10th National Convention on Statistics (NCS)

EDSA Shangri-La Hotel

October 1-2, 2007

Measuring Health and Wellness Tourism in the Philippines

by

Romulo A. Virola and Florande S. Polistico

For additional information, please contact:

Author’s name : Romulo A. Virola

Designation : Secretary General
Affiliation : National Statistical Coordination Board
Address : 403 Sen. Gil Puyat Avenue, Makati City
Tel. no. : (0632) 895-2395
E-mail : ra.virola@nscb.gov.ph

Co-Author’s name : Florande S.Polistico

Designation : Statistical Coordination Officer I
Affiliation : National Statistical Coordination Board
Address : 403 Sen. Gil Puyat Avenue, Makati City
Tel. no. : (0632) 896 -7981
E-mail : fs.polistico@nscb.gov.ph
 Measuring Health and Wellness Tourism in the Philippines1
by
Romulo A. Virola & Florande S. Polistico 2

ABSTRACT

The Philippine government has recognized the potential of the Health and
Wellness Tourism industry in job creation and in spurring economic growth. To be
able to monitor the contribution of this emerging economic sector to national
development, obviously statistics are needed. However, currently the Philippine
Statistical System (PSS) does not generate the necessary information that can
provide a meaningful assessment of the health and wellness tourism industry.

This paper presents the initial efforts of the PSS in the measurement o f this
sector, with special focus on its relationship with the national income accounts,
particularly with the Philippine Tourism Satellite Accounts (PTSA). It shows how the
sector can be articulated as a subsector of private services under personal and
medical services. The paper also shows how the health and wellness services can be
highlighted in the PTSA as part of the tourism -characteristic industries. The paper
further explores the existing statistical data generated by the different institutions in
the PSS and proposes recommendations to make their data collection schemes
respond to the requirements of measuring health and wellness tourism. Finally, it
demonstrates the coordination and collaboration mechanisms that have been put in
place in the PSS with the participation of the private sector to facilitate the generation
of health and wellness tourism statistics.

Keywords: health and wellness tourism, national income accounts, tourism satellite
accounts, personal and medical services, tourism-characteristic industries.

I. Introduction

Many countries, including the Philippines have recognized the potential of health and

wellness tourism for economic growth. In its efforts to promote tourism, the Department of

Tourism (DOT) has noted the country’s compara tive edge in health and wellness tourism due

to abundance of natural resources, unique Filipino healing practices, fluency in the English

language and competitive cost. The DOT (2007) has therefore targeted to position the

country as the health and wellness destination in Asia. Indeed, the Republic of the

Philippines (2007) has recognized that health and wellness is one of the major sectors for

economic growth and has formulated a private sector-driven master plan for the

1
Paper presented during the 10th National Convention on Statistics at the EDSA Shangri-la Plaza Hotel, Mandaluyong City,
Philippines on 1-2 October 2007.
2
Secretary General and Statistical Coordination Officer I, respectively, of the National Statistical Coordination Board. The
views expressed in this paper are those of the authors and do not necessarily reflect the views of the NSCB. The authors
acknowledge the assistance of Vivian R. Ilarina, Cynthia S. Regalado, Regina S. Reyes, Armyl G. Zaguirre, Diana Christine O.
Lizarondo and Noel S. Nepomuceno in the preparation of this paper.
development of this service industry. 3 The Medium Term Philippine Development Plan

(MTPDP) 2004 – 2010 also seeks to enhance and promote health tourism, together with

other tourism products. In support of the MTPDP, the Philippine Statistical Development

Program (PSDP) 2005 – 2010 has included the development of data systems to generate

indicators on medical tourism among the statistical activities to be undertaken in the medium

term.

Based on the Philippine Tourism Satellite Account (PTSA), Virola et. al. (2001)

estimated the total tourism expenditure in the Philippines at 140 billion pesos in 1994 and

274 billion pesos in 1998, translating to an average annual increase of 11 %. Value Added of

Tourism Industries (VATI) was estimated at 200 billion pesos in 1994 and 334 billion pesos in

1998, representing 12% and 13 % respectively of the country’s Gross Domestic Product

(GDP).

However, Virola, et. al. (2002) recognizes that the preliminary results of the PTSA

are limited in scope and coverage due to data constraints that hinder the analysis of the link

between tourism consumption and the supply of tourism goods and services. The coverage

of the PTSA must therefore be expanded to fully and more reliably measure the economic

contribution of tourism; in addition, there is a need for a greater articulation of tourism

aspects considered important in the Philippine setting, such as health and wellness tourism.

Most importantly, there is a need to generate tourism statistics on a sustained manner in

order to enhance the effectiveness of the PTSA as a tool in the formulation and monitoring of

the tourism program of the country.

3
Proclamation 1280 also declares October as National Health and Wellness Tourism Month.
II. Health and Wellness Tourism Statistics, the National Income Accounts and the

Philippine Tourism Satellite Accounts

The Philippine System of National Accounts (PSNA) consists of a coherent and

integrated framework that measures stocks of resources and flows of goods, services,

income and other economic instruments that emanate from using these resources or as

consequence of economic flows. The PSNA is compiled using internationally accepted

guidelines, the latest of which is the System of National Accounts or SNA (1993). One of the

flexibilities offered by the 1993 SNA is the expansion of the analytical capacity of national

accounting for selected areas of concern without overburdening the central framework. This

is done thru satellite accounts. The NSCB has compiled satellite accounts on the

environment, education, tourism and health and has started work on science and

technology/research and development.

The PTSA provides additional information for tourism concerns not present in the

central national accounting framework. While using complementary or alternative concepts,

classification systems and accounting frameworks, the PTSA is consistent and is fully linked

with the PSNA. The PTSA aims to demonstrate the output of tourism industries vis-à-vis

the consumption expenditures of visitors. However, while the Philippines thru the NSCB and

the DOT are actively involved 4 in the UN-WTO efforts to promote and improve the

compilation of tourism satellite accounts, as pointed out earlier, the PTSA has limitations that

need to be addressed. At present, the PTSA consists of ten tables that correspond partially

to the ten tables prescribed by the TSA:RMF (2000) as shown in Annex 1. It can be noted

that the PTSA does not have information on outbound tourism. Moreover, the frequency and

distance dimensions of the concept of usual environment need to be defined more explicitly

4
The principal author attended the 1998 World Conference on the Measurement of the Economic Impact of Tourism and the
2006 International Workshop on Tourism Statistics in Madrid, Spain while the second author attended the Expert Group
Meeting on Tourism Statistics in New York in June 2007.
in operational terms; the borderline between characteristic and connected goods and

services has to be drawn more clearly and the data support and/or the methodology for the

estimation of expenditures of same-day visitors, domestic travels, household expenditures

on behalf of tourists, etc. must be strengthened.

