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.

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Top 20 Illnesses in the Philippines 1Q 2011, Based on Philhealth Claims
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