Kerala and Tamil Nadu have witnessed a drop in authorised hospital admission rates under the Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) in the last three financial years, even as the rest of the states saw a gradual growth in hospital admissions under the scheme, according to data presented by the Ministry of Health and Family Welfare in Parliament.
According to data accessed by Business Standard, authorised hospital admissions under the scheme in Kerala have dropped from 1.69 million in financial year 2021-22 (FY22) to 1.07 million in FY24. Similarly, ministry data suggests that the number of AB-PMJAY admissions in Tamil Nadu hospitals has come down from 4.39 million in FY22 to 1.05 million in FY24.
This performance in Kerala and Tamil Nadu is a stark contrast compared to other southern states. Authorised hospital admissions under AB-PMJAY have seen a gradual increase in Andhra Pradesh (from 1.13 million in FY22 to 1.84 million in FY24), Karnataka (from 1.08 million in FY22 to 3.21 million in FY24) and Telangana (from 323,421 in FY22 to 618,497 in FY24).
The lesser numbers in Telangana are due to the presence of the state’s own health insurance scheme for the poor, ‘Aarogyasri,’ which later merged with AB-PMJAY only in 2021. Queries mailed by Business Standard to the Health Ministry remained unanswered till the time of going to press.
A similar trend has been seen in the population coverage by southern states, in terms of creating Ayushman Bharat Health Account (ABHA) IDs. The ABHA number is a unique 14-digit identification number under which an individual’s medical history, consultation details, prescriptions, etc., are registered, creating a unique health database.
According to data posted on the Ayushman Bharat Digital Mission (ABDM) dashboard, Tamil Nadu and Kerala had covered only 16.7 and 49.6 per cent of their populations with ABHA IDs, compared to Andhra Pradesh and Telangana with 78.4 per cent and 53.7 per cent population coverage, respectively.
The ABHA ID is different in coverage, as it is open to all citizens, whereas AB-PMJAY only covers the healthcare costs of the poor who are eligible under the scheme.
The AB-PMJAY is the world’s largest publicly funded health assurance scheme, which aims to provide health cover for Rs 5 lakh per family per year for secondary and tertiary care hospitalisation to around 550 million (55 crore) individuals, corresponding to 123.4 million families.
The scheme has been rolled out for the bottom 40 per cent of poor and vulnerable citizens, which comes to around 120 million households.
Whether households are included or not depends on the deprivation and occupational criteria of the Socio-Economic Caste Census 2011 (SECC 2011) for rural and urban areas, respectively. This number also includes families that were covered in the Rashtriya Swasthya Bima Yojana (RSBY) for unorganised sector workers belonging to the below poverty line (BPL) category, but were not present in the SECC 2011 database.
According to data available on the National Health Authority (NHA) dashboard, the scheme has so far covered over 350 million citizens who have received Ayushman Cards to avail free health insurance of Rs 5 lakh for hospitalisation.
First Published: Aug 05 2024 | 5:00 PM IST
