A Geospatial Study of Pradhan Mantri Jan Arogya Yojana (PM-JAY) Empaneled Healthcare Facilities across South Indian States.

CONTEXT: To advance universal health coverage (UHC) in India, several healthcare reforms were introduced, including the Pradhan Mantri Jan Arogya Yojana (PM-JAY). The scheme provides secondary and tertiary inpatient care to eligible below-poverty-line and vulnerable populations through empaneled public and private hospitals. AIMS: To examine the spatial distribution of PM-JAY empaneled hospitals and assess its alignment with equitable healthcare access. METHODS: Open-access data on PM-JAY empaneled hospitals in South Indian states were retrieved from National Health Authority's (NHA) Hospital Empanelment Module (HEM) in January 2022. Data were cleaned and analyzed using SPSS, R, and ArcGIS. Distance correlation and Spearman's correlational analyses were performed between hospital-density variables and development indicators (Human Development Index [HDI], literacy rates) at 95% confidence interval. RESULTS: A total of 8,946 hospitals were empaneled across South India. Public hospitals constituted 52.9% and private facilities 47.1%, with inter-state variations. Private facilities dominated in Kerala, while Karnataka had the highest public share. Distance correlation (dCor) and Spearman's correlation analyses showed significant associations (P < 0.05) between private hospitals' availability and development indices. Associations with literacy rates were significantly stronger for private hospitals per million population (dCor = 0.451) and per sq. km (dCor = 0.430). Geospatial analysis revealed a scattered distribution of public hospitals, while private facilities were clustered, specifically in urban pockets. CONCLUSION: The observed distribution patterns suggest state-specific policies for healthcare advancements. Critical gaps identified in private hospitals' distribution need attention to mitigate challenges in underserved areas. Overall, a balanced and well-regulated mix of both sectors may be most effective in ensuring equitable and comprehensive healthcare access.