Many takers for Delhi government’s free medical testing scheme, number doubles in 5 years

The Delhi government’s scheme to provide high-end X-ray and other tests free of charge at private centers has grown in popularity, with the number of people receiving the benefits doubling in the past five years. There were 1.04 lakh people who underwent tests such as MRIs and PET scans under the program in 2021, according to data shared by the Delhi government in response to an RTI request filed by The Indian Express. .

This is an increase from just over 56,700 people benefiting from the scheme in 2020 and over 78,800 in 2019 before the pandemic. No less than 61,638 people benefited from it in 2018. More than 52,000 people had benefited from it in 2017 even when it was launched, according to the data. The government has set up 23 private diagnostic centers across the city where patients can get 13 specialized tests for free.

“There are mainly two reasons for the increase. First, there is increased awareness of the program. More and more patients who come to the hospital know about the program and ask to be referred when they need a CT scan. Secondly, we have seen an increase in the number of patients visiting public hospitals in Delhi since the government ensured that all services are available free of charge.

Patients who would have gone to say Safdarjung or RML Hospital come to us because they know they can get even expensive scans for free,” said a senior administrator at Lok Nayak, Delhi’s largest government hospital. Newly opened hospitals, like the one in Burari, depend on the system for all radiological diagnostics as they have yet to set up the systems themselves.

The government has spent Rs 15.9 crore on the program in 2021, averaging around Rs 1,529 per patient. When the program was launched in 2017, it spent Rs 11.07 crore, averaging about Rs 2,123 per patient, according to RTI data.

Low refunds offered and long waiting times could hamper further expansion of the scheme.

“The government reimburses these tests at CGHS rates which are very low and have not been reviewed for years. With these programs covering more people, hospitals and testing centers are understandably reluctant to take on these patients. Most of the centers have a fixed day for those who come under the Delhi Arogya Kosh (DAK) scheme as they need payment from other patients to keep the centers afloat. This can lead to longer waiting times for DAK patients,” said the owner of a lab that is part of the program, speaking on condition of anonymity.

Information and referral to the program is also not as readily available in hospitals. The brother-in-law of a woman undergoing treatment to prevent miscarriage at Lok Nayak Hospital said, “She needs a CT scan every month which costs around Rs 5,000 to Rs 6,000; At the beginning, we were not even aware of the government program. Then another patient here told us about it, but we were tired of going from one official to another to put the paperwork in place. So we decided to get it only from outside centers.

As for the program to provide free surgeries and procedures at 56 private facilities, the number of beneficiaries increased in 2021 from the previous year, but has yet to reach pre-pandemic levels. In 2021, 2,150 people received free surgeries under the program, compared to 1,459 in 2020. Before the pandemic, 2,248 people had taken advantage of the benefits of the program in 2019 and 2,263 in 2018. There were 1,508 beneficiaries of the program in 2017 when it was launched. The scheme initially only covered 52 procedures, which was later increased to 1,000 in 2019.

The program is largely driven by secondary care hospitals in Delhi, according to hospital administrators.

“We are a teaching hospital, so we prefer to do as many surgeries as possible within the hospital itself. In fact, we only refer a handful of cases each month. These are usually common surgeries with a long waiting time; we want our students to learn from all the complicated cases. It is the small hospitals that refer patients to the surgery program,” said hospital administrator Lok Nayak.

A doctor at Guru Teg Bahadur Hospital agreed: “There was an increase in waiting in some departments last year when services were interrupted for Covid-19, but now we are hardly referring any cases in the framework of the program. We want our students to perform as many surgeries as possible.

The administrator and doctor at both hospitals said there were fewer beneficiaries in 2020 because the lockdown and suspension of all routine services for months meant that hardly any patients were going to the hospitals to get the references.

The government has spent Rs 5.77 crore on the free surgery scheme in 2021, averaging Rs 26,841 per patient. When the program started in 2017, the government spent Rs 3.3 crore, or an average of Rs 22,154 per patient.

Surprisingly, the government’s Farishtey program for the treatment of victims of accidents, fires and acid attacks saw an increase in the number of beneficiaries in 2020, when the lockdown led to fewer road accidents.

There were 6,131 beneficiaries of the scheme in 2020, which fell to 5,456 in 2021. When the scheme started in 2018, there were only 1,540 beneficiaries, according to data from RTI.

Even though the number of beneficiaries has increased under the plan, the cost per patient has dropped significantly, the data shows. The cost per patient stood at Rs 17,811 in 2018, which fell to Rs 21,264 in 2019. It fell to Rs 15,454 in 2020 and Rs 10,915 in 2021.
The scheme requires all hospitals in Delhi to provide emergency treatment – ​​including surgeries and skin grafts – to traffic, fire and acid attack victims, with the Delhi government bearing the cost . This program was set up to encourage private hospitals to refer patients who are unknown or without medical coverage to public hospitals which could be further away.

The owner of a Delhi nursing home, speaking on condition of anonymity, said: ‘Due to the low prices on offer – and with these low paying government programs covering more and more of the population – hospitals are using some loopholes. For example, in the event of an accident, a patient may need orthopedic or other surgery, but only after he has stabilized. So hospitals keep patients for a few days under the program, release them, and when they return, they have to pay for their treatment.