ArticleThe Indian journal of medical research2026
Cost per outcome of ICU care under Biju Swasthya Kalyan Yojana in Odisha.
Article in The Indian journal of medical research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background and objectives The Biju Swasthya Kalyan Yojana (BSKY), a State-run health insurance programme in Odisha, provides financial protection for high-cost care, including intensive care unit (ICU) services. This study aimed to evaluate the clinical outcomes and economic value of ICU care delivered under BSKY over a two-year period at a tertiary centre. Methods A retrospective observational study was conducted among adults (≥18 years) with an APACHE II (acute physiology and chronic health evaluation) score ≥15 who were admitted to the ICU between January 2022 and December 2023 under BSKY coverage. Financial data (government reimbursement, hospital costs) and clinical outcomes (demographics, length of stay, mortality) were analysed. The cost per life saved and the cost per disability-adjusted life year (DALY) averted were calculated using the WHO-CHOICE (World Health Organization Choosing Interventions that are Cost-Effective) methodology. Results Of 2,805 ICU admissions, 1,799 eligible patients were analysed (mean age: 57.1 years; 64% male). The survival rate to discharge was 78.7%. Median ICU stay was 5.46 (1.86 - 9.06) days for survivors and 7.53 (1.4 - 13.66) days for non-survivors. The average hospital cost per patient was INR (₹) 69,381.62 (US$831.28), while the mean BSKY reimbursement was ₹1,03,411.4 (US$1,239) for survivors and ₹1,51,402.97 (US$1,814) for non-survivors. The cost per life saved was ₹1,44,366.99 (US$1,729.7). The study population yielded 8502 DALYs, with a cost per DALY averted of ₹74,941.97 (US$897.9) overall, ₹11,376 (US$136.3) for patients <60 yr, and ₹1,03,194.4 (US$1,236.4) for those ≥60 yr. Interpretation and conclusions ICU care under BSKY reduced patients' financial burden and achieved favourable cost per outcome across age groups, with particularly high value among younger patients. The findings support the need to sustain and expand critical care coverage under State health insurance schemes in India.
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