E-20 | Appropriateness of Percutaneous Coronary Intervention Under Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY)
Year: 2023
Type: conference-abstract
Abstract: In India, a dramatic increase in the burden of ischemic heart disease (IHD) has been accompanied by the expanded use of coronary catheterization and percutaneous coronary intervention (PCI). This growth has occurred during a period of dynamic change within the Indian healthcare system, characterized by substantial investments in healthcare infrastructure, the introduction of national health insurance – Prime Minister’s Jan Arogya Yojana (PM-JAY) - for the vulnerable population under the Ayushman Bharat initiative in 2018, along with the historic step of the National Pharmaceutical Pricing Authority (NPPA) imposing a ceiling limit (2017) on the prices of coronary stents in India. There has been an annual increase of 3.7%, 13.1%, 12.6%, and 12.9% respectively in the number of coronary intervention procedures for the years 2017, 2018, 2019, and 2021. Today, India faces a challenge in ensuring that invasive cardiovascular procedures are performed appropriately, safely, and efficiently. A study was conducted to assess the appropriateness of Percutaneous Coronary Intervention under PM-JAY. In this national level study, data was collected from January to May 2020 from patients who had undergone PCI at both public and private hospitals, and a detailed analysis was carried out to classify the interventions as ‘inappropriate’, ‘may be appropriate’ and ‘rarely appropriate’. The initial analysis gave the percentage of inappropriate PCIs performed as 17% and uncertain cases as 46%. On reassigning, the codes 33% of PCIs performed under the PM-JAY scheme were classified as Inappropriate, 48% as Appropriate, and 19% as Maybe Appropriate. Owing to the large and growing number of cardiac revascularizations performed in India, even a slight reduction in the proportion of inappropriate cases could have a huge impact on health outcomes, which should be analysed. It is possible that with proper training and sensitization, and implementation of the Appropriate Use criteria, such unnecessary procedures can be reduced and quality of care improved. Subsequently, the PM-JAY program could save huge costs by avoiding inappropriate cardiac revascularizations.
Authors: Duggal Bhanu, Indrani Gupta, Uday Kumar, Vasuki Rayapati, Sujata Saunik, Praveen Gedam
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,400
OpenAlex ID: W4382020107