Division of Pulmonary Medicine, University of the Philippines? Philippine General Hospital, Manila, Philippines.
BMC Pulm Med. 2024 Apr 17;24(1):184. doi: 10.1186/s12890-024-03011-y.
Chronic obstructive pulmonary disease (COPD) is a frequent cause of morbidity and mortality in the Philippines and majority of the economic burden lies in hospitalizations during an exacerbation. Despite coverage of hospitalization cost with the national health insurance system (Phil-Health) for COPD exacerbations, patients often pay out-of-pocket. This study aimed to determine the demographic characteristics of COPD admissions at a Philippine tertiary care center, Philippine General Hospital, and assess mean cost of hospitalization, and identify predictors of prolonged hospitalization and cost > 20,000 Philippine pesos (Php). A prospective cross-sectional study was conducted for 6 months by chart review. Patients were categorized as charity service patients, that is, with no charged professional fees and free medications and private service patients who pay for their health care services. A total of 43 COPD admissions were included. The average daily cost of hospitalization (at peso-dollar rate of 56) for service patients was at $ 75.89 compared to private service patients at $ 285.71. Demographic characteristics and type of accommodation were not significant predictors of prolonged hospital stay nor hospitalization cost of ≥ $ 357. Accommodation cost and professional fees accounted for majority or 61.6% of the overall cost for private patients, while medications and diagnostic tests were the major or 76.01% contributor to the overall cost for charity patients. Despite existence of Phil-health, in-patient coverage for COPD remain insufficient. Measures for maximizing COPD control in the out-patient setting could potentially reduce total cost for this disease.
慢性阻塞性肺疾病（COPD）是菲律宾发病率和死亡率的主要原因，大部分经济负担来自于 COPD 恶化导致的住院治疗。尽管 COPD 恶化的住院费用已被国家健康保险制度（Phil-Health）覆盖，但患者通常仍需自掏腰包。本研究旨在确定菲律宾三级医疗中心菲律宾总医院 COPD 住院患者的人口统计学特征，评估住院费用的平均值，并确定延长住院时间和费用超过 20,000 菲律宾比索（Php）的预测因素。这是一项通过图表审查进行的为期 6 个月的前瞻性横断面研究。患者分为慈善服务患者，即不收专业费用和免费药物的患者，以及支付医疗费用的私人服务患者。共纳入 43 例 COPD 住院患者。服务患者的平均日住院费用（按比索-美元汇率 56 计算）为 75.89 美元，而私人服务患者为 285.71 美元。人口统计学特征和住宿类型不是延长住院时间或住院费用≥357 美元的显著预测因素。住宿费用和专业费用占私人患者总费用的 61.6%，而药物和诊断测试是慈善患者总费用的 76.01%的主要贡献者。尽管有 Phil-Health 的存在，COPD 的住院治疗覆盖率仍然不足。最大限度地控制 COPD 门诊治疗的措施可能会降低该疾病的总费用。