Health and wellness tourism is of course a component of the PTSA and the PSNA.

Establishments engaged in health and wellness tourism are part of the tourism characteristic

industry; and the services provided by these establishments are covered by the PSNA under

Private Services more specifically, under two subsectors: Personal Services and Medical

Services.

However, primarily due to data constraints, there is nothing in the current PTSA or

PSNA that can provide an explicit characterization of health and wellness tourism as a

component of the Philippine economy. Health and wellness tourism is “hidden” somewhere

under Personal Services or Medical Services of the PSNA. On the other hand, not one of the

ten tables generated under the current PTSA shows information specifically on health and

wellness tourism. The PTSA tables have data only for categories that are explicitly listed

among the tourism-specific industries, whether characteristic or connected. The PTSA also

does not have information on outbound tourism.

The measurement challenge for the PTSA is to be able to identify and separate

tourism-characteristic industries from the rest of the industries comprising the economy. In

order to be able to highlight the health and wellness tourism industry, the goal therefore is to

separate it statistically from the rest of the tourism-characteristics industries. Information on

the sector has to be collected and disseminated in a more timely manner. This will then

provide a statistical tool for assessing the impact of the health and wellness industry in the
Philippine economy, such as on employment and revenue generation, foreign exchange

earnings, clientele served by origin (residents and nonresidents), value added, investments

and consumption, among others.

III. Efforts of the Philippine Statistical System (PSS) in Measuring Health and

Wellness Tourism

The PSS is a decentralized system with the National Statistical Coordination Board

(NSCB) as the agency tasked with the coordination function. One coordination mechanism

that the NSCB uses is the creation of interagency/technical committees and task forces5. In

recognition of the importance of trade 6 in the Philippine economy, the NSCB created the

Interagency Committee on Trade Statistics (IAC-TrS) in March 2004. In order to address

statistical issues on the emerging health and wellness tourism industry, the IAC-TrS created

the interagency Task Force on the Measurement of Healthcare and Wellness/Medical

Tourism Services (TF) in July 2006. The TF, chaired by the NSCB, is composed of

representatives from the Department of Health (DOH), DOT, Department of Foreign Affairs,

National Economic and Development Authority, National Statistics Office (NSO), Department

of Trade and Industry, Bangko Sentral ng Pilipinas and the Philippine Institute of

Development Studies.

On 22 October 2004, Executive Order No. 372 was issued creating a public-private

sector task force (PPP TF) for the development of globally competitive Philippine service

industries. The PPP TF created a Committee on Health and Wellness which identified four

clusters of health and wellness development for promotion purposes: hospitals, specialty

5
As of September 7, 2007, the NSCB has 11 interagency committees, 6 technical committees and 5 task forces.
6
In 2004-2006, Trade comprised almost 17 % of Philippine GDP in constant prices. The IAC-TrS is chaired by NEDA Deputy
Director General Margarita R. Songco.
clinics, wellness and spa centers and retirement/elderly care homes.

Working on this clustering the NSCB TF has come up with a proposed definition of

health and wellness tourism, drafted a questionnaire for a pilot survey of health and wellness

tourism industry but excluding for the time being the cluster on retirement/elderly care homes

and conducted a consultation workshop with stakeholders7.

The specific health and wellness services covered by each of the four clusters were

determined through the 2002 Philippine Central Product Classification (PCPC), which is

patterned after the United Nations Central Product Classification Version 1.1. On the other

hand, the establishments providing these services were classified according to the 2004

Philippine Standard Industrial Classification (PSIC) patterned after the International Standard

Industrial Classification Rev. 3.18.

The survey questionnaire (Annex 2) was designed to estimate the following, among

others: a) total revenue by client (resident or nonresident) and by type of health and wellness

service 9; b) cost by expenditure items; c) number of clients (resident or nonresident); d)

employment and e) number of establishments.

Definition

As defined by NSCB (2007), health and wellness tourism refers to the activities of

persons traveling to and staying in places outside their usual environment for not more than

one consecutive year for health and wellness purposes not related to the exercise of an

activity remunerated from within the place visited. The DOT (2007) associates it with travel

7
The workshop held on 18 April 2007 was jointly sponsored by the NSCB and the DOT
8
The NSCB is now working on the 2007 PSIC.
9
Under the PCPC, these are hospital services, medical and dental services, other human health services, social services with
accommodation, physical and well-being services and other beauty treatment services, nec.
to health spas or resort destinations where the primary purpose is to improve the traveler’s

physical well being through a regimen of physical exercise and therapy, dietary control and

medical services relevant to maintenance.

Scope And Coverage

From the 3 -digit level of the PSIC, we could identify three groups of activities under

which Health and Wellness Tourism activities fall (Table 1). These are

1) PSIC Group 851 or the Hospital Activities & Medical and Dental Practices;

2) PSIC Group 853 or Social Work Activities; and

3) PSIC Group 930 or Other Service Activities.

Based on the Health and Wellness Tourism Classification (Annex 3)10, the cluster of

Hospital Care and Treatment as well as Specialty Clinics belong to the PSIC group 851,

Wellness and Spa Centers could be found under PSIC Group 930 while the cluster on

Retirement and Rehabilitative Care belongs to PSIC group 853.

Obviously, not all activities falling under these 3 -digit PSIC classifications are health

and wellness tourism. Going down to the 5 -digit level will refine the scope and coverage but

there still remain activities which cannot be classified as health and wellness tourism.

IV. Evaluation of Existing Data Collection vs. Data Requirements of Health and

Wellness Tourism

The biggest issue confronting the PSS in the measurement of the emerging health

and wellness tourism industry is the appropriateness and responsiveness of the existing

data monitoring systems.

