SOCIOECONOMIC IMPACT OF DIALYSIS COSTS PRE- AND POST-AYUSHMAN BHARAT SCHEME

Background: Chronic Kidney Disease (CKD) imposes a significant socioeconomic burden on patients in India, where access to regular dialysis and healthcare financing remains limited. The introduction of Ayushman Bharat Scheme in 2018—India’s flagship health insurance scheme—aimed to reduce out-of-pocket expenses and improve access to secondary and tertiary care, including dialysis, for economically vulnerable populations.

Objective: This study examines the socioeconomic impact of dialysis treatment before and after the implementation of Ayushman Bharat Scheme, with a focus on scheme utilisation, access to scheme related resources and its effect on reduced out-of-pocket expenditure.

Methods: Primary data was collected through conversational interviews with patients undergoing haemodialysis at three branches of a standalone private dialysis center. Key themes explored included healthcare access, cost burden, scheme navigation, and the role of institutional support.

Results: The study surveyed 66 dialysis patients aged 17 to 75 years, with 68.2% being male and 31.8% being female.  Frequency of dialysis sessions varied with 48.5% of patients receiving dialysis thrice a week, and 51.5% receiving it twice weekly. On an average patients’ monthly expenditure pre Ayushman Bharat Scheme was INR 45,939. However, post the enrollment in the Ayushman Bharat Scheme the average monthly expenditure dropped down to INR 14,310. This led to the average monthly saving of INR 31,628, which is a 67.9% decrease in expenses. A total of 35 patients said that without the scheme they would not have been able to afford the treatment. While 28 patients reported that they would have faced difficulty in finances while paying.

Conclusion: While the Ayushman Bharat Scheme has improved affordability and access to dialysis, further efforts are needed to address the indirect economic burden, streamline processes, and expand decentralized dialysis care in India. These improvements are essential to utilise the scheme’s full potential and achieve equitable, universal health coverage.