Awareness, Registration Status, and Perceived Barriers to Ayushman Bharat Health Account (ABHA) Adoption Among Patients in Jharkhand: A Cross-Sectional Study
- 1Hospital Administration, Rajendra Institute of Medical Sciences, Ranchi, IND
- 2Forensic Medicine and Toxicology, Rajendra Institute of Medical Sciences, Ranchi, IND
- 3Community Medicine, Rajendra Institute of Medical Sciences, Ranchi, IND
Abstract
Background: The Ayushman Bharat Health Account (ABHA), introduced under the Ayushman Bharat Digital Mission (ABDM), is intended to facilitate the digital management and exchange of health records in India. However, awareness of ABHA, knowledge of its registration pathway, and actual account creation among patients remain uncertain. This study assessed ABHA awareness and registration-related knowledge among adult outpatients at a tertiary care teaching hospital in Jharkhand, determined the proportion reporting personal ABHA account creation, and examined attitudes, perceived barriers, awareness-to-registration gaps, and their associations with selected sociodemographic characteristics.
Methods: A cross-sectional study was conducted between May and July 2026 among outpatients at Rajendra Institute of Medical Sciences (RIMS), Ranchi, Jharkhand, a 2,327-bed government tertiary care teaching hospital with a daily outpatient department (OPD) footfall of 2,100-3,000 patients. A convenience sample of 400 adult patients (aged ≥20 years) was surveyed. Participants completed a pre-structured bilingual questionnaire with sociodemographic information, baseline awareness, registration status, and barriers to registration. Chi-square tests were used to find the relationship between sociodemographic variables and awareness levels, with statistical significance set at p<0.05.
Results: Among 400 participants, 202 (50.5%) were male. Overall, 187 (46.8%) had heard of ABHA, 64 (16.0%) knew accounts could be created online or via an application, and only 24 (6.0%) had personally created an account. The mean composite knowledge score was 7.34±2.75 (56.5% of maximum), while high perceived barriers (≥75% score) were reported by 295 (73.8%) participants. Composite knowledge was significantly associated with age (χ2(4)=15.795, p=0.003; linear trend M2=10.61, p=0.001), with older adults exhibiting lower knowledge. Gender showed a nominal association (χ2(2)=7.403, p=0.025) that did not survive Bonferroni correction (p<0.003125). Education (χ2(6)=4.854,p=0.563), socioeconomic status (χ2(6)=7.399, p=0.286), occupation, residence, religion, and PM-JAY status showed no significant association with knowledge or perceived barrier levels.
Conclusion: Low ABHA registration (6.0%) in this tertiary care population was accompanied by a pronounced awareness-to-action gap, with the steepest attrition occurring at knowledge of the self-registration route (16.0%) rather than general awareness (46.8%). Pervasive perceived barriers (73.8%) cut uniformly across demographic lines. To bridge this gap, hospital administration should transition from passive promotion to active, assisted on-site registration desks in OPDs, prioritising older outpatients.
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BibTeX
@article{sharan2026awareness,
title = {{Awareness, Registration Status, and Perceived Barriers to Ayushman Bharat Health Account (ABHA) Adoption Among Patients in Jharkhand: A Cross-Sectional Study}},
author = {Esha Sharan and Bhoopendra Singh and Shashi B Singh},
journal = {Cureus},
year = {2026},
month = oct,
doi = {10.7759/cureus.117541},
url = {https://doi.org/10.7759/cureus.117541},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Awareness, Registration Status, and Perceived Barriers to Ayushman Bharat Health Account (ABHA) Adoption Among Patients in Jharkhand: A Cross-Sectional Study
AU - Esha Sharan
AU - Bhoopendra Singh
AU - Shashi B Singh
PY - 2026
DA - 2026/10/06
JO - Cureus
DO - 10.7759/cureus.117541
UR - https://doi.org/10.7759/cureus.117541
AB - Background: The Ayushman Bharat Health Account (ABHA), introduced under the Ayushman Bharat Digital Mission (ABDM), is intended to facilitate the digital management and exchange of health records in India. However, awareness of ABHA, knowledge of its registration pathway, and actual account creation among patients remain uncertain. This study assessed ABHA awareness and registration-related knowledge among adult outpatients at a tertiary care teaching hospital in Jharkhand, determined the proportion reporting personal ABHA account creation, and examined attitudes, perceived barriers, awareness-to-registration gaps, and their associations with selected sociodemographic characteristics. Methods: A cross-sectional study was conducted between May and July 2026 among outpatients at Rajendra Institute of Medical Sciences (RIMS), Ranchi, Jharkhand, a 2,327-bed government tertiary care teaching hospital with a daily outpatient department (OPD) footfall of 2,100-3,000 patients. A convenience sample of 400 adult patients (aged ≥20 years) was surveyed. Participants completed a pre-structured bilingual questionnaire with sociodemographic information, baseline awareness, registration status, and barriers to registration. Chi-square tests were used to find the relationship between sociodemographic variables and awareness levels, with statistical significance set at p<0.05. Results: Among 400 participants, 202 (50.5%) were male. Overall, 187 (46.8%) had heard of ABHA, 64 (16.0%) knew accounts could be created online or via an application, and only 24 (6.0%) had personally created an account. The mean composite knowledge score was 7.34±2.75 (56.5% of maximum), while high perceived barriers (≥75% score) were reported by 295 (73.8%) participants. Composite knowledge was significantly associated with age (χ2(4)=15.795, p=0.003; linear trend M2=10.61, p=0.001), with older adults exhibiting lower knowledge. Gender showed a nominal association (χ2(2)=7.403, p=0.025) that did not survive Bonferroni correction (p<0.003125). Education (χ2(6)=4.854,p=0.563), socioeconomic status (χ2(6)=7.399, p=0.286), occupation, residence, religion, and PM-JAY status showed no significant association with knowledge or perceived barrier levels. Conclusion: Low ABHA registration (6.0%) in this tertiary care population was accompanied by a pronounced awareness-to-action gap, with the steepest attrition occurring at knowledge of the self-registration route (16.0%) rather than general awareness (46.8%). Pervasive perceived barriers (73.8%) cut uniformly across demographic lines. To bridge this gap, hospital administration should transition from passive promotion to active, assisted on-site registration desks in OPDs, prioritising older outpatients.
SN - 2168-8184
ER -