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Abstract
Background The Philippines needs a more inclusive health system for the poor. There is a high prevalence of out-of-pocket spending especially in the country's lower economic classes. The government is unable to cover health insurance premiums of the poor despite legal provisions. Some individuals who already have health insurance lack the information to maximize benefits, thus leading to failed access to health care.
Project LAAN, Inc. is a youth-led non-government organization that envisions universal healthcare for the poor and vulnerable. It aims to enroll marginalized families in the National Health Insurance Program (PhilHealth) and to instruct them in utilizing program benefits.
Objectives The objective of this research is to determine the impact of LAAN on healthcare expenditures of these communities.
Methods Community Updating and Evaluation Sessions (CUES) and Utilization Reports measure LAAN's impact through recording community health status and cases of health service utilization.
Members of LAAN visit partner communities in order to profile them using CUES and educate community members on how to utilize PhilHealth benefits to track health status.
Utilization Reports detail cases of hospitalized community members whose fees were subsidized by Philhealth. These contain the patient's profile, Philhealth reimbursements and narrative descriptions of the utilization of Philhealth benefits. LAAN works closely with these individuals to ensure these benefits are maximized.
Result LAAN has been able to enroll 150 families to Philhealth annually from its partner communities. In 2014, there have been three cases of healthcare utilization from these communities.
Aside from two cases of childbirth that were reimbursed in full by Philhealth, a case of acute gastroenteritis were had a support ratio of 64.91% after LAAN's intervention.
The total hospitalization cost amounts to Php 30, 486 while reimbursements totaled Php 24, 000 giving an aggregate support value of 78.7%.
Conclusion Based on these results, LAAN was able to create a significant impact for the community in lessening out-of-pocket health expenditures.
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