Utilisation and Out-of-Pocket Expenditure for AYUSH Outpatient Care among Older Adults in India
Abstract
Background: Traditional, complementary, and alternative medicine are known to be used across the world for many types of diseases. In India, they are referred to as AYUSH and are known to be used for promotive, preventive, and curative purposes for healthy living and well-being. This study looks at the levels, patterns, and determinants of utilisation and out-of-pocket expenditure for AYUSH outpatient care among older adults in India.
Method: Descriptive analysis, data visualisation, and bivariate and multivariate logistic regression analysis have been used.
Results: The utilisation for AYUSH care is found to be quite low at 8.2% among 52% of respondents in the sample who sought outpatient care during the reference period. The study found the mean OOPE for AYUSH to be ₹ 687 per episode, in comparison with the overall mean OOPE of ₹ 1239 per episode for all types (allopathic and AYUSH combined) of outpatient care.
Conclusions: Despite the policy support for the promotion of AYUSH by the Government of India for a long time, and the common knowledge about the affordability and low cost of AYUSH care, utilisation of AYUSH healthcare remains low. Evidence-based studies on the efficacy and safety of AYUSH treatment, promotion of cross-referral between different streams of medicine, and standardisation of AYUSH medicines can help to build trust and boost utilisation of AYUSH care.
How to cite this article:
Goyanka R, Yadav J, Kumar M, Sagar SK. Utilisation and Out-of-Pocket Expenditure for AYUSH Outpatient Care among Older Adults in India. Chettinad Health City Med J. 2023;12(1):54-64.
DOI: https://doi.org/10.24321/2278.2044.202310
References
George M. Integrative medicine is integral to providing patient-centered care. Ann Allergy Asthma Immunol. 2015;114(4):261-4. [PubMed] [Google Scholar]
Lazarou J, Pomeranz BH, Corey PN. Incidence of adverse drug reactions in hospitalized patients: a meta-analysis of prospective studies. JAMA. 1998;279(15):1200-5. [PubMed] [Google Scholar]
Saroj RK, Murthy KH, Kumar M, Kumar A. Case-control study of STI patients and its associated risk factors. Glob J Med Public Health. 2016;5(5):1-8. [Google Scholar]
Valiathan MS. Towards ayurvedic biology: a decadal vision document [Internet]. Bangalore, India: Indian Academy of Sciences; 2006 [cited 2023 Feb 19]. Available from: https://www.ias.ac.in/public/Resources/Other_Publications/Overview/ayurvedic_biology.pdf
Metcalfe A, Williams J, McChesney J, Patten SB, Jetté N. Use of complementary and alternative medicine by those with a chronic disease and the general population--results of a national population-based survey. BMC Complement Altern Med. 2010;10:58. [PubMed] [Google Scholar]
Ismail IS, Hairon SM, Yaacob NM, Besari AM, Abdullah S. Usage of traditional and complementary medicine among dengue fever patients in the Northeast region of Peninsular Malaysia. Malays J Med Sci. 2019;26(3):90-101. [PubMed] [Google Scholar]
Seo HJ, Baek SM, Kim SG, Kim TH, Choi SM. Prevalence of complementary and alternative medicine use in a community-based population in South Korea: a systematic review. Complement Ther Med. 2013;21(3):260-71. [PubMed] [Google Scholar]
Ogbera AO, Dada O, Adeyeye F, Jewo PI. Complementary and alternative medicine use in diabetes mellitus. West Afr J Med. 2010;29(3):158-62. [PubMed] [Google Scholar]
Niemi M, Ståhle G. The use of ayurvedic medicine in the context of health promotion – a mixed methods case study of an ayurvedic centre in Sweden. BMC Complement Altern Med. 2016;16(1):62. [PubMed] [Google Scholar]
Berra JL, Molho R. Ayurveda in Argentina and other Latin American countries. J Ayurveda Integr Med. 2010;1(3):225-30. [PubMed] [Google Scholar]
Samal J. Role of AYUSH workforce, therapeutics, and principles in health care delivery with special reference to National Rural Health Mission. Ayu. 2015;36(1):5-8. [PubMed] [Google Scholar]
Sarada K, Puthiyedath R, Philip A, Ravindran GC, Pavithran K. Prevalence of the use of traditional complementary and alternative medicine amongst cancer patients in a tertiary care center in Kerala, India. J Ayurveda Integr Med. 2021;12(2):359-64. [PubMed] [Google Scholar]
Naaz F. A study of service utilization and patient satisfaction among patients attending state level AYUSH hospital in Delhi. J Ayu Herb Med. 2019;5(1):1-6. [Google Scholar]
Sahni PS, Singh K, Sharma N, Garg R. Yoga an effective strategy for self-management of stress-related problems and wellbeing during COVID19 lockdown: a cross-sectional study. PLoS One [Internet]. 2021 [cited 2023 Feb 19];16(2):e0245214. Available from: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0245214 [PubMed] [Google Scholar]
Kumar M, Kothe SK, Bala R, Sagar SK, Devi CS, Krishna KK, Kaushik K, Saran M. Self-care and preventive measures of Coronavirus: evidence from India. Epidem Int. 2022;7(2):6-12. [Google Scholar]
Kumar M, Bala R. Health care and health insurance in India: a review based study. In: Innovative socioeconomic trends in BFM (banking, finance & management). Nitya Publication; 2019. p. 118-29. [Google Scholar]
Ministry of AYUSH [Internet]. National AYUSH Mission (NAM) – Introduction; [cited 2023 Feb 19]. Available from: https://namayush.gov.in/content/introduction
Ministry of Ayush [Internet]. Notes on demands for grants, 2023-2024; [cited 2023 Feb 19]. Available from: https://www.indiabudget.gov.in/doc/eb/sbe4.pdf
Saxena SA. Mainstreaming AYUSH & revitalizing local health traditions under NRHM: an appraisal of the Annual State Programme Implementation Plans 2007-10 and mapping of technical assistance needs. National Health System Resource Centre; 2009.
