Arogya Karnataka scheme lacks easy way to identify hospitals

Bengaluru: Thousands of hospitals are enrolled in the Ayushman Bharat-Arogya Karnataka (ABARK) scheme, providing essential services. However, the absence of an efficient system to identify the network of hospitals by the state government has led to difficulties for patients and their families during emergencies.

Several private insurance companies have developed mobile apps and websites to facilitate the identification of registered hospitals, making it easier to locate the nearest hospital in urgent situations. Unfortunately, the state government has not implemented such a system, leaving beneficiaries struggling to identify the nearest hospital even with a card under the ABARK scheme. This has led to patients wandering from one hospital to another to access services in times of emergencies.

Initially, a list of registered hospitals was available on the ‘Arogya Karnataka’ website when the project began. The Suvarna Arogya Suraksha Trust, managing the scheme, also provided a list of hospitals on its website, but both are currently non-functional. Hospitals under the scheme now need to be searched through the central government’s PMJAY (Pradhan Mantri Jan Arogya Yojana) website and app, which users find unsatisfactory.

The ‘Ayushman Bharat-Arogya Karnataka’ scheme, initiated in 2018, offers health insurance of up to ₹5 lakh per annum for BPL (Below Poverty Line) families. While 62.09 lakh families in the state fall under the ‘Ayushman Bharat’ scheme, the remaining are covered by the ‘Aarogya Karnataka’ scheme, with a maximum of ₹1.50 lakh for family members, covering 30% of medical expenses.

Beneficiaries are required to visit government hospitals first to avail of the scheme. If services are unavailable there, they can go to the recommended private hospital for treatment. Although there is provision for direct admission to private hospitals in emergencies, the lack of a proper hospital identification system hampers individuals from benefiting from the scheme.

There is a pressing need for the government to develop a robust system to identify nearby hospitals registered under the scheme, especially in emergencies. With advancements in technology, some insurance companies have implemented GPS technology to easily locate the nearest hospital. However, the government seems to prioritize measures like card distribution without addressing this critical issue, according to a retired department officer who preferred to remain anonymous.

Emergencies such as heart attacks and road accidents demand immediate attention. While over 3,000 hospitals are registered under the Ayushman Bharat-Arogya Karnataka scheme, the majority are government hospitals. Private hospitals, discouraged by non-revised treatment package rates, are reluctant to participate, limiting options for emergency treatment under the scheme.

As per health department data, around 96 thousand people succumb to sudden heart attacks in the state annually. Additionally, the incidence of road accident injuries is on the rise, with an average of 13,000 deaths reported annually due to road accidents and 4 lakh serious injury cases recorded, according to the State Crime Records Bureau. The lack of a streamlined hospital identification process is a critical issue that needs urgent attention to ensure the success of emergency healthcare initiatives.

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