ISSN PHILIPPINE NATIONAL HEALTH ACCOUNTS

Transcription

1 ISSN PHILIPPINE NATIONAL HEALTH ACCOUNTS Republika ng Pilipinas PAMBANSANG LUPON SA UGNAYANG PANG-ESTADISTIKA (NATIONAL STATISTICAL COORDINATION BOARD) October 2013

2 The Philippine National Health Accounts (PNHA) is a publication prepared by the Social Sectors A Division of the Social Statistics Office (SSO) of the NATIONAL STATISTICAL COORDINATION BOARD (NSCB). For technical inquiries, please contact us at: (632) or us at info@nscb.gov.ph. TERMS OF USE OF NSCB PUBLICATIONS The NSCB reserves its exclusive right to reproduce all its publications in whatever form. Any part of this publication should not be reproduced, recopied, lend or repackaged for other parties for any commercial purposes without written permission from the NSCB. Any part of this publication may only be reproduced for internal use of the recipient/customer company. Should any portion of the data in this publication are to be included in a report/article, the source of the data, the title of the publication and the NSCB as publisher should always be cited. Any information derived from the manipulation of data contained in the publication will no longer be the responsibility of NSCB. ISSN Published by the National Statistical Coordination Board Midland Buendia Building 403 Sen. Gil Puyat Avenue Makati City 1200 Philippines. October 2013 The Philippine National Health Accounts (PNHA) is available in printed and electronic formats (Excel/Word/PDF in CDRom). Back issues of this publication are available for purchase. For details, please contact us at (632) or at info@nscb.gov.ph.

3 FOREWORD The Philippine National Health Accounts (PNHA) is a framework for the compilation of information on the country s healthh expenditures. It consists of a set of statistics that systematically presentss national health spending for a given year. Specifically, it tells: (a) how much is being spent on health care; (b) who pays for health care; (c) what health care servicess are being provided; and (d) how much it costs to administer healthh financing schemes. It provides insights on the efficiency and effectiveness of health care financing and helps determine appropriate interventions to improve the delivery of health care. The PNHA is a publication of the Social Statistics Office (SSO) of the National Statistical Coordination Board (NSCB). Major data inputs are provided by the following source agencies: Department of Health (DOH), Department of Budget and Management (DBM), Commission on Audit (COA), National Economic and Development Authority (NEDA), Social Security System (SSS), Government Service Insurance System (GSIS), Philippine Health Insurance Corporation (PhilHealth), National Statistics Office (NSO), Insurance Commission (IC), Securities and Exchange Commission (SEC), Department of Education (DepED), Commission on Higher Education (CHED), Department of Social Welfare and Development (DSWD), and the Association of Health Maintenance Organizations in the Philippines, Inc. (AHMOPI), among others. The 2011 PNHA is the ninth publication to be released by the NSCB, covering the estimates for the years In this edition, the revised estimation methodologies and improved coverage were adopted in accordance with NSCB Resolution No. 8 Series of 2011, Approving the Estimation Methodologies for the Compilation of the Philippine National Health Accounts. This is to maintain and further expand the usefulness of the PNHA, based on recent developments and changes in the reporting systems of the data source agencies. This publication contains analyses, tables and graphs depicting the levels and patterns of healthh care spending in the country. It also includes a discussion of the PNHA Framework with concepts and definitions as well as Technical Notes, which provides information on data sources and estimation procedures. The data presented heree help determine whether the aggregate health care spending from all sourcess is adequate to meet basic minimum requiremen nts and identify probable areas of inefficiencies in allocating health care resources. We hope that policymakers, planners, researchers and the general public will find this publication useful in crafting actual policies, programs and projects. JOSE RAMON G. ALBERT Secretary General October 2013 i

4 NSCB Publications Multisectoral Statistics The Philippine Statistical Yearbook * The Countryside in Figures * (Philippines, selected provinces) Regional Social and Economic Trends (RSET) (CAR, I, V, VI, VIII, IX, X, XI, XII)* Metro Manila: Gateway to the Philippines Economic Statistics National Accounts of the Philippines: Quarterly, Annual and Annual with Consolidated Accounts and Income and Outlay Accounts * Gross Regional Domestic Product * Gross Regional Domestic Expenditure * Input-Output Accounts of the Philippines * Economic Indicators * Quarterly Economic Indices* Foreign Direct Investments* Food Balance Sheet of the Philippines* Leading Economic Indicators Social Statistics Official Poverty Statistics of the Philippines* City and Municipal Level Poverty Estimates Official Poverty Statistics for the Basic Sectors in the Philippines Statistical Handbook on Women and Men (Philippines, CAR, I, V, VI, VIII, IX, X, XI, XII)* Report on the Philippine Human Development Index Philippine National Health Accounts National Education Expenditure Accounts Poverty Maps (Selected Provinces)* Statistical Standards and Classifications Philippine Classification of Individual Consumption According to Purpose (PCOICOP)* Philippine Standard Classification for Education (PSCEd)* Philippine Standard Commodity Classification (PSCC)* Philippine Standard Geographic Classification (PSGC)* Philippine Standard Industrial Classification (PSIC)* Philippine Standard Occupational Classification (PSOC)* Philippine Central Product Classification (PCPC)* Reference Materials Philippine Statistical Development Program* NSCB Annual Report* Profile of Censuses and Surveys conducted by the Philippine Statistical System* Directory of Government Statistical Services in the Philippines (DGSSP)* A Guide to Statistics for Business Planning Framework for the Development of Environment Statistics State of the Philippine Land and Soil Resources Statistics for Entrepreneurs Proceedings of Conventions National Convention on Statistics* Asian Regional Section, International Conference on Statistical Computing Environmental Statistics Compendium of Philippine Environment Statistics* ii

