Impact of primary care benefits on healthcare utilisation and estimated out-of-pocket expenses in urban, rural and remote settings in the Philippines
Background This study aimed to determine the effects of primary care interventions on healthcare utilisation and estimated out-of-pocket (OOP) expenses in selected urban, rural and remote settings in the Philippines.Methodology Context-specific measures relating to expanding healthcare provider netw...
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BMJ Publishing Group
2025-01-01
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| Series: | BMJ Open Quality |
| Online Access: | https://bmjopenquality.bmj.com/content/14/1/e002676.full |
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| author | Antonio L Dans Arianna Maever L Amit Leonila F Dans Gillian Sandigan Regine Ynez H De Mesa Mia P Rey Josephine T Sanchez Cara Lois T Galingana Nannette Bernal-Sundiang Maria Rhodora N Aquino Johanna Faye E Lopez Janelle Micaela S Panganiban Romelei Camiling-Alfonso Jose Rafael A Marfori Ramon Pedro Paterno Carol Stephanie Chua Tan-Lim Noleen Marie Fabian Chad Lester Lastrilla Miguel Callo |
| author_facet | Antonio L Dans Arianna Maever L Amit Leonila F Dans Gillian Sandigan Regine Ynez H De Mesa Mia P Rey Josephine T Sanchez Cara Lois T Galingana Nannette Bernal-Sundiang Maria Rhodora N Aquino Johanna Faye E Lopez Janelle Micaela S Panganiban Romelei Camiling-Alfonso Jose Rafael A Marfori Ramon Pedro Paterno Carol Stephanie Chua Tan-Lim Noleen Marie Fabian Chad Lester Lastrilla Miguel Callo |
| author_sort | Antonio L Dans |
| collection | DOAJ |
| description | Background This study aimed to determine the effects of primary care interventions on healthcare utilisation and estimated out-of-pocket (OOP) expenses in selected urban, rural and remote settings in the Philippines.Methodology Context-specific measures relating to expanding healthcare provider networks, augmenting the health human workforce and subsidising transportation costs were implemented to strengthen primary care systems. In this study, two key outcomes were monitored: (1) monthly healthcare utilisation measured by the total number of outpatient consultations per site and (2) change in OOP expenses from baseline to endline within a 1 year study period.Results All sites had a positive trend in monthly outpatient consultations in healthcare utilisation over 1 year. The remote site had the steepest increase in outpatient consultations, with a 401% increase compared with the baseline during the peak of consultations at month 7. The urban site had a 62% increase in outpatient consultations from baseline to month 6, while the rural site had a 251% increase from baseline to month 11, which corresponded to the peak month in terms of the number of outpatient consultations. The rural site had the largest decrease in estimated OOP expenses (50.3% reduction, 95% CI −88 to –13), followed by the remote site (33.2% reduction, 95% CI −67,+1) and the urban site (16.0% reduction, 95% CI −65,+33).Conclusion The rural site showed a significant reduction in estimated OOP expenses and an increase in healthcare utilisation. The remote site had the steepest increase in utilisation, but the reduction in estimated OOP expenses was not statistically significant. The urban site experienced the lowest increase in utilisation, and the smallest reduction in estimated OOP expenses, which was also not statistically significant. Implementing primary care benefits will necessitate contextualised approaches to avoid the inadvertent aggravation of inequities in healthcare. |
| format | Article |
| id | doaj-art-9bc6c3fa26664a94aced442b4edf99bf |
| institution | Kabale University |
| issn | 2399-6641 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open Quality |
| spelling | doaj-art-9bc6c3fa26664a94aced442b4edf99bf2025-02-03T17:55:09ZengBMJ Publishing GroupBMJ Open Quality2399-66412025-01-0114110.1136/bmjoq-2023-002676Impact of primary care benefits on healthcare utilisation and estimated out-of-pocket expenses in urban, rural and remote settings in the PhilippinesAntonio L Dans0Arianna Maever L Amit1Leonila F Dans2Gillian Sandigan3Regine Ynez H De Mesa4Mia P Rey5Josephine T Sanchez6Cara Lois T Galingana7Nannette Bernal-Sundiang8Maria Rhodora N Aquino9Johanna Faye E Lopez10Janelle Micaela S Panganiban11Romelei Camiling-Alfonso12Jose Rafael A Marfori13Ramon Pedro Paterno14Carol Stephanie Chua Tan-Lim15Noleen Marie Fabian16Chad Lester Lastrilla17Miguel Callo18College of Medicine, University of the Philippines Manila, Manila, PhilippinesNational Clinical Trials and Translation Center, National Institutes of Health, University of the Philippines Manila, Manila, PhilippinesProgram on Health Systems Development - Philippine Primary Care Studies, Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, PhilippinesProgram on Health Systems Development - Philippine Primary Care Studies, Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, PhilippinesProgram on Health Systems Development - Philippine Primary Care Studies, Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, PhilippinesProgram on Health Systems Development - Philippine Primary Care Studies, Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, PhilippinesProgram on Health Systems Development - Philippine Primary Care Studies, Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, PhilippinesProgram