Authors’ response

Sir,

We thank Dr. Basu for his comments on our study¹. The definition of continuum of care given under AYUSHMAN BHARAT, Comprehensive Primary Health Care (CPHC) through Health and Wellness Centres, Operational Guidelines 2018, Government of India, was considered for the analysis². As per the CPHC definition, continuum of care indicates care of an individual from the same facility near the individual’s home and community, and across different levels of care, i.e., primary, secondary, and tertiary². Thus, the two important indicators continuum of care, i.e., follow-up and referral, are presented in the paper³. These indicators were also collected and reported by health facilities in the monthly reports.

Regarding the availability of medications in public health facilities, table III in the publication describes the stockout position of essential medicines in public health facilities². The patient-related concerns, i.e., frequent visits to the hospital to refill medicines and out-of-pocket expenditure, related information have been covered in patient exit interviews of the main survey but not included in this publication.

Based on Indian Public Health Standards (IPHS) and other international standards, as mentioned in the methodology (survey instruments) section of the paper, the study assessed the availability of functional diagnostic services and included both laboratory and non-laboratory investigations for preparedness. Thus, glycated haemoglobin (HbA1c), kidney function tests, lipid profile and other imaging services [as applicable per the level of facility i.e. from community health centre (level-3) to tertiary care centres (level -6)] have been included in each level of facility and presented as six different bar diagrams (Figure A to F) in the result section of the paper. The IPHS standards differ for each level, and relevant tracer items have been included in each domain (medicines, equipment, diagnostic, and staff).

The other concerns are findings of service delivery for chronic care and patient-related outcomes, etc., were not reported as these were beyond the scope of the requisite publication.