1Post-graduate Student, Department of Hospital Administration, M.S. Ramaiah University of Applied Sciences
2Assistant Professor, Department of Hospital Administration, Faculty of Management and Commerce, M.S. Ramaiah University of Applied Sciences
3Chief Hospital Administrator, Ramaiah Medical College Hospital, Bengaluru
Online published on 27 March, 2020.
This paper explores the importance of the Universal Concept of Health which is emerging globally, is achieved through implementation of different disciplinary perspectives for the long-term sustainability. It also represents the multi-dimensional concept of the Universal Health Coverage in terms of Population coverage, financial protection and accessibility to the quality of health care needs. As a health economic study, which explains the emanation of the Out-of-pocket expenditure, comprehensive medical services, minimum basic health package through implementation of shared fiscal systems for the effective function of the Universal Health Coverage. It also emphasizes on the implementation challenges regarding the hospital charges in empaneled private hospitals with the Arogya Karnataka (UHC) scheme package rates to the complex secondary and tertiary care treatments. A descriptive study was conducted to determine the average hospital charges for complex secondary and tertiary care treatments for the period of six months in a tertiary care hospital, where the secondary data is collected from the IT Billing Department. The Quantitative analysis is done by using the pie charts and pareto's diagram for the average total charges of hospitalization. The results showed the average total hospital charges for the complex secondary and tertiary care treatments are 32% and 54% where the Arogya Karnataka packages covered for the selective procedures respectively. The Comparative analysis of the subsumed existing schemes into one comprehensive Arogya Karnataka scheme showed that only Trans Urethral Resection Prostate (TURP) procedure has been revised and relatively increased when compared to selective procedures. Based on the result analysis, there is requirement of reformulating the health policy and regulations as the Out-of-pocket expenditure continues for more than 50%. In a long run, it's not viable for the hospital to accept the government insured patients without any revised package rates of Arogya Karnataka.
Universal Health Coverage, Arogya Karnataka, Complex Secondary and Tertiary care, Out-of-Pocket expenditure, Package rates
