NewKerala.com

PM-JAY Boosts Spine Surgery Access, Cuts Patient Costs: Study

A study from PGIMER Chandigarh shows the Ayushman Bharat PM-JAY scheme has dramatically increased access to complex spine surgeries. Utilization of the scheme for these procedures rose from 58.7% in 2023 to 73.5% in 2024, while self-paid surgeries declined. The program has effectively eliminated out-of-pocket expenses for a majority of patients, engaging previously excluded economically disadvantaged populations. Researchers note that expanding coverage to include postoperative rehab could further improve long-term outcomes.

Key Points: PM-JAY Increases Spine Surgery Access, Reduces Costs

  • PM-JAY spine surgery use rose to 73.5% in 2024
  • Self-financed procedures fell to 18.9% in 2024
  • Covers up to ₹5 lakh per family yearly
  • Study analyzed 410 surgeries at PGIMER Chandigarh
2 min read

PM-JAY boosts access to complex spine surgeries, reduces out-of-pocket costs: Study

A PGIMER study finds Ayushman Bharat PM-JAY significantly increased access to complex spine surgeries and eliminated out-of-pocket costs for patients.

"By eliminating out-of-pocket costs for 73.5 per cent of our 2024 cohort, the scheme has engaged the economically disadvantaged population - PGIMER Research Team"

New Delhi, Feb 4

The government's flagship Ayushman Bharat Pradhan Mantri Jan Arogya Yojana has significantly improved access to complex spine surgeries and eliminated out-of-pocket costs, reducing the financial burden on patients from a lower economic background, according to a new study.

The study conducted by the Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, demonstrated a substantial increase in the utilisation of PMJAY for spine surgery, with a concurrent decline in self-financed procedures.

The retrospective, single-centre observational study was conducted, analysing all spine surgeries performed from January 2023 to December 2024. A total of 410 patients (249 males and 161 females) underwent spine surgery during the study period.

The majority of cases included degenerative spinal disorders (46.1 per cent) and traumatic injuries (33.4 per cent).

Overall, 276 procedures (67.3 per cent) were funded under PM-JAY, while 110 (26.8 per cent) were self-financed.

"PM-JAY utilisation increased from 58.7 per cent (101/172) in 2023 to 73.5 per cent (175/238) in 2024. Correspondingly, self-financed procedures declined from 37.8 per cent in 2023 to 18.9 per cent in 2024," said the team from the Department of Orthopaedic Surgery, PGIMER.

"By eliminating out-of-pocket costs for 73.5 per cent of our 2024 cohort, the scheme has engaged the economically disadvantaged population that was previously excluded," they added.

The findings, published in the Journal of Clinical Orthopaedics and Trauma, suggest that "publicly funded insurance is effectively improving financial access to implant-intensive spine care across a broad spectrum of pathologies. However, robust clinical governance remains essential to ensure equitable implementation and prevent overutilisation".

ABPMJAY, launched in 2018, represents the world's largest publicly funded health insurance programme, providing coverage of up to Rs 5 lakh per family per year for secondary and tertiary care to eligible households.

The scheme aims to reduce catastrophic health expenditure and improve access to essential healthcare services by empanelling both public and private hospitals across the country. Since its inception, PM-JAY has been increasingly utilised for high-cost surgical interventions, including orthopaedic and spine procedures.

"Expansion of coverage to include postoperative rehabilitation and essential orthotic devices could improve continuity of care and long-term functional outcomes. Additionally, standardised data capture and reporting across empanelled institutions would facilitate ongoing evaluation of utilisation patterns, outcomes, and cost-effectiveness," the researchers said.

- IANS

Share this article:

Reader Comments

S
Sarah B
As someone who has worked in public health, the data is very promising. Reducing out-of-pocket costs from ~38% to ~19% in a year is a significant achievement. The focus now must be on ensuring quality and preventing unnecessary procedures.
P
Priya S
A very welcome step. But the real challenge is awareness and last-mile delivery. In my village, many eligible families still don't know how to avail the benefits. Government needs to run more awareness campaigns.
R
Rohit P
Great initiative! Spine surgeries can cost lakhs and push families into debt. PMJAY is a lifesaver. Hope they expand it to cover post-operative physiotherapy as the study suggests. Recovery is a long process.
K
Karthik V
The study is from a premier institute like PGIMER, which adds credibility. However, I hope the scheme is implemented with equal efficiency in district hospitals and not just major cities. Healthcare should be equitable.
N
Nisha Z
This is the kind of development that makes me proud. A health emergency shouldn't mean financial ruin. More such studies should be published to show the on-ground impact of government schemes. 👍

We welcome thoughtful discussions from our readers. Please keep comments respectful and on-topic.

Leave a Comment

Minimum 50 characters 0/50