5 InformationSheets Statwatch (Philippines, CAR, I, V, VI, VIII, IX, X, XI, XII and selected provinces and cities) Factsheets (Philippines, CAR, I, V, VI, VIII, IX, X, XI, XII) MDG Watch (Philippines, CAR, I, V, VI, VIII, IX, X, XI, XII) Genderwatch (VI) Statwatch on Children (VI) Stat Informer (VI) Stat Trivia (CAR) Statistics Series Technical Papers Things Statisticians Wanted to Know About the Tourism Satellite Account but were Afraid to Ask (2012) Major Revisions on the Philippine System of National Accounts: Implementation of the 2008 System of National Accounts (2012) Gearing a National Statistical System Towards the Measurement of the Impact of Climate Change: The Case of the Philippines (2008) Distributive Trade Statistics in the Philippines (2006) Official Poverty Statistics in the Philippines: Methodology and 2003 Estimates (2006) Green GDP Towards Sustainable Development: The Philippine Experience (2005) Real Estate Price Index: A Model for the Philippines (2004) Official Provincial Poverty Statistics in the Philippines and the Issue of Comparability Across Space (2003) The NSCB: Our Products and Services (2003) Enhancing the Relevance of the Philippine System of National Accounts (2002) The Philippine Tourism Satellite Accounts: Dealing with Data Shortfalls (2002) Development, Institutionalization and Improvement of the Philippine National Health Accounts (2001) Measuring the Contribution of the Informal Sector in the Philippines (2001) Rebasing, Linking and Constant Price Estimation of the National Accounts of the Philippines (2001) Recent Initiatives of the NSCB in Improving Official Statistics in the Philippines (2001) Environmental Accounting in the Philippines (2000) Poverty Assessment in the Philippines (2000) Online Articles and References Beyond the Numbers Sexy Statistics StatFocus Statistically Speaking Statistical Indicators for Philippine Development (StatDev) Philippine Standard Geographic Codes Provincial and Municipal Profiles Statistical Reference System Official Concepts and Definitions for Statistical Purposes Technical Notes * CD-ROM versions of publications are available in PDF format. For orders and subscription, Please contact us at: The National Statistical Information Center G/F Midland Buendia Building 403 Sen. Gil Puyat Avenue Makati City Tel. No. (632) Fax No. (632) E mail: info@nscb.gov.ph iii

6 Other NSCB Products and Services Products 1. Statistical policies and measures to resolve specific issues and provide policy directions in the Philippine Statistical System (PSS) 2. The Philippine Statistical Development Program (PSDP) to serve as blueprint of priority programs and activities to be undertaken to improve the PSS in the Medium Term 3. National Accounts and related economic accounts to assess the economic performance of the country thru the following: National Accounts Regional Accounts Input Output (I O) Accounts Consolidated and Income and Outlay Accounts Tourism Satellite Accounts Economic Environmental and Natural Resources Accounts National Health Accounts National Education Accounts Informal Sector Contribution of Women to the Economy 4. Other social and economic indicators Poverty statistics City and municipal level poverty estimates Basic sectors in the Philippines Happiness index Good governance index Environment statistics Gender statistics (including children) Gender development index Food balance sheet Quarterly economic indices Foreign direct investment statistics Leading economic indicators Statistical indicators for Philippine development Human development index Hunger Index 5. Standards and classification systems to prescribe uniform standards in government statistics Philippine Classification of Individual Consumption According to Purpose (PCOICOP) Philippine Standard Classification for Education (PSCEd) Philippine Standard Commodity Classification (PSCC) Philippine Standard Geographic Classification (PSGC) Philippine Standard Industrial Classification (PSIC) Philippine Standard Occupational Classification (PSOC) Philippine Central Product Classification (PCPC) 6. Statistical publications to disseminate the most relevant information produced by the PSS and to make statistics more accessible to the public Services 1. One stop statistical information center the National Statistical Information Center (NSIC) 2. Monitoring of designated statistics 3. Coordination of subnational statistical system 4. Coordination of inter agency concerns on statistics 5. Survey review and clearance 6. Online statistical service through the Internet ( 7. Servicing data requests 8. Technical services 9. Advocacy for statistical awareness 10. National Statistics Month 11. National Convention on Statistics 12. Government Statistics Accessibility Program 13. Hosting of international conferences in statistics 14. Users for a, workshops, seminars iv

