The Cost of Inpatient Scabies Treatment in the Philippines: Secondary Data Analysis from the Philippine Health Insurance Corporation Database.

Background: While outpatient management for classic scabies is the standard, severe cases, such as infected scabies or crusted scabies in immunocompromised individuals, may require inpatient care, increasing the financial burden on healthcare systems. Objective: This retrospective study of the cost of scabies inpatient cases from the Philippine Health Insurance Corporation (PhilHealth) database was undertaken to provide valuable insights for policy-making and resource allocation. Methods: This retrospective secondary data analysis used the PhilHealth claims database for inpatient scabies treatment. We included inpatient claims for scabies (ICD-10: B86) from the inception of the database to 2021. Inclusion criteria were hospitalized patients with scabies as a primary or secondary diagnosis. Exclusion criteria included claims with missing cost data and unpaid claims. The primary outcome was the total claim amount. Other extracted variables included demographics, facility name, province, month and year of admission, hospital stay length, and total amount paid by PhilHealth. Descriptive statistics, comparative analysis, time trend analysis, and regression analysis were used to assess cost differences, trends, and predictors of higher hospitalization costs. Results: There were 877 patients with scabies who filed for claims in the PhilHealth database from 2002 to 2013, which was the last year that scabies was covered. The bulk of the patients were pediatric age (n = 699, 68.7%), most of which belong to the 1- to 5-year-old age group (n = 323, 36.8%). A little more than half of the patients were males (n = 491, 56.0%). The region with the highest number of patients with scabies who filed for claims was Region X (n = 107, 12.2%). The median length of hospital stay was 3 days (IQR = 2, Range = 1 to 353). The median amount for actual claims for scabies was 4992 PhP (IQR, 6335.90) (range, 743.00 PhP to 222,175 Php), with PHIC paying a median percentage of 75.24% (IQR, 50.09, range 2.44 to 169.98) of the actual claim. Increasing length of hospital stay has a corresponding increase in actual cost of treatment, while regions outside NCR have lower costs, after controlling for all other factors. Similarly, increasing length of hospital stay had a corresponding decrease in percentage paid by PhilHealth, while regions outside NCR had higher PhilHealth reimbursements, after controlling for all other factors. Conclusion: This study highlights the epidemiological and economic burden of inpatient scabies treatment in the Philippines based on insurance claims data. The majority of affected individuals were children aged 1-5 years, with a slightly higher prevalence among males. Region X had the highest number of claims, suggesting a regional disparity in disease burden or healthcare access. These findings emphasize the need for targeted interventions to improve scabies management and financial protection for affected patients.