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Funding Pattern Comparison Pre- and Post-Ayushman Bharat National Health Scheme (AB-PMJAY) in Active Females Undergoing TKA for Advanced Knee Arthritis with Clinical, QoL Analysis and AB-PMJAY Technical Data

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Abstract

Introduction

Patients visiting for Knee Arthroplasty have often been treated at neighborhood clinics and bonesetters. India floated world’s largest publicly funded national health insurance program -AB-PMJAY covering Knee Arthroplasty. AB-PMJAY’s data for Arthroplasty has not been published.

Methods

A Prospective study from Jan 2016- Jan 2023 on females undergoing TKA. Age, DEXA Score, Walking Ability, KSS, 10MWT, SF36 Scores, Funding Pattern before and after AB-PMJAY, Time to Approval, Time to discharge, Time to Query reply and Rejection Rates were documented.

Results

790 patients (91.86%) received treatment previously. 650 (78.54%) patients lived with family & 32 patients lost to follow-up. 37.67% & 62.32% patients had Grade. 3 & 4 osteoarthritis respectively. Commonest comorbidity was Vitamin D deficiency followed by Menopause and Hypertension. Post-treatment Vitamin D deficiency reduced from 68.59% to 2.17% at 3 months. Post-surgery, Functional Scores improved significantly at 1st and 6th month. VAS dropped significantly from 7.8 to 3.6 at 1st month follow up. At 6 months, 81.52% patients were independent outdoor walkers compared to 9.42% (baseline). Average hospital stay-54 hours and Return to work- 42 days. Central health scheme beneficiaries rose significantly from 12% (pre-PMJAY) to 42% (post-PMJAY). With AB-PMJAY, no rejection for surgical procedures, Time to surgery approval was 16 hours (mean) and Time to Discharge was 8 hours (mean). Time to reply was 6 hours (mean).

Conclusion

Evident rise in patients getting TKA done through AB-PMJAY. TKA has become an affordable and achievable target for financially deprived patients, post regulation of knee implant prices & AB-PMJAY.

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Funding

This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Orthopedics, Santosh Medical College and Hospital, Ghaziabad, Uttar Pradesh, India

    Nishit Palo

  2. Department of Orthopaedics, Kaling Institute of Medical Sciences, Bhubaneswar, Odisha, India

    Paresh Chandra Dey

  3. Department of Anaesthesiology & Critical Care, Santosh Medical College and Hospital, Ghaziabad, Uttar Pradesh, India

    Mahima Lakhanpal

  4. Department of Orthopedics, Holy Family Hospital, Delhi, India

    Abhishek Shukla

  5. Santosh Medical College & Hospital, Ghaziabad, India

    Govind Narayan Choudhary, Aditya Singh & G. Rakesh Kumar

  6. Department of Pharmacology, SHKM Government Medical College, Nuh, Haryana, India

    Chhavi Malik

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  1. Nishit Palo
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Correspondence to Nishit Palo.

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The authors have no financial or other conflict of interest to declare and no financial or other relationships leading to conflict of interest.

Institution of Work

The work was done at AMRI and KIDS Hospital, Bhubaneswar, Odisha and Manas Hospital, Santosh Medical College and Hospital, Ghaziabad, India. Patients hailed from urban and rural parts of Odisha and Uttar Pradesh, India. Ethical committee Clearance was obtained via letter no. AM-16.34, KDH:2016/2/45 and MAH-18.22/42.

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Palo, N., Dey, P.C., Lakhanpal, M. et al. Funding Pattern Comparison Pre- and Post-Ayushman Bharat National Health Scheme (AB-PMJAY) in Active Females Undergoing TKA for Advanced Knee Arthritis with Clinical, QoL Analysis and AB-PMJAY Technical Data. JOIO 58, 550–557 (2024). https://doi.org/10.1007/s43465-024-01136-0

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