In order to meaningfully quantify the impact of Health and Wellness tourism in the

economy, it is desirable to gather the following data, among others: 1) outputs and

10
Annex 3 comes from the Preliminary Draft of the Medical Tourism Project Terminal Report
intermediate inputs of industries engaged in Health and Wellness tourism; 2) revenues

derived from resident and non-resident users of health and wellness services, including

foreign exchange earnings; 3) employment and compensation; 4) per capita visitors’

consumption expenditure on health and wellness; and 5) gross fixed capital formation of

Health and Wellness industries.

The consultative forum sought to assess the feasibility of the survey/monitoring form

to capture the needed statistics and indicators for the sector. The forum successfully

solicited the commitment of the participants both from government and the private sector to

support the data collection efforts that will be undertaken in the future. During the

consultative forum, the following issues/concerns/suggestions came up: a) coverage should

be extended to traditional (informal, unorganized) providers of health and wellness services;

b) whether establishment-respondents have the capability to provide the details asked, such

as distinguishing between resident and nonresident clients; c) difficulty in providing cost

estimates; d) lack of familiarity with classification systems and e) separation of medical from

nonmedical employees.

Towards quantifying health and wellness tourism, the possible data sources include

the following:

1) Arrival/Departure (A/D) Cards- The A/D cards which are processed by the DOT

provide information on purpose of travel which includes “health/medical reason” as a

category of the purpose of travel.

2) Visitor’s Sample Survey (VSS) - The VSS is a monthly survey that generates

information on visitor characteristics and preferences useful in tourism planning and in

deriving estimates of foreign exchange earnings from visitors. One category under purpose

of travel in the VSS is health reason s. It also asks questions on actual expenditures incurred
but not directly from availment of health and wellness tourism services.

3) Establishment-based surveys of the NSO- The NSO regularly conducts the

Quarterly (QSPBI) and Annual (ASPBI) Surveys of Philippine Business Industries, and the

Census of Philippine Business and Industry (CPBI). The CPBI 11 is a comprehensive

collection and compilation of statistical information on the structure and level of economic

activity of business establishments in the country. Information collected includes revenues,

employment, hours worked, compensation, cost, capital formation, etc. The ASPBI12 collects

the same information but only from a sample of establishments. The QSPBI collects

quarterly data on gross revenue/sales, employment and compensation for each of the major

industry groups, using purposive sampling. A more detailed description and profiles of these

establishment-based surveys/census were compiled by NSCB (2000). The data collected

from these data sources are summarized based on the 1994 PSIC. One limitation of these

data sources is that at present, they cannot segregate revenues from visitors and non-

visitors.

4) Administrative and regulatory forms of the Department of Health (DOH) - The DOH

maintains a Field Health Service Information System, which collects public health statistics

emanating from barangay health stations. The DOH also maintains the Hospital Operations

and Management Information System which is a computer-based system for effective

hospital management that contains admitting and billing records among others. However,

these systems do not currently generate information for health and wellness tourism.

While the data sources cited cannot provide in general, the information needed, they

certainly can be reviewed for more appropriate disaggregation or possible inclusion of data

items/questions that can generate the necessary information for the measurement of health

11
Normally, the CPBI is conducted every 5 years. The latest CPBI was conducted in August 2000 with the year 1999 as the
reference period. The preliminary release came out in April 2004 and the final tables were released by the NSO in June 2005.
12
The ASPBI is a nationwide survey of the NSO that covers all administrative regions of the country usi ng a one-stage
stratified random sampling. For the 2002 ASPBI (reference period 2001) the preliminary release came out in January 2005, the
final release in December 2005; for the 2003 ASPBI (reference period 2003), the preliminary release came out in June 2005,
the final results in February 2007; for the 2005 ASPBI (reference period 2005), the preliminary results came out in April 2007
with the final tables targeted to be released in the last quarter of 2007.
and wellness tourism. For example, if the CPBI and ASPBI data could be processed at the 5-

digit PSIC level, the social work activities and other service activities can be purified to

exclude many of the economic activities now included under health and wellness tourism

statistics such as child care services, caring for the mentally and physically handicapped,

charitable services, barber shops, beauty parlors and funeral and related activities (Table 1).

Moreover, the information from the available data sources does not allow for the separation

or revenues, cost, employment and other variables associated with visitors from those

pertaining to non -visitors.

V. Indicative Analysis

So far, the pilot survey has not generated the response 13 needed to provide

information on health and wellness tourism with some degree of adequacy. As work on

generating statistics for health and wellness tourism is at its initial stages, in addition to the

limitations on the data sources already mentioned, there are also coverage limitations, both

in terms of scope and classification. Subject to these limitation s, below are some of the

statistics on health and wellness tourism based on three PSIC groups namely, hospital

activities and medical and dental practices (851), social work activities (853) and other

service activities (930) derived from the CPBI and the ASPBI.

• EMPLOYMENT INCREASED SUBSTANTIALLY IN 2005 !

While the combined employment of the three groups of activities under health and

wellness tourism barely moved between 1999 and 2003, it surged by 13.2 percent from

2003 to 2005, one year after the issuance of E.O 372 that created the public-private sector

partnership to formulate a development strategy for the industry. However, its share to total

employment remained below one per cent. Hospital Activities and Medical and Dental

13
Two months after the deadline and despite commitments made during the consultative workshop, less than 20 % of the
establishments have responded.
Practices constituted the biggest employer among the three groups with more than 50

percent share and social work activities the smallest at just over one per cent (Table 2).

• REVENUES ROSE BY 36.1 % FROM 2003 TO 2005!

As with employment, revenues of health and wellness tourism industries rose faster

after EO 372. Prior to 2004, revenues grew at slower rates than either Gross Value Added

(GVA) of Total Private Services or Gross Domestic Product (GDP). Revenues however,

remain at about 1.3% of GDP, close to the contribution of the smallest economic sector,

Mining and Quarrying. On the other hand, the share of revenues of health and wellness

tourism to the GVA of total private services, while increasing slightly between 2003 and

2005, is still below 10 percent. Almost 80 percent of the growth in revenues between 2003

and 2005 came from Hospital Activities and Medical and Dental practices (Table 3).

• COST OF HEALTH AND WELLNESS SERVICES SOARED IN 2005!

