Delay in disbursing surgery costs under insurance scheme

July 11, 2010 02:17 am | Updated June 24, 2016 03:20 pm IST - CHENNAI:

The delay in disbursing funds by the government under the Kalaignar Insurance Scheme is delaying the improvement of their departments, which is essential to provide better patient services, say senior hospital authorities.

Through a Government Order, it was stipulated that the departments performing surgeries under the scheme should receive 40 per cent from the Rs.1 lakh granted for each surgery.

According to the G.O., 20 per cent of the money given to the hospital should be used to improve facilities for patients. But six months since the scheme's implementation, most hospitals have yet to receive the money.

In contrast, private hospitals have received the entire amount for each surgery they performed, doctors say.

Adding to the problems is the increased burden of providing expensive diagnoses at government hospitals at a subsidy to patients who later have the surgeries done at private hospitals. Authorities say private hospitals send patients to them for tests such as MRI and angiograms.

At a recent meeting with Health Department officials, doctors took up the issue of the high cost of disposable consumables, which are not part of the surgery cost.

The insurance scheme does not cover items such as pacemakers and prostheses which the government provides free of cost to the patients.

On an average, each surgery could cost the hospital Rs.25,000 said Government Hospital Dean J. Mohanasundaram. “This does not include the cost of prostheses such as heart valves or those used for hip or knee replacements,” he said. The GH has performed over 300 surgeries since the insurance scheme was launched.

The Urology Department, followed by the Cardiology Department, have performed the largest number of surgeries. Sometime ago, a child from Arakkonam received pacemaker at a cost of Rs.52,000.

The Cardiology Department of Government Children's Hospital in Egmore performs one major heart surgery every day. “In six months we have done surgeries worth Rs. 24 lakh under the insurance scheme,” a paediatric surgeon here said.

The department has so far received less than Rs.3 lakh. The funds that were received have been used to create the much-needed pre-operative ward for patients, doctors here said.

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