OBJECTIVES: This study aims to describe the demographic profile and determine the proportion and Active Aging health determinants of staff, faculty, and retired employees who are 55 years of age and older. METHODS: Mixed qualitative and quantitative methods, community-based, and participatory. Participants were working and retired faculty and staff, age 55 years and over, living within an urban campus of a University. The University Ethics Review Board approved the protocol. Focus group discussions (FGDs) led to the development of a pretested survey instrument. Additional health data were obtained using a validated Comprehensive Geriatric Assessment (CGA) tool. Trained and certified health professionals conducted the CGA. A Senior Geriatrician adjudicated the final diagnoses. Progress reports and validation workshops were conducted with study participants, content experts, and stakeholders. CSPRo, SPSS, and STATA were used to generate and analyze disaggregated data. RESULTS: Two hundred thirty-one (n=231) agreed to participate. The matched dataset was used in data analysis, representing a total of n=192 completed both surveys and CGA interview. Of the top 10 Geriatrician diagnoses, the highest-ranking non-communicable disease was hypertension and the top sensory diagnosis was presbyopia. Three of the self-assessed conditions were vision-related. They had better oral health than the recent national report. Most were highly independent and functional. The majority rated their QOL as good. Most had access to health insurance and a University Health Service. CONCLUSION Non-communicable diseases and visual disorders were the most common medical problems among working and retired university workers 55 years and older, living within the campus. To reduce NCDs, maintain functional independence and achieve a better quality of life especially among the retired, programs for older persons are recommended. These include access to medication, improved health financing, and senior wellness programs during and after employment. The results of the study will help understand and create a Framework for Active Aging that is relevant to this academic community.

The Philippines, with a maximum personal income tax rate at 32%1 and a corporate income tax of 35%,1 has one of the highest income tax rates among the Association of South East Asian(ASEAN) member states.2 The new administration is now campaigning to lower the ceilings on capital and personal income tax, through a proposal originally passed in September 2016, and amended in January 2017, following public and private sector opposition for its immediate imposition.3 In its Explanatory Note, House Bill No. 292, "An Act Imposing Excise Tax on Sugar-Sweetened Beverages by Inserting a New Section 150-A in the National Internal Revenue Code of 1997, as Amended," cites this as the reason for imposing an, "excise tax of ten pesos (Php 10.00) on sugar-sweetened beverages, the rate of which shall be increased by four percent (4%) every year thereafter effective on January 1, 2017."4 According to the proposed bill, "this measure is proposed to provide additional revenue collections for our country," further claiming that, "this house bill is timely in its submission as one of the new administration's policies to pursue reforms in income tax rates.

OBJECTIVES

The burden of oral diseases is high in the Philippines. The global burden of disease study in 2019 estimated that 44 million Filipinos are affected by oral disorder. More specifically, 29 million Filipinos have untreated dental caries. Outpatients' dental health services are not covered by PhilHealth benefit package. There is a need to include key oral health interventions such as basic prevention and treatment in PhilHealth benefit package to be delivered at the primary health care settings (WHO TSA 153980). The study aimed to determine the incremental cost-effectiveness ratio (ICER) of a set of oral health care services to be delivered at different levels of health care within a comprehensive PhilHealth benefit package.

METHODS

This study evaluates the cost-effectiveness of including basic oral health services in the PhilHealth benefit package using a Markov modelling approach. The target population consists of Filipino adults and children at risk for dental diseases who are potential beneficiaries of PhilHealth. The intervention under consideration includes dental consultation, oral prophylaxis, topical fluoride application, silver diamine fluoride application, dental filling, and tooth extraction. The comparator is the current standard of care, which involves out-of-pocket payments for oral health services or limited access to subsidized dental care. The primary outcomes assessed include the incremental costeffectiveness ratio (ICER) per quality-adjusted life year (QALY) gained. A Markov model was constructed with a time horizon of 50 years to simulate the lifespan of Filipinos up to the average life expectancy of 70 years old, using a cycle length of one year to reflect disease progression and treatment effects overtime. Model parameters were derived from literature and expert opinion. Sensitivity analyses, including one-way and probabilistic sensitivity analyses, were conducted to assess uncertainty in model inputs. The analysis was carried out from a societal perspective incorporating direct medical and non-medical costs, and indirect costs.

RESULTS

A Markov model showed that a subsidized package is a cost-effective approach compared to the current situation of no subsidy, with an ICER of PhP 75,636 (1,535.76 USD) per disability adjusted life year (DALY) averted. The computed ICER was considered good value for money as it was below 2021 GDP per capita of the Philippines of PhP 174,286 (3,538.80 USD). One-way sensitivity analysis showed that the cost of preventive treatment had the most significant impact on the model, and a price threshold of greater than PhP 3,062 (62.17 USD) for preventive treatment will render the subsidized package no longer cost-effective. The budget impact analysis showed a 1.63% increase in budget annually with the current situation of no subsidy. Rolling out a subsidized oral health package will entail a significant increase in government expenses during the first year but a decreasing trend of 1-2% annually for the following years as the program takes its effect.

CONCLUSION

A subsidized oral health package is a costeffective approach from a societal perspective. It will entail a significant increase in government expenditure during the start of its roll out but will eventually result in a decreasing trend of expenses as the years progress.

Human ; Oral Health ; Insurance ; Cost-effectiveness Analysis