7 TABLES OF CONTENTS Foreword i NSCB Publication ii-iii Other NSCB Products and Services iv Table of Contents v-vii List of Tables viii List of Figures ix List or Acronyms x-xiii Executive Summary Highlights of the 2011 PNHA Results Total Health Expenditure Total health expenditure up by 13.2 percent in Per capita health spending also improves Share of health expenditure to GDP goes up 1.2 Sources of Funds for Health Government expenditures and health benefit payments from 4 social insurance lead increases in health spending Out-of-pocket expenditures comprise more than half of health 4 care expenditure Per capita health expenditure from the rest of the world declines Government Expenditure on Health DOH agencies continue to provide bulk of national government 5 health expenditure Spending of DOH agencies exhibits positive growth Government health spending remains far from HSRA target Health expenditure from local government increases Uses of Funds for Health Spending for personal health care remains the same Bulk of government expenditure shifts to public health care Local government is still the biggest spender in public health 8 care 1.5 Health expenditure of ASEAN Countries 9 2. Historical Tables and Charts, Total Health Expenditure Per Capital Health Expenditure Share of Health Expenditure to GDP and GNI Comparison of Growth Rates of Health Expenditure and GNI Amount of Health Expenditure by Source of Funds Distribution of Health Expenditure by Source of Funds Per Capital Health Expenditure by Source of Funds Details of National Government Health Expenditure 19 v

8 2.8 Total Health Expenditure by Use of Funds Government Health Expenditure by Use of Funds DOH Health Expenditure by Use of Funds Local Government Health Expenditure by Use of Funds Government Health Expenditure by Use of Funds and by Type of 24 Expenditure 2.13 Health Care Financing Indicators: Target versus Actual Levels Selected National Health Accounts Indicators for the Philippines and 26 Other ASEAN Countries 2.15 Health Expenditure and Health Status Philippine National Health Accounts Matrix Philippine National Health Accounts, Philippine National Health Accounts, Philippine National Health Accounts, Philippine National Health Accounts, Philippine National Health Accounts, Philippine National Health Accounts, Philippine National Health Accounts, Government Health Expenditures by Type, The PNHA Framework Concepts and Definitions Health Care Expenditure Health Care Goods and Services 4.2 Design/Matrix Uses of Funds Sources of Funds 4.3 The PNHA Operational Framework Uses of Funds Categories of Uses of Funds Operational Definition of Uses of Funds a Personal Health Care b Public Health Care c Others Sources of Funds Categories of Uses of Funds Operational Definition of Uses of Funds a Government b Social Insurance c Private Sources Full operational Matrix 5. Technical Notes National Government DOH and Other National Government Agencies Foreign-Assisted Projects Local Government 5.2 Social Insurance 54 vi

9 5.3 Private Sources Out-of-Pocket Private Insurance Health Maintenance Organizations Private Establishments Private Schools 5.4 Rest of the World List of NSCB Staff 60 vii

10 1. HIGHLIGHTS OF THE 2011 PNHA RESULTS

11 HIGHLIGHTS OF PNHA The following trends are observed in PNHA estimates from : Total Health Expenditure continuously increased from 2005 to 2011 at an average annual growth rate of 11.7 percent The total health expenditure (THE) grew from P222 billion in 2005 to P431 billion in 2011, an average annual increase of 11.7 percent at current prices or 6.4 percent at constant 2000 prices, (Table 2.1). The growth slowed down by half from 2007 to 2008 (at constant 2000 prices), but picked up again from 2008 increasing at a rate of 7.3 percent in 2009 up to 9.9 percent in Since the rate of increase in population was slower than the increase in THE, per capita health expenditure also grew at 9.7 percent at current prices and at 4.5 percent at constant 2000 prices, (Table 2.2). The share of THE to GDP ranged from 3.9 percent to 4.4 percent from 2005 to The share of THE to GNP, on the other hand, was almost constant at 3.1 percent to 3.3 percent from 2005 to 2011, (Table 2.3).. Health spending from all funding sources increases, but out-of-pocket health spending continues to account for slightly more than half of the Total Health Expenditure throughout 2005 to 2011 Among the sources that had a growth rate in expenditure higher than the THE average growth rate of 11.7 percent are HMOs at 16.3 percent, the National Health Insurance Program of the PhilHealth at 12.5 percent, Local Government at 12.4 percent, and out-of-pocket at 12.0 percent, (Table 2.4). Out-of-pocket health expenditures continued to comprise more than half of the THE, ranging from 51.9 percent to a high of 56.7 percent within the period, (Table 2.5). The share of the local government fluctuated but it is the second largest source in 2011, accounting for 14.7 of the total health expenditure. The share of the National showed a decreasing trend from 2005 to 2009, thereafter the share increased reaching12.3 percent in PhilHealth s share also dipped from 8.7 percent in 2005 to 7.1 percent in 2008, managing to rise in 2009 accounting for 9.1 percent in 2011, still below the target of 19 percent by 2016 based on the DOH Health Care Financing Strategy The share of Foreign Assisted Projects (FAPs) and Loans in national government health expenditure decreases by 21 percentage points from 2005 to 2011 The national government relied less and less on FAPs and loans for its health expenditure. FAPS spending registered a negative 31.0 percent growth from 10

