Table 2.
Details of claims in two CHI schemes in India (01/04/2003 to 31/03/2004)
| ACCORD | SEWA | |
| Type of provider | ||
| Total claims | 683 | 3152 |
| in government hospitals | - | 238 (8%) |
| in NGO hospitals | 683 (100%) | 204 (6%) |
| in private-for-profit hospitals | - | 2710 (86%) |
| Details of claims made | ||
| Median claim amount (95% CI) in US$ | 11.8 (10.9, 12.7) | 46.4 (45.2, 47.5) |
| Median claim honoured (95% CI)@ in US$ | 10.4 (9.5, 11.2) | 12.9 (12.7, 13.1) |
| Number of claims that were honoured (%) | 643 (94%) | 2543 (81%) |
| Number of claims that were fully honoured (%) | 507 (79%) | 1206 (47%) |
| Number of claims that were partially honoured (%) | 136 (21%) | 1337 (53%) |
| Median delay (Q1, Q3) between discharge and reimbursement in days | - | 49 (23, 81) |
| Type of illnesses | ||
| Acute illnesses | 401 (59%)* | 2346 (74%) |
| Pre-existing illnesses | 280 (41%) | 806 (26%) |
@ The term "honoured" has different implications in the two schemes. At SEWA it means "reimbursement" while at ACCORD, it implies the amount paid through direct third party payment.
* Details of 2 episodes not available.