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Parliamentary panel red-flags government’s ambitious healthcare scheme

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New Delhi, March 13: The Modi government has released less than half of the budgeted allocation for health insurance of poor families in fiscal 2017-18, even as it promised to step up coverage with the proposed launch of what is called the world’s largest government healthcare programme.

The revenue allocation of Rs 975 crore for the Rashtriya Swasthya Bima Yojana (RSBY) was reduced to Rs 565 crore and, as the year progressed, the actual release was just Rs 450 crore — less than half of the budget estimate, according to a parliamentary panel’s report.

“Funds as a central share of premium under RSBY of approximately Rs 450 crore were only released for such states that submitted their proposal during the year 2017-18,” said the Parliamentary Standing Committee on Health and Family Welfare in its report.

As for the reason for reducing the budgeted allocation, the panel quoted the Department of Health and Family Welfare, saying: “This ministry had moved a proposal for another scheme with an enhanced cover of Rs 1 lakh per family.

“However, this proposal is still pending with the cabinet. Therefore, such states that were waiting for the new scheme to be launched did not submit any proposal and meanwhile stopped implementation of RSBY.”

Even the amount of Rs 25 crore allocated for capital purposes in 2017-18 for setting up office premises for the proposed scheme with an enhanced cover of Rs 1 lakh remained unutilised during the period as the cabinet approval for the scheme remained pending. The money was surrendered.

The RSBY provided a limited coverage of only Rs 30,000 and there was a proposal to increase it to Rs 1 lakh. While the government had difficulties in implementing the healthcare scheme, it announced the launch a bigger healthcare programme in its Union Budget for 2018-19 last month.

The proposed National Health Protection Scheme (NHPS), which would subsume RSBY, would cover 10 crore poor and vulnerable families, and the coverage is further enhanced to Rs 5 lakh per family per year.

However, the Parliamentary Standing Committee has warned of possible failures.

The committee reported that the enrolment in RSBY was quite low. “Only 57 percent of eligible are enrolled and less than 12 percent of the eligible persons got their hospitalisation covered through RSBY.”

Citing a comprehensive review of various studies on RSBY, the panel said that in a majority of states (eight out of 14) there was an increase in out-of-pocket expenditure related to RSBY, while only two of 14 studies showed a reduction in expenditure.

It further noted that many states have opted out of RSBY in favour of state-run schemes. “The government should form a committee to analyse the failures of RSBY and ensure that inadequacies plaguing the operation and implementation of RSBY are not repeated.”

The panel observed that the new scheme is just a modification of the earlier one as more than half of the target beneficiaries proposed to be covered under the NHPS were already covered under existing government-supported schemes.

“What would indeed have been a step forward is if it covered out-patient treatment as well, but that is lacking,” said the Parliamentary panel.

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India witnesses significant rise in dementia-related cases: Lancet

The results showed that the number of deaths from dementia has increased by 148 per cent over the same 26-year period.

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Moscow, Dec 12 : With number of individuals living with dementia increasing globally owing to ageing population, a Lancet study on Wednesday revealed that India witnessed a significant growth in the number of Alzheimer’s disease and other cases of dementia from 1990 till 2016.

According to the report published in Lancet Neurology journal, India witnessed nearly 2.9 million cases of Alzheimer’s disease and other cases of dementia in the 26-year period and nearly 1.4 lakh deaths arising from the problem.

The results showed that the number of people suffering from Alzheimer’s and other dementia increased from 20.2 million in 1990 to 43.8 million globally in 2016.

Of these, 27 million were women and 16.8 million were men.

To reach this conclusion, an international group of collaborating scientists, including HSE Professor Vasily Vlasov, analysed data from 195 countries on the spread of Alzheimer’s disease and other dementia between 1990 and 2016.

The results showed that the number of deaths from dementia has increased by 148 per cent over the same 26-year period.

Dementia is now the fifth most common cause of death worldwide and the second most common — after coronary heart disease — among people aged 70 or older, said the report.

