Abstract
BACKGROUND: Access to complex, resource-intensive procedures such as spine surgery is often limited for economically disadvantaged populations due to high out-of-pocket expenditure. The Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY) was launched to mitigate these costs, yet data on its specific impact on spine surgery remains limited. This study aims to analyse the impact of PM-JAY on access to spine surgery at a tertiary care centre in North India. METHODS: A retrospective, single-centre observational study was conducted analysing all spine surgeries performed from January 2023 to December 2024. Data regarding patient demographics, clinical diagnosis, surgical procedure, and mode of financing were extracted from institutional records. Financing modes were categorised as PM-JAY, self-paid, and other government schemes. Comparative analysis of financing patterns across the study years was performed using the chi-square test. RESULTS: A total of 410 patients underwent spine surgery during the study period (mean age 49.3 ± 4.1 years). Degenerative spinal disorders (46.1 %) and traumatic injuries (33.4 %) constituted the majority of cases. Overall, 276 procedures (67.3 %) were funded under PM-JAY, while 110 (26.8 %) were self-financed. A significant temporal shift was observed: PM-JAY utilisation increased from 58.7 % (101/172) in 2023 to 73.5 % (175/238) in 2024. Correspondingly, self-financed procedures declined from 37.8 % in 2023 to 18.9 % in 2024 (p < 0.001). CONCLUSION: This study demonstrates a substantial and statistically significant increase in the utilisation of PM-JAY for spine surgery, with a concurrent decline in self-financed procedures. The findings suggest that publicly funded insurance is effectively improving financial access to implant-intensive spine care across a broad spectrum of pathologies. However, robust clinical governance remains essential to ensure equitable implementation and prevent overutilisation.