PIN45 - Economic Burden of Community-Acquired Pneumonia Among Adults In The Philippines Its Clinical and Policy Implications in the Case Rate Payments of The Philippine Health Insurance Corporation

Abstract

To determine (1) the cost of hospitalization and 1-week post-discharge, (2) the difference between estimated costs and the Philippine Health Insurance Corporation (PhilHealth) pneumonia case rate payments, and (3) the economic burden of community-acquired pneumonia (moderate and high-risk, CAP-MR and CAP-HR, respectively) among patients aged > 19 years old in the Philippines. The study involved two tertiary private hospitals in the Philippines. Using the societal perspective, out-of-pocket expenses and productivity losses were computed. A base case and sensitivity analyses were performed and the economic burden of pneumonia was determined using Philhealth claims. The estimated cost of hospitalization for CAP-MR was PhP 36,153 - 113,633 (US$852 – 2,678) and the1-week post-discharge cost for CAP-MR was PhP 1,450 – 8,800 (US$ 34 – 207) The cost of hospitalization for CAP-HR was PhP 104,544 – 249,695 (US$2,464 – 5,885) and PhP 101,248 – 243, 495 (US$2,386 – 5,739) with the use of either invasive ventilation or non-invasive ventilation, respectively. The post discharge cost for CAP-HR was PhP 1,716 – 10,529 (US$40 – 248). In comparison, the present PhilHealth case rate payments for CAP-MR is PhP 15,000 (US$354) and PhP 32,000 (US$754) for CAP-HR. Based on the number of PhilHealth claims for the year 2012 and the study results, the economic burden of pneumonia in 2012 was PhP 8.48 billion for CAP-MR and PhP 643.76 million for CAP-HR. The paper reported the hospitalization and follow-up costs of CAP-MR and CAP-HR based on the societal perspective. It showed significant difference from the current case rate payments of the Philippine Health Insurance Corporation.