Vlasov noted that according to the data, more than 1 million Russians — most over 50 — were suffering from dementia in 2016.

Researchers have linked high BMI, smoking (including all smoked tobacco products), and diet high in sugar-sweetened beverages as risk factors for dementia.

Although differences in coding for causes of death and the heterogeneity in case-ascertainment methods constitute major challenges to the estimation of the burden of dementia, future analyses should improve on the methods for the correction of these biases, said the study.

“Until breakthroughs are made in prevention or curative treatment, dementia will constitute an increasing challenge to health-care systems worldwide,” it added.

There is growing evidence of risk factors for dementia, which shows that lifestyle and other interventions might, if implemented effectively, contribute to delaying the onset and reducing the future number of people who have dementia.

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Late childbirth linked to high breast cancer risk

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New York, Dec 11: Women who had their first child after 35 may be at an increased risk of developing breast cancer than their peers who do not have children, according to a study contrary to conventional wisdom that childbirth is protective against breast cancer.

Besides late childbirth, women who had a family history of breast cancer or who had a greater number of births also had an increased risk for breast cancer after childbirth. The pattern looked the same whether or not women breastfed.

While the risk was higher for women who were older at first birth, there was no increased risk of breast cancer after a recent birth for women who had their first child before 25, said researchers from the University of North Carolina (UNC) in the US.

“This is evidence of the fact that just as breast cancer risk factors for young women can differ from risk factors in older women, there are different types of breast cancer, and the risk factors for developing one type versus another can differ,” said Hazel B. Nichols, Professor at the UNC.

Although childbirth is still protective against breast cancer, researchers say it can take more than two decades for benefits to emerge.

Breast cancer is more common in older women, with the median age of 62 at diagnosis. But, the study, published in the Annals of Internal Medicine, identified elevated breast cancer risk after childbirth in women younger than 55.

In women 55 years and younger, breast cancer risk peaked about five years after they gave birth, with risk for mothers 80 per cent higher compared with women who did not gave birth.

Twenty-three years after giving birth, women saw their risk level off, and pregnancy started to become protective.

For their analysis, the team pooled data from 15 prospective studies from around the globe that included 889,944 women. In addition to looking at breast cancer risk after childbirth, they also evaluated the impact of other factors such as breastfeeding and a family history of breast cancer.

The findings could be used to develop better breast cancer risk prediction models to help inform screening decisions and prevention strategies, Nichols said.

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Fish oil reduces bleeding risk in surgery patients: Study

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New York, Dec 5: Fish oil, containing the omega-3s, lowers the risk of bleeding during surgery, say, researchers, challenging current recommendations to stop fish oil.

Fish oil is among the most common natural supplement for treatment of hypertriglyceridemia or prevention of cardiovascular disease.

However, concerns about theoretical bleeding risk have led to recommendations that patients should stop taking fish oil before surgery or delay in elective procedures for patients taking fish oil by some healthcare professionals.

The study, published in the journal Circulation, found that higher blood omega-3 levels — eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) — were associated with lower risk of bleeding.

For the study, 1,516 patients scheduled for cardiac surgery were randomised to omega-3s or placebo.

The dose was 6.5-8 grams of EPA+DHA over two-five days before surgery, and then 1.7 grams per day beginning the morning of surgery and continuing until discharge.

The findings showed that there was a significant reduction in the number of units of blood needed for transfusions.

In another analysis, the higher the blood EPA+DHA level on the morning of surgery, the lower the risk for bleeding, according to the Bleeding Academic Research Consortium (BARC) criteria.

“The researchers in this study concluded that these findings support the need to reconsider current recommendations to stop fish oil or delay procedures for people on fish oil before cardiac surgery,” said Bill Harris, Founder of OmegaQuant.

While Omega-3s, specifically EPA and DHA, are important for heart, brain, eye and joint health, most people do not get enough of these valuable fatty acids, which can increase their risk of the most serious health issues.

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