12 P7.1 billion in 2005 to only P0.8 billion in 2011, with the share in national government health spending decreasing from 22.0 percent to 1.4 percent; GOP counterpart decreased accordingly, (Table 2.7). About half of the national government spending is contributed by the DOH and its attached agencies, ranging from 46.8 percent to 56.6 percent. The health spending of Other National Agencies tripled from P7.8 billion in 2005 to P22.4 billion in 2011, with the share in national government health spending almost doubling from 24.2 percent to 42.1 percent for the same period, (Table 2.7). Trend in use of health expenditures remains almost the same There were only slight movements in the share of public health care, personal care, and other types of health care in the total health expenditure from 2005 to 2011, (Table 2.8). The share of public health care ranged from 9.8 percent to 12.7 percent, although there was a 1.6 percentage points increase from 2010 to The share of personal care ranged from 77.6 percent to 81.2 percent, and remained constant at 78.6 percent in 2010 and Other types of care comprised 8.8 percent to 10.7 percent of the THE. Government health expenditure shifts to public health care There was an observed shift in the use of government funds from personal care and other types of care to public health care, which was more pronounced from 2010 to 2011 with the share of public health care increasing from 34.0 percent to 43.1 percent, (Table 2.9). This can be mainly attributed to DOH which doubled its public health care spending from 2010 to The Local Government is consistently the largest spender for public health care Among all funding sources, the local government accounts for more than half of total public health spending from 2005 to 2011, (Table 2.11). Public health comprised 44.4 percent to 45.3 percent of local government health expenditure for this period. 11

13 Percent Highlights of the 2011 PNHA Results 1.1 TOTAL HEALTH EXPENDITURE Total health expenditure up by 13.2 percent in 2011 Total health expenditure (THE) of the country reached P431.0 billion in 2011, growing at a faster rate of 13.2 percent compared to 11.3 percent growth in In real terms, total health expenditure went up by 9.9 percent, higher than the 8.1 percent growth in ITEM Total Health Expenditure (in million pesos, at current prices) Total Health Expenditure Growth Rate (in percent, at current prices) Total Health Expenditure (in million pesos, at constant 2000 prices) 2/ / / , , , , , ,585 Total Health Expenditure Growth Rate (in percent, at constant 2000 prices) 1/ Revised 2/ Derived using the consumer price index (CPI) for all items Per capita health spending also improves ITEM / / 2011 Per Capita Health Expenditure (in pesos, at current prices) 3,759 4,112 4,577 Per Capita Health Expenditure (in pesos, at constant 2000 prices) 2/ 2,298 2,442 2,639 Population (million) 3/ Population Growth Rate (in percent) Per Capita Health Expenditure Growth Rate (in percent, at current prices) Per Capita Health Expenditure Growth Rate (in percent, at constant 2000 prices / Revised 2/ Derived using the consumer price index (CPI) for all items 3/ Computed annual population estimates by the NSO and the NSCB-TS using interpolation at decelerating rates, with the 2000 and 2010 Censuses of Population and Housing (CPH) as start and end dates of the reference population With the total health expenditure growing faster than the population, per capita health spending increased by P465 or an 11.3 percent growth between the period 2010 and In real terms, per capita health spending increased by 8.1 percent in 2011, higher than the 6.3 percent growth in Share of health expenditure to GDP goes up Share of Health Expenditure to GDP The share of health expenditure to GDP was higher at 4.4 percent in 2011 compared to 4.2 percent in It is still below the desired 5 percent. On the other hand, the share of health expenditure to GNI increased to 3.3 percent which is within the National Objectives for Health (NOH) target of 3-4 percent. 3

14 Highlights of the 2011 PNHA Results 1.2 SOURCES OF FUNDS FOR HEALTH Government expenditures and health benefit payments from social insurance lead increases in health spending Government expenditures and social insurance led increases in health spending, but the private sector remained the highest health spender. The government increased spending from P101.4 billion in 2010 to P116.4 billion in 2011, demonstrating a 14.9 percent growth. Both the national and local governments contributed to this increase, registering a growth of 22.3 percent and 9.2 percent, respectively. Social insurance benefit payments hiked from P33.9 billion to P39.1 billion, translating to a 15.3 percent increase. This was mainly due to the National Health Insurance Program (NHIP) whose spending increased by 15.5 percent. Employees Compensation decreased further by 17.1 percent. GOVERNMENT National Government Local Government SOCIAL INSURANCE National Health Insurance Program Employees' Compensation PRIVATE SOURCES Out-of-Pocket Private Insurance Health Maintenance Organizations Private Establishments Private Schools REST OF THE WORLD Grants SOURCE OF FUNDS AMOUNT (in million pesos) / / 2011 Growth Rate , , , ,949 43,375 53, ,773 58,003 63, ,897 33,925 39, ,791 33,799 39, (17.1) 217, , , , , , ,083 6,401 7, ,199 21,170 24, ,809 7,937 9, ,404 3,649 3, ,681 6,384 3,478 (45.5) 7,681 6,384 3,478 (45.5) ALL SOURCES 342, , , / Revised Although the private sector registered a relatively lower growth of 13.7 percent in 2011, it continued to be the highest spender at P272.0 billion, with out-of-pocket accounting for P227.2 billion. For the rest of the world, there was a significant decrease of 45.5 percent from P6.4 billion in 2010 to P3.5 billion in Out-of-pocket expenditures comprise more than half of health care expenditure The shares of the different sectors remained almost the same, with slight increases for the following from 2010 to 2011: social insurance from 8.9 percent to 9.1 percent, and government from 26.6 percent to 27.0 percent. The share of grants and loans from the rest of the world decreased from 1.7 percent to percent Gov't Social Ins. OOP Other private sources ROW Within the private sources, out-ofpocket alone also still accounted for more than half of the THE, from 52.5 percent in 2010 to 52.7 percent in