The cost, or the expenses incurred during the year whether paid or payable as defined

in the CPBI and the ASPBI, likewise indicated comparatively greater increases after EO 372,

rising by 18.3 % from 1999 to 2001, by 19.4 % from 2001 to 2003 and by 40.6 % from 2003

to 2005 (Table 4). As with revenue and employment, the bulk of the costs came from

Hospital Activities and Medical and Dental Practices. Compared to revenue, the cost

increased faster, causing the Revenue to Cost ratio to continuously decline from 1.86 in

1999 to 1.72 in 2001 then to 1.65 and 1.60 in 2003 and 2005, respectively. The decline was

caused mainly by the continuing decline in the Revenue to Cost ratio of the biggest

component of health and wellness tourism, namely, Hospital Activities and Medical and

Dental Practices, from 1.85 in 1999, 1.71 in 2001, 1.61 in 2003 and 1.56 in 2005. This

deserves careful scrutiny (Table 5).

If these statistics are indicative of the performance of the health and wellness tourism
industry, it would be interesting to know if the 2005 trend was replicated in 2006 14 and if the

trend is being sustained in 2007. It must be stressed however, that the information shown is

very preliminary and cannot be conclusively used as a measure of the performance and

contribution of the Health and Wellness Industry in the country. Nonetheless, these statistics

show that it is possible to provide estimates of the importance of the health and wellness

tourism industry to the entire economy.

In this regard, the Philippine Statistical System (PSS) must take on the challenge to

enhance the health and wellness tourism statistics in the country.

VI. Strengthening Coordination and Collaboration Mechanisms in the PSS

At present, the NSCB and the DOT are the two agencies with the most active role

towards the measurement of health and wellness tourism in the country. Because of the

collaborative work of NSCB and DOT, the Philippines has been actively participating in

moving the TSA agenda at the international level. However, the other stakeholders have

important roles to play. Institutional arrangements have to be agreed upon to address data

gaps. Fortunately, aside from the IAC-TrS and the TF, the NSCB has also created an Inter-

agency Committee on Tourism Statistics (IAC-TS) that in fact, paved the way for the

development of the PTSA. These bodies serve as venues for discussion of technical and

operational issues covering the sector. Based on the Philippine experience, inter-agency

committees are effective tools for coordination and provide the fora for a meaningful

exchange of views and expertise and the resolution of statistical issues. The member

agencies of the IAC-TrS, the IAC-TS and the TF have been supporting and cooperating in

the joint activities. However, it is necessary to further strengthen the roles and the monitoring

the commitment of these bodies.

14
It would be possible to assess this because the NSO is conducting a 2006 CPBI.
VII. Concluding Remarks

Obviously, despite the availability of some data collection mechanisms, the PSS is

not yet able to generate the data needed to adequately measure health and wellness

tourism. And while collaboration and cooperation among the stakeholders exist, stronger

commitment is needed from concerned sectors in order to efficiently and effectively

implement plans and agreements that have been formulated. Concerned data compiling

government agencies like the DOT, the NSCB and the NSO should try harder to collect and

disseminate the necessary health and wellness tourism statistics. The NSO should be

ready to produce statistics with lower levels of disaggregation or at least produce Public Use

Files of its establishments surveys/censuses to allow researchers access to information on

health and wellness tourism. At the same time, tourism planners from both the private

sector and government should develop the capacity to use statistics in their decision-making

and policy formulation. Likewise, households, establishments and data source agencies from

government must show greater willingness and to provide support to data collection efforts.

This includes the willingness to provide data that have not been provided in the past, such

as on foreign exchange earnings and clientele served. Finally, statistics require resources; it

is therefore imperative that both the government and the private sector develop the political

will to invest in statistics.

References

Commission of the European Communities, International Monetary Fund, Organization for Economic
Cooperation and Development, United Nations and World Bank (1993). System of National
Accounts (SNA) 1993

Commission of the European Communities, Organization for Economic Cooperation and

Development, World Tourism Organization and United Nations (2000). Tourism Satellite
Accounts: Recommended Methodological Framework. New York

DOT, Department of Tourism (2007). Philippine Health and Wellness Tourism Program. Consultative
Forum on the Pilot Survey on Health and Wellness To urism Statistics

NEDA, National Economic Development Authority (2000). Medium Term Philippine Development
Program (MTPDP) 2004 - 2010

NSCB, National Statistical Coordination Board (2006). Philippine Statistical Development Program
(PSDP) 2005- 2010

NSCB, National Statistical Coordination Board (2000). Profile of Censuses and Surveys Conducted
by the Philippine Statistical System.

NSCB, National Statistical Coordination Board (2007). Study on the Measurement and Generation of
Statistics on International Trade in Services (Focus on Healthcare and Wellness/Medical
Tourism Services) for Use in Trade Negotiations and as Data Support in the Formulation of
National Positions. First Draft.

Republic of the Philippines (2007). Proclamation No. 1280, 24 April 2007.

NSO, National Statistics Office. Technical Notes for CPBI and ASPBI
http://www.census.gov.ph/data/technotes/index.html

Virola, R., M. Remulla, L. Amoro and M. Say (2001). Measuring the Contribution of Tourism to the
th
Philippine Economy: The Philippine Tourism Satellite Account. Convention Papers, 8
National Convention on Statistics, Westin Philippine Plaza, Manila 1 -2 October 2001.

Virola, R., M. Remulla, L. Amoro and M. Say (2002). Dealing with Data Shortfalls. An article in the
publication “Best Practice in Tourism Satellite Account Development in APEC Member
Economies” by the Asia-Pacific Economic Cooperation (APEC) Tourism Working Group, June
2002.
Table 1. Summary of Activities under PSIC Codes 851, 853 and 850 a /
PSIC Code INDUSTRY DESCRIPTION Health and Wellness Activity?
851 HOSPITAL ACTIVITIES & MEDICAL & DENTAL PRACTICES
85111 PUBLIC HOSPITALS, SANITARIA AND OTHER SIMILAR ACTIVITIES Yes
85112 PUBLIC MEDICAL ACTIVITIES Yes
85113 PUBLIC DENTAL AND LABORATORY SERVICES Yes
85119 PUBLIC MEDICAL, DENTAL AND OTHER HEALTH SERVICES, N.E.C. Yes
85121 PRIVATE HOSPITALS, SANITARIA AND OTHER SIMILAR ACTIVITIES Yes
85122 PRIVATE MEDICAL ACTIVITIES Yes
85123 PRIVATE DENTAL AND LABORATORY SERVICES Yes
85124 PRIVATE CHILD CARE CLINICS Yes
85129 PRIVATE MEDICAL, DENTAL AND OTHER HEALTH SERVICES, N.E.C. Yes
85190 OTHER HOSPITAL ACTIVITIES & MEDICAL & DENTAL PRACTICES, N.E.C Yes

