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290 Economic Survey 2020-21 Volume 1

that cost in this range. The distribution is heavily right tailed indicating relatively fewer
claims for more expensive procedures. The high number of claims for low cost procedures
could be indicative of people utilizing PM-JAY as a delivery channel for primary healthcare
services.

9.12 Figure 2 details the share of overall PM-JAY claims by the nature of clinical specialty over
July-September 2018 to october-December 2019.

Figure 2: Share of claims by clinical specialty

Source: NHA data secured from PMJAY

9.13 General medicine has been the overwhelmingly major clinical specialty used since 2018
with its share continuously growing. It is followed by general surgery and obstetrics and
gynaecology. These three categories combined made up close to 56 per cent of claims received
in october-December 2019. An important caveat to note here is that Dialysis itself comprises
a large chunk (30 per cent) of the ‘general medicine’ category claims under PM-JAY. This is
despite the fact that the Pradhan Mantri National dialysis Programme, which was rolled out
in 2016, also provides free dialysis to kidney patients in district hospitals. According to data
from the National Health Ministry, every year, about 2.2 lakh new patients with end stage renal
disease get added in India, resulting in additional demand for 3.4 crore dialysis every year
(Ghosh 2016). These facts corroborate India’s growing burden of non-communicable diseases
in the form of hypertension and kidney disease.

Box 1: Specialties, Packages and Procedures in PM-JAY

Specialty Packages Procedures

Burns Management 6 20
Cardiology 20 26
Cardio-thoracic & Vascular surgery 34 113

Emergency Room Packages 3 4