1.Health benefit utilization and out-of-pocket expenses in outpatient care and hospitalizations: Baseline surveys of three primary care sites in the Philippines
Leonila F. Dans ; Jose Rafael A. Marfori ; Regine Ynez H. De Mesa ; Cara Lois T. Galingana ; Noleen Marie C. Fabian ; Mia P. Rey ; Josephine T. Sanchez ; Jesusa T. Catabui ; Nannette B. Sundiang ; Ramon Pedro P. Paterno ; Edna Estifania A. Co ; Carol Stephanie C. Tan-Lim ; Antonio Miguel L. Dans
Acta Medica Philippina 2024;58(Early Access 2024):1-8
Background:
The Philippine Primary Care Studies (PPCS) is a network of pilot studies that developed, implemented, and tested strategies to strengthen primary care in the country. These pilot studies were implemented in an urban, rural, and remote setting. The aim is to use the findings to guide the policies of the national health insurance program (PhilHealth), the main payor for individualized healthcare services in the country.
Objective:
The objective of this report is to compare baseline outpatient benefit utilization, hospitalization, and health spending, including out-of-pocket (OOP) expenses, in three health settings (urban, rural, and remote). These findings were used to contextualize strategies to strengthen primary care in these three settings.
Methods:
Cross-sectional surveys were carried out using an interviewer-assisted questionnaire on a random sample of families in the urban site, and a stratified random sample of households in the rural and remote sites. The questionnaire asked for out-patient and hospitalization utilization and spending, including the OOP expenses.
Results:
A total of 787 families/households were sampled across the three sites. For outpatient benefits, utilization was low in all sites. The remote site had the lowest utilization at only 15%. Unexpectedly, the average annual OOP expenses for outpatient consults in the remote site was PhP 571.92/per capita. This is 40% higher than expenses shouldered by families in the rural area, but similar with the urban site.
For hospital benefits, utilization was lowest in the remote site (55.7%) compared to 75.0% and 78.1% for the urban and rural sites, respectively. OOP expenses per year were highest in the remote site at PhP 2204.44 per capita, probably because of delay in access to healthcare and consequently more severe conditions. Surprisingly, annual expenses per year for families in the rural sites (PhP 672.03 per capita) were less than half of what families in the urban sites spent (PhP 1783.38 per capita).
Conclusions
Compared to families in the urban site and households in the rural sites, households in remote areas have higher disease rates and consequently, increased need for outpatient and inpatient health services. When they do get sick, access to care is more difficult. This leads to lower rates of benefit utilization and higher out-of-pocket expenses. Thus, provision of “equal” benefits can inadvertently lead to “inequitable” healthcare, pushing disadvantaged populations into a greater disadvantage. These results imply that health benefits need to be allocated according to need. Families in poorer and more remote areas may require greater subsidies.
2.Health benefit utilization and out-of-pocket expenses in outpatient care and hospitalizations: Baseline surveys of three primary care sites in the Philippines.
Leonila F. Dans ; Jose Rafael A. Marfori ; Regine Ynez H. De Mesa ; Cara Lois T. Galingana ; Noleen Marie C. Fabian ; Mia P. Rey ; Josephine T. Sanchez ; Jesusa T. Catabui ; Nannette B. Sundiang ; Ramon Pedro P. Paterno ; Edna Estifania A. Co ; Carol Stephanie C. Tan-Lim ; Antonio Miguel L. Dans
Acta Medica Philippina 2024;58(16):133-140
BACKGROUND
The Philippine Primary Care Studies (PPCS) is a network of pilot studies that developed, implemented, and tested strategies to strengthen primary care in the country. These pilot studies were implemented in an urban, rural, and remote setting. The aim is to use the findings to guide the policies of the national health insurance program (PhilHealth), the main payor for individualized healthcare services in the country.
OBJECTIVEThe objective of this report is to compare baseline outpatient benefit utilization, hospitalization, and health spending, including out-of-pocket (OOP) expenses, in three health settings (urban, rural, and remote). These findings were used to contextualize strategies to strengthen primary care in these three settings.
METHODSCross-sectional surveys were carried out using an interviewer-assisted questionnaire on a random sample of families in the urban site, and a stratified random sample of households in the rural and remote sites. The questionnaire asked for out-patient and hospitalization utilization and spending, including the OOP expenses.
RESULTSA total of 787 families/households were sampled across the three sites. For outpatient benefits, utilization was low in all sites. The remote site had the lowest utilization at only 15%. Unexpectedly, the average annual OOP expenses for outpatient consults in the remote site was PhP 571.92/per capita. This is 40% higher than expenses shouldered by families in the rural area, but similar with the urban site. For hospital benefits, utilization was lowest in the remote site (55.7%) compared to 75.0% and 78.1% for the urban and rural sites, respectively. OOP expenses per year were highest in the remote site at PhP 2204.44 per capita, probably because of delay in access to healthcare and consequently more severe conditions. Surprisingly, annual expenses per year for families in the rural sites (PhP 672.03 per capita) were less than half of what families in the urban sites spent (PhP 1783.38 per capita).
CONCLUSIONSCompared to families in the urban site and households in the rural sites, households in remote areas have higher disease rates and consequently, increased need for outpatient and inpatient health services. When they do get sick, access to care is more difficult. This leads to lower rates of benefit utilization and higher out-of-pocket expenses. Thus, provision of “equal” benefits can inadvertently lead to “inequitable” healthcare, pushing disadvantaged populations into a greater disadvantage. These results imply that health benefits need to be allocated according to need. Families in poorer and more remote areas may require greater subsidies.
Primary Health Care ; Insurance, Health
3.A comparative study of the effectiveness of tea tree oil and benzoyl peroxide in the treatment of acne vulgaris among Filipino teenagers and adults in Metro Manila
Erica Felicia Despuig ; Paz Ines Domingo ; Karla Shayne Feliciano ; Fritz Angelo Casama ; Ma. Inez Angela Carballo ; Camille Erika Chan ; Audrey Marie Chua ; Stephanie Co ; Steffi Grace Cocos ; Roger Junior Colobong ; Jose Ronilo G. Juangco
Health Sciences Journal 2016;5(1):20-24
Introduction:
The researchers aimed to determine the efficacy of tea tree oil in comparison to
benzoyl peroxide in treating mild acne. This study also aimed to identify the side effects of both
treatment modalities.
Methods:
Using a randomized single blinded controlled clinical trial, teenagers and young adults with
mild acne vulgaris were allocated to receive tea tree oil gel or benzoyl peroxide for four weeks. The
effectiveness of the agents was measured using the Investigator's Global Assessment Scale. Posttreatment scores were compared with the baseline within groups. The difference was compared
between the two study arms. Adverse reactions to the two agents were also noted.
Results :
Both tea tree oil and benzoyl peroxide groups showed a significant decrease in the posttreatment lesion counts compared to the baseline, however when the mean differences were
compared between groups, the difference was not significant.
Conclusion
Tea tree oil is comparable to benzoyl peroxide in treating mild acne vulgaris among
teenagers and young adults.
Tea Tree Oil
;
Benzoyl Peroxide