Impact of India's publicly financed health insurance scheme on public sector district hospitals: a health financing perspective.
District hospitals
Financial perspective
Government health insurance
Health system strengthening
Public hospitals
Publicly financed health insurance
Journal
The Lancet regional health. Southeast Asia
ISSN: 2772-3682
Titre abrégé: Lancet Reg Health Southeast Asia
Pays: England
ID NLM: 9918419282806676
Informations de publication
Date de publication:
Feb 2023
Feb 2023
Historique:
received:
10
02
2022
revised:
04
09
2022
accepted:
21
11
2022
medline:
29
6
2023
pubmed:
29
6
2023
entrez:
29
6
2023
Statut:
epublish
Résumé
Districts hospitals in India play a pivotal role in delivering health care services in the public sector and are empanelled under India's national health insurance scheme i.e. We used cost data from India's nationally representative costing study-'Costing of Health Services in India' (CHSI) to determine the incremental cost of treating PMJAY patients, after adjusting for resources that are paid through supply-side government financing route. Second, we used data on number and claim value paid to public district and sub-district hospitals during 2019, to determine the additional revenue generated through PMJAY. The annual net financial gain per district hospital was estimated as the difference between payments under PMJAY, and the incremental cost of delivering the services. At current levels of utilisation, the district hospitals in India gain a net annual financial benefit of $ 26.1 (₹ 1839.3) million, which can potentially increase up to $ 41.8 (₹ 2942.9) million with an increase in the share of patient volume. For an average district hospital, we estimate net annual financial gain of $ 169,607 (₹ 11.9 million), increasing up to $ 271,372 (₹ 19.1 million) per hospital with increased utilisation. Demand-side financing mechanisms can be used to strengthen the public sector. Increasing utilisation of district hospitals, by either gatekeeping or improving availability of services will enhance financial gains for district hospitals and strengthen public sector. Department of Health Research, Ministry of Health & Family Welfare, Government of India.
Sections du résumé
Background
UNASSIGNED
Districts hospitals in India play a pivotal role in delivering health care services in the public sector and are empanelled under India's national health insurance scheme i.e.
Methods
UNASSIGNED
We used cost data from India's nationally representative costing study-'Costing of Health Services in India' (CHSI) to determine the incremental cost of treating PMJAY patients, after adjusting for resources that are paid through supply-side government financing route. Second, we used data on number and claim value paid to public district and sub-district hospitals during 2019, to determine the additional revenue generated through PMJAY. The annual net financial gain per district hospital was estimated as the difference between payments under PMJAY, and the incremental cost of delivering the services.
Findings
UNASSIGNED
At current levels of utilisation, the district hospitals in India gain a net annual financial benefit of $ 26.1 (₹ 1839.3) million, which can potentially increase up to $ 41.8 (₹ 2942.9) million with an increase in the share of patient volume. For an average district hospital, we estimate net annual financial gain of $ 169,607 (₹ 11.9 million), increasing up to $ 271,372 (₹ 19.1 million) per hospital with increased utilisation.
Interpretation
UNASSIGNED
Demand-side financing mechanisms can be used to strengthen the public sector. Increasing utilisation of district hospitals, by either gatekeeping or improving availability of services will enhance financial gains for district hospitals and strengthen public sector.
Funding
UNASSIGNED
Department of Health Research, Ministry of Health & Family Welfare, Government of India.
Identifiants
pubmed: 37383034
doi: 10.1016/j.lansea.2022.100123
pii: S2772-3682(22)00140-8
pmc: PMC10305929
doi:
Types de publication
Journal Article
Langues
eng
Pagination
100123Informations de copyright
© 2022 The Author(s).
Déclaration de conflit d'intérêts
Dr Shankar Prinja is the Executive Director (HP&QA) of National Health Authority, Ayushman Bharat PMJAY, Government of India. Dr Vipul Aggarwal is the Deputy Chief executive officer (CEO) of National Health Authority, Ayushman Bharat PMJAY, Government of India. Dr Kavitha Rajsekar is the Scientist-E of Department of Health Research, Government of India. Dr Praveen Gedam is the Additional Chief Executive Officer of the National Health Authority, Ayushman Bharat PMJAY & Managing Director of the Ayushman Bharat Digital Mission, Government of India. All authors declare no other conflict of interests.
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