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A unique model of Universal Health Cover in India is proposed for funding by government and service delivery by private generalist doctors This model contrasts with the current government schemes of funding only in-patient services by the private sector and ignoring primary health care as an overall cost-reduction strategy The current government schemes rely on public facilities to deliver out-patient services, even while 70% of such services are availed from private practitioners The proposed model would have been highly effective in the current Covid-19 crisis and will enable a much more robust response to future pandemics and other disasters Local Area Health Networks (LAN) are proposed, based on residential pin codes, comprising of private generalists, public facilities, and diagnostic centers The beneficiaries of the model would be able to obtain services from within the Local Area Health Networks and refer to designated hospitals only for in-patient services Virtual Local Area Health Networks (VLAN) are areas without the health services and these areas van be attached to LAN Legislative assemblies define the boundaries of Wide Area Health Networks (WLAN) that link up LAN and VLAN for integrated professional management of healthcare A group of LANs can lead to a tertiary care provider to create Systems Area Health Networks (SAN) for super-specialties Payments are proposed to be made on a Prospective Payment System based on Diagnosis Related Groups and accounting for geographical variations, with incentives for clinical quality The cost of the proposed model for 100% Universal Health Cover is estimated to be about Rs 11,369 crores for out-patient services and Rs 28,896 crores for in-patient services The estimates are based on a detailed analysis of data from the 75th Round of NSS Report and case-mix costing has been applied
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Journal_of_the_Indian_Medical_Association
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Proposal for an affordable and sustainable universal health cover model for india: LAN, WAN and SAN
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