853 SOCIAL WORK ACTIVITIES

85311 CHILD CARE SERVICES Not in the list
85313 CARING FOR THE AGED AND THE ORPHANS Yes
85314 CARING FOR THE MENTALLY AND PHYSICALLY HANDICAPPED Not in the list
85315 REHABILITATION OF PEOPLE ADDICTED TO DRUGS OR ALCOHOL Yes
85319 OTHER SOCIAL WORK WITH ACCOMODATION, N.E.C. Not in the list
85321 CHILD-CARE ACTIVITIES (INCLUDING FOR THE HANDICAPPED) Not in the list
85322 WELFARE AND GUIDANCE COUNSELLING ACTIVITIES Not in the list
85323 VOCATIONAL REHABILITATION AND HABILITATION ACTIVITIES Not in the list
85324 CHARITABLE ACTIVITIES Not in the list
85329 OTHER SOCIAL WORK WITHOUT ACCOMODATION, N.E.C. Not in the list

930 OTHER SERVICE ACTIVITIES

93010 WASHING & (DRY-) CLEANING OF CLOTHING & TEXTILE Not in the list
93021 BARBER SHOPS ACTIVITIES Not in the list
93022 BEAUTY PARLOR ACTIVITIES Not in the list
93029 BEAUTY TREATMENT AND PERSONNAL GROOMING ACTIVITIES, N.E.C. Yes
93030 FUNERAL & RELATED ACTIVITIES Not in the list
93092 SAUNA AND STEAM BATH ACTIVITIES Yes
93093 SLENDERING AND BODY BUILDING ACTIVITIES Yes
93099 MISCELLANEOUS SERVICE ACTIVITIES Yes
a/ Health and Wellness Toruism Activities are all covered by this three groups of activities. Correspondence between Health and Wellness Tourism
Clusters, Philippine Central Product Classification (PCPC) and Philippine Standard Industrial Classification (PSIC) for Health and Wellness
Tourism Services can be found in the Annex 2 of the project report on the "Study on the Measurement and Generation of Statistics on International
Trade in Services with Focus on Health and Wellness Tourism Services
Table 2. Employment Data of Selected Health and Wellness Tourism Activities
Activities in Health and Wellness Total Employment Growth Rates (%)
a/
Tourism 1999 2001 2003 2005 1999 - 01 2001 - 03 2003 - 05
Hospital Activities & Medical and
129,852 130,711 131,087 145,468 0.7 0.3 11.0
Dental Practices
Social Work Activities 2,278 1,861 1,397 2,912 -18.3 -24.9 108.4
Other Service Activities 79,881 77,743 78,525 90,575 -2.7 1.0 15.3
Total 212,011 210,315 211,009 238,955 -0.8 0.3 13.2
Employment of Health & Social Work and
Other Community, Social & Personal Service * 1,229,000 1,221,000 1,143,000 -0.7 -6.4
b/
Activities
Total Employment (Philippines) b/ 29,003,000 30,090,000 31,553,000 32,875,000 3.7 4.9 4.2
% Share to
Employment of Health & Social Work and
Other Community, Social & Personal Service * 17.11% 17.28% 20.91%
Activities
Total Employment (Philippines) 0.73% 0.70% 0.67% 0.73%
Source: a/ Census of Philippine Business and Industry (CPBI), 1999 and Annual Survey of Philippine Business and Industry 2001, 2003 & 2005
b/ Labor Force Survey (October round), NSO 2001, 2003 & 2005
* Classification of Major Industry Groups using the 1994 Philippine Standard Classification (PSIC) started only in 2001.
Employment data in 1999 is still lumped in broader levels.

Table 2a. Explanatory Table on the Industry Classification used in Employment Data
PSIC
Activities in Health and Wellness Tourism
CODE (3-digit)
Hospital Activities & Medical and Dental Practices 851
Social Work Activities 853 Health and Wellness*
Other Service Activities 930
Health & Social Work and Other Community, Social & Personal Service
Activities
Hospital Activities and Medical And Dental Practices 851
Veterinary Activities 852 Health and Social Work
Social Work Activities 853
Sewage and refuse disposal, sanitation and similar activities 900
Activites if business, employers and professional organizations 911
Activites of Trade Unions 912
Activities of Other membership Organizations 919 Other Community, Social,
Motion picture, radio, television and other entertainment activities 921 and Personal Service
News Agency Activities 922
Activities
Library, achives, museums and other cultural activities 923
Sporting and Other recreational activities 924
Other Service Activities 930
* Out of 12 Industries (3-digit PSIC classification) in Health and Social Work and other
community, social and personal service activities, only three are identified as Health
and Wellness Activities
Table 3. Revenue Data of Selected Health and Wellness Tourism Activities
a/
Revenues (Php '000) Growth Rates (%)
Activities
1999 2001 2003 2005 1999 - 01 2001 - 03 2003 - 05
Hospital Activities & Medical and
29,970,709 33,462,035 39,359,225 53,831,498 11.6 17.6 36.8
Dental Practices
Social Work Activities 545,473 520,509 424,803 1,105,768 -4.6 -18.4 160.3
Other Service Activities 9,727,580 9,848,886 10,553,324 13,574,428 1.2 7.2 28.6
Total (in thousand pesos) 40,243,762 43,831,430 50,337,352 68,511,694 8.9 14.8 36.1

Gross Value Added of Total Private Services

b/ 335,404 433,674 556,490 741,984 29.3 28.3 33.3
(in million pesos: at current prices)

Gross Domestic Product (GDP), In million

b/ 2,976,905 3,631,474 4,316,402 5,437,906 22.0 18.9 26.0
pesos: at current prices
% Share to

Gross Value Added of Total Private Services 12.00% 10.11% 9.05% 9.23%

Gross Domestic Product (GDP) 1.35% 1.21% 1.17% 1.26%

Source: a/ Census of Philippine Business and Industry (CPBI), 1999 and Annual Survey of Philippine Business and Industry 2001, 2003 & 2005
b/ National Income Accounts, National Statistical Coordination Board

