Sancheti Pooja, Shastri Suresh G, Krishnamurthy Aditi, Dayananda Gagana G, Srinivas Pujari K, Jayaprakash Murugesh, Srinivasa Balu P, Singarajipura Anil, Devendiran Randeep
AB-ArK Cell, Commissionerate of Health & Family Welfare Services, Bangalore, Karnataka, India.
Independent Public Health Consultant, Bangalore, India.
Indian J Tuberc. 2025 Apr;72(2):162-168. doi: 10.1016/j.ijtb.2023.12.008. Epub 2023 Dec 27.
Tuberculosis (TB) is a major global health concern, causing millions of cases and deaths worldwide. India, particularly Karnataka, grapples with a significant TB burden, imposing a substantial economic strain on affected individuals and their families. Hospitalization for TB treatment is crucial but often results in financial distress, hindering inpatient care access due to exorbitant costs, leading to catastrophic medical expenses for many households.
This study evaluates the utilization of TB-specific healthcare packages within the AB-PMJAY-ArK in Karnataka State. The primary objective is to assess utilization patterns based on socio-demographic factors, geographical distribution, healthcare facility types, and the cost savings for TB patients and their families.
Utilizing observational data from the AB-PMJAY-ArK preauthorization and claims database through Suvarna Arogya Suraksha Trust (SAST) portal, this study covers a 24-month period from July 2021 to June 2023. TB-specific treatment packages were identified, and descriptive statistics were employed for analysis.
Of the 39,89,802 approved preauthorizations, 9173 patients with confirmed TB were analysed. Majority were male (68.3 %) and belonged to the below poverty line category (96.2 %). The public sector accounted for 97.9 % of TB treatment, with 96.4 % of approved preauthorization amounts. On average, the scheme averted catastrophic costs of approximately Rs. 10,000 per TB patient. Various healthcare facilities were utilized, with medical colleges being the most frequented.
Addressing the financial burden of TB hospitalization is crucial for ensuring equitable healthcare access. While AB-PMJAY-ArK has made significant strides in alleviating financial distress, policymakers and healthcare providers can amplify its impact through targeted interventions, healthcare system strengthening, and fostering public-private collaborations. Further research is needed to assess the long-term effects of these measures on patient outcomes and healthcare systems. This study provides valuable insights into strategies for mitigating financial distress resulting from TB hospitalization, with the potential to support the sustainable management of this global health challenge and enhance healthcare system resilience.
结核病是全球主要的健康问题，在全球导致数百万病例和死亡。印度，尤其是卡纳塔克邦，面临着巨大的结核病负担，给受影响的个人及其家庭带来了沉重的经济压力。因结核病治疗而住院至关重要，但往往会导致经济困境，由于费用过高而阻碍了住院治疗的可及性，给许多家庭带来了灾难性的医疗费用。
本研究评估了卡纳塔克邦AB-PMJAY-ArK内结核病特定医疗保健套餐的使用情况。主要目的是根据社会人口因素、地理分布、医疗机构类型以及结核病患者及其家庭的成本节约情况来评估使用模式。
本研究利用通过苏尔纳阿罗吉亚苏拉克沙信托（SAST）门户网站从AB-PMJAY-ArK预授权和理赔数据库获取的观察性数据，涵盖2021年7月至2023年6月的24个月期间。确定了结核病特定治疗套餐，并采用描述性统计进行分析。
在3989802份批准的预授权中，对9173例确诊结核病患者进行了分析。大多数为男性（68.3%），属于贫困线以下类别（96.2%）。公共部门占结核病治疗的97.9%，占批准预授权金额的96.4%。该计划平均为每位结核病患者避免了约10000卢比的灾难性费用。使用了各种医疗机构，其中医学院是就诊最频繁的。
解决结核病住院的经济负担对于确保公平的医疗服务可及性至关重要。虽然AB-PMJAY-ArK在减轻经济困境方面取得了重大进展，但政策制定者和医疗服务提供者可以通过有针对性的干预措施、加强医疗系统以及促进公私合作来扩大其影响。需要进一步研究来评估这些措施对患者结局和医疗系统的长期影响。本研究为减轻结核病住院导致的经济困境的策略提供了有价值的见解，有可能支持应对这一全球健康挑战的可持续管理并增强医疗系统的复原力。
