BACKGROUND: In 2016, the Philippine Health Insurance Corporation (PhilHealth) introduced the Z-package to provide financial coverage for, among others, intramedullary nailing procedures and implant costs for eligible patients with femoral shaft fractures. OBJECTIVE: To compare health care durations and expenses between patients with closed femoral shaft fractures requiring intramedullary fixation who utilized the PhilHealth Z-package and those who did not. DESIGN: Retrospective cohort study. PARTICIPANTS: 66 male and female patients, aged 19 to 39 years, who underwent intramedullary nailing for closed femoral shaft fractures. SETTING: Orthopedic Ward, Southern Philippines Medical Center, Davao City, January to December 2018. MAIN OUTCOME PROCEDURE: Time to surgery, length of hospital stay, total hospital bill, total PhilHealth coverage, other funds for medical assistance (OFMA) coverage, and out-of-pocket (OOP) expenses. MAIN RESULTS: Among the 66 patients, 33 had the Z-package, while the remaining 33 did not. The median time to surgery (19 days vs 24 days; p=0.156), median length of hospital stay (24 days vs 29 days; p=0.546), and median total hospital bill (Php 62,392.00 vs Php 62,404.80; p=0.314) were comparable between those without the Z-package and those who had, respectively. However, patients without the Z-package had significantly lower total PhilHealth coverage (Php 30,740.00 vs Php 48,740.00; p<0.001) and higher OFMA coverage (Php 49,909.90 vs Php 34,409.20; p=0.024), and OOP expenses (Php 0.00; IQR: Php 0.00 to Php 20,000.00 vs Php 0.00; IQR: Php 0.00 to Php 0.00; p=0.004) compared to those with the Z-package. CONCLUSION Patients with the Z-package had a slightly longer time to surgery, although this difference was not statistically significant. However, they benefited from significantly lower remaining bills after PhilHealth coverage and reduced OOP expenses compared to patients without Z-package coverage.
PhilHealth coverage ; out-of-pocket expenses ; medical assistance ; length of stay

No abstract available.
Health Expenditures*

Objective: To determine the effectiveness of the Philippine Health Insurance Corporation (PhilHealth) case rate system in reducing out-of-pocket expenses among non-no balance billing (NBB) patients undergoing thyroidectomy under the Department of Otorhinolaryngology – Head and Neck Surgery of the Baguio General Hospital and Medical Center from February to September 2018. Methods: Design: Prospective Cross- Sectional. Setting: Tertiary Government Hospital. Participants: Sixty-four (64) randomly selected patients with PhilHealth who underwent thyroidectomy who agreed to participate and reveal their statements of accounts. Results: Among the study population, 20% belonged to the no balance billing (NBB) category, with zero out-of-pocket expenses during their confinement. Eighty percent (80%) belonged to the non-NBB category and also incurred zero hospital charges. In addition, there was no significant difference in the individual categories of the hospital expenses between the two groups except for the surgical procedures (p= .018, 95% CI). The accumulated total expenses also did not significantly differ between the two groups (p= .063, 95% CI). The minimum amount billed was PhP 1,984.95, while the maximum amount charged was PhP 38,898.65, with a median of PhP 18,703.28 and interquartile range of PhP 4,251.78 (XU: PhP 20,848.74, XL : PhP 16,596.96). There were no reported out-of-pocket expenses from non-NBB patients. The actual cost of thyroidectomy did not differ significantly from the case rate provided by PhilHealth among all the RVS categories. Conclusion The PhilHealth case rate system is effective in reducing out-of-pocket expenses among non-NBB patients who underwent thyroidectomy in our institution during the study period.
Health Expenditures ; Thyroidectomy ; Health Expenditures

Results from some studies in rural area of Vietnam have shown that poor people are likely tend to sell assets while non poor people are able to pay for health care services. This makes poor people fall into poverty trap. Objectives: To identify the average household health expenditure during a year and sources of borrowing money and average amount of borrowing as well for health care services. Methods: 621 households were selected randomly from the Filabavi, Bavi District, Ha Tay Province. A longitudinal descriptive study was conducted for one year from July 2001 to June 2002. All selected households were interviewed one time per month. Results and conslusion: average payment household for health care services for one year was VND 519.000 (6.4% of total annual household income). Annual household income of poor group was VND 6,576,000, among this 8.4% was paid for health care services. There was 16.9% household had to borrow money for health care services average1y, while 23.1% of poor household had to borrow money for health care services. Borrowing sources included relatives (85%), neighbours (50%), Bank (26%), friends (15%), community organizations (9%) and private organizations with some interest (18%).
Health Expenditures, Rural Health

