in India is classified into two major divisions, namely public and private sector. The

public health sector provides numerous medical services to the patients than the

private health sector free of cost. In spite of this, most of the people prefer private

health sector, due to its attractive and hygienic environment, polite and friendly

relationship with medical professionals, quality of patient care, and good room facility

and so on. Whatever may be the reason, though the private health care suits the

people, the patients face many embarrassments namely high medical fess, improper

treatment, substandard medicines, indirect expenses and more. Yet people have not

shunned private hospitals. Especially in Corona period, many people sought out a

private hospital, even though they knew that a private hospital would charge more.

Not only for this reason, the researcher has conducted this study to know what people

expect the private health care to be like there, once Tenkasi has become a district.

management in Tenkasi District, because all the functions of private hospital depend

upon their administration/management. Hence, the researcher attempts her best to find

out answer for the following research questions.

Which department provides better service to its consumer?

in Tenkasi District?

What kind of factors mostly induces the consumer to select a particular private

hospital in Tenkasi District?

What is the attitude of consumer while going to a private hospital in Tenkasi

District?

What is their opinion regarding Quality of service?

What are the problems faced by the consumer in private hospital?

How to improve the private hospital management in Tenkasi District?

sector is an essential one. Hence, the researcher attempts to conduct research on

the topic entitled as, TOWARDS

PRIVATE HOSPITAL MANAGEMENT IN TENKASI DISTRICT .

1.3 Scope of the Study

Scope of the study plays an important role in research work, because it helps

to give the clarity of result and to explain the restriction of the study. Additionally, it

increases the credibility and validity of a research work. Here, the researcher

classified the scope of the study into two heads, namely, Subject scope and

Geographical scope. The details of those heads are given below.

1.3.1 Subject Scope

The subject scope of this research is limited to the private hospital

private hospital management in Tenkasi District. In this study, the researcher has

selected private hospitals with ten and more bed facilities, especially in allopathic

medicine. In general, the private hospital in the health sector has a great place in the
minds of the people, both in providing high quality service and setting up a clean

environment. There is no doubt that the services they receive are satisfactory, even if

the reserves of the people are depleted. For example, in the last two years, during the

Corona period, which has affected the livelihoods of the people and the economy of

the rest of the world, many people have sought treatment only at private hospitals,

despite the various intensive forms of treatment available at Government hospitals.

This is due to the standing belief of the private medical sector that they guarantee

better health and life. Although, there are various medical systems available in India,

the first thing that comes to mind is allopathic treatment. In this instant world, all

people think to get rid of the disease sooner and to be cured permanently. This is what

motivates the people to choose allopathic treatment. Mainly these two factors

encourage the researcher to select this topic. In this study, the researcher has used the

term consumer as the sample. Here, the consumer refers not only in-patients but also

their attendants because, a patients in emergency treatment or otherwise does not get

total exposure to the quality of hospitals other than the wards such as pharmacy, food

facility, total hygiene etc. It will be more appropriate to interview the attendants also

to get valued information which will form an absolute basis/data for the analysis. In

simple words, the private hospitals offer a variety of services to their patients. The

researcher has chosen in-patients because all of these services are used in a bigger

magnitude and gravity by the in-patients than out-patients. In this study, to measure

the attitude of consumers towards private hospital management, hence the researcher

has collected data from not only the patients but also from the medical attendants who

accompany the patients. Due to the elasticity of disease or the ailment the patients

may or may not be in a position to express their attitude. So, to know about the

management, the services, quality in treatment and other facilities provided by

medical attendants in the present study.

1.3.2 Geographical Scope

The geographical scope of this study is restricted to Tenkasi District. This

District is chosen for this study, because it was recently bifurcated from Tirunelveli

District.Domestic tourists and also foreign tourists are excited to visit Courtallam in

Tenkasi District. In this situation, the health department of this district is forced to

take much more effort to protect not only the local residents but also the tourists who

were the floating population. As a consequence, the researcher has selected Tenkasi

District as her study area. During the monsoon season between June to August lakhs

of people will come to Courtallam to have their bathing and enjoy the climate. Then

people are surrounded in large number quite naturally disease will also spread. So, the

floating population need a treatment. For that purpose the public and private hospitals

are giving emergency treatment to the visiting people from adjoining districts and

nearby states. Therefore, the hospitals in Tenkasi District assume greater importance.