Table 4. Cost Data of Selected Health and Wellness Tourism Activities

Cost ('000 Php) Growth Rates (%)
Activities
1999 2001 2003 2005 1999 - 01 2001 - 03 2003 - 05
Hospital Activities & Medical and
16,166,471 19,571,716 24,374,952 34,420,291 21.1 24.5 41.2
Dental Practices
Social Work Activities 306,239 321,827 263,310 587,838 5.1 -18.2 123.2
Other Service Activities 5,129,717 5,654,078 5,856,104 7,872,965 10.2 3.6 34.4
Total 21,602,427 25,547,621 30,494,366 42,881,094 18.3 19.4 40.6
Source: Census of Philippine Business and Industry (CPBI), 1999
Annual Survey of Philippine Business and Industry 2001, 2003 & 2005

a/
Table 5. Revenue to Cost Ratio by Activity
Revenue to Cost Ratio Growth Rates (%)
Activities
1999 2001 2003 2005 1999 - 01 2001 - 03 2003 - 05
Hospital Activities & Medical and
1.85 1.71 1.61 1.56 -7.8 -5.6 -3.1
Dental Practices
Social Work Activities 1.78 1.62 1.61 1.88 -9.2 -0.2 16.6
Other Service Activities 1.90 1.74 1.80 1.72 -8.1 3.5 -4.3
Total 1.86 1.72 1.65 1.60 -7.9 -3.8 -3.2
a/ Derived by dividing the Revenue data (Table 3) by the Cost data (Table 4)
 a/
Annex 1 Tables Generated in the Philippine Tourism Satellite Accounts (PTSA)

WTO TSA
Table
Table Title Table Description
Number
Number
1 Tourism Demand in the No Total tourism demand cross tabulated by
Philippines, 1994 and 1998 equivalent tourism characteristic products and
categories of demand
2 Tourism Consumption Tables 1, 2 Total consumption expenditures cross
Expenditures in the Philippines, and 4 tabulated by tourism characteristic products
1994 and 1998 and type of visitors

3 Tourism Collective Consumption Table 9 Total collective consumption expenditures

Expenditures in the Philippines,
1994 and 1999
4 Gross Fixed Capital Formation of
Tourism Industries in the
Philippines, 1994 and 1998
5 Estimated Value Added of
Tourism Industries (VATI) in the equivalent
Philippines, 1994 and 1998
6 Production Accounts of Tourism
Industries and Non-Tourism
Industries in the Philippines,
1994
7 Supply and Use Table of
Tourism Industries and Non-
Tourism Industries in the
Philippines, 1994
8 Estimated Tourism Ratio Based
on the Tourism Final Demand, equivalent
1994 and 1998
9 Employment Generated by the
Tourism Industries in the
Philippines, 1994 and 1998
10 Various Tourism Statistics
(Physical Indicators)
by type of tourism collective Non-Market
Services
Table 8 GFCF of Tourism Industries cross tabulated
by Type of Fixed Capital Formation
No VATI presented by Type of Tourism
Characteristic Industries
Table 5 Table derived from the 1994 Input-Ouput
(IO) Accounts
Table 6 Table derived from the 1994 Input-Ouput
(IO) Accounts
No Tourism Ratio was computed by comparing
Internal Tourism Consumption expenditures
with the final demand for the tourism
industries
Table 7 Employment Classified by type of Tourism
Industries
Table 10 Includes Tourist Arrivals, Means of
Transportation and Port of entry and Forms
of Accommodation Available for Tourists

a/ Due to data constraints, not all tables prescribed by the World Tourism Organization (WTO) were compiled. Table on Outbound Tourism
(Table 3 in WTO) was not compiled. The other tables, while compiled had their limitations. Table 2 (Tables 1, 2 and 4 in WTO) did not
include same day visitors and other components of visitor consumption such as final consumption expenditures in kind, tourism social
transfers in kind other than individual non-market cultural services and tourism business expense.Table 7 (Table 6 in WTO) was short of
establishing the linkage between tourism supply and internal tourism consumption. Table 8 was established with the objective of estimating
tourism ratios to eventually come up with Tourism Value Added (TVA). but this still needs refinements to correct doubtful tourism ratios.Table
9 (Table 7 in WTO) did not include information on the number of jobs and status of employment. Table 4 (Table 8 in WTO) classified capital
goods on the basis of available disaggregation. Table 3 (Table 9 in WTO) did not provide disaggregation by level of government and in Table
10 (also Table 10 in WTO) not all suggested sub-tables were compiled.
Annex 2 Survey Form of the 2006 Pilot Survey on Health and Wellness Tourism
COVER PAGE

2006 Pilot Survey on Health and Wellness Tourism*

OBJECTIVE
The Pilot Survey on Health and Wellness Tourism aims to gather information on
health and wellness tourism providers. This information will be used as basis for
informed policy decisions and advocacy for legislative support for the health and
wellness tourism sector.

REFERENCE PERIOD
Report should refer to the period from January 1, 2005 to December 31, 2006.

INQUIRIES
For inquiries please contact
Name: _________________________
or E-mail us at: ____________________________
Tel. No.: _________________

DUE DATE
Duly accomplished form should be submitted ON or BEFORE MAY 31, 2007

* - Health and Wellness Tourism

Health and wellness tourism comprises the activities of persons traveling to and
staying in places outside their usual environment for not more than one
consecutive year for health and wellness purposes not related to the exercise of
an activity remunerated from within the place visited (UNWTO and DOT)
 ð Page 1 PLEASE ENTER THE DATA REQUESTED ON THE APPROPRIATE SPACE OR BOX. ð Page 2 PLEASE ENTER THE DATA REQUESTED ON THE APPROPRIATE SPACE OR BOX.
Part I - GENERAL INFORMATION ABOUT THE ESTABLISHMENT Part III - REVENUE
1. Company Name (or Name of Establishment) Revenue refers to cash received and receivables for services rendered. Please include revenues of all branches.

2. Location (City/Province) 1. Revenue from Health and Wellness Tourism Services (CY From Local From Foreign
Total a b
2005) In PhP Client Client

a. Hospital Services

b. Medical and Dental Services

Part II - OUTPUT OF THE ESTABLISHMENT in 2006 c. Other Human Health Services

Output refers to the goods and services produced in the Philippine economy. Primary/main output refers to the output that
contributes the biggest or major portion of revenue of the establishment d. Social Services with accomodation
Does your establishment provide any of the services listed below? Please tick ( √ ) only one for Primary Output. Tick e. Physical and Well-Being Services
any applicable service/s for "Secondary Output"
f. Other beauty treatment services, n.e.c.