Press Information Bureau [Internet]. Prime Minister Shri Narendra Modi lays foundation stone of WHO Global Center for Traditional Medicine at Jamnagar, Gujarat; 2022 Apr 19 [cited 2023 Feb 24]. Available from: https://pib.gov.in/PressReleasePage.aspx?PRID=1818164
Bala R, Kumar M, Krishna KK, Devi CS. Has Ayushman Bharat dwindled the out-of-pocket expenditure? J Evol Med Dent Sci. 2021;10(25):1895-8. [Google Scholar]
Mishra LC. Scientific basis for ayurvedic therapies. CRC Press; 2004. [Google Scholar]
Perianayagam A, Bloom D, Lee J, Parasuraman S, Sekher TV, Mohanty SK, Chattopadhyay A, Govil D, Pedgaonkar S, Gupta S, Agarwal A, Posture A, Weerman A, Pramanik S. Cohort profile: the Longitudinal Ageing Study in India (LASI). Int J Epidemiol. 2022;51:e167-76. [PubMed] [Google Scholar]
StataCorp. Stata Statistical Software: release 13. College Station, TX: StataCorp LP; 2013.
Vishnuprasad CN, Pradeep NS, Cho YW, Gangadharan GG, Han SS. Fumigation in Ayurveda: potential strategy for drug discovery and drug delivery. J Ethnopharmacol. 2013;149(2):409-15. [PubMed] [Google Scholar]
Mukherjee PK, Nema NK, Venkatesh P, Debnath PK. Changing scenario for promotion and development of Ayurveda--way forward. J Ethnopharmacol. 2012;143(2):424-34. [PubMed] [Google Scholar]
Thottapillil A, Kouser S, Kukkupuni SK, Vishnuprasad CN. An ‘Ayurveda-Biology’ platform for integrative diabetes management. J Ethnopharmacol. 2021;268:113575. [PubMed] [Google Scholar]
Goyal M. Threats and challenges of emerging viral diseases and scope of Ayurveda in its prevention. Ayu. 2019;40(2):67-8. [PubMed] [Google Scholar]
Paudel P, Fiaz S, Malashree SG. Role of Ayurveda in prevention of communicable diseases. Int Res J Ayur Yoga [Internet]. 2022 [cited 2023 Feb 19];5(5):148.Available from: https://irjay.com/index.php/irjay/article/view/Role-Of-Ayurveda-in-Prevention-of-Communicable-Diseases
Patwardhan B. Public perception of AYUSH. J Ayurveda Integr Med. 2015;6(3):147-9. [PubMed] [Google Scholar]
Rastogi S. Exploring larger evidence base for contemporary Ayurveda. Int J Ayurveda Res. 2010;1(3):195-6. [PubMed] [Google Scholar]
Shrivastava SR, Shrivastava PS, Ramasamy J. Mainstreaming of Ayurveda, Yoga, Naturopathy, Unani, Siddha, and Homeopathy with the health care delivery system in India. J Tradit Complement Med. 2015;5(2):116-8. [PubMed] [Google Scholar]
Goyanka R, Garg CC. Patient perception of attributes of primary care: a study of Aam Aadmi Mohalla Clinics in Delhi, India. Fam Pract [Internet]; 2023 [cited 2023 Feb 19]. Available from: https://academic.oup.com/fampra/advance-article-abstract/doi/10.1093/fampra/cmac154/6992893?redirectedFrom=fulltext
