Ayushman Bharat: Service Adoption Challenges in Universal Healthcare System

2021 ◽  
Vol 10 (1) ◽  
pp. 35-49
Author(s):  
Neeraj Pandey ◽  
Sumi Jha ◽  
Vaibhav Rai
Keyword(s):  
Healthcare System ◽  
Service Adoption ◽  
Utaut Model ◽  
Adoption Theory ◽  
Universal Healthcare ◽  
Healthcare Program ◽  
Research Questions ◽  
Facilitating Conditions ◽  
Universal Healthcare System

The Ayushman Bharat, the universal healthcare scheme in India, faced service adoption challenges after its launch in 2018. It was an enigma for the top management in Ayushman Bharat regarding slower service adoption of a free mass healthcare coverage scheme by the target population. The case focuses on the service adoption challenges from patient and physician perspectives while implementing a universal healthcare system. It provides insights to policymakers, physicians, service operations managers, and healthcare administrators regarding managing the universal healthcare system’s implementation challenges in a developing country context. Research questions/Objective: This study aims to understand service adoption challenges in a universal healthcare system setting. The study explores the following research questions: How is service adoption theory applied in a universal health coverage program? What should be the integrated marketing communication plan to improve the awareness about a universal healthcare program? Links to theory: The study uses service adoption theory. It analyzes service adoption challenges for the universal healthcare system in India called Ayushman Bharat. It also uses literature on the Unified Theory of Acceptance and Use of Technology (UTAUT) model. Phenomenon studied: The case study uses pan India patient and physician data to explore service adoption issues in Ayushman Bharat - a universal healthcare scheme in India. Case context: The primary data collected through the field (hospital) visits and interaction with patients and physicians of Ayushman Bharat form the basis of this case study. Findings: The study emphasizes on performance expectancy, ease in availing of the service, positive social influence, and facilitating conditions for service delivery of Ayushman Bharat. The Ayushman Bharat scheme’s performance expectancy means how being a healthy individual would contribute to better performance at the workplace. The effort expectancy is the level of ease an eligible Ayushman Bharat scheme can avail the service at the empanelled hospital. The social acceptance of the Ayushman Bharat scheme by friends, peers, and people in the vicinity would create a positive social influence. The facilitating conditions in the Ayushman Bharat scheme are the government’s capacity to provide organizational and technological infrastructure to support this universal healthcare program. Discussions: The use of service adoption theory and the UTAUT model to enhance the adoption of the universal healthcare system in India have been discussed in the case study.

scholarly journals Molecular Sovereignty: Building a Blood Screening Test for the Brazilian Nation

2021 ◽  
Vol 8 (2) ◽  
pp. 1-25
Author(s):  
Koichi Kameda
Keyword(s):  
Healthcare System ◽  
Transition To Democracy ◽  
Universal Healthcare ◽  
National Imaginary ◽  
Constitutional Right ◽  
National Boundaries ◽  
Acid Test ◽  
Diagnostic Technologies ◽  
Universal Healthcare System ◽  
Blood Screening

This article interrogates the relationship between the development of national diagnostic technologies and the exercise of sovereignty, by analysing a Brazilian project to produce a nucleic acid test (NAT) for the country’s blood screening programme. The concept of ‘molecular sovereignty’ is proposed to demonstrate that exercising sovereignty demands not only technological resources but also a sufficiently powerful and national imaginary to support local knowledge production as a means of advancing national healthcare priorities. First, this research article contextualises the political importance of blood safety for Brazil during its transition to democracy in the 1980s and the creation of its universal healthcare system. Then, it investigates how adopting the NAT led the state to invest in the production of a national technology. Third, the article unpacks the diagnostic test to consider how certain aspects of the project might ultimately strengthen the ability of global capital to cross national boundaries and create new markets. Lastly, it discusses how the project ended up creating a centralised and ‘closed’ system to avoid leaving the country vulnerable to the entry of global diagnostic companies. This case demonstrates how the molecularisation of blood, through the construction of a unified healthcare system driven by the constitutional right to health, can be deployed to construct imagined communities on the scale of a nation.

