Assessment of Utilisation and Impact of Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (ABPMJAY) on Out-of-Pocket Expenditure in Jammu and Kashmir

Shafiqa Rasool; Mohammad Ishaq Geer

Shafiqa Rasool Research Scholar, Department of Pharmaceutical Sciences, University of Kashmir, Hazratbal, Srinagar, Jammu and Kashmir, India
Mohammad Ishaq Geer Professor Pharmacology, Department of Pharmaceutical sciences, University of Kashmir, Hazratbal, Srinagar, Jammu and Kashmir, India

Keywords: Universal Health Care (UHC), AB-PMJAY, Financial Burden, Out-of-Pocket Expenditure (OOPE), Catastrophic Health expenditure (CHE)

Abstract

Background & Objective: Economic barriers significantly affect access to healthcare. Health insurance is essential to prevent financial hardship and ensure service utilization. To reduce this burden, the Government
of India launched Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) in Jammu and Kashmir on December 1, 2018. This study focuses on assessing the utilisation and impact of AB-PMJAY in reducing Out-Of- Pocket Expenditure (OOPE) and Catastrophic Health Expenditure (CHE) among the population of Jammu and Kashmir.
Methods: A primary survey was carried out in four districts of Jammu and Kashmir which includes districts Srinagar, Baramulla, Anantnag and Budgam. Simple random sampling technique was used to determine
the sample size and around 192 hospitalisation cases were selected. The interview schedule was developed based on the 71st round of the National Sample Survey Office (NSSO) and details on health expenditure for inpatient care and outpatient care were collected separately.
Results: Out of 192 hospitalisation cases, 11% did not utilise services under the AB-PMJAY scheme and out of these, around 6.71% faced financial hardship.
Conclusion: From this study, it was found that out-of-pocket spending was lower among those hospitalisation cases who utilised services under the Ayushman Bharat SEHAT scheme. Ayushman Bharat PM-JAY scheme has the potential to reduce the financial burden to a great extent if more services like OPD services in major and common illnesses (like diabetes, hypertension and CVS diseases) are made available. Also, modification and upgradation of hospital infrastructure and easing the claim process can also play a key role.

How to cite this article:
Rasool S, Geer M I. Assessment of Utilisation
and Impact of Ayushman Bharat Pradhan Mantri
Jan Arogya Yojana (AB-PMJAY) on Out-of-Pocket
Expenditure in Jammu and Kashmir. Chettinad
Health City Med J. 2025;14(1):12-18.

DOI: https://doi.org/10.24321/2278.2044.202503

References

World Health Organization. Monitoring progress on universal health coverage and the health-related

Sustainable Development Goals in the WHO SouthEast Asia Region 2021 update. https://digitalcommons. fiu.edu/srhreports/health/health/59/.

Evans DB, Marten R, Etienne C. Universal health coverage is a development issue. Lancet. 2012 Sep

;380(9845):864-5. [PubMed] [Google Scholar]

Alebachew A, Hatt L, Kukla M. Monitoring and evaluating progress towards universal health coverage

in Ethiopia. PLoS Med. 2014 Sep 22;11(9):e1001696. [PubMed] [Google Scholar]

Vega J. Universal health coverage: the post2015 development agenda. Lancet. 2013 Jan 19;381(9862):179-80. [PubMed] [Google Scholar]