1.4 Objectives of the Study

Primary objective

management

Secondary objectives

private hospitals

ds private hospital

management
 To analyse the service quality gap exists in private hospitals by using

HEALTHQUAL

To analyse the factors inducing to select private hospitals

To examine the problems faced by the consumer in private hospitals

To offer suggestions to enhance the service quality of private hospitals

1.5 Hypotheses

H01: The age of the respondents does not influence the attitude related to private

hospital management.

H02: The educational qualification of the respondents does not influence the attitude

related to private hospital management.

H03: The level of awareness about service offered by private hospitals does not

depend on the educational qualification of the respondents.

H04: The level of awareness about the services offered by private hospitals does not

depend on the nature of treatment, taken by the respondents.

H05: The gender of the respondents and the overall opinion about private hospital

management are same.

H06: The age of the respondents does not influence the overall opinion about private

hospital management.

H07: The marital status of the respondents and the overall opinion about private

hospital management are same.

H08: expectations from private hospital management do not differ

significantly due to the occupational status of the respondents.

H09: The problem faced by the consumer in private hospital does not differ due to the

gender of the respondents.

status in hospital of the respondents.

H011: The family income of the respondents does not influence the service quality

measurement in private hospital management

H012: The suggestions given by the respondents do not differ significantly due to the

educational qualification of the respondents.

H013: The suggestions given by the respondents do not differ significantly on the

nature of treatment taken by the respondents.

1.6 Research Methodology

1.6.1 Nature of Research

In this study, the researcher has conducted a total description of hospital

administration both private and public sector. In addition, to measure the attitude of

the patients or the respondents adequate statistical tools both traditional and modern

Descriptive

and Empirical R

1.6.2 Data

The pair of primary and secondary data are used in this study. The Primary

data are those which are new and original in nature. These data are the first-hand

information generated to achieve the purpose of the research. With the guidance of the

supervisor and the guide the questionnaire was drafted and pre-tested and

subsequently the data was collected with the help of a well-structured questionnaire as

well as an interview schedule for that purpose the researcher has used the services of

enumerators.

Secondary data are those data, which are already published. These data are

obtained from published or unpublished sources. The secondary data are collected
from the health department reports in Tenkasi, Taluk office in Tenkasi and various

books, journals and websites.

1.6.3 Period of the Study

The data are collected from the consumers in other words, patients and the

attendants who were undergoing treatment in private hospitals of Tenkasi District

during the period from February 2021 to October 2021.

1.6.4 Sampling Design

The primary data were collected from 368 consumers as sample respondents,

by adopting Judgement sampling method and 46 employees as sample respondents,

by adopting Chunk sampling method.

1.6.5 Sample Unit

The sampling unit of this study is Consumers and employees of Private

hospitals in Tenkasi District. Here, the consumer refers not only in-patients but also

their attendants. The researcher selected both of them as her sample unit because they

have completely known about the private hospitals management.

There are 79 private hospitals available in Tenkasi District, the details of

which were obtained from the health department. Due to lack of time, caused by

pandemic the researcher did not cover all the hospitals in her study. Therefore, for the

study the researcher has selected 46 hospitals, which has 10 or more beds. This is

because she believes that more data can be obtained from hospitals, where there are

more bed facilities. The list and profile of the 46 hospitals are briefly described in

third chapter. These profiles are collected from employees, who are working in

selected private hospitals in Tenkasi District.

For the purpose of the study, 377 respondents were decided on it. The size of

sample was fixed by the researcher, with the help of Rao soft sample size calculator.

Here, the following aspects are used for calculating sample size. The margin of error

is 5%, the confidence level is 95%, population size is 20,000 (default in unknown

population), response distribution is 50% (default in unknown population).

Thus, the researcher has issued 377 interview schedule and questionnaire but

received only 368 responses, in return, accurately done. Hence, the sample size of this

study is 368.

employees of selected private hospitals. For this purpose, she selected 46 employees

as the sample, on the basis of Chunk sampling method.

