UTILIZATION ANALYSIS

NATIONAL GRID
CORPORATION
OF THE PHILIPPINES
(NGCP)

(3 YEARS COMPARISON)
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UTILIZATION SUMMARY

TOP DIAGNOSIS

TOP HOSPITALS

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 TOTAL
UTILIZATION
67,831,514.56 69%
AT 6 MONTHS 2019
MS TESTS AND PROCEDURES HAD
THE HIGHEST UTILIZATION COST
OUTPATIENT
CONSULTS AND
CLINIC PROCEDURES,
3,819,223.92, 6%
MS TESTS AND
PROCEDURES,
26,632,754.50,
INPATIENT - SURGICAL,
39%
10,533,456.89, 15%

ER, 3,594,416.95, 5%

DENTAL, 360,565.00,
1%
REIMBURSEMENT (IP),
INPATIENT - MEDICAL, 1,185,229.92, 2%
21,235,007.10, 31% REIMBURSEMENT (OP),
465,870.28, 1%
MEDICARD PHILS. INC. 2019 FOR 4
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 MS TESTS HAD THE HIGHEST COST,
PRINCIPAL
44% OF PRINCIPAL UTILIZATION
AT 6 MONTHS 2019
No. of Freq. of
Services Principal No. of Availers
Incidents Availment
Inpatient Medical 6,222,397.68 198 183 1
Surgical 4,911,608.60 67 67 1
OP Consults and
Clinic Procedures 1,241,389.25 3,631 1,498 2
MS Tests and
11,751,850.51 3,898 1,528 3
Procedures
ER 1,310,799.40 364 293 1
Dental 133,240.00 360 238 2
Reimbursement (IP) 624,067.32 27 26 1
Reimbursement (OP) 332,737.23 85 39 2
TOTAL 26,528,089.99 8,270 2,113 3
*TOTAL INCIDENTS, AVAILERS, FREQ AVAILMENT EXCLUDE DENTAL

MEDICARD PHILS. INC. 2019 FOR 5

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 MS TESTS HAD THE HIGHEST COST,
36% OF DEPENDENT UTILIZATION DEPENDENTS

AT 6 MONTHS 2019

No. of Freq. of
Services Dependents No. of Availers
Incidents Availment
Inpatient Medical 15,012,609.42 651 583 1
Surgical 5,621,848.29 135 127 1
OP Consults and
Clinic Procedures 2,577,834.67 7,684 3,186 2
MS Tests and
14,885,893.99 5,643 2,460 2
Procedures
ER 2,283,617.55 866 649 1
Dental 227,325.00 644 484 1
Reimbursement (IP) 561,162.60 51 51 1
Reimbursement (OP) 133,133.05 85 52 2
TOTAL 41,303,424.57 15,115 4193 4
*TOTAL INCIDENTS, AVAILERS, FREQ AVAILMENT EXCLUDE DENTAL
MEDICARD PHILS. INC. 2019 FOR
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 MOST AVAILED SERVICE WAS OP
CONSULTS AND CLINIC PROCEDURES

PRINCIPAL DEPENDENT TOTAL

POPULATION COUNT 5,551 13,462 19,013
Inpatient MEDICAL 3% 4% 4%
SURGICAL 1% 1% 1%
OP Consults and
Clinic Procedures 27% 24% 25%
MS Tests and Procedures 28% 18% 21%
ER 5% 5% 5%
TOTAL 38% 31% 33%

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 HISTORICAL UTILIZATION RATE
September 24, 2016 -
September 23, 2017 PRINCIPAL DEPENDENTS TOTAL
(12 MONTHS)
UTILIZATION 38,775,852.33 65,438,881.58 104,214,733.91
UTILIZATION RATE 88% 58% 67%
September 24, 2017 –
December 31, 2017
(3.26 MONTHS)
UTILIZATION 10,118,396.57 17,878,174.55 27,996,571.12
UTILIZATION RATE 80% 55% 62%
January 01, 2018 –
December 31, 2018
(12 MONTHS)
UTILIZATION 46,324,203.14 73,414,337.38 119,738,540.52
UTILIZATION RATE 91% 57% 67%
January 01, 2019 –
June 30, 2019
(6 MONTHS)
UTILIZATION 26,528,089.99 41,303,424.57 67,831,514.56
UTILIZATION RATE 95% 59% 69%
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 TOP DIAGNOSIS: IP
6 MONTHS 2019 PRINCIPAL

