20 Highest-Costing Illnesses in the Philippines 1Q 2011, Based on Philhealth Payments

Here’s a list of the 20 highest-costing illnesses in the Philippines in the January-March quarter of 2011, based on the total amounts of money spent by Philhealth to reimburse hospitals, doctors and other health provides for the treatment of these illnesses.

As you see in the list below, the top costing illness in the first quarter was pneumonia. In the new Case Rates payment system implemented by Philhealth for patients admitted starting September 1, 2011, the fixed Philhealth payment for each case of pneumonia (moderate risk) is 15,000 pesos, regardless of hospital category. For high-risk pneumonia, the fixed payment is 32,000.

The second cost-driving illness was chronic renal failure. In the Case Rates scheme, each hemodialysis is paid at a fixed rate of 4,000 pesos.

The third cost driving medical service — normal spontaneous child delivery — is paid at a fixed rate of 8,000 pesos if done in Level 1 hospitals and in maternity/lying-in clinics, and paid at a fixed rate of 6,500 pesos if done in Levels 2 to 4 hospitals. Newborn package benefits are worth 1,750 pesos.

Rank Illness Amounts Paid in Million Pesos
1 Pneumonia 565.2
2 Chronic renal failure 279.1
3 Single normal spontaneous delivery of child    271.5
4 Dengue haemorrhagic fever 262.4
5 Senile cataract 252.6
6 Diarrhea and gastroenteritis 225.9
7 Single delivery by caesarean section 210.6
8 Other disorders of urinary system 172.5
9 Dengue fever (classic dengue) 141.5
10 Primary (primary) hypertension 108.1
11 Asthma 92.2
12 Acute upper respiratory infections 91.4
13 Typhoid and paratyphoid fevers 79.9
14 Malignant neoplasm of breast 75.3
15 Gastritis and duodenitis 71.1
16 Chronic nephritic syndrome 65.9
17 Amoebiasis 58.5
18 Liveborn infant care 53.5
19 Acute bronchitis 52.5
20 Viral infection 45.3

Note: Data was sourced from the Philhealth website.

Related Articles:
Top 20 Illnesses in the Philippines 1Q 2011, Based on Philhealth Claims
Top 20 Illnesses in the Philippines in 2010, Based on Philhealth Claims

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