PSIC Primary/Main
PCPC Code Output Description Secondary Output 2. Revenue from Health and Wellness Tourism Services (CY From Local From Foreign
Code Output Total a b
2005) In PhP Client Client
Hospital Services (Includes surgical,medical,
a. Hospital Services
gynecological, rehabilitation, psychiatric services and
other hospital services delivered under the direction of
9311 b. Medical and Dental Services
medical doctors chiefly to in-patients, aimed at curing,
restoring and/or maintaining health c. Other Human Health Services

d. Social Services with accomodation

Medical and Dental Services (Includes general
1 2 3 e. Physical and Well-Being Services
medical , specialized medical and dental services
9312 consisting of the prevention of physical and/or mental f. Other beauty treatment services, n.e.c.
diseases of general nature thru consultations, physical
a
check-ups and can be provided in general practice Includes OFW who are permanent residents of the Philippines
b
Includes Overseas Filipinos (OF) holding Philippine Passport who are permanently residing abroad and expats.

Other Human Health Services (Includes deliveries and

related services, nursing services, physiotherapeutic and Part IV Cost
9319
paramedical services provided by authorized persons,
Cost refers to cash paid and payable for goods and services incurred. Please include costs of all branches.
other than medical doctors)4

1. Cost/ Expenses incurred to the following items (In PhP) 2005 2006
Social Services with accomodation (Includes social
9331 assistance services involving round the clock services by a. Compensation of Employees *
5
residential institutions)
b. Supplies and Materials (Incl. Drugs & Medicines)

Physical and well-being services (Includes physical c. Machineries and Equipment

9723 well-being services such as those delivered by d. Sub-Total [(d) = (a) + (b) + (c )]
solarioums, spas, reducing and slimming salons, fitness
centers, massage (exclusing therapeutic massage) and 2. Other Cost (other cost items not included under Items a,b and c above)
the like (e.g Turkish baths, sauna and steam bath)
3. Total Cost [(3) = (1.d) + (2)]

Other beauty treatment services, n.e.c. ( Includes * - Includes salaries and wages, commissions, other remuneration plus the actual or estimate of professional fees.
personal hygiene, body care, depilation, treatment with
9729
ultraviolet rays and infra-red rays and other hygiene
services)
 ð Page 4
ð Page 3 PLEASE ENTER THE DATA REQUESTED ON THE APPROPRIATE SPACE OR BOX.

Part V - PATIENT INFORMATION NOTES:

Local Foreign Total 1
General medicine refers to the branches of medicine dealing with the general care and treatment of the
Total Number of Patients in 2006
diseases of adults who have not yet reached old age. Includes public medical services (including perdiculture
and laboratory services) under PSIC code 85112, and Private medical services (inc. laboratory services) under
PSIC code 85122.

Part VI - EMPLOYMENT 2
Specialized medicine refers to branches of medicine devoted to particular practice areas; e.g. podiatry,
Average Total Employment (ATE) is the average total number of persons who worked in or for this establishment. It
proctology, ophthalmology, cardiology, ear-nose-throat, etc.n. Includes public specialized medical services that
includes employees of all branches
is part of PSIC code 85111, 85119; and private specialized medical services that is part of PSIC code 85121
2005 2006 and
3
85129
Dental medicine refers broadly to diagnosing and treating dental problem. Includes public dental and
Average Total Employment laboratory services with PSIC code 85113 and private dental and laboratory services with PSIC code 85123

4
Includes private child care clinics (PSIC code 85124), other services provided by midwives, nurses,
physiotherapists and paramedical personnel (part of PSIC code 85119 and 85129), private ambulance
Part VII - COMMENTS ON THE QUESTIONNAIRE
services (part of PSIC code 85119), public ambulance services (part of PSIC code 85129), residential health
facilities services other than hospital services (part of PSIC code 85112) and other human health services,
Part I - General Information n.e.c (part of PSIC code 85190)
5
This includes caring for the aged (PSIC code 85313) and rehabilitation of people addicted to drugs or alcohol
(PSIC code 85315)

6
Part II - Output of the Establishment This includes sauna and steam bath services (PSIC code 93092), slendering and body-building services (PSIC
(Additional comments to improve the description of services/output will be appreciated. Your comments will serve as valuable code 93093) and other physical and well-being services, nec (PSIC code 93099)
inputs in the updating of the Philippine Central Product Classification)
ACRONYMS
PSIC - Philippine Standard Industrial Classification
PCPC - Philippine Central Product Classification
Part III - Revenue

Part IV - Cost

Part V - Patient Information

Part VI - Employment

Part VIII - CERTIFICATION

I hereby certify that this report for the period ________________ to ________________ has been completed as
accurately as the records of this establishment allow and with the best estimates in some instances.

Name: _____________________________________ Signature: ________________________

Title/Designation: ____________________________ Date: ____________________________

E-mail Address: _____________________________ Contact Number/s: _________________

Annex 3. Health and WellnessTourism Classification
Clusters Based on EO 372*
a. Hospital care and treatment
b. Specialty Clinics
PAGE 1
PCPC** PSIC**
9311 - Hospital Services
This includes:
surgical services delivered under the direction of medical
doctors chiefly to in-patients, aimed at curing, restoring
and/or maintaining the health of a patient;
medical services delivered under the direction of medical
doctors chiefly to in-patients, aimed at curing, restoring
and/or maintaining the health of a patient;
gynecological and obstetrical services delivered under
the direction of medical doctors chiefly to in-patients,
aimed at curing, restoring and/or maintaining the health
of a patient;
rehabilitation services delivered under the direction of
medical doctors chiefly to in-patients, aimed at curing,
restoring and/or maintaining the health of a patient;
psychiatric services delivered under the direction of
medical doctors chiefly to in-patients, aimed at curing,
restoring and/or maintaining the health of a patient;
other hospital services delivered under the direction of
medical doctors chiefly to in-patients,aimed at curing,
restoring and/or maintaining the health of a patient.
These services comprise medical, pharmaceutical and
paramedical services, nursing services, laboratory and
technical services including radiological and
anaesthesiological services, etc.;
military hospital services;
prison hospital services.
This subclass does not include:
services delivered by hospital out-patient clinics,
classified in 9312;
dental services, classified in 93123;
ambulance services, classified in 93192.
93111 - Public hospitals, sanitaria and other similar 85111 - Public Hospitals, Sanitaria and Other
services Similar Activities
93112 - Private hospitals, sanitaria and other similar 85121 - Private Hospitals, Sanitaria and Other
services Similar Activities
85190 - Other hospital activities and medical
and dental practices, n.e.c
9312 - Medical and Dental Services
93121 - General medical services
This subclass includes:
services consisting of the prevention, diagnosis, and
treatment by doctors of medicine of physical and/or
mental diseases of a general nature, such as:
- consultations;
- physical check-ups, etc. These services are
not limited to specified or particular conditions,
diseases or anatomical regions. They can be
provided in general practitioner's practices and
also delivered by out-patient clinics, clinics
attached to firms, schools, etc.
931211 - Public medical services 85112 - Public medical activities
931212 - Private medical services 85122 - Private medical activities
93122 - Specialized medical services
This subclass includes:
consultation services in pediatrics, gynecology-
obstetrics, neurology and psychiatry, and various
medical services;
surgical consultation services;
treatment services in out-patients clinics, such as
dialysis, chemotherapy, insulin therapy, respiratory
treatment, radiation treatment and the like; analysis
Thisand interpretation
subclass does notofinclude
medicalservices
imagesof (X'ray,
medical
laboratories, classified in 93199.
 Annex 3 PAGE 2

