90
of insured men towards expenses arising in that connection, although this benefit is sometimes treated as a family benefit! or even as a medical care benefit (reimbursement of medical care costs of confinement). Data arising out of the operation of such a benefit can evidently serve to provide a better estimate of the fertility rate.
(ii) Medical care benefit schemes
The type of volume of statistical data which can be obtained from medical care benefit schemes would depend primarily on whether the scheme is based on the principle of direct service where the care is dispensed in clinics and hospitals owned and operated by the scheme itself or on that of indirect service, i.e. based cn reimbursement of medical care costs, capitation fee, etc. The volume of data can be expected to be larger in the former cases, and would consist of the following:
numbers of ambulatory consultations and of home visits;
as
medicaments, applications,
diathermic
numbers of miscellaneous out-patient treatments, such injections, laboratory examinations, X-rays, dressing, minor operations, etc.;
number of cases of hospital in-patient care, and the corresponding bed days, sometimes analysed by cause.
number of
The above data are usually presented separately in respect of (a) persons protected in their own right, (b) wives, (c) children, and (d) other dependants, and sickness and maternity in general treated independently.
as
In addition, data on the number of hospital establishments and their capacity well as on the number of and types of medical personnel employed by the social security institution would also normally be available in the case of direct service of medical care by the institution.
The above data can be
very valuable for morbidity studies and analysis of medical care consumption as well as for health planning in general. However, care should be taken when interpreting and using data arising out of the operation of schemes limited in coverage in planning health services for population outside social security coverage. In particular, it should be noted that certain schemes provide for "cost sharing" on the part of the insured person and this might have an influence on the consumption of medical care. Further it should also be remarked that the very introduction of a medical care scheme may induce changes in the attitude of the protected population towards the needs experienced, and in consequence, in the demand for care, so that the data resulting from the operation of medical care schemes may nct represent the "true" inherent morbidity of the covered population.
(iii) Old-age invalidity and death benefit
In case of schemes, under which pensions are granted in respect of the above- mentioned contingencies, the data available will usually be the following:
number of pensioners and corresponding amounts of pensions current at a given date, by age, and distinguishing old-age, invalidity, widows, orphans and other beneficiaries;
new pensions granted and pensions terminated during a given period, and corresponding amounts of pensions, again distinguishing the various categories of pensions.
In the case of provident fund schemes, the data available would consist of number of cases of withdrawal from the fund during a given period and the corresponding amounts, analysed by cause (attainment of retirement age, incapacity for work, death, leaving country permanently, etc.).
These data generated by these schemes can evidently be of great interest to social planners. The number of current beneficiaries, especially when related to
1 See section (v) below.
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