1.6.7 Method of Data Collection

Primary data were collected from 368 respondents with the help of both a

structured questionnaire and interview schedule. This data was collected through

direct contact with respondents, Google form and over the Phone. Before undertaking

the survey, a pre-test was conducted and in the light of it, the questionnaire was

prepared, modified and restructured. Further, the hospital profiles were collected

from 46 employees, working in selected hospitals, with the help of a structured

questionnaire through direct contact.

1.6.8 Area of the study

For the purpose of this study, the researcher selected Tenkasi District as her

study area, only for two criteria. The first criterion is this District was recently

bifurcated from Tirunelveli District. The second criterion is the world famous tourist

spot of Courtallam is situated in this area. Courtallam is well-known not only for
entertainment and pilgrimage tourism, but also as a health resort. Hence, the

researcher chose to study about hospital management in this area.

1.6.9 Framework of Analysis

The data thus collected was analysed and interpreted with relevant statistical

tools for drawing conclusions. For analysing the data, the SPSS (statistical package

for social science) was used. Relevant tools such as Chi-Square Test, ANOVA, factor

analysis, independent sample t test, Kruskal Wallis Test, and Mann-Whitney U test.

Moreover, Percentage, Weighted arithmetic Mean score, and Garrett score & Garrett

rank, Friedman Test have also been used to interpret the primary data. The details of

statistical tools and its relevance of application are summarized below:

1.6.9.1 Percentage

It refers to a special kind of rates, percentage are used in making comparison

between two or more series of data. A percentage is used to determine the relationship

between the series.

Percentage =

1.6.9.2 Weighted Arithmetic Mean

Weighted mean (also known as weighted average) is the average of the given data

set. It is an average calculated by assigning different weights to some of the individual

values. It is calculated by three simple steps

Weighted average is the average of a set of numbers, each with different

associate weights or values.

To find a weighted average, multiply each number by its weight, then add the

results.

The sum of all the variables multiplied by their weight divided by the sum of

the weights.
 Weighted arithmetic mean =

1.6.9.3 Garrett Ranking Score

Garrett's Ranking Technique was applied to study the preference, change of

orders of constraints and advantages into numerical scores. The prime advantage of

this technique over simple frequency distribution is that the constraints are arranged

based on their severity from the point of view of respondents. The Garret ranks were

calculated by using appropriate Garret Ranking formula. The based on the Garret

ranks, the garret value was calculated.

Percent position =

1.6.9.4 Friedman Test

The Friedman test is a non-parametric statistical test developed by Milton

Friedman. It is used to detect differences in treatments across multiple test

attempts. The Friedman test is conducted by the following ways

Rank the each row (block) together and independently of the other rows.

When there are ties, the average ranks of the observations.

Sum the ranks for each columns (treatments) and then sum the squared

columns total

Compute the test statistic

Determine critical value from Chi-Square distribution table with k-1 degrees

of freedom

Formulate decision and conclusion

Q=

where Rj is the sum of the ranks for sample j.

n is the number of independent blocks

k is the number of groups or treatment levels

Chi-square test is applied in statistics to test the goodness of fit to verify the

distribution of observed data with assumed theoretical distribution. Therefore, it is a

measure to study the divergence of actual and expected frequencies. It has great use in

statistics, especially in sampling studies, where we expect a doubted coincidence

between actual and expected frequencies, and the extent to which the difference can

be ignored, because of fluctuations in sampling. If there is no difference between the

discrepancy between theory and observation.

Formula:

2=

O = Observed frequencies

E = Expected frequencies

Expected frequency =

R = the sum of row

C= the sum of column

N = No. of sample

1.6.9.6 ANOVA:

The analysis of variance, frequently referred by the contraction ANOVA, is

statistical technique specially designed to determine whether the means of more than

in such problems where we want to test for the significance of the

difference among more than two sample means. This method was developed by R.A.

Fisher.
One Way ANOVA:

One way ANOVA is performed for only one independent variable and

samples belong to different groups of same population. If the effect is tested only for

one factor (one independent variable) on the variable (dependent) in question, then it

is called univariate analysis.

