NEW DELHI: The 10-week long nationwide Covid-19 lockdown resulted in a 51 per cent drop in average weekly hospitalisations under the Ayushman Bharat Pradhan Mantri Jan Aarogya Yojana - the Centre’s flagship health insurance scheme. However, essential health services such as institutional deliveries and cancer treatment were the worst hit.
While the cancer treatment under the scheme that offers free hospitalisation benefit to crores of the poorest people by up to Rs 5 lakh in the country fell by nearly 64 per cent, childbirth - both normal deliveries and Caesarean Sections - fell by 26 per cent, says a just-released government report.
The report titled “PM-JAY Under Lockdown: Evidence on Utilization Trends PM-JAY” by the National Health Authority, the government agency that runs the PMJAY also said that women, children and the elderly were the worst hit than men.
There was wide variation in claim volume trends across states, with the steepest declines - over 75 per cent - in Assam, Maharashtra and Bihar, while much smaller declines - about 25 percent or less - were observed in Uttarakhand, Punjab and Kerala.
The total decline in outlays over 10 weeks compared to a hypothetical no-lockdown amounted to over Rs 1000 crore, or 15 per cent of the Centre’s PM-JAY annual budget allocation.
Senior authorities in the NHA conceded that the report has underlined how health-seeking behaviour took a beating during the restrictions imposed to contain the pandemic.
“While there is still the possibility of some makeup in the lost-out treatment in procedures like knee replacement surgeries, cataract surgeries etc—people who would have lost out on cancer surgeries, treatment for high fever among others cannot be made up,” said Indu Bhushan, CEO of the NHA.
He added that while there has been some improvement in the number of hospitalisations this month, it could take at least one more month or longer for the situation to be anywhere near normal.
Among procedures, planned surgeries such as cataract operations and joint replacements suffered a decline of over 90 per cent, while haemodialysis declined by only 6 per cent.
The analysis has shown that there was a larger decline in utilization of surgical procedures -57 per cent- than medical cases -46 per cent. “This is to be expected since surgeries are more commonly planned in advance, whereas medical cases are not.”
It also showed that there more people benefitted under the scheme in private hospitals during the lockdown period while this trend was just the opposite earlier.
The report highlighted that the weekly nationwide PMJAY claim volume during the first week of lockdown was 64 per cent lower than just two weeks earlier and also that the decrease in claim volumes started during the week prior to the lockdown.
“This may partly reflect the one-day ‘Janata Curfew’ on March 22nd ..and other measures related to international travel and restrictions on the congregation of people already in place that week,” it said.
“Together these events likely heralded the arrival of the COVID-19 pandemic in the national consciousness.”
- Average weekly claim volumes during ten weeks of lockdown were 51 % lower than the weekly average observed during the twelve weeks prior to the lockdown.
- There was wide variation in claim volume trends across states, with the steepest declines in Assam, Maharashtra and Bihar and smallest declines in Uttarakhand, Punjab and Kerala.
- Among demographic groups, women, younger and older populations (under 20 and over 60) reduced their utilization by more than men, young adults or the middle-aged.
- More people utilised the scheme in private hospitals than in government facilities during the lockdown period
- Among procedures, planned surgeries such as cataract operations and joint replacements suffered a decline of over 90 percent, while haemodialysis declined by only 6 percent.
- There was also a sharp fall in cardiovascular surgeries, admissions for child delivery and oncology