IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v75y2012i10p1820-1827.html
   My bibliography  Save this article

Financial protection mechanisms for inpatients at selected Philippine hospitals

Author

Listed:
  • Caballes, Alvin B.
  • Söllner, Walter
  • Nañagas, Juan

Abstract

The study was undertaken to determine, from the patient's perspective, the comparative effectiveness of locally established financial protection mechanisms particularly for indigent and severely-ill hospitalized patients. Data was obtained from a survey conducted in 2010 in Philippine provinces which were part of the Health Systems Development Project and involved 449 patients from selected private and public hospitals. Direct medical expenses incurred during the confinement period, whether already paid for prior to or only billed upon discharge, were initially considered. Expenses were found to be generally larger for the more severely ill and lower for the poor. Hospital-provided discounts and social health insurance (PhilHealth) reimbursements were the financial protection mechanisms evaluated in this study. In average terms, only up to 46% of inpatient expenses were potentially covered by the combined financial support. Depending on the hospital type, 28–42% of submitted PhilHealth claims were invalidated. Multiple linear regression analysis was utilized to determine the relationship of the same set of patients' demographic characteristics, socioeconomic status, severity of illness, and hospital assignments with selected expense categories and financial protection measures. Pre-discharge expenditures were significantly higher in public hospitals. The very ill also faced significantly larger expenses, including those for final hospital charges. Hospital-derived discounts provided significantly more support for indigent as well as very sick patients. The amounts for verified PhilHealth claims were significantly greater for the moderately-ill and, incongruously, the financially better-off patients. Sponsored Program members, supposed indigents enjoying fully-subsidized PhilHealth enrollment, qualified for higher mean reimbursements. However, there was a weak correlation between such patients and those identified as poor by the hospital social service staff. Thus, while hospital discounts, subsidies for practical purposes, and PhilHealth reimbursements progressively supported sicker patients, discounts were more responsive in assisting the poor. PhilHealth processes therefore need to be improved so as to more effectively support indigent patients.

