Background: Launched in September 2018, the ABPMJAY is the world's largest publicly funded health insurance (PFHI) program with population coverage of 500 million. A systematic review was conducted. Methods: A comprehensive literature search was conducted in four databases: PubMed, Web of Science, Scopus, and Google Scholar. The literature search was conducted with the search terms: “Ayushman Bharat OR ABPMJAY OR modicare AND RSBY.” The search was set to title and Gray literature and government websites were also searched for relevant documents. A total of 881 documents were identified (PubMed: 53, Web of Science: 46, Scopus: 97, Google Scholar: 681, government websites: two, and gray literature: two). Fifty-two duplicates were identified. After the elimination of the duplicates, 829 unique documents were identified. These 829 unique citations were then subjected to a review of title and abstract independently by 2 reviewers. Six-hundred and ninety-two articles were rejected after review of title and One-hundred and thirty-seven articles were screened for full text independently by two reviewers. Sixty-six articles were rejected after review of the full text. Disagreements were resolved by discussion. Seventy-one unique articles were included in the final review. To attain the objective of the study, which is to critically analyze and provide an overview of Ayushman Bharat, a narrative synthesis was performed. Results: Seven themes were identified from the review: (1) health and wellness centers (HWCs); (2) out-of-pocket health expenditure (OOPHE); (3) fraud; (4) upcoding and provision of unnecessary medical care; (5) moving focus away from primary care; (6) coverage; and (7) lop-sided access, exclusion at the periphery, and brain drain. There is very little impact evidence of the ABPMJAY available. Conclusions: The government could plan impact evaluation studies in every state that the ABPMJAY is functional in. Any high-quality feedback generated might enable the National Health Authority, the government body leading and coordinating the ABPMJAY, to take necessary steps operationally and advice the government on strategy. Another concern is that the ABPMJAY PFHI might negatively impact the ongoing process of continuous strengthening and development of the government health-care system at all levels—primary, secondary, and tertiary. Continual recalibration and course corrections on the basis of high-quality feedback might enable ABPMJAY reduce catastrophic OOPHE for 500 million Indians. This is more than 6% of humanity: the largest block of people served by a single PFHI in history.

Introduction: Out-of-pocket expenditure (OOPE) constitutes a substantial portion of healthcare costs in India, accounting for 47.1% of the Total Health Expenditure in 2019–20. Despite a decline from previous years, OOPE remains a significant financial burden, contributing to catastrophic health expenditures and impoverishment for households.Methods: A systematic review was conducted to analyze factors influencing out-of-pocket expenditures (OOPE) in India. The review adhered to predefined inclusion and exclusion criteria. Search terms were tailored to the syntax of each database to maximize retrieval, using combinations of keywords such as “out of pocket,” “India,” and “national survey.” A total of 702 citations were retrieved (PubMed: 185, Web of Science: 183, Scopus: 334), with 316 identified as duplicates. After title and abstract screening of 386 citations, 128 articles were subjected to full-text review, leading to the inclusion of 36 studies. A narrative synthesis and thematic analysis identified determinants of OOPE in the Indian healthcare context, with findings organized in tables and descriptive formats to address study heterogeneity and enhance interpretation.Results: This systematic and rigorous methodology ensures a comprehensive and reliable understanding of the determinants of OOPE in the Indian healthcare context. Eleven themes emerged from the review: (1) source of care and disease/ condition, (2) place of residence, (3) economic status, (4) components of OOPE, (5) age, (6) gender, (7) strategies for coping with OOPE, (8) educational attainment, (9) OOPE and institutional deliveries, (11) health insurance.Discussion: India’s heavy reliance on OOPE emphasizes healthcare gaps, necessitating reforms in public investment, insurance, primary care, and affordable access to ensure equity and financial protection. The lack of equitable healthcare financing instigates the challenges, leading to widespread reliance on distress financing methods.

