Determinants of Philippine Health Insurance Corporation (Philhealth) Coverage and Benefit Utilization

ABSTRACT

The World Health Organization (WHO) encourages every nation to implement a Universal Health Care (UHC) system that would ensure that every citizen is granted with affordable and quality health care services. In the Philippines, UHC was integrated into the National Health Insurance Program (NHIP) through PhilHealth, a program that provides health insurance to every citizen in the country. Accordingly, the determinants of coverage and benefit utilization of PhilHealth members were identified using the National Demographic and Health Survey 2013 data. Significant predictors of coverage, in-patient benefit utilization, and out-patient benefit utilization were determined using stepwise and weighted logistic regression. Results showed that coverage was influenced by the household member’s socio-demographic characteristics, relationship to household head, and region, while age, among all other variables, was found to be the only significant determinant of in-patient benefit utilization. Out-patient benefit utilization, on the other hand, was found to have five determinants: (1) time it takes to travel from house to the health facility, (2) consultation place, (3) consultation cost, (4) wealth index, and (5) reasons for visiting health facilities. Further analyses showed that only 61% of the population are covered by PhilHealth, misclassifications exist in its current membership system, and that both in-patient and out- patient benefits have low utilization rates.
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AUTHORS

Camille Pauline Ricamata, Nancy Tandang

KEYWORDS

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