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 Most of the times, the patients are referred to the secondary care by primary
health care providers / primary physician.
C.Tertiary healthcare :
 Tertiary Health care is specialized consultative healthcare, usually for inpatients
and on referralfrom primary/secondary care providers.
 e.g. Oncology (cancer treatment), Organ Transplant facilities, High risk
pregnancy specialists etc.
Factors affecting the health systems in India:

 Demographic or Population related trends

 Social trends
 Life expectancy
Evolution of Health Insurance in India
a) Employees‟ State Insurance Scheme :
 Introduced by ESI Act,1948.
 All workersearning wages up to Rs. 15,000 are covered under the
contributory scheme wherein employee and employer contribute 1.75%
and 4.75% of pay roll respectively; state governments contribute 12.5% of
the medical expenses.
 The benefits covered include:
a)Free comprehensive healthcare at ESIS facilities
b)Maternity benefit
c)Disability benefit
d)Cash compensation for loss of wages due to sickness and survivorship
e)Funeral expenses in case of death of worker
b) Central Government Health Scheme :
 Introduced in the year 1954.
 This scheme is for central governmentemployees including pensioners and their
family membersworking in civilian job.
 The contribution from employees is quite nominal though progressively linked to
salary scale –Rs.15 per month to Rs.150 per month

Sterling Insurance ATI Services