15 Highlights of the 2011 PNHA Results Per capita health expenditures increase for all funding sources except the rest of the world With the increases in expenditure from social insurance, government and private sources, the per capita health expenditure went up by 13.4, 12.9 and 11.8 percent, respectively. However, a large decrease in expenditure from the rest of the world resulted in a 46.4 percent decline in the per capita health expenditure for the rest of the world. In real terms, there was an increase of 10.1 percent in social insurance, 9.7 percent in government sources and 8.6 percent in private sources. On the other hand, decrease in per capita health expenditure was reflected in the rest of the world at 48.0 percent. SOURCE OF FUNDS At current prices Government Social Insurance Private Sources Rest of the World At constant 2000 prices 2/ Government Social Insurance Private Sources Rest of the world 1/ Revised 2/ Derived using the consumer price index (CPI) for all items Amount (in pesos) / / 2011 Growth Rate ,095 1, ,394 2,582 2, (46.4) ,463 1,534 1, (48.0) 1.3 GOVERNMENT EXPENDITURE ON HEALTH DOH agencies continue to provide bulk of national government health expenditure Total national government health expenditure registered a 22.3 percent growth, from P43.4 billion in 2010 to P53.1 billion in This was largely due to the 31.6, 23.2, and 21.2 percent increases in Loans, DOH expenditure, and expenditure of Other National Agencies, respectively. A decline was, however, noted in the GOP counterpart expenditure by 9.7 percent. Other national agencies include Philippine Charity Sweepstakes Office, Philippine Amusements and Gaming Corporation, Department of Social Welfare and Development, University of the Philippine System, Armed Forces of the Philippines - General Headquarters, Food and Nutrition Research Institute, Department of Labor and Employment, Department of Education and Bureau of Fire Protection. The DOH agencies continued to provide the bulk of health expenditure, funding 56.2 percent of the national government expenditure for health care in AMOUNT (in million pesos) PERCENT SHARE YEAR / / 2011 Growth Rate DOH and its Attached Agencies Other National Agencies GOP counterpart FAPS Loans Total DOH Other National Agencies GOP counterpart FAPS Loans 20,926 15, , ,208 18, , ,816 22, , (9.7) / Revised The share of health 5

16 Highlights of the 2011 PNHA Results Spending of DOH agencies exhibits positive growth Spending of DOH and its attached agencies increased by 23.2 percent, from P24.2 billion in 2010 to P29.8 billion in Spending on public health care doubled from P5.9 billion in 2010 to P11.9 billion in 2011, resulting to a large increase in share from 24.4 percent to 39.9 percent. Year Expenditure of DOH Agencies by Use of Funds AMOUNT (in million pesos) PERCENT SHARE Personal Public Others TOTAL Personal Public Others / 11,119 6,378 3,430 20, / 12,916 5,917 5,376 24, ,164 11,883 3,769 29, Growth Rate (29.9) / Revised Note: DOH agencies include PHC, NKTI, LCP, PCMC, NNC, PopCom, and PITAHC Government health spending remains far from the HSRA target The share of government on health expenditure remained at 27 percent which is still below the target of 40 percent based on the Health Sector Reform Agenda (HSRA). The government's target to depend less on out-of-pocket payments and provide more social health insurance is still far from being realized as the share of out-of-pocket payments still remained at 53 percent while the share of social insurance payments is also unmoved at 9 percent in Based on the HSRA, the target for out-of-pocket is 20 percent while the target for social insurance is 30 percent. USE OF FUNDS Personal Health Care GOVERNMENT SOCIAL INSURANCE SOURCE OF FUNDS TOTAL BY USE PRIVATE SECTOR Target Actual Target Actual Out of Pocket Others Actual Actual Target Target Target Actual / / / / / 2011 (in percent) Public Health Care Others TOTAL BY SOURCE / Revised Note: To allow for comparison with HSRA targets, the percentage distribution of actual expediture by source The of funds was adjusted by excluding the "other sources." Others under private sector include private insurance, HMOs, employer-based plans and private schools. As such, this is not exactly the same as the percentage share in table 2.5 on page 17. 6

17 Highlights of the 2011 PNHA Results Health expenditure from local government increases Local government spending on health went up by 9.2 percent or around P5.3 billion in This was reflected by the 9.0 percent increase in both personal and other services, and the 9.5 percent increase in public health care services. The largest share of local government expenses on health consists of expenditure on public health care at 45.1 percent. Local Government Health Expenditure by Use of Fund YEAR AMOUNT (in million pesos) PERCENT SHARE Personal Public Others TOTAL Personal Public Others / 14,367 23,469 13,937 51, / 16,037 26,108 15,857 58, ,487 28,586 17,290 63, Growth Rate / Revised 1.4 USES OF FUNDS FOR HEALTH Spending for public health care increased Spending for public health care increased from 10.7 percent in 2010 to 12.3 percent in Personal health care, however, continues to account for bulk of total health expenditure, having a consistent share of 78.6 percent in 2010 and Public 12.7% Total Health Expenditure by Use of Funds, 2009 Others 9.7% Total Health Expenditure by Use of Funds, 2010 Public 10.7% Others 10.7% Personal 77.6% Total Health Expenditure by Use of Funds, 2011 Public 12.3% Others 9.1% Personal 78.6% Personal 78.6% The 7

