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

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 cost...

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Autores principales: Singh, Maninder Pal, Prinja, Shankar, Rajsekar, Kavitha, Gedam, Praveen, Aggarwal, Vipul, Sachin, Oshima, Naik, Jyotsna, Agarwal, Ajai, Kumar, Sanjay, Sinha, Setu, Singh, Varsha, Patel, Prakash, Patel, Amit C., Joshi, Rajendra, Hazra, Avijit, Misra, Raghunath, Mehrotra, Divya, Biswal, Sashi Bhusan, Panigrahy, Ankita, Gaur, Kusum Lata, Pankaj, Jai Prakash, Sharma, Dharmesh Kumar, Madhavi, Kondeti, Madhusudana, Pulaganti, Narayanasamy, K., Chitra, A., Velhal, Gajanan D., Bhondve, Amit S., Bahl, Rakesh, Sachdeva, Amit, Kaur, Sharminder, Nagar, Anu, Bhargava, Balram
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9216290/
https://www.ncbi.nlm.nih.gov/pubmed/35733075
http://dx.doi.org/10.1007/s41669-022-00342-6
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author Singh, Maninder Pal
Prinja, Shankar
Rajsekar, Kavitha
Gedam, Praveen
Aggarwal, Vipul
Sachin, Oshima
Naik, Jyotsna
Agarwal, Ajai
Kumar, Sanjay
Sinha, Setu
Singh, Varsha
Patel, Prakash
Patel, Amit C.
Joshi, Rajendra
Hazra, Avijit
Misra, Raghunath
Mehrotra, Divya
Biswal, Sashi Bhusan
Panigrahy, Ankita
Gaur, Kusum Lata
Pankaj, Jai Prakash
Sharma, Dharmesh Kumar
Madhavi, Kondeti
Madhusudana, Pulaganti
Narayanasamy, K.
Chitra, A.
Velhal, Gajanan D.
Bhondve, Amit S.
Bahl, Rakesh
Sachdeva, Amit
Kaur, Sharminder
Nagar, Anu
Bhargava, Balram
author_facet Singh, Maninder Pal
Prinja, Shankar
Rajsekar, Kavitha
Gedam, Praveen
Aggarwal, Vipul
Sachin, Oshima
Naik, Jyotsna
Agarwal, Ajai
Kumar, Sanjay
Sinha, Setu
Singh, Varsha
Patel, Prakash
Patel, Amit C.
Joshi, Rajendra
Hazra, Avijit
Misra, Raghunath
Mehrotra, Divya
Biswal, Sashi Bhusan
Panigrahy, Ankita
Gaur, Kusum Lata
Pankaj, Jai Prakash
Sharma, Dharmesh Kumar
Madhavi, Kondeti
Madhusudana, Pulaganti
Narayanasamy, K.
Chitra, A.
Velhal, Gajanan D.
Bhondve, Amit S.
Bahl, Rakesh
Sachdeva, Amit
Kaur, Sharminder
Nagar, Anu
Bhargava, Balram
author_sort Singh, Maninder Pal
collection PubMed
description 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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s41669-022-00342-6.
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spelling pubmed-92162902022-06-22 Cost of Surgical Care at Public Sector District Hospitals in India: Implications for Universal Health Coverage and Publicly Financed Health Insurance Schemes Singh, Maninder Pal Prinja, Shankar Rajsekar, Kavitha Gedam, Praveen Aggarwal, Vipul Sachin, Oshima Naik, Jyotsna Agarwal, Ajai Kumar, Sanjay Sinha, Setu Singh, Varsha Patel, Prakash Patel, Amit C. Joshi, Rajendra Hazra, Avijit Misra, Raghunath Mehrotra, Divya Biswal, Sashi Bhusan Panigrahy, Ankita Gaur, Kusum Lata Pankaj, Jai Prakash Sharma, Dharmesh Kumar Madhavi, Kondeti Madhusudana, Pulaganti Narayanasamy, K. Chitra, A. Velhal, Gajanan D. Bhondve, Amit S. Bahl, Rakesh Sachdeva, Amit Kaur, Sharminder Nagar, Anu Bhargava, Balram Pharmacoecon Open Original Research Article 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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s41669-022-00342-6. Springer International Publishing 2022-06-22 /pmc/articles/PMC9216290/ /pubmed/35733075 http://dx.doi.org/10.1007/s41669-022-00342-6 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by-nc/4.0/Open AccessThis article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Original Research Article
Singh, Maninder Pal
Prinja, Shankar
Rajsekar, Kavitha
Gedam, Praveen
Aggarwal, Vipul
Sachin, Oshima
Naik, Jyotsna
Agarwal, Ajai
Kumar, Sanjay
Sinha, Setu
Singh, Varsha
Patel, Prakash
Patel, Amit C.
Joshi, Rajendra
Hazra, Avijit
Misra, Raghunath
Mehrotra, Divya
Biswal, Sashi Bhusan
Panigrahy, Ankita
Gaur, Kusum Lata
Pankaj, Jai Prakash
Sharma, Dharmesh Kumar
Madhavi, Kondeti
Madhusudana, Pulaganti
Narayanasamy, K.
Chitra, A.
Velhal, Gajanan D.
Bhondve, Amit S.
Bahl, Rakesh
Sachdeva, Amit
Kaur, Sharminder
Nagar, Anu
Bhargava, Balram
Cost of Surgical Care at Public Sector District Hospitals in India: Implications for Universal Health Coverage and Publicly Financed Health Insurance Schemes
title Cost of Surgical Care at Public Sector District Hospitals in India: Implications for Universal Health Coverage and Publicly Financed Health Insurance Schemes
title_full Cost of Surgical Care at Public Sector District Hospitals in India: Implications for Universal Health Coverage and Publicly Financed Health Insurance Schemes
title_fullStr Cost of Surgical Care at Public Sector District Hospitals in India: Implications for Universal Health Coverage and Publicly Financed Health Insurance Schemes
title_full_unstemmed Cost of Surgical Care at Public Sector District Hospitals in India: Implications for Universal Health Coverage and Publicly Financed Health Insurance Schemes
title_short Cost of Surgical Care at Public Sector District Hospitals in India: Implications for Universal Health Coverage and Publicly Financed Health Insurance Schemes
title_sort cost of surgical care at public sector district hospitals in india: implications for universal health coverage and publicly financed health insurance schemes
topic Original Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9216290/
https://www.ncbi.nlm.nih.gov/pubmed/35733075
http://dx.doi.org/10.1007/s41669-022-00342-6
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