Vol. 11, Issue 4 (2025)

Background: Amputation is a major cause of locomotor disability in India, yet only a small proportion of individuals have access to prosthetic devices. Government health insurance schemes like Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (ABPMJAY) and Tamil Nadu Chief Minister Comprehensive Health Insurance Scheme (TNCMCHIS) aim to improve access for socioeconomically disadvantaged populations.

Aim: To analyse the effectiveness of ABPMJAY-TNCMCHIS in providing prosthetic rehabilitation through Coimbatore Medical College Hospital (CMCH), especially for patients below poverty line in unreached districts of Tamil Nadu.

Methods: A retrospective study was conducted at the Institute of Orthopaedics and Traumatology and Department of Physical Medicine and Rehabilitation, CMCH, between August 2020 and April 2025. All 213 patients with amputations who received prostheses under ABPMJAY-TNCMCHIS were included. Pre- and post-prosthetic rehabilitation involved physiotherapy, occupational therapy, psychological counselling, and vocational rehabilitation.

Results: Of 213 beneficiaries, 82.7% were men and 17.3% women, with a mean age of 55 years (range 3-85). Below-knee amputations (118) were most common, followed by above-knee (72), below-elbow (12), and above-elbow (11). The total claim amount was ₹92.56 lakhs, while actual expenditure was ₹37.27 lakhs, generating a net saving of ₹55.90 lakhs for the government. Beneficiaries came from 20 of 38 districts, covering a mean distance of 223 km from Coimbatore.

Conclusion: The Coimbatore model demonstrates that government-funded insurance schemes can successfully deliver cost-effective prosthetic rehabilitation while generating surplus revenue for infrastructure development. This approach not only restores mobility but also improves quality of life, reduces social and economic dependence, and sets a replicable model for universal prosthetic rehabilitation in India.