PMJAY: 1 in 20 patients readmitted within 30 days of discharge, 1 in 50 patients within 7 days

A study done by the National Health Authority (NHA) to determine the quality of care in Ayushman Bharat-Pradhan Mantri Jan Arogya Yojna (AB-PMJAY) has estimated two common quality of care indicators -- unplanned readmission and hospital mortality under the healthcare scheme.

Approximately 1 in 20 patients in PMJAY is readmitted to the hospital within 30 days of discharge and 1 in 50 is readmitted within seven days, the study revealed.

According to the findings of the study, in-hospital mortality data said that 0.58 per cent of PMJAY patients died since the launch of the scheme in September 2018.

The study is based on a quantitative analysis of 59.6 lakh claims covering 36.8 lakh beneficiaries, who were enrolled since the launch of the scheme on September 23, 2018, to 30 November 30, 2019. In order to calculate 30-day readmission rates, all claims up to October 31, 2019, were analysed.

"Readmission rates also vary widely across specialities and procedures. Overall 30-day readmission rates are higher for medical procedures than surgical procedures, at 8.4 and 3.2 per cent respectively. In general, due to poor diagnosis, patients who have co-morbidities and the elderly generally come for readmissions in medical cases in hospitals. In surgical cases, complications during surgery or post-operative care are the main drivers. Among medical specialities, general medicine and pediatric medical management have the highest observed readmission rates," Dr Vipul Aggarwal, Deputy CEO at NHA, told .

"Readmission rates vary widely across states, ranging from just over 1 per cent in Arunachal Pradesh and Karnataka to over 11 per cent in Kerala. The rates are higher for males and increase with the age of the patient," Dr Aggarwal said and added that readmission rates are slightly higher in private hospitals than in public ones.

"In addition to the impact on the health and well-being of patients and families, readmissions also impose a financial burden, some of which could be avoidable. The estimated cost of readmissions to PMJAY is between 3.4 and 4.9 per cent of total spending. Policies to improve quality of care could improve health outcomes and reduce spending," he said.

"As in-hospital mortality data showed that about 0.58 per cent of PM-JAY patients died since the launch of the scheme in September 2018, the study states that patients who died were on average older and sick, and had variation in mortality rates across states, and hospital type points to additional areas to improve quality of care," noted the study.

According to Aggarwal, the findings of the study offer insights into how and where to achieve improved performance.

"Importantly, the exercise has also pointed out key areas to improve data collection and data quality to help advance the quality of care measurement agenda under PMJAY," he said.

( With inputs from ANI )