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					Discovery Health Benefit Tracker
August 2008




1. Membership                                                                                                   2.2 Top conditions ranked by average cost
                                                                    August 2008
Total number of lives managed                                                                    2.06 million   The top conditions ranked by the average cost per admission are shown below. The average cost per condition
                                                                                                                represents the total cost for all admissions divided by the number of admissions.

2. Hospital-related costs

Hospital costs represent the total cost for all authorised hospital admissions paid by the scheme. Total cost   Top conditions ranked by average cost                                      September 2007 to August 2008
includes all payments to hospitals, specialists and support providers such as radiology and pathology.          Liver transplant                                                                                      R547 370
                                                                                                                Long term ventilation through tracheostomy                                                            R466 897
                                                                                                                Babies less than 30 days old, with organ transplant                                                   R461 746
                                                                                          September 2007 to     Burns with skin graft                                                                                 R326 050
                                                                    August 2008
                                                                                          August 2008           Heart and/or lung transplant                                                                          R324 581
Total hospital costs                                                    R383.45 million         R8.33 billion   Premature babies < 1000 g with major operations                                                       R300 161
                                                                                                                Babies > 2499 g with operations                                                                       R292 856
2.1 Top ten conditions ranked by number of admissions                                                           Premature babies 1000-1499 g with major operations                                                    R273 523
                                                                                                                Major cardiac operations with catheterisation                                                         R259 638
All conditions are defined using diagnosis related groups (DRGs) that group admissions into clinically          Major operation to repair heart malformation                                                          R246 918
homogeneous groups. The top conditions ranked by number of admissions are shown below.
                                                                                                                2.3 Top 10 highest hospital cost admissions

                                                                             Number of admissions               Highest hospital costs related to admissions in the period between September 2007 to August 2008
                                                                                          September 2007 to
Top conditions ranked by number of admissions                       August 2008
                                                                                          August 2008                                                                 Age of member                             Length of stay
                                                                                                                Condition                                                                  Total cost
Pneumonia and whooping cough                                                      1 354              15 581                                                           (years)                                   (days)
Caesarean deliveries                                                              1 225              21 743     Babies > 2499 g with operations                              Less than 1           R1 298 543                     57
Gastroenteritis and abdominal pain                                                1 081              22 378     Operations for major injuries                                        37            R1 282 327                     55
Cataract operations                                                                 826              14 899     Babies > 2499 g with operations                              Less than 1           R1 197 986                     56
Tonsil and adenoid operations                                                       825              13 626     Babies > 2499 g with operations                              Less than 1           R1 197 282                     58
Digestive system disorders                                                          756              14 048     Major operation to repair heart malformation                           4           R1 149 317                     64
Other ear, nose, mouth and throat disorders                                         626               8 681     Burns with skin graft                                                49            R1 111 143                     68
Symptoms related to the respiratory system                                          623               7 148     Major operations of the small and large bowel                        56             R984 865                      61
Operations of the ear, nose and throat                                              577               7 901     Premature babies < 1000 g                                    Less than 1            R936 477                     131
Arm and hand operations                                                             554               9 575     Babies > 2499 g                                              Less than 1            R922 801                     121
                                                                                                                Major operations of the gall bladder                                 66             R856 217                      80
Total cost for top 10 conditions                                            R87 million         R1.61 billion
3. Chronic conditions and further disease management                                                                4. Preventive care

The following table shows the number of members claiming for a registered chronic condition through Discovery       Vitality incentivises members to get actively involved in improving their health. Apart from encouraging members to
Health’s Chronic Illness Benefit. The total paid represents the total amount paid for chronic medicines over the    exercise and lead a healthy lifestyle, Vitality also encourages the early detection of disease. The Screening Benefit
past year.                                                                                                          offers members access to preventive screening for a number of chronic conditions. Members are rewarded through
                                                                                                                    the Vitality programme for participating in these screening tests.

                                                                       Members              Total paid
Chronic overview                                                                  215 098           R1.15 billion
                                                                                                                                                                                                           Number of tests
3.1 Top 10 chronic conditions as shown by the total cost to the scheme                                                                                                                                               September 2007 to
                                                                                                                    Vitality screening                                                        August 2008
                                                                                                                                                                                                                     August 2008
The chronic conditions below represent the conditions that accounted for the largest spend on chronic medicines     Blood pressure                                                                          4 636                38 762
for the scheme. These conditions represent the conditions defined in terms of the Prescribed Minimum Benefits,      Cholesterol                                                                            18 365               374 027
as well as the additional chronic conditions approved by Discovery Health - up to 65 conditions depending on plan
                                                                                                                    Glucose                                                                                21 571               253 813
choice.
                                                                                                                    HIV                                                                                     6 994                80 251
                                                                                                                    Mammograms                                                                                866                63 112
                                                                                                                    Pap smears                                                                              6 198               112 096
                                                                       Members registered in August 2008
                                                                                                                    Prostate screening                                                                      4 771                58 530
Hypertension                                                                                            160 705
Hyperlipidaemia                                                                                          88 915     5. Emergency care
Asthma                                                                                                   49 838
Diabetes mellitus type 2                                                                                 33 473     Discovery 911 and the International Travel Benefit provides peace of mind to Discovery Health members in the event
Major depression                                                                                         16 217     of an emergency, locally or internationally.
Diabetes mellitus type 1                                                                                 14 714
Epilepsy                                                                                                 11 384     Discovery 911 is a nationwide group of highly trained paramedics in rapid response vehicles who will assist Discovery
HIV and AIDS                                                                                             10 510     Health members with all aspects of their emergency.
Bipolar mood disorder                                                                                     7 152
Multiple sclerosis                                                                                          629     Members on all plans, except KeyCare have cover for medical emergencies when travelling internationally. The
                                                                                                                    International Travel Benefit provides cover for emergency medical expenses outside the borders of South Africa,
                                                                                                                    including evacuation and medically necessary repatriation costs.
3.2 Oncology Management Programme

The table below shows the total number of members enrolled on the Oncology Management Programme.
                                                                                                                                                                                                                     September 2007 to
                                                                                                                                                                                              August 2008
                                                                                                                                                                                                                     August 2008
                                                                       Number of members on active                  Number of incidents that Discovery 911 paramedics attended to                            1 321               18 321
                                                                       treatment in August 2008                     Number of international emergency cases managed                                            534                7 318
Organ cancer                                                                                             14 697
Blood cancer                                                                                              2 019
Localised cancer                                                                                          1 103     Note
Other cancers                                                                                               573
                                                                                                                    The data presented in the Health Benefit Tracker includes information on Discovery Health Medical Scheme and the
Total cost over last 12 months                                                                      R1.22 billion   11 closed schemes administered by Discovery Health.

				
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