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Ayushman Bharat is a flagship programme of Government of India and has been much publicised; however, the extent of its translation to the ground level has not been documented. A study was conducted to assess the implementation and satisfaction of the AB-PMJAY scheme in the inpatient department of AIIMS, New Delhi. Data were collected from January 2019 to June 2019. The sample size was a universal sample, and therefore, all the beneficiaries who availed the services at AIIMS, New Delhi were enrolled. A total of 120 patients were enrolled in the study. The mean age of the participant was 36.37 years, about 45.83% of the participants were illiterate and 69.17% resided in the rural area. A total of 88% of patients did not face any problem in availing the scheme, while 18% of the patients were asked to purchase medications from outside. Patients were highly satisfied with the ease and benefits of availing the scheme. The government should examine the reasons why some medications are being purchased from outside, and a contingency fund may be given to the hospital to prevent people from purchasing the medications from outside. [ABSTRACT FROM AUTHOR]

To review the importance of evidence-based methods in health insurance reimbursement for achieving universal health coverage in India. A narrative literature review was performed. The out-of-pocket (OOP) healthcare expenditure in India is among the highest in the world. This situation is despite the implementation of numerous government health schemes and the availability of a large number of health insurance programs, both public and private. Compromised quality of care in many public healthcare facilities is a major factor driving the average Indian citizen to increasingly depend upon private healthcare facilities, further escalating OOP spending. The low awareness and poor uptake of insurance policies among Indians is one of the biggest challenges in the implementation of universal health coverage (UHC) in India. The catastrophic burden of high OOP expenses on individual households could be reduced by taking steps to enhance health insurance uptake, which can be in turn achieved by strengthening the healthcare reimbursement system in India. The application of the principles of evidence-based healthcare for reimbursement requires the systematic assessment of all health technologies, which is already being done in developed countries. The enactment of health schemes such as Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana and setting up of Health Technology Assessment in India are steps toward reducing OOP expenditure and achieving UHC in India. We review the importance and challenges of evidence-based reimbursement and health technology assessment toward achieving UHC in India. • Indian households bear a high out-of-pocket expenditure on healthcare in India. • Introducing evidence-based reimbursement and health technology assessment would encourage the insurance uptake. • This would reduce the expenditure and improve the access to quality healthcare. • By launching the Ayushman Bharat public health insurance and assurance scheme, and by setting up Health Technology Assessment in India, the country is taking bold steps for providing universal health coverage to its citizens. [ABSTRACT FROM AUTHOR]

Compared to its peers, India has always spent far less on health. This is slowly changing as are the drivers that are forcing some of these changes. Demographical and epidemiological changes have moved the disease burden away from communicable and maternal and childhood diseases to non-communicable diseases. More people are city dwellers and achieving UHC is one of Sustainable Development Goals. To tackle these commitments and shifting demands, in 2017, there was a committed move towards improving primary health care by introducing comprehensive PHC through health and wellness centres. These centres are close to the community and by improving the quality of care given and increasing the range of services that they provide, there should be an increase in access to health. However, much needs to be done to ensure that these centres will provide high quality care to the local populations. Training the healthcare workers needed to staff these HWCs will take time. Keeping the required funding to expand the programme will be challenging in the current fiscal space. There is a need to integrate care and flow of funds between primary and secondary care and empowering local populations to engage in governance of the HWCs will take time. [ABSTRACT FROM AUTHOR]