Catastrophic out-of-pocket expenditure on health: evidence from the regions in the Philippines

Abstract

Background: The Philippines’ healthcare financing system is intended to shield households from excessive healthcare spending. Still, regional differences in financial risk exposure are not really looked at enough, so you kind of need a regional-level view of catastrophic and impoverishing out-of-pocket health expenditures. Objective: To gauge catastrophic and impoverishing out-of-pocket healthcare expenditures across the main Philippine regions, and also judge how effective the national healthcare financing framework really is, in terms of fair financial safeguards. Methods: Data came from the 2018 and 2021 Family Income and Expenditure Survey, which is basically a nationally representative household survey. The observations were grouped into four big regions: National Capital Region, the rest of Luzon, Visayas, and Mindanao. Logistic regression was used to find determinants that are statistically significant for catastrophic healthcare expenditures. Results: Between 2018 and 2021, the incidence of catastrophic out-of-pocket healthcare spending fell overall, but the depth of payments rose across all regions, yes even where incidence went down. The largest incidence values showed up in the rest of Luzon and Visayas, while Mindanao showed the strongest intensity. Inpatient medical services were the main push behind catastrophic expenditure, even though medicines and pharmaceuticals still dominated total out-of-pocket spending. Poverty worsening caused by health payments was more evident in Mindanao. Lastly, the logistic regression results pointed to aging household heads, employment situation, and socioeconomic status as key predictors for the likelihood of catastrophic spending. Conclusion: Financial risk linked to healthcare spending is still happening across regions in the Philippines. The reduction in catastrophic expenditure rates might be showing that some households, especially the less advantaged ones, are not getting treatments as much during COVID 19, so the spending that should have been catastrophic may not be happening. Because of that, there’s a need to keep reinforcing and also refreshing healthcare financing approaches in order to lessen the out-of-pocket strain on people and to make sure health protection is fairer and evenly experienced in all places.