Out-of-pocket expenditure (OOPE) directly reflects households’ financial burden for healthcare. Despite efforts to enhance accessibility and affordability through government initiatives and insurance schemes, OOPE remains problematic, especially in rural areas with inadequate public healthcare infrastructure. This study examines factors influencing OOPE in Karnataka’s Dakshina Kannada, Udupi, and Shimoga districts, investigating socioeconomic characteristics, healthcare infrastructure, and accessibility to inform policies for equitable healthcare access and reduced household financial strain. Using purposive sampling, 61 semi-structured interviews were conducted in rural and urban South Karnataka, recorded in Kannada after obtaining consent, and thematically analyzed. Results revealed mixed perceptions of healthcare quality, cost, and accessibility between government and private hospitals. Government facilities were lauded for improved infrastructure and affordability, while private hospitals were preferred for quality and personalized care despite higher costs. Health insurance significantly impacted OOPE reduction. Participants emphasized the need for increased awareness of government insurance programs and improved quality in public hospitals. The study concludes that private hospitals are favored for superior care despite expenses, while government hospitals are valued for affordability. Expanding insurance coverage and improving public awareness are crucial for enhancing healthcare accessibility and affordability.

India faces multiple major challenges on the COVID-19 front. It is densely populated: 464 people/km2 compared with Italy’s 206, Spain’s 91, Iran’s 52 and the US

Background: The Ayushman Bharat Digital Mission (ABDM) aims to enhance healthcare delivery in India through digital integration. The ABDM, an essential part of India’s healthcare system, aspires to transform healthcare delivery through digitization, by emphasizing affordability, accessibility, and transparency. This qualitative study investigated the awareness, challenges, and perceptions of the ABDM among postgraduate students in coastal Karnataka, focusing on their experiences and interactions with digital health technologies. Methodology: A qualitative descriptive approach was employed, involving semi-structured interviews with 17 purposively selected participants from a health science university. The interviews were audio-recorded, transcribed, and analyzed using the NVivo 12 software for thematic analysis. Results: This study revealed that, while many students recognized the ABDM’s goal of establishing comprehensive digital health infrastructure to seamlessly integrate healthcare services and information systems, detailed knowledge about its functionalities, implementation processes, and challenges was limited. Participants highlighted the need for improved digital literacy and support to maximize the effective use of the ABDM. Conclusions: The successful implementation of the ABDM depends on overcoming major challenges such as poor awareness and concerns about data security. Addressing these issues will require focused educational campaigns, increased accessibility, and joint efforts by the government, healthcare providers, and technological partners.

Background. In todays world, Internet-based medical information plays a significant role in patient education. There are several accessible health-related websites. It has become common to search Internet before going for a medical consultation. The main objective of this study was to determine the prevalence of cyberchondriasis and its association with demographic variables. Methods. A cross-sectional study was carried out among metabolic syndrome patients attending the cardiology, endocrinology, and neurology outpatient departments of a tertiary care hospital in South India. The prevalence of cyberchondriasis and its constructs were measured using the cyberchondria severity scale (CSS). Inferential statistics revealed no statistically significant difference in the average CSS scores across sociodemographic variables. Spearman correlation was conducted to determine the relationship between the constructs. Results. A total of 379 participants with metabolic syndrome were included in the study. 42.5 of them were severely affected, and 28.0 were moderately affected by cyberchondriasis. Among the constructs studied, compulsion (85.7), distress (91.8), excessiveness (96.6), and reassurance (76.1) constructs had an impact on a greater number of study participants, compared to mistrust of medical professional construct (33.0). Cyberchondriasis had a significant relationship with the history of myocardial infarction (p value=0.03). There was a statistically significant positive linear relationship between mistrust and reassurance (r_s=0.169, p value<0.001). Reassurance had a significant negative linear relationship with distress (r_s=0.147, p value=0.004). Conclusion. In India, cyberchondriasis is a growing public mental health issue. Awareness among the general population is necessary to minimize the possible outcomes of cyberchondriasis like anxiety and depression. Screening individuals for possible risk factors is recommended.