PROJECT REPORT

ON

HEALTH AND WELLBEING

AYUSHMAN BHARAT AND THE COVID-19

SUBMITTED BY

GROUP - 4

ATUL KUMAR - MBA21033

AYUSHI BHALLA - MBA21036

KARAN CHAWLA - MBA21081

SHRUTI GOEL - MBA21188

INDIAN INSTITUTE OF MANAGEMENT JAMMU

DECEMBER 2021
CONTENT
INTRODUCTION-

Ayushman Bharat Pradhan Mantri Jan Arogya Yojana(AB-PMJAY) is a program launched by

the Government of India in 2018 to provide free access to health insurance coverage for people
with low income. This program comes under the Ministry of Health and Family Welfare,
funded by both state and central government. Each of the 28 states and eight union territories
was free to choose whether to participate in this program or not. This scheme covers 5 lakh
rupees per year per family for medical treatment at the hospitals under the AB-PMJAY
program; public and private hospitals come under this.

During the Covid 19 crisis, we saw the failure of the Healthcare Infrastructure. Many factors
like supply, demand, and infrastructure failure lead to the worsening of the condition in our
country. According to surveys conducted, the providers face many challenges in implementing
the program, especially during Covid, like delays in financial and service supply, shortage of
PPE kits, high price, and oxygen cylinder crisis. Our objective is to highlight the challenges
that the state and the central government faced during the Covid and what can be done to
improve it.

We have compared the number of hospitals that come under the AB-PMJAY scheme before
and after COVID and what were the problems faced by people in those hospitals.
AB PMJAY collected genuine data from the ground using an IT system. In
every hospital admission, the patient's demographic information, as well as
the specifics of the therapy administered, are digitally captured in the
hospital utilising NHA's Transaction Management System (TMS).
Throughout treatment, this system is updated with all admission-related
activities, such as surgical data, discharge, claim submission, and
payment. The National Hospital Association(NHA)'s Hospital Empanelment
System(HES) keeps the record of each hospital, such as specialisations,
bed capacity, personnel, and other amenities (HEM). The National Data
Warehouse, a centralised data repository, holds all of this information. This
study's findings and conclusions are largely based on these two data
sources.

The data for this study was collected across two weeks in the month of
March, April, and May of 2020.

To compare AB PMJAY consumption with each of the above-mentioned

time intervals, the following time periods were used. The chosen time
periods were discovered to be the most accurate representations.
The analysis matrices were built at these times to see how things changed
during early or late lockdown compared to prior lockdown.
The supply-side analysis looked at how many functioning hospitals stayed
open during early and late shutdowns. If a hospital has one or more
hospital admissions in a given period, it is considered to be registered.
● Percentage of Active Hospitals (Early vs. Before Lockdown) — The
proportion of active hospitals during early lockdown compared to
active hospitals before lockdown.
 ● Percentage of Active Hospitals (Late vs. Prior to Lockdown) — The
proportion of active hospitals during late lockdown compared to active
hospitals prior to lockdown.

Hospital admissions before to lockdown were compared to admissions

during early and late lockdown in a demand side analysis.
● Hospital Admissions (Early vs. Before Lockdown) — The ratio of early
lockdown versus pre-lockdown hospital admissions.
● Hospital Admissions (Post-Lockdown vs. Pre-Lockdown) — The
percentage of post-lockdown hospital admissions versus early
lockdown hospital admissions.

To identify states, the following cutoffs were utilised to compare the

performance of supply and demand side indicators during late lockdown vs
before lockdown.

In addition to the percentages below, a state's reliance on the public or

private sector before to shutdown was considered a crucial indication to
mention.When compared to the total number of hospital admissions, the
percentage of admissions served by private hospitals.The aforementioned
indicators were used to group nations in order to gain valuable insights,
which are detailed in the next section.

Key pointsg of the analysis

 ● A state's reliance on the public or private sector before a shutdown
was regarded a key indicator to highlight in addition to the
percentages below.
● The percentage of admissions served by private hospitals when
compared to the overall number of hospital admissions.
● The aforementioned indicators were utilised to group countries in
order to gather significant insights, which will be discussed in the
following section.

Analysis and Findings

The lockdown has had a negative impact on the utilisation of services in all
districts, at all levels of care, and for the bulk of services, according to
AB-PMJAY statistics on utilisation and hospital activities.The supply and
demand sides of the programme have both been affected by the epidemic.
The following are some of the key conclusions of the study:

● Hospital Activity

The AB PMJAY plan had 21,573 hospitals registered as of May 23, 2020.
Public hospitals made up 56 percent of empaneled hospitals, while private
hospitals made up 44 percent. In the three months leading up to the
shutdown, 51% of all empaneled hospitals were open. This percentage
plummeted to 25% during the late lockdown phase. The data reveals a
downward trend in the number of active hospitals in both the public and
private sectors, with the number of active hospitals falling by about 40%
compared to active hospitals before the lockdown. In comparison to before
the lockdown, 63 percent of hospitals were open during the late shutdown
(59 percent for public hospitals and 66 percent for private hospitals). Small
and medium-sized hospitals with less than 100 beds were the most hit, with
activity dropping at a faster rate than other empaneled institutions.

In numerous regions, the number of functioning hospitals has decreased

significantly, with certain states running at less than half of their capacity
compared to before the lockdown: Uttar Pradesh (30%), Bihar (32%),
Karnataka (50%), Tamil Nadu (52%), Jammu and Kashmir (53%), and
Jharkhand (53%). (55 percent ).

Fear of catching COVID19 infection among hospital owners and personnel,

or fear of being stigmatised and losing business if they treat COVID19
patients, might explain the drop in hospital activity in private hospitals. At
the same time, the decrease at public hospitals might be ascribed to a lack
of manpower and resources due to the fact that they are responsible for the
bulk of COVID19 treatments. Other possibilities include:
a. Hospitals are providing treatments but are not booking them on the AB
PMJAY IT platform due to a high volume of patients or a lack of resources
due to a decrease in usage.
b. Due to a lack of resources or strong demand, hospitals are overcharging
for treatment, resulting in a decrease in patient inflow.
c. Hospitals may be suffering a liquidity shortage as a result of limited
operations and rising expenses, even for non-COVID19 treatments, or
greater costs and limited supply of medical equipment, forcing them to
scale back or shut down their activities.
The majority of these may be verified by qualitative evaluations or surveys
of service providers.

Service Utilization
Conclusion and Recommendations

● The first findings of the study will be useful in determining the impact
of post-COVID 19 use on various states and AB PMJAY from both
sides of the market. If beneficiary and provider surveys are conducted
to better understand qualitative elements of the difficulties, this
information may be complemented and enhanced.

● To guarantee that poor and disadvantaged people have access to

vital healthcare, it is critical to utilize the ever-growing capacity of the
health sector, as well as dramatically improve infrastructure and level
of care offered in public hospitals.

● Careful monitoring of the quality of care provided, as well as having a

clear standard for hospitals making the employees and beneficiaries
aware of the prevention methods and guaranteeing safety throughout
this epidemic, are also crucial.

● To summarise, during COVID19, AB PMJAY plays a key role in

delivering healthcare to the impoverished and vulnerable people. All
measures must be ramped up to guarantee that all important and
unimportant hospitalisation treatment is supplied through government
and commercial appointed hospitals underneath the AB PMJAY
programme, in conjunction with basic care provided through the
healthcare system.