Evaluation of disparity in care for perforated appendicitis in a universal healthcare system

2019 ◽  
Vol 36 (2) ◽  
pp. 219-225 ◽  
Author(s):  
Laura M. Fluke ◽  
Christian S. McEvoy ◽  
Anne H. Peruski ◽  
Christina A. Shibley ◽  
Brian T. Adams ◽  
...  
Keyword(s):  
Healthcare System ◽  
Perforated Appendicitis ◽  
Universal Healthcare ◽  
Universal Healthcare System

scholarly journals Inequalities in heart failure care in a tax‐financed universal healthcare system: a nationwide population‐based cohort study

2020 ◽  
Vol 7 (5) ◽  
pp. 3095-3108
Author(s):  
Inge Schjødt ◽  
Søren P. Johnsen ◽  
Anna Strömberg ◽  
Jan B. Valentin ◽  
Brian B. Løgstrup
Keyword(s):  
Heart Failure ◽  
Cohort Study ◽  
Healthcare System ◽  
Population Based ◽  
Heart Failure Care ◽  
Universal Healthcare ◽  
System A ◽  
Universal Healthcare System

scholarly journals Obstetrical brachial plexus injury: burden in a publicly funded, universal healthcare system

2016 ◽  
Vol 17 (2) ◽  
pp. 222-229 ◽  
Author(s):  
Christopher J. Coroneos ◽  
Sophocles H. Voineskos ◽  
Marie K. Coroneos ◽  
Noor Alolabi ◽  
Serge R. Goekjian ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clinical Practice ◽  
Brachial Plexus ◽  
Healthcare System ◽  
Quality Indicators ◽  
Brachial Plexus Injury ◽  
Shoulder Dystocia ◽  
Publicly Funded ◽  
Universal Healthcare ◽  
Universal Healthcare System

OBJECT The aim of this study was to determine the volume and timing of referrals for obstetrical brachial plexus injury (OBPI) to multidisciplinary centers in a national demographic sample. Secondarily, we aimed to measure the incidence and risk factors for OBPI in the sample. The burden of OBPI has not been investigated in a publicly funded system, and the timing and volume of referrals to multidisciplinary centers are unknown. The incidence and risk factors for OBPI have not been established in Canada. METHODS This is a retrospective cohort study. The authors used a demographic sample of all infants born in Canada, capturing all children born in a publicly funded, universal healthcare system. OBPI diagnoses and corresponding risk factors from 2004 to 2012 were identified and correlated with referrals to Canada’s 10 multidisciplinary OBPI centers. Quality indicators were approved by the Canadian OBPI Working Group’s guideline consensus group. The primary outcome was the timing of initial assessment at a multidisciplinary center, “good” if assessed by the time the patient was 1 month of age, “satisfactory” if by 3 months of age, and “poor” if thereafter. Joinpoint regression analysis was used to determine the OBPI incidence over the study period. Odds ratios were calculated to determine the strength of association for risk factors. RESULTS OBPI incidence was 1.24 per 1000 live births, and was consistent from 2004 to 2012. Potential biases underestimate the level of injury identification. The factors associated with a very strong risk for OBPI were humerus fracture, shoulder dystocia, and clavicle fracture. The majority (55%–60%) of OBPI patients identified at birth were not referred. Among those who were referred, the timing of assessment was “good” in 28%, “satisfactory” in 66%, and “poor” in 34%. CONCLUSIONS Shoulder dystocia was the strongest modifiable risk factor for OBPI. Most children with OBPI were not referred to multidisciplinary care. Of those who were referred, 72% were assessed later than the target quality indicator of 1 month that was established by the national guideline consensus group. A referral gap has been identified using quality indicators at clinically relevant time points; this gap should be addressed with the use of knowledge tools (e.g., a clinical practice guideline) to target variations in referral rates and clinical practice. Interventions should guide the referral process.

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