on Health Systems Development - Philippine Primary Care Studies, Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, PhilippinesProgram on Health Systems Development - Philippine Primary Care Studies, Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, PhilippinesProgram on Health Systems Development - Philippine Primary Care Studies, Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, PhilippinesProgram on Health Systems Development - Philippine Primary Care Studies, Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, PhilippinesProgram on Health Systems Development - Philippine Primary Care Studies, Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, PhilippinesProgram on Health Systems Development - Philippine Primary Care Studies, Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, PhilippinesProgram on Health Systems Development - Philippine Primary Care Studies, Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, PhilippinesProgram on Health Systems Development - Philippine Primary Care Studies, Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, PhilippinesProgram on Health Systems Development - Philippine Primary Care Studies, Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, PhilippinesProgram on Health Systems Development - Philippine Primary Care Studies, Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, PhilippinesProgram on Health Systems Development - Philippine Primary Care Studies, Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, PhilippinesProgram on Health Systems Development - Philippine Primary Care Studies, Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, PhilippinesBackground This study aimed to determine the effects of primary care interventions on healthcare utilisation and estimated out-of-pocket (OOP) expenses in selected urban, rural and remote settings in the Philippines.Methodology Context-specific measures relating to expanding healthcare provider networks, augmenting the health human workforce and subsidising transportation costs were implemented to strengthen primary care systems. In this study, two key outcomes were monitored: (1) monthly healthcare utilisation measured by the total number of outpatient consultations per site and (2) change in OOP expenses from baseline to endline within a 1 year study period.Results All sites had a positive trend in monthly outpatient consultations in healthcare utilisation over 1 year. The remote site had the steepest increase in outpatient consultations, with a 401% increase compared with the baseline during the peak of consultations at month 7. The urban site had a 62% increase in outpatient consultations from baseline to month 6, while the rural site had a 251% increase from baseline to month 11, which corresponded to the peak month in terms of the number of outpatient consultations. The rural site had the largest decrease in estimated OOP expenses (50.3% reduction, 95% CI −88 to –13), followed by the remote site (33.2% reduction, 95% CI −67,+1) and the urban site (16.0% reduction, 95% CI −65,+33).Conclusion The rural site showed a significant reduction in estimated OOP expenses and an increase in healthcare utilisation. The remote site had the steepest increase in utilisation, but the reduction in estimated OOP expenses was not statistically significant. The urban site experienced the lowest increase in utilisation, and the smallest reduction in estimated OOP expenses, which was also not statistically significant. Implementing primary care benefits will necessitate contextualised approaches to avoid the inadvertent aggravation of inequities in healthcare.https://bmjopenquality.bmj.com/content/14/1/e002676.full |
| spellingShingle | Antonio L Dans Arianna Maever L Amit Leonila F Dans Gillian Sandigan Regine Ynez H De Mesa Mia P Rey Josephine T Sanchez Cara Lois T Galingana Nannette Bernal-Sundiang Maria Rhodora N Aquino Johanna Faye E Lopez Janelle Micaela S Panganiban Romelei Camiling-Alfonso Jose Rafael A Marfori Ramon Pedro Paterno Carol Stephanie Chua Tan-Lim Noleen Marie Fabian Chad Lester Lastrilla Miguel Callo Impact of primary care benefits on healthcare utilisation and estimated out-of-pocket expenses in urban, rural and remote settings in the Philippines BMJ Open Quality |
| title | Impact of primary care benefits on healthcare utilisation and estimated out-of-pocket expenses in urban, rural and remote settings in the Philippines |
| title_full | Impact of primary care benefits on healthcare utilisation and estimated out-of-pocket expenses in urban, rural and remote settings in the Philippines |
| title_fullStr | Impact of primary care benefits on healthcare utilisation and estimated out-of-pocket expenses in urban, rural and remote settings in the Philippines |
| title_full_unstemmed | Impact of primary care benefits on healthcare utilisation and estimated out-of-pocket expenses in urban, rural and remote settings in the Philippines |
| title_short | Impact of primary care benefits on healthcare utilisation and estimated out-of-pocket expenses in urban, rural and remote settings in the Philippines |
| title_sort | impact of primary care benefits on healthcare utilisation and estimated out of pocket expenses in urban rural and remote settings in the philippines |
| url | https://bmjopenquality.bmj.com/content/14/1/e002676.full |
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