PGI asked to ascertain cost of health care services in country

Mohit Khanna

Tribune News Service

Chandigarh, May 19

In a major breakthrough, the School of Public Health of Post Graduate Institute of Medical Education and Research (PGIMER) has been selected to conduct a study for ascertaining the cost on health care services in the country.

The one-of-its-kind study will be conducted in 10 states across the country, including Jammu & Kashmir, Himachal Pradesh, Delhi, Gujarat, West Bengal, Tamil Nadu, Andhra Pradesh and Uttar Pradesh.

Sources said the study was being conducted for the successful implementation of ‘Ayushman Bharat’, a mega scheme to provide free health treatment up to Rs 5 lakh to people living below poverty line. The objective of the study is to help the government in ascertaining the insurance claims of particular ailment.

Dr Shankar Prinja, Additional Professor of Health Economics at the PGI and Principal Investigator, lauded the role of the Department of Health Research for providing support to conduct the national-level study which will involve more than 500 health facilities, including sub-centers and district hospitals.

“We have identified 73 health procedures which constitutes 80 per cent of medical insurance claims in the country. We will focus on these procedures and ascertain the cost of their treatment. The study will be used as evidence for the government in setting the reimbursement rates under the National Health Protection Scheme,” said Prinja.

He further added that the study would provide information to the government on cost of various treatments/procedures for making informed choices and determining the package rates for the same with the insurance companies.

For this purpose, Prof Rajesh Kumar, Dean (Academics) at the PGI, had also organised the first national workshop to train participants from 10 states on costing of health care services from May 16 to 18. The workshop was held in collaboration with the Department of Health Research, Ministry of Health and Family Welfare.

A total of 30 senior researchers and academicians from leading organisations and medical colleges of the country such as the Department of Health and Research (DHR), New Delhi; TISS Mumbai, MCC Madras; KGMU, Lucknow; SMIMER, Gujarat; SMS Medical College, Jaipur; VSSMC (Burla), Odisha; Seth GSMC and KEM Hospital, Mumbai, were part of this workshop.

Ayushman Bharat to benefit 10 crore families 

Touted as the world’s largest government-funded health care insurance programme, Ayushman Bharat — National Health Protection Mission (AB-NHPM) will provide an insurance coverage of Rs 5 lakh per family annually and benefit more than 10 crore families belonging to the poor and vulnerable sections of society. The Centrally-sponsored scheme will target deprived rural families and identified occupational category of urban workers’ families, who constitute 8.03 crore in rural and 2.33 crore in urban areas, respectively, as per the latest Socio Economic and Caste Census (SECC) 2011 data, and will cover around 50 crore people. The Health Ministry has prepared a detailed timeline to ensure completion of all steps to enable rolling out of the scheme anytime after July, while allocating around Rs 10,000 crore for the project.