By Our Reporter
SHILLONG, Jan 2: An estimated 10.26 per cent of the claims under Megha Health Insurance Scheme (MHIS) pertain to cat and dog bite cases.
According to health officials, there were 18,979 cat and dog bite cases in 2023 while 6,734 patients were registered.
Recently, Chief Minister Conrad K Sangma told a gathering at the PHS programme that cat and dog bite cases make up the second highest insurance claims under MHIS. This is followed by chronic haemodialysis (18,877 cases, 535 patients).
The state government spent around Rs 129 crore under MHIS-V with a total number of around 18.43 lakh registered beneficiaries.
The MHIS was launched in 2013 to reduce household out-of-pocket expenditures on health and provide access to high-quality essential healthcare.
After the first analysis of six years of enrolment and claims data (2013-2018) covering three phases of the scheme, it was found that anti-rabies injections for dog/cat bite contributed to 11 per cent of total claims under MHIS-III, and 1.6 per cent of all claims under MHIS-I.
The exercise was carried out to understand the pattern of enrolment, utilisation and care provision under MHIS.
The study suggested that this warrants investigation to better understand the burden of animal bites and implementation of cost-effective strategies.
The ‘dog/cat bite’ package was not included in MHIS-I.
A high financial provision for claims made under dog/cat bite was made in MHIS II (1.2%, Rs 43,86,375), and this increased substantially in MHIS III (2.3%, Rs 1,16,43,535). The
majority of these claims were made in public sector facilities in both phases of MHIS (96% in MHIS III and 98% in MHIS II).
According to the study, approximately 55 per cent of the eligible population are currently enrolled in MHIS. Enrolment increased consistently from phase I through II and remained broadly stable across districts, gender, age group and occupation categories, with a small decline in males aged 19-60 years.
Claims were disproportionately skewed towards private provision; 57 per cent of all claims accrued to the 18 empanelled private hospitals and 39 per cent to the 159 public sector facilities.
The package “General Ward Unspecified” was responsible for the highest volume of claims and highest financial dispensation across all three phases of the scheme.