Title : Public Health Insurance for Children in Tamilnadu, India, 2024
Abstract:
Introduction
Universal health coverage can reduce the child mortality rate significantly. Universal health coverage can be achieved through public health insurance. Public health insurance was initiated by the Government of Tamilnadu in 2012 under the name of the Chief Minister’s Comprehensive Health Insurance Scheme (CMCHIS). Both public and private hospitals were empanelled to provide secondary and tertiary care for all paediatric population. We analyzed the paediatric packages to describe the health services covered under CMCHIS for children.
Methods
We did a cross-sectional study in December 2024. We collected the data on packages which cover paediatric services exclusively. We also collected the data on paediatric package covered under psychiatry and follow up procedures. We collected the data from CMCHIS website. We calculated proportions to describe the packages by services.
Results
There are 108 packages for paediatric surgery, 48 for general treatment, 19 for intensive care unit (ICU), and 74 for neonatal treatment. In addition, some clinical conditions are covered under follow-up procedures and psychiatric packages. When most paediatric surgery packages(n=88) are for congenital anomalies (81%), some packages covered Tumours {7%, (n=8)}. Among the general packages, 19% covered anemia (n=9). There were 4 packages each for Celiac disease, epileptic encephalopathy, infantile cholestasis, and intellectual disability each contributing to 8%. Among ICU packages, Bronchiolitis/Pneumonia (21%) is majorly covered (4/19). There are two packages each for AEFI, Hepatitis, and snake bite. The majority of the neonatal packages cover sepsis {42%, (31/74)} and respiratory distress {13%, (13/74)}. Jaundice {11%, (8/74), neonatal monitoring {9%, (7/74)}, and congenital heart diseases/congestive cardiac failure {8%, (6/74) are also covered under neonatal packages. Among the 20 follow-up packages, there is one package each for cochlear implant surgery and auditory brain stem implants. There were 16 psychiatric packages for children, which covered Behavioural disorders (n=5), Neurodevelopmental disorders other than intellectual disability (n=4), and Autism (n=3).
Conclusion
CMCHIS covers the majority of the clinical conditions prevalent among the paediatric groups. Thus, properly utilizing CMCHIS will help reduce child mortality and morbidity.
