Need for Inclusion of Primary & Preventive care packages under CMCHIS Dr. T. S. Selvavinayagam. MD, DPH, DNB Additional Director of Public Health & Preventive Medicine, Government of Tamil Nadu

Out Line Why? What are the packages? Financial Sustainability Expected Benefits

Why? To ensure better access / Availability of services close to community. Reducing load at Tertiary care institutions To increase health awareness To reduce OOPE To ensure better outcome – following interventions like Renal transplantations, CABG, PTCA.,

Packages Screening – Amma Arogya Thittam Package of 25 tests – HT/ DM/ CVD / Cancers/ Hematological profile/ TB / Visual acuity, Etc., Management of uncomplicated DM / HT along with distribution of drugs through empanelled Hospitals Identification of high risk pregnancy / Complication of pregnancy Management of uncomplicated fevers / Diarrhea / Dehydration Follow up care with better package cost.

Institutional Services in Government Health Facilities Average Per Day Primary Health Care System is the the major care providers both in volume and reach except IP and higher level services S. No Service DPH DMS DME 1 Out Patients Treated 2,51,880 1,88,322 72,744 2 In Patients Treated 4,200 20,303 25,188 3 Deliveries conducted 657 530 424 4 Family Planning done 223 218 98

Financial Sustainability Wellness package – AAT – 100% claims state funds. Use of mandatory set of generic drugs for HT / DM can handle 80 % cases. Negotiated price at designated centres based on the volume of business. Cost sharing – Benefit vouchers from PHC / Philanthropists Linking with NHM – NPCDCS / RCH

Expected Benefits Increases health awareness Morbidity profile for planning interventions Early diagnosis and Management gives better quality of life. Strengthen primary care institutions including HSCs Overall reduction in health care cost.

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