The cost to PhilHealth of pneumonia is interesting, but needs to be explained and put in perspective.
There’s no requirement in the Philippines for causes of death to be medically determined prior to registration, so national statistics for causes cannot always be accurately substantiated.
There are two main types of pneumonia – lobar ( affecting 1 or more lobes ) and broncho pneumonia ( more patchy than lobar ). Bronchopneumonia is a common terminal event in old age both in the Philippines and UK, often complicating other conditions. Streptococcus pneumoniae ( for which there is a vaccine ) is not the only cause of pneumonia. There are other causes – such as measles - and other vaccines. Lung tuberculosis is extremely serious – up to 100 filipinos dying every day from this condition.
However, we do know that cardiovascular diseases are followed by cancers as the most serious diseases, both in Philippines and UK. Lung, breast, and large bowel cancers are common in both countries ; liver relatively much commoner in Philippines. Yet only breast cancer is listed in the top 20 ( see below ). This is presumably because of low prevention awareness and the tendency of Filipinos to seek medical help for cancer too late, if at all. Accidents compete with pneumonia ( including TB ) as the next commonest cause of death.
As for the top 20 illnesses or causes of hospitalisation based on claims - again interesting, but not a true reflection of health in the Philippines. At number 2 is “ chronic renal failure “ - not a disease, but the result of several conditions such as diabetes, high blood pressure, and infections ( chronic nephritis separately listed at 14 ). Numbers 7 and 8 would have been better combined as dengue fever. “ Malignant neoplasm of breast “ means breast cancer, at number 16 the only cancer mentioned – surely not ? “ Viral infection “ – at 20 – is vague. Similar comments apply to the top 20 based on costs – no mention of cardiovascular disease – except possibly as a complication of hypertension, but not specified. Cancer is common and expensive to treat, but it seems PhilHealth only deals with that arising in breast. Influenza and malaria don’t get a mention.
The conclusion that pneumonia is being successfully treated because it’s not the top cause of death is surprising in view of its position at the top of claims and cost to PhilHealth. An expanded programme of vaccination, as planned by the Department of Health, would be welcome if it included all those available ( BCG, Haemophilus Type B, Pneumococcal, Measles ) to reduce cases of pneumonia at a young age ( and Influenza at an older age ).