DISTINCT COST PER

DIAGNOSIS INCIDENTS AMOUNT
USER DU
CHOLELITHIASIS 10 10 1,035,326.87 103,532.69
CHRONIC ISCHAEMIC HEART DISEASE 14 12 875,451.39 72,954.28
CALCULUS OF KIDNEY AND URETER 5 5 424,869.23 84,973.85
NEOPLASM OF UNCERTAIN OR UNKNOWN
BEHAVIOUR OF ORAL CAVITY AND
DIGESTIVE ORGANS 3 3 382,227.03 127,409.01
OUTCOME OF DELIVERY 15 14 374,112.38 26,722.31
OTHER INTERVERTEBRAL DISC DISORDERS 3 3 283,647.79 94,549.26
HAEMORRHOIDS 5 5 282,351.83 56,470.37
ESSENTIAL (PRIMARY) HYPERTENSION 18 17 258,889.90 15,228.82
PNEUMONIA, ORGANISM UNSPECIFIED 7 7 249,875.45 35,696.49
CHOLECYSTITIS 2 2 249,160.28 124,580.14

MEDICARD PHILS. INC. 2019 FOR 10

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 TOP DIAGNOSIS: OP/MS
6 MONTHS 2019 PRINCIPAL

DISTINCT COST PER

DIAGNOSIS INCIDENTS AMOUNT
USER DU
ESSENTIAL (PRIMARY) HYPERTENSION 662 389 1,620,280.01 4,165.24
UNSPECIFIED DIABETES MELLITUS 563 291 1,206,956.42 4,147.62

CALCULUS OF KIDNEY AND URETER 223 104 772,503.80 7,427.92

CHRONIC ISCHAEMIC HEART DISEASE 175 102 569,934.70 5,587.60

DISORDERS OF LIPOPROTEIN METABOLISM
AND OTHER LIPIDAEMIAS 302 231 508,587.20 2,201.68
HYPERTENSIVE HEART DISEASE 129 82 328,001.26 4,000.02
OTHER DISEASES OF LIVER 139 91 281,738.03 3,096.02
DORSALGIA 198 44 266,803.10 6,063.71
OTHER CATARACT 31 15 263,839.11 17,589.27

RETINAL DETACHMENTS AND BREAKS 14 4 250,793.25 62,698.31

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6 MONTHS 2019 PRINCIPAL

DISTINCT COST PER

INSTITUTION INCIDENTS AMOUNT
USER INCIDENT
ADVENTIST MEDICAL CENTER- ILIGAN, INC. 18 13 810,904.91 45,050.27
ST. LUKE`S MEDICAL CENTER 6 6 509,774.07 84,962.35
LORMA MEDICAL CENTER 11 9 459,749.58 41,795.42
DELOS SANTOS MEDICAL CENTER 4 2 453,134.52 113,283.63
CAPITOL MEDICAL CENTER, INC. (FORMERLY
CAPITOL MEDICAL CENTER) 4 2 383,756.02 95,939.01
CARDINAL SANTOS MEDICAL CENTER 4 4 349,464.00 87,366.00
DAVAO DOCTORS HOSPITAL 5 4 303,647.51 60,729.50

THE MEDICAL CITY 4 3 288,808.00 72,202.00

MANILA DOCTOR`S HOSPITAL 3 3 282,635.07 94,211.69
PERPETUAL SUCCOR HOSPITAL 4 4 270,325.85 67,581.46

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 TOP HOSPITALS: OP/MS
6 MONTHS 2019 PRINCIPAL

DISTINCT COST PER

INSTITUTION INCIDENTS AMOUNT
USER INCIDENT
ST. LUKE`S MEDICAL CENTER 300 69 1,121,802.91 3,739.34
MEDICARD PHILIPPINES, INC. - CENTRIS
CLINIC 957 289 655,121.00 684.56
DAVAO DOCTORS HOSPITAL 245 69 544,405.26 2,222.06
CHONG HUA HOSPITAL 174 76 448,553.59 2,577.89
PROVIDENCE HOSPITAL, INC. 222 39 386,681.13 1,741.81
THE MEDICAL CITY 158 32 351,242.65 2,223.05
CEBU DOCTORS` UNIVERSITY HOSPITAL, INC.
(FORMERLY CEBU DOCTORS HOSPITAL) 106 49 322,605.85 3,043.45
ASIAN HOSPITAL AND MEDICAL CENTER 78 27 282,040.25 3,615.90
MOUNT CARMEL DIOCESAN GENERAL
HOSPITAL-LUCENA 224 15 256,471.00 1,144.96
MAKATI MEDICAL CENTER 83 14 228,521.50 2,753.27

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 TOP DIAGNOSIS: IP
6 MONTHS 2019 DEPENDENTS

