A Cross-sectional Study of the Length of Stay of Persons with Mental Illnesses and Revenue to a Government Tertiary Neuropsychiatric Hospital Under Ayushman Bharat.

Abstract

Background: Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) is a health insurance scheme launched by the Government of India (GOI) in 2018 to cover the in-patient (IP) treatment expenditures, including mental illness treatment expenditures, for 500 million Indians. AB-PMJAY pays 100% of treatment expenditures for persons below the poverty line (BPL) and 30% for people above the poverty line (APL). Ayushman Bharat Arogya Karnataka (ABAK) trust implements this scheme in Karnataka, a southern Indian state.

Methods: Data of persons with mental illness (PMI) admitted under AB-PMJAY at a tertiary care neuropsychiatric hospital between 2018 and 2021 was analyzed to understand the socio-demographic and clinical variables, the average length of stay (LOS), and the amount claimed by the hospital.

Results: Median LOS for PMI with any clinical diagnoses was 18 days (range 2-145),14 for those with substance use or mood disorders, and 24 days for those with schizophrenia and other psychotic disorders. The hospital claimed an amount of Indian Rupees (INR) 15,291,349 for treating 868 PMI under AB-PMJAY.

Conclusions: The minimum and maximum LOS varied 70-fold, and there was a significant difference between different PMIs based on their clinical diagnosis. ABAK paid ₹3,488-12,750 per PMI for their treatment. Further research is needed to determine the variables influencing the LOS and the cost to the implementing agency.