Formula:

SS between =

SS within =

SS for total variance =

SSB = Sum of square between

SSW = Sum of square within

V = Variance

1.6.9.7 Independent sample T test

The independent samples T test (also called the unpaired samples T test) is the

most common form of the T test. It helps to compare the means of two sets of data.

That means it compares the means of two independent groups in order to determine

whether there is statistical evidence that the associated population means are

significantly different. The Independent Samples T Test is a parametric test.

X = Sample Mean

s = Sample standard deviation

N =Number of samples
1.6.9.8 Mann Whitney U Test

Mann-Whitney u-Test is a non-parametric test used to test whether two

independent samples were selected from population having the same distribution.

Another name for the Mann-Whitney U Test is Wilcoxon Rank Sum Test. In other

words it is used to compare whether there is a difference in the dependent variable for

two independent groups. It compares whether the distribution of the dependent

variable is the same for the two groups and therefore from the same population.

Ustat = Rank sum -

n = Number of items in the sample

1.6.9.9 Kruskal Wallis Test

A Kruskal-Wallis test is used to determine whether or not there is a

statistically significant difference between the medians of three or more independent

groups. This test is the nonparametric equivalent of the one-way ANOVA and is

typically used when the normality assumption is violated.

H=

n= Sum of sample sizes for all samples

c= Number of samples

Tj = Sum of ranks in the jth sample

nj = Size of the jth sample

1.6.9.10 Factor Analysis:

Factor analysis, a Multivariate interdependence statistical technique is a data

reduction tool. Factor analysis removes redundancy or duplication from a set of

correlated variables. It is helpful in representing correlated variables with a smaller set

another.
Eigen value:

When we take the sum of squared values of factor loadings relating to a factor,

then such sum is referred to as Eigen value or latent root.

Factor loading:

It explains how closely the variables are related to each one of the factors

discovered.

Principal Component Method (PCM):

It is a procedure to convert a set of observations of possibly correlated

variables into a set of values of linearly uncorrelated variables called principal

components. It seeks to maximize the sum of squared loadings of each factor

extracted in turn.

1.7 Operational Definitions

1.7.1 Consumer

He/she is the patients who have undergone treatment in private hospital and

the medical attendant who had accompanied the patients.

1.7.2 Private Hospital

Private health facility or hospital is owned by an individual or company and

not by the Government.

1.7.3 Hospital Management

Hospital management is the process where healthcare providers effectively

and efficiently administer everything from patient registration to appointment

scheduling, document management, consultation management, lab management, drug

safety, report generation, staff management, outpatient management and so much

more.
1.7.4 Consumer attitude

Consumer attitude is the feeling of favourableness or unfavourableness that an

individual has towards an object.

1.7.5 Consumer Opinion

It denotes a view or judgement formed about something, not necessarily based

on fact or knowledge. In simple words, it is an unedited and first impression.

1.7.6 Consultant

A doctor or an expert who gives consultancy to the patients

1.7.7 In-patient

A person who goes into hospital to receive medical care, and stays there one

or more days while they are being treated

1.7.8 Attendant

to care for themselves.

1.7.9 HEALTHQUAL

HEALTHQUAL is a tool for measuring or evaluating the quality of services in

health sector.

1.7.10 COVID-19

COVID-19 refers to an infectious disease caused by a Corona virus that

usually causes fever, tiredness, a cough and change to the sense of smell &taste, and

can lead to breathing problems and severe illness in some people.

1.7.11 Pathology

Pathology is the science or the study of the origin, nature and course of

disease.
1.7.12 Diagnosis

Diagnosis is the process of determining by examination the nature and

circumstances of ailments.

1.7.13 Medical & supportive service

Medical services mean any healthcare related service. Supportive service

means services, drugs, supplies and appliances provided by a person other than a

physician or hospital.

1.7.14 Auxiliary Service

Auxiliary service is non-medical service which includes dietary, laundry,

housekeeping and the like.

1.7.15 Gynaecology

Gynaecology means the branch of medical science that deals with the health

maintenance and disease of women, especially of the reproductive organs.

1.7.16 Diabetics/ Diabetes

Diabetes is a chronic disease associated with abnormally high levels of the

sugar glucose in the blood.

