Economic burden of hospitalisation for congestive heart failure among adults in the Philippines

Abstract

ObjectivesHospitalisation for congestive heart failure (CHF) was reported to be 1648 cases for every 100 000 patient claims in 2014 in the Philippines; however, there are no data regarding its economic impact. This study determined CHF hospitalisation cost and its total economic burden. It compared the healthcare-related hospitalisation cost from the societal perspective with the payer’s perspective, the Philippine Health Insurance Corporation (PhilHealth).MethodsThis is a cost analysis study. Data were obtained from representative government/private hospitals and a drugstore in all regions of the country. Healthcare costs included cost of diagnostics/treatment, professional fees and other CHF-related hospital charges, while non-healthcare costs included production losses, transportation and food expenses.ResultsThe overall mean healthcare-related cost for CHF hospitalisation (class III) in government hospitals in the Philippines in 2014 was PHP19 340–PHP28 220 (US$436–US$636). In private hospitals, it was PHP28 370–PHP41 800 (US$639–US$941). In comparison, PhilHealth’s coverage/CHF case rate payment is PHP15 700 (US$354). The mean non-healthcare cost was PHP10 700–PHP14 600 (US$241–US$329). Using PhilHealth’s case rate payment and the prevalence of CHF hospitalisation in 2014, the total economic burden was PHP691 522 200 (US$15 574 824). Using the study results on healthcare-related cost meant that the total economic burden for CHF hospitalisation would instead be PHP851 850 000–PHP1 841 563 000 (US$19 185 811–US$41 476 644).ConclusionsThe calculated healthcare-related hospitalisation cost for CHF in the Philippines in 2014 demonstrates the disparity between the actual cost and PhilHealth’s coverage. This implies a need for policymakers to review its coverage to make healthcare delivery affordable.

Direct medical costs of type 2 diabetes mellitus in the Philippines: findings from two hospital databases and physician surveys

“…27 In a separate study, the average medical cost of CHF hospitalisation in 2014 was estimated to range from US$436 to US$636 per person in government hospitals, and it was US$639 to US$941 in private hospitals. 28 The cost of haemodialysis estimated in this study was also lower than expected. A typical individual would usually need dialysis three times a week, totalling 156 sessions a year.…”

Cost‐utility analysis of add‐on dapagliflozin in heart failure with reduced ejection fraction in the Philippines

“…PhilHealth provides hospitalization coverage; however, this does not cover the entire hospitalization cost as demonstrated in the study on hospitalization for HF. 22 In addition, for most diseases, provision for maintenance medications is through out‐of‐pocket expenses. This must be considered for chronic conditions like heart failure.…”

“…In the Philippines, more than 50% of healthcare delivery is obtained through out‐of‐pocket expenses. PhilHealth provides hospitalization coverage; however, this does not cover the entire hospitalization cost as demonstrated in the study on hospitalization for HF 22 . In addition, for most diseases, provision for maintenance medications is through out‐of‐pocket expenses.…”

“…The cost for HF hospitalization in both government and private hospitals in the country for 2014 was previously published. 22 The cost was converted to 2019 values, being the study's reference year. This was carried out through the use of the consumer price indices for 2014 and 2019.…”

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“…21 Moreover, out-of-pocket medical expenditures, including medicines and hospitalization, continue to be an economic burden. 22,23 More than 50% of the total health-related expense of the country fall under out-of-pocket expenses, which may potentially worsen the poverty status of many Filipinos. 20,21 Other determinants include personal relationships and past performance.…”