A PIDS study analyzed 39.7 million claims from 2018 to 2024 for PhilHealth benefits and found that:
⚪ Inpatient services accounted for most health spending
⚪ Hospital charges rose faster than reimbursements
⚪ About 1 in 3 hospital admissions were for ambulatory care sensitive conditions, conditions for which timely and effective primary care could potentially prevent complications or reduce the need for hospitalization.
As the country advances Universal Health Care, what do health insurance data reveal both progress and persistent gaps? How can these insights guide reforms to strengthen primary care, improve public spending, cost control, and reduce preventable hospitalizations and inequities in healthcare?
Read the full study: https://doi.org/10.62986/dp2025.63.
This study was carried out with support from the PBSP, the Department of Health (Philippines), and the Philippine Health Insurance Corporation.
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