Spatiotemporal Analysis of Health Service Coverage in the Philippines

• Published in: Journal of Philippine development Vol. 47; no. 2; pp. 61 - 92
• Main Authors: Flaminiano, Clarisa Joy A, Puyat, Vicente Alberto R, Antonio, Victor Andrew A, Uy, Jhanna, Ulep, Valerie Gilbert T
• Format: Journal Article
• Language: English
• Published: Makati City Philippine Institute for Development Studies 01.07.2023
• Subjects: Accreditation; Datasets; Health care access; Health care expenditures; Health care policy; Health facilities; Health insurance; Health services; Infectious diseases; Insurance claims; Insurance coverage; Maternal & child health; Mortality; Performance evaluation; Provinces; Socioeconomic factors; Spatial analysis; Philippines
• ISSN: 2508-0954; 2508-0849

In this paper, the authors conducted a spatiotemporal analysis of trends and disparities in health service coverage indicators from 2018 to 2021 using data from the Philippine Health Insurance Corporation (PhilHealth) on insurance claims, membership, and accredited facilities, merged with auxiliary datasets from the Department of Health and the Philippine Statistics Authority It examined PhilHealths performance using the Tanahashi framework for effective health service coverage. The authors measured population coverage, service coverage, and financial risk protection and analyzed the spatial and distributional equity and disparities in accessing health services across Philippine cities and provinces. The results found clear disparities across different subpopulations. Membership coverage is high in urban areas, such as Laguna and Southern Leyte, but low for provinces in Mindanao. Provinces with good membership coverage are mostly composed of direct contributors from the formal and informal economy. The scarceness of accredited facilities in provinces leads to low health service accessibility. Greater admission rates are observed in more economically developed provinces, possibly due to increased transmissibility of infectious diseases in densely populated areas. High admission rates for noncommunicable diseases (NCDs) across locations, particularly in Mindanao, and different socioeconomic conditions suggests that NCDs are pervasive nationwide. About 33.61 percent of admission rates are considered ambulatory care sensitive conditions, which means almost one-third is considered avoidable if primary health care in the country was effective and efficient. In terms of financial risk, the National Health Insurance Program covers about 60 percent of hospital charges, suggesting that out-of-pocket and other sources of expenditure cover the rest. The average support value is highest for provinces in Visayas, followed by provinces in Luzon, Mindanao, and the Greater Manila Area.