DISTINCT COST PER

DIAGNOSIS INCIDENTS AMOUNT
USER DU
PNEUMONIA, ORGANISM UNSPECIFIED 130 124 3,279,993.96 26,451.56
OTHER GASTROENTERITIS AND COLITIS OF
INFECTIOUS AND UNSPECIFIED ORIGIN 81 78 1,121,773.98 14,381.72
OUTCOME OF DELIVERY 50 39 920,286.31 23,597.08
DENGUE FEVER [CLASSICAL DENGUE] 31 30 779,637.73 25,987.92
CHOLELITHIASIS 11 11 754,690.63 68,608.24
ESSENTIAL (PRIMARY) HYPERTENSION 28 24 572,604.14 23,858.51
ASTHMA 29 29 571,160.18 19,695.18
OTHER DISORDERS OF URINARY SYSTEM 30 28 525,449.44 18,766.05
CELLULITIS 11 11 439,369.82 39,942.71
ACUTE BRONCHITIS 15 14 376,844.61 26,917.47

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 TOP DIAGNOSIS: OP/MS
6 MONTHS 2019 DEPENDENTS

DISTINCT COST PER

DIAGNOSIS INCIDENTS AMOUNT
USER DU
ESSENTIAL (PRIMARY) HYPERTENSION 1,147 618 2,502,293.65 4,049.02
UNSPECIFIED DIABETES MELLITUS 773 398 1,538,174.01 3,864.76
HYPERTENSIVE HEART DISEASE 265 145 674,321.25 4,650.49
DISORDERS OF LIPOPROTEIN METABOLISM
AND OTHER LIPIDAEMIAS 300 228 536,484.83 2,353.00
CHRONIC ISCHAEMIC HEART DISEASE 181 130 475,750.87 3,659.62
DORSALGIA 252 51 373,473.91 7,323.02
CALCULUS OF KIDNEY AND URETER 136 76 360,999.91 4,750.00
MALIGNANT NEOPLASM OF BREAST 67 22 323,693.97 14,713.36
ACUTE UPPER RESPIRATORY INFECTIONS OF
MULTIPLE AND UNSPECIFIED SITES 763 565 310,909.45 550.28
CHOLELITHIASIS 137 93 253,424.56 2,725.00

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 TOP HOSPITALS: IP
6 MONTHS 2019 DEPENDENTS

DISTINCT COST PER

INSTITUTION INCIDENTS AMOUNT
USER INCIDENT
ADVENTIST MEDICAL CENTER- ILIGAN, INC. 46 41 1,088,908.29 23,671.92
CHONG HUA HOSPITAL 17 16 570,720.68 33,571.80
CAPITOL MEDICAL CENTER, INC. (FORMERLY
CAPITOL MEDICAL CENTER) 15 12 566,822.06 37,788.14

DAVAO DOCTORS HOSPITAL 15 13 533,937.31 35,595.82

BETHANY HOSPITAL-LA UNION 28 24 504,835.55 18,029.84
CEBU DOCTORS` UNIVERSITY HOSPITAL, INC.
(FORMERLY CEBU DOCTORS HOSPITAL) 13 9 421,057.88 32,389.07
CAGAYAN DE ORO POLYMEDIC MEDICAL
PLAZA 9 8 403,191.47 44,799.05
LORMA MEDICAL CENTER 24 23 399,443.55 16,643.48
RIVERSIDE MEDICAL CENTER 11 9 388,916.51 35,356.05
DIVINE WORD HOSPITAL 12 11 341,482.53 28,456.88

MEDICARD PHILS. INC. 2019 FOR 17

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 TOP HOSPITALS: OP/MS
6 MONTHS 2019 DEPENDENTS

DISTINCT COST PER

INSTITUTION INCIDENTS AMOUNT
USER INCIDENT
ST. LUKE`S MEDICAL CENTER 299 86 976,116.87 3,264.60
CHONG HUA HOSPITAL 305 125 613,162.96 2,010.37

DAVAO DOCTORS HOSPITAL 328 103 468,149.96 1,427.29

CEBU DOCTORS` UNIVERSITY HOSPITAL, INC.
(FORMERLY CEBU DOCTORS HOSPITAL) 157 57 415,200.07 2,644.59
CAPITOL MEDICAL CENTER, INC. (FORMERLY
CAPITOL MEDICAL CENTER) 264 72 385,630.01 1,460.72
MEDICARD PHILIPPINES, INC. - CENTRIS
CLINIC 581 146 383,605.00 660.25
THE MEDICAL CITY 170 53 350,664.00 2,062.73
LORMA MEDICAL CENTER 267 75 327,853.11 1,227.91
NOTRE DAME DE CHARTRES HOSPITAL 287 90 271,032.50 944.36
ST. LUKE`S MEDICAL CENTER - GLOBAL CITY 66 24 257,114.69 3,895.68

MEDICARD PHILS. INC. 2019 FOR 18

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