Vol. 46 | No. 1 | January-June 2018 Back

Open Access

Economic Burden of Fatal and Non-fatal Acute Coronary Syndrome to Filipinos Admitted at a Tertiary Care Center

Augusto Niccolo S. Salalima, Ariel Miranda, Joselito Ramos, Charlies Esteban
Jun 2018 DOI 10.69944/pjc.4c1bc15595

Abstract

INTRODUCTION: Acute coronary syndrome (ACS) contributes to approximately 30% of deaths in the Philippines  based on the latest available data from the Department of Health. This study aimed to determine  the economic burden of ACS to patients and their families and to determine the incidence of  catastrophic healthcare expenditure among patients with ACS. 

Methods: This was a retrospective study that reviewed the computerized medical records of patients admitted  due to fatal or non-fatal ACS from January to December 2016. We extracted and analyzed patient  demographic information, length of hospital stay, disposition, type of management, cost of  hospitalization and coverage of the Philippine Health Insurance Corporation (PhilHealth). We  also calculated the percentage of patients with catastrophic expenditure, defined as >30% of the  patient’s annual household income lost to healthcare services. 

Results: Of the 310 patients diagnosed and managed for ACS during the study period, 90.97% had  PhilHealth coverage. However, across the ACS spectrum, the actual PhilHealth case rate only  covered an average of 10.21% of the total hospitalization costs. Over half (57.42%) of ACS patients  incurred catastrophic expenditure. 

Conclusion: This study showed that despite the high number of patients with PhilHealth, almost six out of ten  Filipino patients still had to shoulder a majority of the hospitalization costs due to ACS. These  costs do not even include productivity losses and costs due to consumption of other resources. As the ACS becomes severe and requires revascularization, the average cost of hospitalization and  the average expense incurred by the patient and his or her family also increases. However, the  percentage of the expenses shouldered by PhilHealth does not increase commensurately. Thus, the  main goal of PhilHealth to provide universal health coverage remains unfulfilled.

References
  1. Jan S, Lee S, Sawhney J, et al. Catastrophic expenditure on acute  coronary events in Asia: A prospective study. Bull World Health  Organ 2016; 94:193-200. 
  2. Garcia DR, Lu LC, Perez-Rubio BR. In sickness and in PhilHealth:  Congress sets lofty goals for Philippine health care. The Guidon  2017;2017. Available at: http://www.theguidon.com/1112/ main/2017/11/in-sickness-and-in-philhealth/. Accessed 17  September 2018. 
  3. Philippine Health Insurance Corporation. List of Medical Case Rates  (Updated February 2017). Available at: https://www.philhealth.gov. ph/circulars/2017/annexes/0019/AnnexA-MedicalCaseRates.pdf.  Accessed 17 September 2018. 
  4. Tumanan-Mendoza B, Mendoza V, Morales D. Cost analysis for the  management of acute coronary syndrome using different quality of  care indicators. ACTA Medica Philippina 2009;43:15-22. 
  5. Tumanan-Mendoza B, Mendoza L, Punzalan FE, et al. Economic  burden of community-acquired pneumonia among adults in the  Philippines: Its equity and policy implications in the case rate  payments of the Philippine Health Insurance Company. Value in  Health Regional Issues 2015;6:118-25. 
License

Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License, which permits use, share — copy and redistribute the material in any medium or format, adapt — remix, transform, and build upon the material, as long as you give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use. You may not use the material for commercial purposes. If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original. You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit https://creativecommons.org/licenses/by-nc-sa/4.0/.