1.7.17 Paediatrics

Paediatrics is the branch of medicine that deals with children and their

diseases

1.7.18 Cardiology

A branch of medicine that specializes in diagnosing and treating diseases of

the heart, blood vessels and circulatory system

Surgery is a medical treatment of injuries or diseases that involves by making

an open in or catheterisation and often removing or replacing some

parts.

1.7.20 General Medicine/General Practice

General medicine is a medicine not specializing in the treatment of particular

illness or of patients of a particular gender or age group.

1.7.21 Orthopaedics

Orthopaedics is the branch of surgery concerned with disorders of the spine

and joints and the repair of deformities of these parts.

1.7.22 Allopathy

Allopathy also called Modern Medicine. The treatment of disease by

conventional means, i.e. with drugs having effects opposite to the symptoms

1.7.23 Doctor

A person who is qualified to treat people who are ill

1.8 Limitations of the Study

Due to the COVID-19 period, the researcher had great difficulty in getting

permission from the numerous hospitals for data collection.

The researcher had difficulty in getting some information as it was recently

separated from Tirunelveli as Tenkasi district.

Hospital employee gave the information about their hospitals which may have

personal bias

According to the objectives, the number of questions too long due to this fact

the respondents have not been filled seriously

This study did not cover all the patients and it covered in-patients only.
1.9 Area of the study

1.9.1 Introduction

Tenkasi district was formed on 21.12.2019 vide. G.O. (ms) No.476, dated

21.12.2019 of Revenue and Disaster Management Department, Revenue

Administration wing [RA 1(1)] section, by bifurcating from Tirunelveli District.

District. Tenkasi is famous spiritual place equivalent to North Indian Kasi. Kasi

Viswanathar Temple is dedicated to the Hindu God Shiva, which is constructed in the

Diravidian style of architecture and was built by the Pandyan ruler Parakkirrama

Pandian during the 13th Century.

1.9.2 Geographical Location

The Geographical area of the district is 2882.44 sq.kms which lay in the south

western portion of Tamil Nadu. It lies in between 8º.57' and 8º.95' of the Northern

latitude and 77º.18' and 77º.31' of Eastern longitude.

1.9.3 Topography

The district is located in the south western part of Tamil Nadu, surrounded by

Virudhunagar district in the north, Western Ghats and Kerala in the west, the South

East is covered by Tirunelveli district and North East by Thoothukudi district.

Chitharu, Gundaru, Karuppanathi, Gadana, Ramanathi and Hanuman nathi are main

source of irrigation for Agriculture and Allied activities.

1.9.4 Administrative Set Up

The district has two revenue divisions viz Tenkasi and Sankarankovil and 8

Taluks, 30 firkas 246 revenue villages, 10 Development blocks, 5 Municipalities 18

Town Panchayats and 221 Village Panchayats as per G.O.(ms) No.426 Revenue and

Disaster Management Department, dated: 12.11.2019

The Population of the district was 1440795 as per 2011 census. The density of

population per sq.km was 500 persons in the 2011 census. The sex ratio is 1017

females for every 1000 males. The literacy rate is 78% in the district as per 2011

census. Out of total population, males were 714215 and females were 726580 as per

2011 census. The schedule caste population is 292900 which represent 20% to the

total population as per 2011 census. Schedule tribes are found to be very small in

numbers of 3656 which is 0.3% to the total population.

1.9.6 Agriculture

Agriculture is playing a very crucial role in the district economy. The gross

cropped area for the year 2019-20 was 124460 hectares which covers about 43.18% of

the total geographical area. Out of which 74675 hectares were irrigated and 49785

were unirrigated. Around 60% of the total cropped was irrigated and 40% of the total

cropped area was unirrigated. The net area shown to total cropped area was 112764

hectares which is about 91% of gross cropped area, 11687 hectares were shown as

more than once. Paddy is cultivated as major crop in the district and 39403 hectares

were cultivated during 2019-20 which cover about 32% of the gross cropped area and

followed by Pulses 31,100 hectares were showed. Coconut, Cashewnut, Mango,

Maize and Cotton are other principal crops. Lemon Cultivation is famous in

Puliyangudi, popularl

in 105234 hectares out of the total cropped area of 124460 hectares which is around

85%. This covers 85% of the total cropped area. Non-food crops were cultivated in

19228 hectares which is around 15%.

