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ORIGINAL ARTICLE
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Trends in cardiac care utilization under ayushman bharat pradhan mantri jan arogya yojana


1 Delhi University, New Delhi, India
2 Tata Institute of Social Sciences, Mumbai, Maharashtra, India
3 London School of Hygiene and Tropical Medicine, University of London, London, England
4 Harvard University, Cambridge, Massachusetts, USA

Correspondence Address:
Pulkit Kumar,
L-526 Sarita Vihar, New Delhi
India
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Source of Support: None, Conflict of Interest: None

Background: Ayushman Bharat, the flagship scheme of the Government of India, was launched in September 2018 to achieve the vision of universal health coverage in India. Objectives: One of the important components of Ayushman Bharat is the Pradhan Mantri Jan Arogya Yojna (PM-JAY) that provides a benefit cover of INR 5 lakhs per family per year for secondary and tertiary care hospitalization. Methods: The present study explores key trends in the utilization of cardiac care packages under the Ayushman Bharat AB PM-JAY. This would have an implication in making cardiac care more accessible by bridging the existing gaps in cardiac care delivery under PM-JAY. All cardiac claims under PM-JAY were analyzed for a period of 17 months (from the inception of the scheme in September 2018 to February 2020). Results: The analysis shows that claims from cardiac (cardiology as well as cardiothoracic and vascular surgery) specialty accounted for 5% of the total PM-JAY claim volume, however, it shares in the total claim volume. It was significantly higher at 26% indicating that a very high proportion of the scheme was utilized to provide free cardiac care to beneficiaries coming from the poorest segment of the population. Conclusion: The analysis also indicates significant variation in the supply of the cardiac facilities and the need to further develop health infrastructure for cardiac care, particularly in certain states where the supply is found to be inadequate.


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