ABSTRACT
Objectives@#This study aims to analyze the cost of patient care among ORL-HNS patients admitted in a tertiary, teaching government hospital in a low- to middle-income country.@*Methods@#This is a prevalence-based, prospective, bottom-up, cost-of-illness analysis among patients of the Department of Otorhinolaryngology-Head and Neck Surgery in a tertiary training government hospital admitted from July 2021 to March 2022. The value assessment method used is the human capital approach. The societal perspective is used for analysis to estimate and reflect payer (insurance providers) and patient perspectives.@*Results@#A total of one hundred fifty seven (157) patients were admitted for elective surgery under the service of ORL-HNS consisting of 75 females and 82 males. The average total overall cost was $3,851.10 (Php 199, 870.50 ± 164, 725.60). The total direct health care cost for all patients within the study period amounted to $3,712.18 (Php 192, 662.22 ± 159, 548.60) while the direct non-health care cost was $58.60. The workforce cost (58.5%) and medication cost (18.8%) comprised the majority of in-patient expenses with a mean cost of $2,221.36 (Php 37,083.66) and $714.51 (Php 44,363.14), respectively. In this study, an average of $80.29 was lost due to illness and hospitalization (± $81.74). The total PHIC coverage pays a range from zero to 67.5% with an average coverage of only 17%.@*Conclusion@#Our analysis has shown that workforce and medication expenses are the main cost drivers for the direct healthcare costs among Otolaryngology patients admitted for elective procedures. Stakeholders, such as the otolaryngologists and hospitals should coordinate closely to create a more encompassing coverage of Philhealth to prevent patients from suffering from financial crises due to their illness.
Subject(s)
Costs and Cost Analysis , Otolaryngology , PhilippinesABSTRACT
@#<p><strong>Objective:</strong> To determine the prevalence of hearing loss and otologic diseases among Filipinos living in the Southern Tagalog Region IV-A: CALABARZON (Cavite, Laguna, Batangas, Rizal and Quezon), Philippines.</p><p><strong>Methods:</strong></p><p><strong> Design:</strong> Retrospective Review of Community Survey Data</p><p><strong> Setting:</strong> Communities in Region IV-A provinces, Philippines</p><p><strong> Participants:</strong> 3267 residents of the five provinces aged 0 months and above</p><p> <strong>Results:</strong> About 71.29% and 74.60% had at least mild hearing loss, in right and left ears, respectively. For disabling hearing impairment, overall prevalence was 26.33%, distributed into 11.87% among 4 to 18-year-olds; 8.97% for 19 to 64-year-olds; and 3.17% for 65-year-olds and above. Absence of prevalent and hearing loss-associated diseases: serous otitis media [OR 0.362, 95% CI 0.167 to 0.782, p = .010], CSOM [OR 0.407, 95% CI 0.236 to 0.703, p = .001] COM [OR 0.229, 95% CI 0.106 to 0.494, p < .001] can decrease the risk for hearing loss development in the region. Prevention of noise-induced hearing loss or delay in the manifestation of presbycusis can reduce the risk of having hearing loss by as much as 75% [OR 0.253, 95% CI (0.180 to 0.355), p < .001]. All pure tone audiometry measurements were obtained with surrounding median ambient noise of 55dB (IQR 46 to 60dB).</p><p><strong>Conclusion:</strong> The prevalence of hearing loss among surveyed residents of the Southern Tagalog Region IV-A provinces was high compared to the previous nationwide study but low compared to other low- and middle-income countries. The top otologic conditions of this population (ear occlusion with ear wax, chronic suppurative otitis media, chronic otitis media, presbycusis, noise-induced hearing loss) were associated with hearing loss and their absence decreased the risks for hearing impairment.</p>