Tenkasi, Surandai, Pavoorchatram, Alangulam, Puliyangudi and

Sankarankovil are having many markets for agricultural produce. Puliyangudi market

is very famous for Lemon and exporting Lemon to various states and International

level. Lemon City for its famous quality due to natural

climate and favourable soil for Lemon cultivation. Sankarankovil market is very

famous for Millets, Pulses, Cotton, Groundnut and Chillies. Many commission

mandies are functioning in Sankarankovil, Surandai, Pavoorchatram and Puliyangudi

for agricultural commodities.

1.9.8 Industries

Agriculture is the predominant role in the district. Apart from agriculture

many other industries are functioning in the district. Such as Modern Rice mills and

Oil mills particularly in Keelapavoor and Alangulam blocks are a hup for both boiled

and raw rices and marketing in TamilNadu and Kerala. Beedi rolling, handloom,

power loom, Match factories, Brick kiln, Sugar mill, Wind mill, Solar energy, Cattle

rearing, Poultry farming, Mining & Quarrying, Weaving and sizing industries, Plastic

molding industries, Spinning mills, Furniture manufacturing industries and Jaggary

production are other important tiny and small scale industries which are providing

more employment opportunities and earnings as subsidiary income to the people of

this district.

1.9.9 Irrigation

The district is blessed with Western Ghats from which all the rivers viz,

Chitharu, Hanuman Nathi, Ramanathi and Karuppanathi flow from west to east.

Gundaru, Adavinainar, Karuppanathi, Gadana, Ramanathi are the main source of

irrigation dams and also for drinking purpose. The other sources of irrigation are
wells, tanks and canals which cover the gross and net cultivated area of 74675 and

63403 hectares. Among total Well irrigation the gross and net irrigated area covers

48415 and 40343 hectares which cover about 64%. Tanks and Canals covered by

20792 and 5468 hectares during 2019-20 as gross and net cultivated area.

1.9.10 Tourist Attractions

Courtallam is situated in the Western Ghats in Tenkasi Taluk. The famous

waterfalls on rocks and tiny droplets are sprinkled in the air. The water falls of

Courtallam have medicinal value as they run through forest and herbs before their

decent. The Courta

Indians to Courtallam and Tenkasi.

Gundar, Adavinainar and Karuppanathi dams are the tourist places which are

located at the foothills of Western Ghats. RELIGIOUS SIGNIFICANCE The Kasi

Viswanathar temple at Tenkasi, Dhackshinamoorthy temple at Puliarai, Thirumalai

kovil temple at Panpoli, Sankaranainar temple at Sankarankovil, Meenakshi

Sundareswarar temple, Maipparai Sri Venketasa Perumal temple at Kurivikulam are

the landmarks of the district signifying the Hindu culture. Pottalpudur Mukaitheen

Dargah and Tenkasi Periya Mosque are famous for Muslim culture. St. Micheal shrine

in Tenkasi and Our Lady of Lourdes shrine at Thirumalapuram in Kadayanallur taluk

are famous for Christian culture.

