Representational image of patients at a hospital
Representational image of patients at a hospital | Photo: Suraj Singh Bisht | ThePrint
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New Delhi: Patients who want to move out of their states in search of better healthcare facilities have made Gujarat their most preferred destination under the Narendra Modi government’s flagship insurance scheme Ayushman Bharat or Pradhan Mantri Jan Arogya Yojana (PM-JAY).

According to the National Health Authority (NHA) — the agency implementing the scheme — Gujarat has treated more than 15,000 patients in the last one year under the ‘portability’ option, which allows patients to go to the best hospital in any state to avail of free treatment. One-fourth of portability patients have availed treatment in Gujarat, spending a sum of around Rs 50 crore.

“Portability is an important feature of the scheme that has been built into the design of the scheme to focus on two issues — migrants, and the lack of quality tertiary-level services in some states,” Indu Bhushan, CEO of Ayushman Bharat, told ThePrint.

“When migrant people get sick, they do not have to go back to their home states to seek treatment. In addition, in many under-served states, portability has come a boon since people can choose to go anywhere in the country to seek treatment. We see a large number of treatments being given in Gujarat, Delhi and Mumbai, which have good tertiary care facilities,” he said.

A majority of patients have chosen Gujarat for cancer treatment, including radiation oncology and medical oncology. Those going in for cardio-thoracic surgery — procedures involving organs in the chest, like the heart, lungs, oesophagus — and vascular surgery — procedures involving arteries, veins and lymphatic circulation — have also been going to Gujarat.


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Why is Gujarat so popular?  

According to the NHA, Gujarat has been at the forefront of establishing and maintaining good health infrastructure. There are 2,917 hospitals empanelled under the scheme, with more than 80,000 beds.

So far, with 10,161 patients, Madhya Pradesh tops the list of states whose residents have gone to Gujarat for treatment. Neighbouring union territories Daman and Diu and Dadra and Nagar Haveli have sent 1,918 and 1,568 patients respectively, followed by Uttar Pradesh (627), Maharashtra (440) and Bihar (287).

“Data shows maximum cases of portability have taken treatment in Vadodara and Surat, which have high migratory population from Madhya Pradesh, Uttar Pradesh, and Bihar,” the NHA said in a statement.

“Most of the patients from Madhya Pradesh travel to Vadodara or Dahod for treatment. UTs like Daman and Diu and Dadra and Nagar Haveli do not have adequate health infrastructure and travel to Surat, Valsad and Vapi for treatment,” it said.


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Institutions like AIIMS, Safdarjung are 2nd choice 

After Gujarat, the second top portability destination is a cluster of national healthcare providers (NHCPs), meaning premier medical institutes in India across states. NHCPs have treated more than 10,400 patients under the scheme.

Ayushman Bharat portability
Graphic: Arindam Mukherjee | ThePrint

The list of NHCPs includes the All India Institutes of Medical Sciences (AIIMS), hospitals under the railway ministry, Employees’ State Insurance Corporation (ESIC) hospitals, as well as top government hospitals in New Delhi, including Safdarjung Hospital, Ram Manohar Lohia Hospital and Lady Hardinge Medical College.

NHCPs also include private hospitals such as Delhi’s Sir Ganga Ram Hospital, which have been empanelled directly under Ayushman Bharat despite Delhi not being a subscriber to the scheme.

Uttar Pradesh, Maharashtra and Uttarakhand are next on the list of destinations for incoming patients.

MP tops outgoing patients’ list

Madhya Pradesh tops the list of states with the most outgoing patients — 15,000 people have opted for healthcare in other states, either because they are migrant workers there or went in search of better healthcare facilities. Uttar Pradesh is second on this list, and its presence in the top five of both incoming and outgoing patients is a pointer to the sheer number of migrant workers it sends to other states.

Bihar, Jharkhand and Haryana round out the top five states for outgoing patients.

According to the NITI Aayog’s second annual health index released in June, UP and Bihar are the worst performing states in healthcare, while Haryana and Jharkhand have posted incremental improvements.


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Top treatment categories for portability

The top selling treatment packages are cardio-thoracic surgery and vascular surgery. Cardiology, which includes bypass surgery and angioplasty, is second.

Cardiovascular diseases are the top reasons for deaths in India, where one in every eight persons suffers from high blood pressure.

Radio oncology, neurosurgery and orthopaedics are the other treatments for which patients go to other states.


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