Success Barriers Conclusions Areas to improve
“The concept of the scheme is good”.
“The emergency phone numbers do not work for pre-authorization in nights".
The limited phone lines may not serve the needs of the entire state.
The number of emergency
telephone lines and technical staff may be increased to provide adequate services. “Poor patients are benefiting from expensive treatment”.
"Area hospitals have been empanelled without any discussion with us".
There is no opportunity to discuss issues related to empanellment. Government hospitals need to be consulted during empanellment. “We are able to
renovate the wards, and other hospital facilities using the Aarogyasri money”.
"There is no place for arbitration while signing the MOU"
MOU execution is unilateral. “There is now a possibility of appointing additional contractual staff”. “There is no appropriate mechanism by which
admin/technical issues can be shared with appropriate authority".
Since the scheme is evolving, there may be
operational issues.
The AHCT needs to develop mechanisms for sharing information and learning to strengthen the scheme. "Many screening facilities are
not available in govt hospitals such as MRI/CT scan and radiologists/pathologists, hence we are forced to refer the cases to private hospitals" Many government hospitals do not have adequate diagnostic facilities and specialists. The government hospitals need to explore different options for enhancing their diagnostic facilities and specialist services.
Beneficiaries
Success Barriers Conclusions Areas to
improve Beneficiaries were unanimous in their appreciation of the scheme.
“Money has to be spent for pre diagnostic investigations”. There needs to be a monitoring mechanism in network hospitals to ensure free OP services. Awareness of the program is good. "The follow up treatment is expensive, follow up transport expenses are too much".
Most of the patients who need regular medicines are purchasing on their own and are facing a substantial financial burden. There should be a provision for follow-up treatment. “I am able to receive costly treatment from a private hospital”.
Some spinal surgical /medical treatments have not provided relief as expected.
The treatment for some (neuro-spinal, orthopaedic) conditions was not to the expected level of patients.
There is a need to review and establish evidence based standard treatment protocols, as well as to conduct a medical audit to evaluate the impact of treatment. Rehabilitative treatment and long term follow up need to be mandatory for some chronic illness especially for neuro-spinal and orthopaedic cases.
"It is a boon for the poor patients like us".
Many screening
facilities and specialists are not available in govt hospitals such as
MRI/CT scan, radiologists, and pathologists; hence these investigations are being done from outside the hospital.
Diagnostic facilities at the government hospitals are not sufficient. There is a need to improve the screening and treatment facilities at the government hospitals.
"Travel to the
Hyderabad hospitals is expensive but there is no other way for us"
There are no treatment facilities at most of the empanelled government hospitals for conditions such as cancer and cardiac disease The enhancement of diagnostic facilities and specialist services needs to be based on local health needs. “The monthly
medicines are expensive to purchase as I am having heart problem, the surgery relieved my heart problem to a large extent but I need to continue the medicines regularly”
There is a need to take medicines at regular intervals for chronic conditions such as
rheumatic heart disease and these are expensive for poor patients. There should be provision of free medicines for post surgical patients, especially those who are suffering from chronic disease. There is also a need to ensure that other basic requirements such as good nutrition and modifications to lifestyles (such as quitting smoking) are addressed to ensure that the benefit from high cost treatment is not lost.
Patients had to pay for investigations, some medicines - especially follow up medicines.
Some private hospitals are charging for prediagnostic investigations and are subsequently offering free treatment, if it is approved under the Aarogyasri scheme. Regular monitoring of the hospital and feedback from beneficiaries is essential to improve the services.
Aarogyamitras
Achivement Barriers Conclusions Areas to improve
Majority are happy to work in health services
Phone facility is limited, can not make calls to patients
To call outside star network such as to call patients, the
Aarogyamitras are
required to pay from their pocket
The provision of funding for monthly phone calls may be useful.
"We feel we are doing good job"
The travel allowance is not provided to visit the villages
The travel allowance restricts the
Aarogyamitras’ ability to visit villages, to attend village organisations and meetings to spread the message about the Aarogyasri The provision of travel allowance is necessary for Aarogyamitras to be more effective. "We are contented with the job profile"
“Some of the PHCs do not treat us as their staff”
The functioning of
Aarogyamitras is not well integrated with the PHC
Regular reviews, clear accountability lines and appraisals of Aarogyamitras is needed. “The Aarogyasri has provided us the job, which is good”
“For some conditions the network hospitals keep postponing the admissions and we are unable to convince the patients in villages of the reasons for this”
Some private hospitals are not accepting patients with specific medical
conditions although these are included in the AHCT list. Excuses are made to turn patients away.
Regular monitoring and strengthening of the system to address complaints is
necessary.
The posting is far from the home town
Some Aarogyamitras are placed far from their residence especially those who are posted to urban settings and they find it difficult to function optimally.
Offering
appointments close to homes may improve the functioning of Aarogyamitras
Formal training not given. They have only attended workshops that are not sufficient to ensure full competence.
The present methods of training are insufficient
On the job training in small groups will help to build their capacity.
“Mostly we learn from senior Aarogyamitras but it is inadequate to undertake our duties”.
There is no organized uniform training for every Aarogyamitra.
Standardization of training for all Aarogyamitras may improve their competence and effectiveness.