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Economic burden of hospitalisation for congestive heart failure among adults in the Philippines
  1. Bernadette A Tumanan-Mendoza1,2,
  2. Victor L Mendoza3,4,
  3. April Ann A Bermudez-Delos Santos1,
  4. Felix Eduardo R Punzalan1,5,
  5. Noemi S Pestano1,
  6. Rudy Boy Natividad1,
  7. Louie Alfred Shiu1,
  8. Renelene Macabeo1,
  9. Hilton Y Lam6
  1. 1 Department of Internal Medicine, Section of Cardiology, Manila Doctors Hospital, Manila, Philippines
  2. 2 Department of Clinical Epidemiology, University of the Philippines Manila, College of Medicine, Manila, Philippines
  3. 3 Department of Internal Medicine, Section of Cardiology, De La Salle University Medical Center, Dasmariñas, Cavite, Philippines
  4. 4 Department of Physiology, De La Salle Health Sciences Institute, Dasmariñas, Cavite, Philippines
  5. 5 Department of Internal Medicine, Section of Cardiology, Philippine General Hospital, Manila, Philippines
  6. 6 Institute of Health Policy Development, National Institutes of Health, University of the Philippines, Manila, Philippines
  1. Correspondence to Dr Bernadette A Tumanan-Mendoza, Manila Doctors Hospital 667 United Nations Avenue, Ermita, Manila, Philippines; bernadette.tumanan{at}


Objectives Hospitalisation for congestive heart failure (CHF) was reported to be 1648 cases for every 100 000 patient claims in 2014 in the Philippines; however, there are no data regarding its economic impact. This study determined CHF hospitalisation cost and its total economic burden. It compared the healthcare-related hospitalisation cost from the societal perspective with the payer’s perspective, the Philippine Health Insurance Corporation (PhilHealth).

Methods This is a cost analysis study. Data were obtained from representative government/private hospitals and a drugstore in all regions of the country. Healthcare costs included cost of diagnostics/treatment, professional fees and other CHF-related hospital charges, while non-healthcare costs included production losses, transportation and food expenses.

Results The overall mean healthcare-related cost for CHF hospitalisation (class III) in government hospitals in the Philippines in 2014 was PHP19 340–PHP28 220 (US$436–US$636). In private hospitals, it was PHP28 370–PHP41 800 (US$639–US$941). In comparison, PhilHealth’s coverage/CHF case rate payment is PHP15 700 (US$354). The mean non-healthcare cost was PHP10 700–PHP14 600 (US$241–US$329). Using PhilHealth’s case rate payment and the prevalence of CHF hospitalisation in 2014, the total economic burden was PHP691 522 200 (US$15 574 824). Using the study results on healthcare-related cost meant that the total economic burden for CHF hospitalisation would instead be PHP851 850 000–PHP1 841 563 000 (US$19 185 811–US$41 476 644).

Conclusions The calculated healthcare-related hospitalisation cost for CHF in the Philippines in 2014 demonstrates the disparity between the actual cost and PhilHealth’s coverage. This implies a need for policymakers to review its coverage to make healthcare delivery affordable.

  • heart failure
  • public health
  • delivery of care

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  • Contributors All authors have contributed to the protocol development. BAT-M monitored the data collection, analysed the data, prepared the draft of the paper and did revisions prior to its submission to Heart Asia. VLM contributed to the data collection, analysis of the data and revisions of the draft prior to the submission process. AAAB-dS helped in the data collection, revising the drafts and completing the requirements for the submission process. FERP reviewed the draft of the paper before submission for possible publication. NSP, RBN, LAS and RM contributed to the data collection and NSP also reviewed the draft. HYL reviewed the draft prior to the publication process. BAT-M is the guarantor. All authors have given approval to this version for publication.

  • Funding The paper was funded through a research service agreement from Novartis Healthcare Philippines, Inc. to De La Salle Health Sciences Institute, Dasmariñas, Cavite. The authors developed the protocol, analysed the results and wrote the paper independently of the sponsor.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval Independent Ethics Committee, De La Salle Health Sciences Institute.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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