18 Highlights of the 2011 PNHA Results Bulk of government expenditure shifts to public health care The share of public health care in government health expenditure increased by 9.1 percentage points from 2010 to The public health care increased from 34.0 percent in 2010 to 43.1 percent in 2011, while the share of personal care declined from 38.6 percent in 2010 to 35.8 in YEAR / / 2011 Government Health Expenditures by Use of Funds AMOUNT (in billion pesos) PERCENT SHARE Personal Public Others TOTAL Personal Public Others 31,386 35,662 21,674 88, ,145 34,466 27, , ,693 50,125 24, , Growth Rate (11.4) / Revised Local government is still the biggest spender in public health care The local government remained as the biggest source of public health care spending, accounting for as much as 57.9 percent of the government s expenditure on public health care. While public health care spending in local government and other national agencies amounted to P28.6 billion and P8.9 billion, respectively, the DOH allocated a large chunk of their budget to personal health care, amounting to P14.2 billion Government Health Expenditures by Use of Fund and by Type of Expenditure SOURCE OF FUND AMOUNT (in million pesos) PERCENT SHARE PS MOOE CO Total PS MOOE CO DOH and its Attached Agencies 11,531 13,308 4,977 29, Personal Health Care 8,438 4,102 1,624 14, Public Health Care 1,541 7,692 2,649 11, The Others share 1,552 1, , Gen. Admin. & Operating Cost 1,386 1, , Research and Training Other National Agencies 4,844 13,214 1,830 19, Personal Health Care 3,301 2,630 1,537 7, Public Health Care 519 8, , The Others share 1,024 2, , Gen. Admin. & Operating Cost 963 2, , Research and Training 1/ Local Government 26,325 28,547 8,491 63, Personal Health Care 6,807 8,518 2,162 17, Public Health Care 12,649 12,030 3,907 28, The Others share 6,869 7,999 2,422 17, Gen. Admin. & Operating Cost 6,869 7,999 2,422 17, Research and Training In this particular table, government health expenditure does not include foreign-assisted projects (FAPs) since available data on FAPs spending has no breakdown by type of expenditure (i.e., whether PS. MOOE, CO). 1/ Includes bio-medical research, operation/policy research, survey and monitoring, and manpower training activities. The 8

19 Highlights of the 2011 PNHA Results 1.5 HEALTH EXPENDITURE OF ASEAN COUNTRIES Health spending in the Philippines still at par with majority of ASEAN countries Based on the report of the World Health Organization (WHO), the share of total health expenditure to GDP in the Philippines reached 3.6 percent in 2009, a decrease of 0.1 percentage point from the previous year. While based on the NSCB report, total health expenditure as percentage of GDP increased to 4.3 percent in Among the other ASEAN countries, Brunei Darussalam, Indonesia, Myanmar, Singapore and Thailand had lower percentage share of total health expenditure to GDP than the Philippines. Those countries in the ASEAN Region in which their governments contributed more than half of their respective total health expenditure include Brunei Darrusalam at 85.2 percent, Thailand at 74.6 percent, and Malaysia at 55.7 percent. While the Philippine government merely posted 25.9 percent on the total health spending of the country. Private expenditure on health in the Philippines decreased slightly from 66.9 percent in 2008 to 63.7 percent in 2009, but still maintaining a share of more than 50 percent. The only countries that showed higher private health expenditure shares are Myanmar with 88.7 percent, Singapore with 63.9 percent, and Lao People s Democratic Republic at 71.7 percent. Selected National Health Accounts Indicators for the Philippines Member State Total expenditure on health as % of GDP General government expenditure on health as % of total expenditure on health Private expenditure on health as % of total expenditure on health External resources for health as % of total expenditure on health Brunei Darussalam n/a n/a Cambodia Indonesia Lao People's Democratic Rep Malaysia n/a n/a - The The Myanmar Philippines - WHO Philippines 2/ Singapore n/a n/a n/a Thailand Viet Nam / The World Health Statistics Report 2010, 2011, 2012, WHO website 2 / PNHA, NSCB. n/a - not available 9

20 2. HISTORICAL TABLES and CHARTS

21 in million pesos Historical Tables and Charts, TOTAL HEALTH EXPENDITURE, ITEM / / 2011 Growth Rate Total Health Expenditure (in million pesos, at current prices) 222, , , , , , ,047 Total Health Expenditure Growth Rate (in percent, at current prices) Total Health Expenditure (in million pesos, at constant 2000 prices) 2/ Total Health Expenditure Growth Rate (in percent, at constant 2000 prices) , , , , , , , / Revised 2/ Derived using the consumer price index (CPI) for all items Figure 1: Total Health Expenditure 500, , , , , , , , , , , , , , , , , , , , , , ,000 50,000 at current prices at constant 2000 prices

