Abstract- Poster

Abstract

Introduction:Government-funded tertiary care psychiatric hospitals (TCPH), if empanelled with the government of India launched Ayushman Bharat Health Insurance (ABHI) can charge up to INR 1500/- per day for providing inpatient (IP) care for persons with mental illnesses (PMI). Suvarna Arogya Karnataka Trust pays the National Institute of Mental Health and Neurosciences (NIMHANS) INR 750/- per day per PMI, for all PMI admitted under ABHI. A report “National strategy for inclusive and community-based living (NSICL) for persons with mental health issues 2019” reveals that 4869 PMI are admitted in 43 state-funded TCPH spread across 24 states of India for more than one year. Significant variation both in the number of PMI across the states and the duration of hospitalisation of PMI in each state is observed in this report.Objectives:To estimate the potential revenue loss for each state health department due to the non-availability of psychiatric beds occupied by persons admitted for prolonged periods i.e. beyond one year.Methods:In-depth analysis of the data in the report described under introduction with an assumption that each psychiatric bed, if allocated to a PMI under the government of India launched ABHI would fetch an amount of at least INR 750/-per day to the hospital.Results:We estimate that all these TCPH and therefore various state health departments could be potentially losing revenue of about a total of INR 36,51,750/- per day for offering free IP care for 4869 PMI. Maharastra has the highest 1358 persons with LOS beyond one year, and Nagaland has the lowest four persons. Our estimation indicates that the state of Maharastra could be losing a potential revenue of INR: 10,18,500 per day, west Bengal 7,28,250/-Tamil Nadu INR 4,59,000/-, Uttar Pradesh 240,000/-, Jharkhand 218,250/-, Punjab 174,750, Kerala 126,000/- Madhya Pradesh 154,500/-,Gujarat 111,750/- and many other states with a potential loss below one lakh per day.Conclusions:These estimates suggest that by continuing prolonged hospitalisation, health family welfare departments of various states could be potentially losing significant revenue. The amount spent by these departments for offering free IP care could be an additional economic burden to this potential revenue loss.Implications:Our projections on estimated revenue loss to the state could assist the appropriate state agencies to expedite the process of creating regulations and systems for facilitating early discharge of PMI from these state-funded TCPH.