The expenditure structure and the sharing of the cost from in patients and out patient betweem subject with and without insurance subscriptive subject at commune and district level were analysed. Health Insurance service had supported importantly the subject at basic level especially the poors and the pensioneers who received 100% of allowance to access to the health care. Other expenditures, included also the gifts, from the insurance subscribers were higher consisderably than the subjects without insurance. For old person and pensioneers who hospitalized, these other expenditures account for high rate (60,91% at commune level and 60,32% at district level)
Health Expenditures ; Insurance

A multiple regression analysis using ordinary least square (OLS) is frequently used for the projection of healt expenditure as well as for the identification of factors affecting health care costs. Data for the analysis often have mixed characteristics of time series and cross section. Parameters as a result of OLS estimation, in this case, are no longer the best linear unbiased estimators (BLUE) because the data do not satisfy basic assumptions of regression analysis. The study theoretically examined statistical problems induced when OLS estimation was applied with the time series cross section data. Then both the OLS regression and time series cross section regression (TSCS regression) were applied to the same empirical data. Finally, the difference in parameters between the two estimations were explained through residual analysis.
Health Care Costs ; Health Expenditures*

BACKGROUND: It is expected that the demand for the information about the primary medical service in the forthcoming supersede age of communication will be on the increase. For that reason, family doctors who are in charge of the primary medical service have to play an important part in constructing a data-base for furnishing the medical information. This article presents a model which includes the roles of family doctors, constructing medical-related information site of family medicine in the communications net with PC to gat,her fundamental data in operating the system of medical information and elucidating the formation of medical-related information site and the effect of operating that system. METHODS: Since Aug. 20 in 1996, the site of family medicine, the program of medical information, has been set up in Unitel. The medical information of the site of family medicine is to be classified into two parts : for doctors and for the public. The former is composed of medicine documents, several kinds of medical data, a linkage with medicine site in Internet, movements of an academic society and information exchanges for friendship. The latter is mainly made up of some practical medical sense and medical counsel. RESULTS: From the opening the medical information site to Jul. 30 in 1997, 250 persons a day have connected with medical information site and this fact implied 15 hours connection a day in terms of the daily mean. The cases of health counsel averaged 6 cases connection a day and the annual statistics of those cases were about, 1980 cases. The major content of health counsel was related to common symptoms that could be settled in primary medical problem. According to the survey for connectors, most of connectors answered that the medical information through communications net was much more effective t.han that from other media in the educational aspects and very helpful in the prevention of diseases and in the medical expenditure. Above all, the medical information through communications net was very effective in correcting the mistaken practical medical sense. CONCLUSIONS: It is necessary for family doctors to give thought to the connection of both information communication and medicine and to have correct understanding of medical domain in the cyberspace. On the foundation of these necessities, all the family doctors have to make the best of their way to construct a database with rnedical data and to transfer these data into the computer sites.
Friends ; Health Expenditures ; Humans ; Internet

No abstract available.
Cervix Uteri* ; Female ; Health Expenditures*

Health ; Papua New Guinea ; Expenditures

Objective. This research aimed to determine the in-patient expenditure of COVID-19 adult patient s and their out-of-pocket (OOP) payments at the University of the Philippines-Philippine General Hospital (UP-PGH) after the new PhilHealth case rate coverage was instituted last 15 April 2020. It also intended to present the preliminary data on the expenses incurred by COVID patients during the initial phase of the pandemic in the country. Methods. This study was a retrospective chart review of admitted COVID-19 patients aged 19 years old and above from 15 April to 14 August 2020 at UP-PGH that availed of PhilHealth COVID-19 case rate benefits package (C19C1-C4). Data were analyzed to extract overall expenses, out-of-pocket (OOP) charges, cost centers utilization, and other hospitalization expenditure sources. Results. Of the 691 COVID-19 patients included during the study period, 55.72% were male, mostly belonging to the 61-70 age range with a median age of 58. The average in-hospital stay was 14.20 days, and 76.99% were under charity services, with the moderate (42.84%) and mild (25.33%) pneumonia cases accounting for 68.17% of the admissions. Total hospital expenses clustered around Php51,000 to 200,000 (~USD 1,041 to 4,156), most spending between Php101,000 to 150,000 (~USD 2,078 to 3,118). The top three cost centers and expenditure sources were pharmacies, personal protective equipment (PPE) usage, and laboratory. The average OOP payment for patients less than 60 years old was higher, ranging from Php 25,899 to Php 44,428.63 (USD 538 to USD 924.44) compared to patients older than 60 (Php4,005.60 to Php 32,920.20 ~ USD 83.35 to 684.98). The most OOP charges were for the age group 19-30, amounting to Php 44,428.63 (USD 924.44). Conclusion. Preliminary findings of this study gave an actual representation of the expenses of COVID-19 patients, which can guide future utilization of the national health insurance during unexpected pandemics. Early price regulation of new therapeutic interventions, diagnostic tests, and medical supplies, e.g., PPEs, disinfectants, air filters, are measures that can be implemented.
Health Expenditures ; COVID-19 ; Insurance, Health