Out-of-Pocket Expenditure and Treatment Outcomes Among Rural Beneficiaries of Ayushman Bharat Pradhan Mantri Jan Arogya Yojana in Banda District, Uttar Pradesh: A Cross-Sectional Study

Abstract Background: Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) was launched to improve access to healthcare and provide financial risk protection to economically vulnerable populations in India. However, evidence regarding beneficiary satisfaction and financial protection in underserved regions such as Bundelkhand remains limited. The objectives of the study are to evaluate hospital utilization, benefit coverage, and treatment outcomes among Ayushman Bharat Yojana beneficiaries, and to assess the financial protection provided by AB-PMJAY by measuring the out-of-pocket expenditure incurred by beneficiaries during the healthcare services received. Material & Methods: A hospital-based cross-sectional study was conducted from January to December 2024 among 300 AB-PMJAY beneficiaries admitted to selected government and empanelled private hospitals in Banda district. Data were collected through face-to-face interviews using a pre-tested semi-structured questionnaire. Information on healthcare experiences, scheme awareness, service utilization, hospitalization-related problems, satisfaction, and out-of-pocket expenditure (OOPE) was analysed using descriptive statistics. Results: Among 300 beneficiaries, 73.3% were admitted to government hospitals and 36.7% received treatment in medicine departments. Most patients had gradually progressive illnesses (52.3%) and hospital stays of less than 7 days (76.0%). Awareness of AB-PMJAY was reported by 72.0%. Coverage was highest for surgical items (93.0%). Overall, 78.0% improved or were cured, while 63.0% incurred no OOPE. Conclusion: AB-PMJAY improved healthcare access and financial protection, with favourable outcomes in 78.0% and no out-of-pocket expenditure in 63.0%. However, persistent awareness gaps and residual expenses highlight the need for better coverage.