1.9.11 District Profile in Statistical Data

Table No. 1.1

District profile in Statistical Data

1.GEOGRAPHICAL POSITION
North Latitude Between 8o.05` and 9o.30`
East Longitude Between 77o.05` and 78o.25`
2.AREA AND POPULATION (2011 Census)
Area ( Sq. Km.) 288243.8
Population Male 714215
Female 726580
Total 1440795
Density / Sq. Km 500
Literates Male 551165
Female 453890
Main Workers Cultivators 61979
Agricultural Labours 200229
Household Industry 134575
Other Workers 258783
Non-Workers 711414
Language Spoken in the District Tamil, English, Telugu,
Urdu& Malayalam
3.VITAL STATISTICS
Birth 19009
Death 8387
Infant Deaths 150
Birth Rate (per 1000 12.34
Population)
Death Rate (per 1000 5.53
Population)
Infant Mortality 8.6
Rate(Per 1000 Live
Births )
4. TEMPERATURE (IN CELSIUS)
Plains Maximum 36.5
Minimum 24.2
Hill Stations Maximum NA
Minimum
5. RAINFALL (in mm)
Normal (819.5) North East Monsoon 473
South West Monsoon 128.4
Winter season 64.2
 Summer 153.9
Actual (1093.6) North East Monsoon 684
South West Monsoon 269
Winter season 17.9
Summer 122.7
6. AGRICULTURE (in Hec.) Fasli 1428 (2018-2019)
Total Cultivated Area (Hec.) 124460
Net Area Sown (Hec.) 112764
Area Sown more than once (Hec.) 11697
Area and Production Paddy 39403
of Principal Crops Millets and Other Cereals 7424
Pulses 1684
Sugar Crops 2230
Groundnut 355
Gingelly 16
Cotton 1854
Sugarcane 8.0
Agricultural Land Holdings (Nos) 297720
Holdings2015-16 Area in (Hec.) 197829
(10th Agri Census) Average Size of holdings in (Hec.) 0.66
Important Food Crops Paddy, Black gram, Banana,
Green gram, Sugarcane ,
Cashewnut and Maize
Important Non Food Crops Groundnut, Coconut, Cotton
& Gingelly
7. IRRIGATION (Fasli 1428)
Net Area Irrigated by Government Canals 4260
(In Hec.) Private Canals Nil
Tanks (Small & Large) 18800
Tube Wells 226
Other Wells 40117
Other Sources Nil
Net Area Irrigated 63403
Gross Area Irrigated 74675
Name of the River Kadananathi, Karuppanathi,
Kundaru & Chittaru
8. ANIMAL HUSBANDRY
Veterinary Institutions Veterinary Hospitals 3
Veterinary Dispensaries 59
Sub- 18
Poultry Development Birds sold for food 1016900
Livestock and Poultry Cattle 137992
Population Buffaloes 9648
Sheep 80915
Goat 134418
Poultry 699621
9. DAIRY DEVELOPMENT (Govt)
No. of Milk Co-operative Societies 56
Milk Production (Lakh Litres) 1804.78
10. FISHERIES
Inland Fish Production (Tonnes) 328.77
11. FOREST
Forests 43999
12. ELECTRICITY (IN M.U)
Generation of Wind Mill Generation 6257.514
Electricity in MU
Consumption of Agriculture 142
Electricity (in m.u.) Industry 104
Commercial 130
Domestic 649
Public Lighting & Public Works 57
Rural Electrification No. of Pump sets Electrified 82502
No. of Villages Electrified 425
Number of Hamlets Electrified 1727
13. ENTERPRISES 6th Economic Census 2011 ( Provisional )
No. of Enterprises With premises 303006
(317542) Without premises 14536
Total enterprises in rural 172855
Total number in urban 144687
14. INDUSTRIES
No. of Working Factories 886
No. of Workers 29375
No. of Trade Unions 3
Name of the important industries in the district Dharani Sugars Ltd. Dharani
Nagar, Syed cotton mills
Alangulam
15. KHADI AND VILLAGE INDUSTRIES
Production Sales (Rs.in
(Rs.in Lakhs)
Lakhs)
Khadi Khadi 3.79 38.67
Woollen - -
Silk Nil Nil
Yarn 5.18 -
Village Industries Soaps 11.42 11.42
Leather Goods - -
Industrial Co. Op Societies Nil Nil
16. MEDICAL AND HEALTH ( in numbers)
Modern Medicine No. of Hospitals 17
(Government only) Primary Health Centers 52
Health Sub Centers 177
Other Medical Institution -
Beds in Hospitals 1609
Doctors 201
Nurses 290
Indian Medicine Hospitals 17
(Government only) Primary Health Centers 21
Beds in Hospitals 80
Doctors 47
Nurses 2
Unani Hospitals 1
(Government only)
17. EDUCATION
Arts and Science Colleges 15
Engineering College 3
Primary Schools 831
Middle Schools 208
High & Hr. Sec Schools 234
18. TRANSPORT