22 in pesos Historical Tables and Charts, PER CAPITA HEALTH EXPENDITURE, ITEM Per Capita Health Expenditure (in pesos, at current prices) Per Capita Health Expenditure (in pesos, at constant 2000 prices) 2/ / / ,624 2,873 3,061 3,377 3,759 4,112 4,577 2,022 2,083 2,159 2,179 2,298 2,442 2,639 Average Annual Growth Rate Population (million) 3/ Per Capita Health Expenditure Growth Rate (in percent, at current prices) Per Capita Health Expenditure Growth Rate (in percent, at constant 2000 prices) 1/ Revised 2/ Derived using the consumer price index (CPI) for all items / Computed annual population estimates by the NSO and the NSCB-TS using interpolation at decelerating rates, with the 2000 and 2010 Censuses of Population and Housing (CPH) as start and end dates of the reference population Figure 2: Per Capita Health Expenditure 5,000 4,500 4,000 3,500 3,000 2,624 2,873 3,061 3,377 3,759 4,112 4,577 2,500 2,000 1,500 2,022 2,083 2,159 2,179 2,298 2,442 2,639 1, at current prices at constant 2000 prices

23 percent Historical Tables and Charts, SHARE OF HEALTH EXPENDITURE TO GDP AND GNI, Total Government Expenditure (in billion pesos) 3/ Government Health Expenditure (in billion pesos) 3/ Exchange Rate 4/ ITEM Total Health Expenditure (in billion pesos, at current prices) GDP (in billion pesos, at current prices) 2/ GNI (in billion pesos, at current prices) 2/ Share of Health Expenditure to GDP (in percent) Share of Health Expenditure to GNI (in percent) / / 2011 Average Annual Growth Rate , , , , , , , , , , , , , , , , , , (4.0) 1/ Revised 2/ Revised/Rebased National Accounts of the Philippines, National Statistical Coordination Board, March / Budget of Expenditures and Sources of Financing (BESF), Table A.4 Sectoral Distribution of Public Expenditures for National Government. 4/ Exchange rate from Bangko Sentral ng Pilipinas, Date: May 6, Figure 3: Share of Health Expenditure to GDP and GNI, Share to GNI Share to GDP

24 in percent Historical Tables and Charts, COMPARISON OF GROWTH RATES OF HEALTH EXPENDITURE AND GNI, ITEM / / 2011 Average Annual Growth Rate Total Health Expenditure (in billion pesos, at constant 2000 prices) 2/ Health Expenditure Growth Rate (in percent) at constant 2000 prices GNI (in billion pesos, at constant 2000 prices) 5,630 5,911 6,276 6,590 6,989 7,561 7, GNI Growth Rate (in percent) at constant 2000 prices (7.2) 1/ Revised 2/ Derived using the consumer price index (CPI) for all items Source: PNHA, NSCB. 12 Figure 4: Growth Rates of Health Expenditure and GNI (at 2000 prices), GNI 0 Health expenditure

25 in billion pesos Historical Tables and Charts, AMOUNT OF HEALTH EXPENDITURE BY SOURCE OF FUNDS, SOURCE OF FUNDS AMOUNT (in million pesos), at current prices / / 2011 Growth Rate Average Annual Growth Rate GOVERNMENT 63,629 67,509 74,036 74,875 88, , , National 32,139 33,687 32,749 36,554 36,949 43,375 53, Local 31,490 33,821 41,288 38,320 51,773 58,003 63, SOCIAL INSURANCE 19,360 19,098 19,972 21,434 27,897 33,925 39, National Health Insurance Program 19,270 19,005 19,838 21,345 27,791 33,799 39, Employees' Compensation (17.1) 2.4 PRIVATE SOURCES 136, , , , , , , Out-of-Pocket 115, , , , , , , Private Insurance 4,112 3,925 4,175 5,108 6,083 6,401 7, HMOs 9,905 11,188 13,123 15,638 18,199 21,170 24, Private Establishments 5,411 5,520 5,996 7,043 7,809 7,937 9, Private Schools 2,138 2,401 2,820 3,148 3,404 3,649 3, REST OF THE WORLD 2,271 4, ,682 7,681 6,384 3,478 (45.5) 7.4 Grants 2,271 4, ,682 7,681 6,384 3,478 (45.5) 7.4 ALL SOURCES 222, , , , , , , / Revised Figure 5: Health Expenditure by Source of Funds (in billion pesos), GOVERNMENT SOCIAL INSURANCE 250 PRIVATE SOURCES OTHERS

26 Historical Tables and Charts, DISTRIBUTION OF HEALTH EXPENDITURE BY SOURCE OF FUNDS, SOURCE OF FUNDS PERCENT SHARE / / 2011 GOVERNMENT National Government Local Government SOCIAL INSURANCE National Health Insurance Program Employees' Compensation 2/ PRIVATE SOURCES Out-of-Pocket Private Insurance Health Maintenance Organizations Private Establishments Private Schools REST OF THE WORLD Grants ALL SOURCES / Revised 2/ Less than 0.05 in Figure 6. Distribution of Health Expenditure by Source of Funds, % 90% 80% 70% % 50% 40% 30% 20% 10% 0% GOV'T SOCIAL INSURANCE REST OF THE WORLD PRIVATE SOURCES 17

