Implementation challenges of government-funded health schemes for cancer treatment at Tata Memorial Centre

IF 2 Q3 HEALTH POLICY & SERVICES

Journal of Cancer Policy Pub Date : 2025-02-22 DOI:10.1016/j.jcpo.2025.100564

Suvarna Gore , Sharyu Mhamane , Sunita Jadhav , Narpat Padvi , Amruta Mhatre , Prachi Joshi , Sandeep Sawakare , Vinit Samant , Pankaj Chaturvedi , C.S. Pramesh , Sudeep Gupta , Atul Budukh

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Abstract

Background

The study aims to understand the Ayushman Bharat- Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) and Mahatma Jyotirao Phule Jan Arogya Yojana (MJPJAY)health scheme awareness, challenges faced by the scheme beneficiaries, facilitators and out-of-pocket expenditure (OOPE) for cancer treatment at Tata Memorial Hospital, Mumbai.

Methods

We conducted an observational cross-sectional study approved by the Tata Memorial Centre Ethics Committee. We collected data by interviewing participants through a structured questionnaire.

Results

Out of 515 participants, 489 (95 %) were beneficiaries (patients/caregivers) of the schemes, 15 (2.9 %) MJPJAY staff, 6 (1.1 %) medical social workers (MSW), and 5 (1.0 %) AB PM-JAY staff. Of the 489 beneficiaries, only 162 (33.1 %) were aware of the scheme. Most patients were satisfied with the benefits of the scheme; of the 83 (17 %) who were dissatisfied, 30 (36 %) cited incomplete coverage at a 95 % Confidence Interval (CI) [0.26–0.46] and 19 (23 %) 95 % CI [0.14–0.32] cited OOPE as the reason for dissatisfaction. Participants opined a need to increase package coverage of cancer treatment and essential investigations. The beneficiaries highlighted delays in the approval process and technical issues of the scheme as potential areas of improvement.

Conclusion

Government health schemes are effective in improving treatment completion without impoverishment and have the potential to improve treatment outcomes and cancer survival. Study results indicate the need to increase awareness about these schemes in the general population, improving the health benefit packages for cancer treatment, with inclusion investigations, supportive care, nutritional care, palliative care, immunotherapy, chemotherapy drugs, targeted therapy, bone marrow transplantation, and hormonal therapy.

Policy summary

Government-funded health schemes are effective in reducing impoverishment related to healthcare costs and promoting Universal Health Coverage. However, periodic review of the breadth of coverage as well as feasibility of completing treatment using these packages is necessary to eliminate out-of-pocket expenditure and facilitate treatment completion.

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在塔塔纪念中心实施政府资助的癌症治疗保健计划所面临的挑战

本研究旨在了解Ayushman Bharat- Pradhan Mantri Jan Arogya Yojana （AB PM-JAY）和Mahatma Jyotirao Phule Jan Arogya Yojana （MJPJAY）健康计划的意识，计划受益人面临的挑战，促进者和自付费用（OOPE）在孟买塔塔纪念医院进行癌症治疗。方法我们进行了一项经塔塔纪念中心伦理委员会批准的观察性横断面研究。我们通过结构化问卷采访参与者来收集数据。结果515名参与者中，489名（95% %）是计划的受益人（患者/照顾者），MJPJAY工作人员15名（2.9 %），医务社会工作者（MSW） 6名（1.1 %），AB PM-JAY工作人员5名（1.0 %）。在489名受益人中，只有162人（33.1% %）知道该计划。大多数患者对该方案的效益感到满意；在83名（17 %）不满意的人中，30名（36 %）以95% %的置信区间（CI）[0.26-0.46]引用不完全覆盖，19名（23 %）95 % CI[0.14-0.32]引用OOPE作为不满意的原因。与会者认为有必要增加癌症治疗和基本调查的一揽子覆盖范围。受益者强调指出，核准程序的延误和该计划的技术问题是可能改进的领域。结论政府卫生计划可有效提高患者的治疗完成度，并有可能改善治疗效果和癌症生存率。研究结果表明，需要提高一般人群对这些方案的认识，改善癌症治疗的健康福利方案，包括调查、支持性护理、营养护理、姑息治疗、免疫治疗、化疗药物、靶向治疗、骨髓移植和激素治疗。政策摘要政府资助的保健计划在减少与保健费用有关的贫困和促进全民健康覆盖方面是有效的。然而，有必要定期审查覆盖范围的广度以及使用这些一揽子方案完成治疗的可行性，以消除自付费用并促进治疗的完成。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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