Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, Chandigarh, India
Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, Chandigarh, India.
BMJ Open. 2020 Jul 20;10(7):e035170. doi: 10.1136/bmjopen-2019-035170.
To achieve universal health coverage, the Government of India has introduced a large tax-funded national health insurance scheme for the provision of secondary and tertiary care services in public and private hospitals. AB - PMJAY reimburses care for 1573 health benefit packages (HBPs). HBPs are designed to cover the treatment of diseases/conditions with high incidence/prevalence or which contribute to high out-of-pocket expenditure. However, there is a dearth of reference cost data against which provider payment rates can be assessed.
The CHSI (Cost of Health Services in India) study will collect cost data from 13 Indian states covering 52 public and 40 private hospitals, using a mixed economic costing methodology (top-down and bottom-up), to generate unit costs for the HBPs. States will be sampled to capture economic status, development indicators and health service utilisation heterogeneity. The public sector hospitals will be chosen at secondary and tertiary care level. One tertiary facility will be selected from each state. At secondary level, three districts per state will be selected randomly from the district composite development score ranking. The private sector hospital sample will be stratified by nature of ownership (for-profit and not-for-profit), type of city (tier 1, 2 or 3) and size of the hospital (number of beds). Average costs for each HBP will be calculated across the different facility types. Multiple scenarios will be used to suggest rates which could be negotiated with the providers. Overall, the study will provide economic cost data for price setting, strategic purchasing, health technology assessment and a national cost database of India.
The approval has been obtained from the Institutional Ethics Committee and Institutional Collaborative Committee of the Post Graduate Institute of Medical Education and Research, Chandigarh, India. The results shall be disseminated in conferences and peer-reviewed articles.
为实现全民健康覆盖，印度政府推出了一项大型的税收资助的国家医疗保险计划，为公立和私立医院的二级和三级护理服务提供资金。AB-PMJAY 报销了 1573 种健康福利套餐（HBPs）的护理费用。HBPs 的设计目的是覆盖发病率/患病率高或导致自费支出高的疾病/病症的治疗。然而，缺乏可以评估提供者支付率的参考成本数据。
CHSI（印度卫生服务成本）研究将从覆盖印度 13 个邦的 52 家公立和 40 家私立医院收集成本数据，使用混合经济成本核算方法（自上而下和自下而上），为 HBPs 生成单位成本。将对各州进行抽样，以捕捉经济状况、发展指标和卫生服务利用的异质性。公立部门医院将在二级和三级护理水平选择。每个邦将选择一家三级医院。在二级水平，将从每个邦的地区综合发展得分排名中随机选择三个地区。私立部门医院样本将按所有制性质（营利性和非营利性）、城市类型（1 级、2 级或 3 级）和医院规模（床位数量）进行分层。将根据不同的医疗机构类型计算每个 HBP 的平均成本。将使用多种方案来建议可以与提供者协商的费率。总的来说，该研究将为定价、战略采购、卫生技术评估和印度国家成本数据库提供经济成本数据。
该研究已获得印度昌迪加尔 PGIMER 研究所机构伦理委员会和机构合作委员会的批准。研究结果将在会议和同行评议的文章中传播。
