UHI Review (Meeting Regarding ISDF)
UHI Review (Meeting Regarding ISDF)
91 million patients have availed treatment worth ~PKR 63 Bn under the Sehat Sahulat Program since its inception in 2016
2,500,000 60,000
2,272,152
50,000
2,000,000
40,000
1,500,000
30,000
1,000,000 49,029
20,000
35,159
363,000
500,000
10,000
Admissions
Admissions
Admissions
Admissions
(% of total)
(% of total)
(PKR mil)
(PKR Mil)
(PKR Mil)
Claims
person
Claims
Treatment
Total
1 Dialysis 628,605 2,792,752,540 4,443 361,590 58% 1,749,605,265 267,015 42% 1,043,147,275
2 Cesarean delivery 274,926 6,546,137,416 23,811 247871 90% 5,927,240,470 27055 10% 618,896,946
3 Cataract with IOL Phacoemulsification - Unilateral 221,545 3,538,619,535 15,972 215442 97% 3,444,756,445 6103 3% 93,863,090
4 Chemotherapy - Per sitting 74,728 2,526,201,713 33,805 60,651 81% 2,054,124,066 14,077 19% 472,077,647
5 Normal Delivery 68,729 1,385,338,344 20,157 56565 82% 1,136,183,680 12164 18% 249,154,664
6 Coronary Angiography 64,555 1,297,427,631 20,098 34814 54% 702,293,000 29741 46% 595,134,631
7 Hernioplasty (mesh repair) 42,165 1,136,549,013 26,955 38,079 90% 1,031,209,468 4,086 10% 105,339,545
8 Hysterectomy – abdominal 36,945 1,059,957,090 28,690 35502 96% 1,019,028,990 1443 4% 40,928,100
9 Appendicectomy 31,851 689,241,535 21,640 29102 91% 637,615,885 2749 9% 51,625,650
10 Laparoscopic Cholecystectomy 26,803 949,339,385 35,419 24,858 93% 884,155,550 1,945 7% 65,183,835
11 Angioplasty - single Stent (Drug Eluted) 21,221 3,580,965,892 168,746 12174 57% 2,067,367,000 9047 43% 1,513,598,892
12 Cholecystectomy (Open) 19,841 585,845,258 29,527 18,075 91% 536,660,453 1,766 9% 49,184,805
13 Oncology – Medical 16,530 439,756,415 26,604 14887 90% 416,175,638 1643 10% 23,580,777
14 Tonsillectomy 14,065 306,172,475 21,768 13153 94% 289,573,590 912 6% 16,598,885
15 Pneumonia / LRTI 12,602 134,102,672 10,641 6,765 54% 80,727,460 5,837 46% 53,375,212
16 Hernia – Repair 12,193 286,900,170 23,530 11319 93% 267,939,120 874 7% 18,961,050
17 Acute Gastroenteritis 12,127 80,363,670 6,627 7411 61% 52,482,850 4716 39% 27,880,820
18 Angioplasty - two Stents (Drug Eluted) 11,291 2,791,547,664 247,237 7,894 70% 1,962,765,500 3,397 30% 828,782,164
Total Private Sector Public Sector
Admissions
Admissions
Admissions
Admissions
(% of total)
(% of total)
(PKR mil)
(PKR Mil)
(PKR Mil)
Claims
person
Claims
Treatment
Total
19 Ischemic Heart Disease 11,196 78,823,931 7,040 3179 28% 29,930,500 8017 72% 48,893,431
20 Hemorrhoidectomy 10,648 222,992,070 20,942 10000 94% 209,758,610 648 6% 13,233,460
(total for top 20 treatments) 1,612,566 30,429,034,419 18,870 1,209,331 75% 24,499,593,540 403,235 25% 5,929,440,879
Sr.
Particular FY 2021-22 FY 2022-23 FY 2023-24 FY 2024-25 Total %age
No.
A Programme Cost 67,525 130,517 132,087 68,048 398,177 99.64%
B Non-Programme Cost (Operating Cost) 228 343 376 411 1,358 0.34%
C Capital / Asset Cost 65 9 2 0.1 76 0.02%
Total: 67,869 130,869 132,465 68,460 399,612 100%
Phase Premium Paid Tentative Claims Admin Cost Total Spending Unspent Premium Due Date
A B C D=B+C E=A-D
Phase-III 53,139 37,127 7,229 44,356 8,783* February 2024 (For Year 1)
Phase-II 34,082 23,262 5,831 29,093 4,989 May-24
Phase-I 4,493 2,732 917 3,649 844 May 2021**
Total 91,714 63,121 13,977 77,098 14,616
* Claims generated are approximately more than 6 billion per month. SLIC will need payment from GoPb for claim payment to hospitals.
** SLIC has initiated the process of hiring firm for third party audit of claims.
HOSPITAL CLAIMS AND RECEIPTS DEPOSITED INTO GOVERNMENT TREASURY (FOR YEAR 2022)
Claims Expected
Claims Claims Funds
Received by Claim Return of
Incurred Pending at Pending Deposited
Sr. Hospital Department SLIC for Paid by Government
Claims Hospital at SLIC in to Govt.
Reimbursemen SLIC (% of Paid
End End Treasury
t Claims)
1 Cardiac Hospitals SHC&MED 4,729 3,503 1,226 781 2,722 981 476
2 SHC&MED Other Tertiary Care (38+6=44) 3,084 1,536 1,548 251 1,286 720 298
3 DHQ PSHD 1,048 539 509 51 488 273 20
4 THQs -150 944 542 401 86 456 255 23
Grand Total (194) 9,805 6,121 3,684 1,169 4,952 2,230 817