27 in pesos in pesos Historical Tables and Charts, PER CAPITA HEALTH EXPENDITURE BY SOURCE OF FUNDS, SOURCE OF FUNDS AMOUNT (in pesos) / / 2011 Growth Rate Average Annual Growth Rate At Current Prices Government ,095 1, Social Insurance Private Sources 1,617 1,817 1,980 2,259 2,394 2,582 2, Rest of the world (46.4) 5.5 At Constant 2000 Prices 2/ Government Social Insurance Private Sources 1,246 1,318 1,397 1,458 1,463 1,534 1, Rest of the world (48.0) 0.5 1/ Revised 2/ Derived using the consumer price index (CPI) for all items 3,500 3,000 2,500 2,000 1,500 1, ,800 1,600 1,400 1,200 1, ,617 Figure 7.1 Per Capita Health Expenditure by Source of Funds at current prices, ,817 1,980 2, , ,582 1,095 Figure 7.2 Per Capita Health Expenditure by Source of Funds at 2000 prices, ,888 1, ,246 1,318 1,397 1,458 1, ,534 1, Government Social Insurance Private Sources Rest of the world

28 Historical Tables and Charts, DETAILS OF NATIONAL GOVERNMENT HEALTH EXPENDITURE, AMOUNT (in million pesos) PERCENT SHARE YEAR DOH and its Attached Agencies 1/ Other National Agencies GOP counterp art FAPS Loans Total DOH and its Attached Agencies 1/ Other National Agencies GOP counterp art FAPS Loans ,954 7, ,064 32, ,775 12, ,016 33, ,053 10, ,346 32, ,977 16, , / 20,926 15, , / 24,208 18, , Growth Rate Average Annual Growth Rate ,816 22, , (9.7) (15.3) (31.0) 8.7 Note: Government health service provision and financing underwent a transition in the period 1992 to 1994 as devolution was gradually being implemented is pre-devolution period while 1995 onwards is post devolution period. 1/ DOH includes the following agencies: Philippine Heart Center, National Kidney and Transplant Institute, Lung Center of the Philippines, Philippine Children's Medical Center, Commission on Population, National Nutrition Council, and Philippine Institute of Traditional and Alternative Health Care. 2/ Revised 19

29 Historical Tables and Charts, TOTAL HEALTH EXPENDITURE BY USE OF FUNDS, YEAR / / 2011 AMOUNT (in million pesos) PERCENT SHARE Personal Public Others Total Personal Public Others 177,880 24,796 19, , ,339 28,385 22, , ,463 28,251 26, , ,182 29,464 27, , ,633 43,284 33, , ,463 40,637 40, , ,921 53,061 39, , / Revised Figure 8. Health Expenditure by Use of Funds, , , , , , , , , , , , , , , , , , , , , , , ,000 50,000-24,796 28,385 28,251 29,464 43,284 19,542 22,092 26,214 27,397 33,247 40,726 40, ,061 39,065 Personal Public Others Total 20

30 Historical Tables and Charts, GOVERNMENT HEALTH EXPENDITURE BY USE OF FUNDS, YEAR / / 2011 Growth Rate AMOUNT (in million pesos) PERCENT SHARE Personal Public Others TOTAL Personal Public Others 27,195 23,819 12,615 63, ,658 23,922 14,929 67, ,093 27,357 17,586 74, ,654 26,025 17,196 74, ,386 35,662 21,674 88, ,145 34,466 27, , ,693 50,125 24, , (11.4) / Revised Figure 9: Percentage Distribution of Government Expenditure by Use of Funds, 2011 Others 21.1% Personal 35.8% Public 43.1% 21

31 Historical Tables and Charts, DOH 1/ HEALTH EXPENDITURE BY USE OF FUNDS, YEAR / / 2011 AMOUNT (in million pesos) PERCENT SHARE Personal Public Others TOTAL Personal Public Others 12,024 2,302 2,627 16, ,437 2,005 3,333 15, ,518 2,460 4,076 17, ,027 3,855 4,095 18, ,119 6,378 3,430 20, ,916 5,917 5,376 24, ,164 11,883 3,769 29, / Growth Rate Average Annual Growth Rate (29.9) DOH includes the following agencies: Philippine Heart Center, National Kidney and Transplant Institute, Lung Center of the Philippines, Philippine Children's Medical Center, Commission on Population, National Nutrition Council, and Philippine Institute of Traditional and Alternative Health Care. 2/ Revised Figure 10.1: Percentage Distribution of DOH Expenditure by Use of Funds, 2009 Others 16.4% Figure 10.2: Percentage Distribution of DOH Expenditure by Use of Funds, 2010 Public 24.4% Others 22.2% Public 30.5% Personal 53.1% Personal 53.4% Figure 10.3: Percentage Distribution of DOH Expenditure by Use of Funds, 2011 Public 39.9% Others 12.6% Personal 47.5% 22

32 in billion pesos Historical Tables and Charts, LOCAL GOVERNMENT HEALTH EXPENDITURE BY USE OF FUNDS, / Revised YEAR / / 2011 Growth Rate Average Annual Growth Rate AMOUNT (in million pesos) PERCENT SHARE Personal Public Others Total Personal Public Others 8,243 13,997 9,250 31, ,446 15,677 8,698 33, ,434 18,540 11,313 41, ,481 17,274 10,566 38, ,367 23,469 13,937 51, ,037 26,108 15,857 58, ,487 28,586 17,290 63, Figure 11: Local Government Health Expenditure by Use of Funds, Personal Public Others Figure 12: Percentage Distribution of Local Government Health Expenditure by Use of Funds, 2011 Others 27.3% Public 45.1% Personal 27.6% 23