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Abstract
Chronic obstructive pulmonary disease (COPD) is a frequent cause of morbidity and mortality in the Philippines and majority of the economic burden lies in hospitalizations during an exacerbation. Despite coverage of hospitalization cost with the national health insurance system (Phil-Health) for COPD exacerbations, patients often pay out-of-pocket. This study aimed to determine the demographic characteristics of COPD admissions at a Philippine tertiary care center, Philippine General Hospital, and assess mean cost of hospitalization, and identify predictors of prolonged hospitalization and cost > 20,000 Philippine pesos (Php). A prospective cross-sectional study was conducted for 6 months by chart review. Patients were categorized as charity service patients, that is, with no charged professional fees and free medications and private service patients who pay for their health care services. A total of 43 COPD admissions were included. The average daily cost of hospitalization (at peso-dollar rate of 56) for service patients was at $ 75.89 compared to private service patients at $ 285.71. Demographic characteristics and type of accommodation were not significant predictors of prolonged hospital stay nor hospitalization cost of ≥ $ 357. Accommodation cost and professional fees accounted for majority or 61.6% of the overall cost for private patients, while medications and diagnostic tests were the major or 76.01% contributor to the overall cost for charity patients. Despite existence of Phil-health, in-patient coverage for COPD remain insufficient. Measures for maximizing COPD control in the out-patient setting could potentially reduce total cost for this disease.
Highlights
Chronic obstructive pulmonary disease (COPD) is an increasing cause of morbidity and mortality in the Philippines
This study aims to identify the amount of out-of-pocket expenses by patients admitted for COPD exacerbation at the Philippine General Hospital and predictors for prolonged stay and hospitalization costs
There were a total of 43 admissions between June 2019 to November 2019 at the Philippine General Hospital with a diagnosis of COPD exacerbation
Summary
Chronic obstructive pulmonary disease (COPD) is an increasing cause of morbidity and mortality in the Philippines. Chronic Obstructive Pulmonary Disease (COPD), the seventh leading cause of death in the Philippines, has a destructive impact on patients’ function and quality of life, and increases the risk of developing heart disease, lung cancer, and a variety of other conditions. In the case of highly prevalent chronic diseases, it is essential to quantify the social and financial magnitude of the disease in all spheres (direct and indirect costs, health and non-medical costs, labor losses and intangible costs) This will improve the ability to design, prioritize, and apply preventive and health promotion measures, investments in public health or social policies and protocols and care guidelines in the most equitable and efficient way possible. With our country’s life expectancy of 67 years, a COPD patient who dies at 50 loses 17 potential years where he could have earned around PHP 2.8 million (based on the minimum daily wage of $ 9.14 for NCR and a peso dollar rate of 56) [24]
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