A single hospital admission for tuberculous meningitis at the Philippine General Hospital cost patients a mean of PHP 202,596 in billed charges — about USD 3,716 in 2024 values — which corresponds to 58.4 percent of the 2023 national mean annual family income, according to a retrospective cost-of-illness study published in Cost Effectiveness and Resource Allocation.
The study included 130 adults with clinically diagnosed tuberculous meningitis admitted to the Manila hospital between 2022 and 2024. Among the 129 admissions with a numeric total billed cost, the mean was PHP 202,596 with a standard deviation of PHP 294,957, while the median was substantially lower at PHP 114,743 — a skewed distribution indicating that a minority of severe episodes drove much of the average.
Medications dominated the cost structure, accounting for 48.0 percent of total billed charges.
Mortality in the cohort was high: 50 of the 125 patients with a known outcome died, a fatality rate of 40.0 percent. The patients were on average 40.4 years old, with a standard deviation of 14.8 years, and 59.2 percent were male.
In the adjusted model, based on 119 admissions, two factors were independently associated with higher cost: surgery, with a cost ratio of 2.504 (95 percent confidence interval 1.791 to 3.503), and nosocomial infection, with a cost ratio of 1.976 (95 percent confidence interval 1.290 to 3.027). In other words, admissions involving surgical procedures cost roughly two and a half times more, and those complicated by hospital-acquired infection nearly twice as much, after adjustment for the other covariates.
HIV-positive status also showed a positive association with cost, with a ratio of 2.154 (95 percent confidence interval 1.081 to 4.295). However, the authors report this association was unstable across robust-variance estimators and therefore present it as hypothesis-generating rather than a confirmed independent driver of cost.
Against that benchmark, 89.9 percent of admissions exceeded 10 percent of mean annual family income, 61.2 percent exceeded 25 percent, and 37.2 percent exceeded 40 percent. Under this population-benchmark framing, a single episode of tuberculous meningitis represented a catastrophic financial exposure for a large majority of admitted patients.
The reimbursement gap emerged as a central policy finding. The Philippines does not have a PhilHealth case rate specific to tuberculous meningitis, and the study found that no PhilHealth schedule examined between 2013 and 2025 contained one. The nearest listed rate — for bacterial and other meningitides — ranges from PHP 25,700 to PHP 33,410. That would cover an estimated 12.7 to 16.5 percent of the mean billed cost, and 91.5 percent of admissions exceeded even the higher of those two reimbursement values.
The authors conclude that nominal PhilHealth reimbursement, benchmarked against the nearest available case rate, covered only a small fraction of billed charges, and that surgery and nosocomial infection were independently associated with higher cost. They frame these observational, single-center findings as highlighting the potential need for a dedicated tuberculous meningitis case rate and stronger financial risk protection. As a retrospective study at one hospital using billed charges rather than actual payments, the analysis has inherent limitations, and the authors caution that the financial-burden measure is a population benchmark rather than a direct assessment of household-level catastrophic expenditure.
Subject of Research: In-hospital costs and insurance reimbursement gaps for adult tuberculous meningitis admissions at a Philippine hospital
Article Title: In-hospital costs of tuberculous meningitis in adult patients admitted at the Philippine General Hospital
Article References: Guinal, S. M., Baladjay, K. J. E., Vidal, M. S., Jr., & Jamora, R. D. G. (2026). In-hospital costs of tuberculous meningitis in adult patients admitted at the Philippine General Hospital. Cost Effectiveness and Resource Allocation. https://doi.org/10.1186/s12962-026-00848-4
Image Credits: AI Generated
DOI: 10.1186/s12962-026-00848-4
Keywords: tuberculous meningitis, cost of illness, Philippines, PhilHealth, hospital costs, financial burden, retrospective study, nosocomial infection, health insurance, extrapulmonary tuberculosis, In-hospital, costs
News Source: Courtney Benton. (October 29, 2026). Research report: In-hospital costs of tuberculous meningitis in adult patients admitted at the Philippine General Hospital. Scienmag.
