Impact of Ayushman Bharat (PM-JAY) on access to spine surgery at a tertiary care centre in North India: A retrospective analysis

Q2 Medicine

Journal of Clinical Orthopaedics and Trauma Pub Date : 2026-02-01 Epub Date: 2026-01-18 DOI:10.1016/j.jcot.2026.103352

Vishal Kumar , Tharun Teja Aduri , Aditya Gupta , Sarvdeep Singh Dhatt

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Abstract

Background

Access to complex, resource-intensive procedures such as spine surgery is often limited for economically disadvantaged populations due to high out-of-pocket expenditure. The Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY) was launched to mitigate these costs, yet data on its specific impact on spine surgery remains limited. This study aims to analyse the impact of PM-JAY on access to spine surgery at a tertiary care centre in North India.

Methods

A retrospective, single-centre observational study was conducted analysing all spine surgeries performed from January 2023 to December 2024. Data regarding patient demographics, clinical diagnosis, surgical procedure, and mode of financing were extracted from institutional records. Financing modes were categorised as PM-JAY, self-paid, and other government schemes. Comparative analysis of financing patterns across the study years was performed using the chi-square test.

Results

A total of 410 patients underwent spine surgery during the study period (mean age 49.3 ± 4.1 years). Degenerative spinal disorders (46.1 %) and traumatic injuries (33.4 %) constituted the majority of cases. Overall, 276 procedures (67.3 %) were funded under PM-JAY, while 110 (26.8 %) were self-financed. A significant temporal shift was observed: PM-JAY utilisation increased from 58.7 % (101/172) in 2023 to 73.5 % (175/238) in 2024. Correspondingly, self-financed procedures declined from 37.8 % in 2023 to 18.9 % in 2024 (p < 0.001).

Conclusion

This study demonstrates a substantial and statistically significant increase in the utilisation of PM-JAY for spine surgery, with a concurrent decline in self-financed procedures. The findings suggest that publicly funded insurance is effectively improving financial access to implant-intensive spine care across a broad spectrum of pathologies. However, robust clinical governance remains essential to ensure equitable implementation and prevent overutilisation.

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阿尤什曼巴拉特（PM-JAY）对印度北部三级护理中心脊柱手术的影响：回顾性分析

由于高额的自付费用，经济上处于不利地位的人群往往无法获得复杂的、资源密集型的手术，如脊柱手术。为了降低这些成本，印度政府推出了《印度脊骨外科计划》（PM-JAY），但关于该计划对脊柱外科手术具体影响的数据仍然有限。本研究旨在分析PM-JAY对印度北部三级护理中心脊柱手术的影响。方法对2023年1月至2024年12月进行的所有脊柱手术进行回顾性、单中心观察性研究。从机构记录中提取有关患者人口统计、临床诊断、手术程序和融资模式的数据。融资模式分为PM-JAY、自付和其他政府计划。采用卡方检验对各研究年份的融资模式进行比较分析。结果研究期间共410例患者接受脊柱手术，平均年龄49.3±4.1岁。退行性脊柱疾病（46.1%）和外伤性损伤（33.4%）占多数。总体而言，276例手术（67.3%）由PM-JAY资助，110例（26.8%）由自筹资金。观察到显著的时间变化：PM-JAY利用率从2023年的58.7%（101/172）增加到2024年的73.5%（175/238）。相应的，自费手术从2023年的37.8%下降到2024年的18.9% （p < 0.001）。结论：本研究表明，PM-JAY在脊柱外科手术中的使用率显著增加，同时自费手术的使用率下降。研究结果表明，公共资助的保险有效地改善了广泛病理范围内的植入密集型脊柱护理的经济渠道。然而，强有力的临床治理对于确保公平实施和防止过度使用仍然至关重要。

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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来源期刊

Journal of Clinical Orthopaedics and Trauma Medicine-Orthopedics and Sports Medicine

CiteScore

4.30

自引率

0.00%

发文量

181

审稿时长

92 days

期刊介绍： Journal of Clinical Orthopaedics and Trauma (JCOT) aims to provide its readers with the latest clinical and basic research, and informed opinions that shape today''s orthopedic practice, thereby providing an opportunity to practice evidence-based medicine. With contributions from leading clinicians and researchers around the world, we aim to be the premier journal providing an international perspective advancing knowledge of the musculoskeletal system. JCOT publishes content of value to both general orthopedic practitioners and specialists on all aspects of musculoskeletal research, diagnoses, and treatment. We accept following types of articles: • Original articles focusing on current clinical issues. • Review articles with learning value for professionals as well as students. • Research articles providing the latest in basic biological or engineering research on musculoskeletal diseases. • Regular columns by experts discussing issues affecting the field of orthopedics. • "Symposia" devoted to a single topic offering the general reader an overview of a field, but providing the specialist current in-depth information. • Video of any orthopedic surgery which is innovative and adds to present concepts. • Articles emphasizing or demonstrating a new clinical sign in the art of patient examination is also considered for publication. Contributions from anywhere in the world are welcome and considered on their merits.