Exploring Usage And Coverage Of Ayushmann Bharat Digital Mission (Abdm) : Assessing And Analyzing The Usgae And Coverage In Teritary Care Hospital In Northern Maharastra

Abstract

Introduction: The Ayushman Bharat Digital Mission (ABDM) was launched to create a federated digital health ecosystem in India, with the Ayushman Bharat Health Account (ABHA) serving as the central tool for linking patient health records. Despite its potential to enhance healthcare access and affordability, concerns remain regarding its actual adoption and utilization in diverse healthcare settings.

Methodology: A cross-sectional descriptive study was conducted over two months at a tertiary care hospital in Northern Maharashtra, enrolling 496 patients from outpatient and inpatient departments using convenience  sampling.  Data  were  collected  through  a  pre-tested  structured  questionnaire covering demographics, ABHA registration, utilization, out-of-pocket expenditure (OOPE), and barriers. Statistical analysis was performed using descriptive measures, Chi-square tests, and t- tests, with p < 0.05 considered significant.

Results: Among 496 participants, 60.9% were registered with ABHA, but only 4% reported utilization of benefits. Surgical care accounted for 80% of cases among utilizers, and 65% preferred private hospitals.  The  mean  total  OOPE  in  private  hospitals  was  ₹15,850  compared  to  ₹4,731  in government  hospitals  (p  =  0.0086),  with  significantly  higher  expenses  for  diagnostics  and consumables in private facilities. Loss of wages was greater among government hospital users. The most common barriers to utilization were lack of awareness (27.7%), registered but never used (25.2%), digital illiteracy (8.9%), and preference for other schemes (5.7%).

Conclusion: The study demonstrates a  substantial  gap  between  ABHA  registration   and  actual  service utilization, with persistent reliance  on private healthcare  leading  to  higher  financial burden. Strengthening awareness, digital literacy, hospital empanelment, and trust in public facilities is essential to realize the transformative potential of ABDM in achieving equitable and affordable healthcare.