Road Length (Km.) National Highways 71.40
State Highways 221.745
Major District Road 184.16
Other District Road 690.038
Registered Motor Commercial 1966
Vehicles 2018-19 Non-Commercial 26880
Railway Length(in Route Length 170.24
Km) Track Length 239.42
Number of Railway Stations 26
Name of the Export Commodity MAT, Cloth, Onion, Chillies
19. COMMUNICATION
Post & Telegraph (in Post Offices doing Postal business 193
No.) alone
Telephones No. of Telephones in use 496
No. of Public Call Offices 943
No. of Telephones Exchanges 87
20. CO-OPERATION
District Central Cooperative Banks (including branches) 17
District Cooperative Union 1
Cooperative Printing Press 1
P.A.C.B 158
Primary Agricultural and Rural 8
Development Bank
Cooperative Urban Bank 14
Whole Sale Cooperative Store 1
Primary Cooperative Stores 30
Students Cooperative Store 17
Cooperative Employees Thrift and Credit Society 68
21. REGISTRATIONS
No. of Registration Offices 18
Aggregate Value of property Transferred (Rs. 773.37
in Crores)
22. SOCIAL WELFARE (in Nos.)
Old Age Pension for aged 19574
Physically Handicapped Pension 2
Widow Pension 5286
Deserted Wives Pension 5343
Unmarried woman Pension 543
CMUPT Pension 3800
23. NUTRITION MEALS PROGRAMME (No. of Beneficiaries)
I.C.D.S Scheme 2562
Purachi Thalaivar Noon Meal 2068
24.REVENUE ADMINISTRATIVE DIVISIONS
Revenue Divisions 2
Revenue Taluks 8
Revenue Firkas 30
Revenue Villages 246
25. LOCAL BODIES
Municipalities 5
Panchayat Unions 10
Town Panchayats 18
Village Panchayats 221
26.COMMUNITY DEVELOPMENT
No. of Blocks Covered 10
Population Covered (Lakhs) 1440795
Area Covered (Sq.Km.) 288243.8
27. POLICE AND PRISIONS
Local 3375 (Exclude Pattalian 9)
Armed Reserve 929 (Exclude Pattalian 9)
Police Stations 98
Central Prisons 1
Other Prisons 12
28. LEGISLATURE
Elected 5
Members of Parliament(Lok Sabha) 1
29
Permanent (Excluding Full Air-conditioned 10
Tirunelveli Div) Non-Air conditioned 9
30.BANKS / INSURANCE
Commercial Banks 196
DCCB etc. 32
Private Sector Banks 100
Regional rural Banks 65
Lead Bank 1
Life Insurance Offices 37 (Including Divisional,
Branch & Micro Office)
Policies Issued 273684
Premium Received (Rs.in Crores) 3105.43
31. NATURAL RESOURCES
Name of the mineral found in the District Rough stone Jelly, Kankar
32.GENERAL
Name of the important Sankarankoil Arulmigu Sankaranarayana Temple
pilgrim Centre Tenkasi Arulmigu KasiviswanatharTemple
Courtalam Arulmigu Courtaleesuwar Temple
Panpozhi Arulmigu Thirumalai Kumarasamy Temple
Pottal Pudur: Dharga
Chithirasabai Courtallam
A/M Aanjanayar Temple, Kadayanallur
A/M Balasubramaniayaswamy Temple, Ayikudi.
Name of the important Courtalam: Main falls, Old Falls, Five Falls, Honey Falls, Tiger
Tourist Centre Falls and Boating
Source: District Profile 2019 - 2020
1.10 Scheme of the Report

The present study comprises of six chapters. The first three chapters deal with

various theoretical aspects relating to the study and the next two chapters are used for

analyzing the data collected and the last chapter is designed to summaries and

concludes the study. The chapter titles and contents in each chapter are given below:

Chapter I: Introduction and Research Design

It covers objectives, scope, and methodology, limitation of the study and

profile of the study area

Chapter II: Review of Literature

It brings Review of literature relevant to the topic.

Chapter III: An overview of private hospital management and profile of selected

hospitals in the study area

It presents brief information relevant to the topic

Chapter IV: opinion regarding private

hospital management

It encloses Analysis, and interpretation of data with the help of basic statistical

tools.

Chapter V:

It comprises the result of testing hypotheses with the help of SPSS package.

Chapter VI: Findings, Suggestions and Conclusion

It discovers the summary of findings, suggestions and the conclusion of the

study.