Cost of Surgical Care at Public Sector District Hospitals in India: Implications for Universal Health Coverage and Publicly Financed Health Insurance Schemes

Autor: Maninder Pal Singh, Shankar Prinja, Kavitha Rajsekar, Praveen Gedam, Vipul Aggarwal, Oshima Sachin, Jyotsna Naik, Ajai Agarwal, Sanjay Kumar, Setu Sinha, Varsha Singh, Prakash Patel, Amit C. Patel, Rajendra Joshi, Avijit Hazra, Raghunath Misra, Divya Mehrotra, Sashi Bhusan Biswal, Ankita Panigrahy, Kusum Lata Gaur, Jai Prakash Pankaj, Dharmesh Kumar Sharma, Kondeti Madhavi, Pulaganti Madhusudana, K. Narayanasamy, A. Chitra, Gajanan D. Velhal, Amit S. Bhondve, Rakesh Bahl, Amit Sachdeva, Sharminder Kaur, Anu Nagar, Balram Bhargava
Jazyk: angličtina
Rok vydání: 2022
Předmět:
ISSN: 2509-4262
Popis: BACKGROUND: In low- and middle-income countries (LMICs), provisioning for surgical care is a public health priority. Ayushman Bharat Pradhan Mantri-Jan Aarogya Yojana (AB PM-JAY) is India's largest national insurance scheme providing free surgical and medical care. In this paper, we present the costs of surgical health benefit packages (HBPs) for secondary care in public district hospitals. METHODS: The costs were estimated using mixed (top-down and bottom-up) micro-costing methods. In phase II of the Costing of Health Services in India (CHSI) study, data were collected from a sample of 27 district hospitals from nine states of India. The district hospitals were selected using stratified random sampling based on the district's composite development score. We estimated unit costs for individual services-outpatient (OP) visit, per bed-day in inpatient (IP) and intensive care unit (ICU) stays, and surgical procedures. Together, this was used to estimate the cost of 250 AB PM-JAY HBPs. RESULTS: At the current level of utilization, the mean cost per OP consultation varied from US$4.10 to US$2.60 among different surgical specialities. The mean unit cost per IP bed-day ranged from US$13.40 to US$35.60. For the ICU, the mean unit cost per bed-day was US$74. Further, the unit cost of HBPs varied from US$564 for bone tumour excision to US$49 for lid tear repair. CONCLUSIONS: Data on the cost of delivering surgical care at the level of district hospitals is of critical value for evidence-based policymaking, price-setting for surgical care and planning to strengthen the availability of high quality and cost-effective surgical care in district hospitals.
Databáze: OpenAIRE
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