Suggested Citation

  • Caballes, Alvin B. & Söllner, Walter & Nañagas, Juan, 2012. "Financial protection mechanisms for inpatients at selected Philippine hospitals," Social Science & Medicine, Elsevier, vol. 75(10), pages 1820-1827.
    • Handle: RePEc:eee:socmed:v:75:y:2012:i:10:p:1820-1827
    DOI: 10.1016/j.socscimed.2012.07.027
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277953612005680
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.socscimed.2012.07.027?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Wagstaff, Adam, 2008. "Measuring financial protection in health," Policy Research Working Paper Series 4554, The World Bank.
    2. Xiaoyun Sun & Sukhan Jackson & Gordon Carmichael & Adrian C. Sleigh, 2009. "Catastrophic medical payment and financial protection in rural China: evidence from the New Cooperative Medical Scheme in Shandong Province," Health Economics, John Wiley & Sons, Ltd., vol. 18(1), pages 103-119, January.
    3. Obermann, Konrad & Jowett, Matthew R. & Alcantara, Maria Ofelia O. & Banzon, Eduardo P. & Bodart, Claude, 2006. "Social health insurance in a developing country: The case of the Philippines," Social Science & Medicine, Elsevier, vol. 62(12), pages 3177-3185, June.
    4. Menno Pradhan & Nicholas Prescott, 2002. "Social risk management options for medical care in Indonesia," Health Economics, John Wiley & Sons, Ltd., vol. 11(5), pages 431-446, July.
    5. Pablo Gottret & George Schieber, 2006. "Health Financing Revisited : A Practitioner's Guide," World Bank Publications - Books, The World Bank Group, number 7094, December.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Caballes, Alvin B., 2015. "Institutional Financing of Catastrophic Health Expenditures," Philippine Journal of Development PJD 2013 Vol. 40 Nos. 1-2, Philippine Institute for Development Studies.
    2. Paqueo, Vicente B. & Abrigo, Michael Ralph M., 2017. "Social Protection and Access to Health Care among Children in the Philippines," Discussion Papers DP 2017-36, Philippine Institute for Development Studies.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Nikolaos Grigorakis & Christos Floros & Haritini Tsangari & Evangelos Tsoukatos, 2017. "Combined social and private health insurance versus catastrophic out of pocket payments for private hospital care in Greece," International Journal of Health Economics and Management, Springer, vol. 17(3), pages 261-287, September.
    2. Mohammad Abu-Zaineh & Habiba Romdhane & Bruno Ventelou & Jean-Paul Moatti & Arfa Chokri, 2013. "Appraising financial protection in health: the case of Tunisia," International Journal of Health Economics and Management, Springer, vol. 13(1), pages 73-93, March.
    3. Omar Galárraga & Sandra Sosa-Rubí & Aarón Salinas-Rodríguez & Sergio Sesma-Vázquez, 2010. "Health insurance for the poor: impact on catastrophic and out-of-pocket health expenditures in Mexico," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 11(5), pages 437-447, October.
    4. Adam Wagstaff, 2010. "Social health insurance reexamined," Health Economics, John Wiley & Sons, Ltd., vol. 19(5), pages 503-517, May.
    5. Ebaidalla Mahjoub Ebaidalla & Mohammed Elhaj Mustafa Ali, 2017. "Determinants and Impact of Households’s Out-of-Pocket Health Care Expenditure in Sudan: Evidence From Urban and Rural Population," Working Papers 1170, Economic Research Forum, revised 12 2017.
    6. Grigorakis, Nikolaos & Floros, Christos & Tsangari, Haritini & Tsoukatos, Evangelos, 2016. "Out of pocket payments and social health insurance for private hospital care: Evidence from Greece," Health Policy, Elsevier, vol. 120(8), pages 948-959.
    7. Indrani Gupta & William Joe, 2013. "Refining estimates of catastrophic healthcare expenditure: an application in the Indian context," International Journal of Health Economics and Management, Springer, vol. 13(2), pages 157-172, June.
    8. S. Savitha & K. Kiran, 2015. "Effectiveness of micro health insurance on financial protection: Evidence from India," International Journal of Health Economics and Management, Springer, vol. 15(1), pages 53-71, March.
    9. Kuangnan Fang & BenChang Shia & Shuangge Ma, 2012. "Health Insurance Coverage and Impact: A Survey in Three Cities in China," PLOS ONE, Public Library of Science, vol. 7(6), pages 1-8, June.
    10. Erik Schokkaert & Jonas Steel & Carine Van de Voorde, 2017. "Out-of-Pocket Payments and Subjective Unmet Need of Healthcare," Applied Health Economics and Health Policy, Springer, vol. 15(5), pages 545-555, October.
    11. Besstremyannaya, Galina, 2015. "Measuring the effect of health insurance companies on the quality of healthcare systems with kernel and parametric regressions," Applied Econometrics, Russian Presidential Academy of National Economy and Public Administration (RANEPA), vol. 38(2), pages 3-20.
    12. Bruno Nikolic, 2015. "Slovenian Complementary Health Insurance Reform - Dichotomy between the Internal Market and the Social Dimension," DANUBE: Law and Economics Review, European Association Comenius - EACO, issue 4, pages 205-216, December.
    13. Sowmya Dhanaraj, 2014. "Health Shocks and Coping Strategies: State Health Insurance Scheme of Andhra Pradesh, India," WIDER Working Paper Series wp-2014-003, World Institute for Development Economic Research (UNU-WIDER).
    14. Arnab Acharya & Melisa Martínez-Álvarez, 2012. "Aid Effectiveness in the Health Sector," WIDER Working Paper Series wp-2012-069, World Institute for Development Economic Research (UNU-WIDER).
    15. Kim, Chang-O & Joung, Won Oh, 2014. "Effect of the Crisis Assistance Program on poverty transition for seriously ill people in South Korea: A quasi-experimental study," Social Science & Medicine, Elsevier, vol. 101(C), pages 28-35.
    16. Rama Pal, 2012. "Measuring incidence of catastrophic out-of-pocket health expenditure: with application to India," International Journal of Health Economics and Management, Springer, vol. 12(1), pages 63-85, March.
    17. Adam Wagstaff & Marcel Bilger & Zurab Sajaia & Michael Lokshin, 2011. "Health Equity and Financial Protection : Streamlined Analysis with ADePT Software," World Bank Publications - Books, The World Bank Group, number 2306, December.
    18. Qun Wang & Alex Z Fu & Stephan Brenner & Olivier Kalmus & Hastings Thomas Banda & Manuela De Allegri, 2015. "Out-of-Pocket Expenditure on Chronic Non-Communicable Diseases in Sub-Saharan Africa: The Case of Rural Malawi," PLOS ONE, Public Library of Science, vol. 10(1), pages 1-15, January.
    19. Marcel Fafchamps & Bart Minten, 2007. "Public Service Provision, User Fees and Political Turmoil," Journal of African Economies, Centre for the Study of African Economies, vol. 16(3), pages 485-518, June.
    20. Dubey, Jay Dev, 2020. "Income elasticity of demand for health care and it's change over time: Across the income groups and levels of health expenditure in India," Working Papers 20/324, National Institute of Public Finance and Policy.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:75:y:2012:i:10:p:1820-1827. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.