The Epidemiologic Burden of Hospitalization for Coronary Artery Disease Among Adults Aged 19 years and above in the Philippines

Abstract

INTRODUCTION: Most deaths from cardiovascular disease result from coronary artery disease (CAD). In the country, it consistently has been the most common cause of overall mortality for the last 10 years. OBJECTIVE AND METHODOLOGY: The study aimed to determine the prevalence of hospitalization due to CAD using data collected from PhilHealth hospitalization claims from January 1 to December 31, 2017. The data retrieved included the demographic profile, management done, duration of hospitalization, facility type, and condition on discharge. Data analysis was done using median and interquartile range for continuous data, and frequency and percent distribution for categorical data. RESULTS: There were a total of 7,739,396 PhilHealth medical and procedural claims for adult Filipino patients in 2017. Of the total claims, 2,787,401 were for medical conditions, with 51,053 claims for CAD (42,866 claims for medically managed cases and 8,187 claims for those with invasive procedures). This translated to an estimated prevalence rate of 1.8% or 1,831 claims for CAD for every 100,000 PhilHealth hospitalization claims for a medical condition. The majority of patients were male (57.4%), with a median age of 63 years. There were 42,328 claims (82.9%) for acute coronary syndrome (ACS) among the claims for CAD. The median (quartile 1, quartile 3) length of hospitalization for CAD patients who received pharmacologic therapy alone was 4 (3, 6) days, whereas it was 3 (1, 5) days for those who underwent procedures. Only 162 admissions (0.4%) had invasive procedures done during the index hospitalization. The overall in-hospital mortality rate for CAD claims who received only pharmacologic therapy was 9.2%. For CAD patients who underwent invasive procedures, the in-hospital mortality rate was 1.7%. The in hospital mortality for ACS patients who received pharmacologic therapy alone was 9.2%. For ACS patients with an invasive procedure done during the index hospitalization, it was 5.6%. CONCLUSION: In 2017, hospitalization claims for CAD were 1.8% or 1,831 claims for every 100,000 PhilHealth claims for a medical condition. The majority of CAD patients were admitted for an ACS. Most of the ACS patients were given pharmacologic therapy alone. Low revascularization rate on index admission was noted. KEYWORDS: coronary artery disease, acute coronary syndrome, prevalence, mortality