Clusters Based on EO 372* PCPC** PSIC**

931211 - Public specialized medical services 85119 - Public medical, dental and other health
activities, n.e.c.
93122 - Private specialized medical services 85129 - Private medical, dental and other health
services, n.e.c.
93123 - Dental services
This subclass includes:
orthodontic services, e.g., treatment of protruding
teeth, crossbite, overbite, etc., including dental
surgery even when given in hospitals to in-patients;
services in the field of oral surgery;
other specialized dental services, e.g., in the field
of periodontics, paedodontics, endodontics and
reconstruction;
diagnosis and treatment services of diseases
affecting the patient or aberrations in the cavity of
the mouth, and services aimed at the prevention
of dental diseases.
Note : These dental services can be delivered in
health clinics, such as those attached to schools,
firms, homes for the aged, etc., as well as in own
consulting rooms. They cover services in the field
of general dentistry, such as routine dental
examinations, preventive dental care, treatment of
caries, etc.
931231 - Public dental and laboratory services 85113 - Public dental and laboratory activities
931232 - Private dental and laboratory services 85123 - Private dental and laboratory activities

9319 - Other human health services

93191 - Deliveries and related services, nursing services,

physiotherapeutic and para-medical services

This subclass includes:
services such as supervision during pregnancy and
childbirth;supervision of the mother after birth;services
in a field of nursing care (without admission), advice
and prevention for patients at home, the provision of
maternity care, children's hygiene, etc.

services provided by physiotherapists and other

paramedical persons (including homeopathological and
similar services);
physiotherapy and paramedical services are services in
the field of physiotheraphy, ergotherapy, occupational
therapy, speech therapy,homeopathy, acupuncture,
nutrition, etc. These services are provided by
authorized persons,other than medical doctors.

931911 - Private child care clinics
931919 - Other services provided by midwives,
nurses,physiotherapists and paramedical personnel
93192 - Ambulance services
This subclass includes services involving transport of
patients by ambulance, with or without resuscitation
equipment or medical personnel.
931921 - Public ambulance services
931922 - Private ambulance services
85124 - Private child care clinics
85119 - Public medical, dental and other health
activities, n.e.c.
85129 - Private medical, dental and other health
services, n.e.c.
Part of 85119 - Public medical, dental and other
health activities, n.e.c
Part of 85129 - Private medical, dental and other
health services, n.e.c

Clusters Based on EO 372*
c. Wellness and Spa Centers
9729 - Other beauty treatment services, nec
d. Retirement and rehabilitative 9331 - Social Services with accomodation
care
* Based on the Committee on Health and Wellness, under the PPP Task Force on Globally Competitive Industries, created by virtue of EO 372
* Highest revenue was the basis for coming up with the correspondence between clusters and the PCPC/PSIC.
Annex 3 PAGE 3
PCPC** PSIC**
93193 - Residential health facilities services other than
hospital services
This subclass includes combined lodging and medical Part of 85112 - Public medical activities
services provided without the supervision of a medical Part of 85119 - Public medical, dental and other
doctor located in the premises. health activities, n.e.c
Part of 85129 - Private medical, dental and other
health services, n.e.c
93199 - Other human health services, n.e.c. 85190 - Other hospital activities and medical and
This subclass includes: dental practices, n.e.c
services provided by medical laboratories; services
provided by blood, sperm and transplant organ
banks;diagnostic imaging services without analysis or
interpretation, e.g., X-ray, ultrasound, magnetic
resonance imaging (MRI), etc.;dental testing
services;medical analysis and testing services;other
human health services, n.e.c.
9723 - Physical and Well-Being Services
This subclass includes physical, well-being services
such as delivered by sauna and steam baths, solarium,
spas, reducing and slimming salons, fitness centers,
massage (excluding therapeutic massage) and the like.
This subclass does not include medical treatment
services, classified in 931.
97231 - Sauna and steam bath services 93092 - Sauna and Steam Bath Activities
97232 - Slendering and body building services 93093 - Slendering and body- building activtities
97239 - Other physical well-being services, n.e.c. 93099 - Other physical well-being services, nec
93029 - Beauty treatment and personal grooming
This subclass includes personal hygiene, body care, activities, nec
depilation, treatment with ultraviolet rays and infra-red
rays and other hygiene services.
This subclass does not include medical treatment
services, classified in 931
93311 - Welfare services delivered through residential
institutions to elderly persons (and persons with
disabilities)
This subclass includes:
social assistance services involvinground-the-clock
care services by residentialinstitutions for elderly
persons;
social assistance services involvinground-the-clock
care services by residentialinstitutions for persons with
physical orintellectual disabilities including those
havingdisabilities in seeing, hearing or speaking.
This subclass does not include:
combined lodging and medical services,classified in
93110 (Hospital services) if under thedirection of
medical doctors, and 93193 if withoutsupervision by a
medical doctor.
933111 - Caring for the aged and orphans 85313 - Caring for the aged and orphans
933194 - Rehabilitation of people addicted to drugs or 85315 - Rehabilitation of people addicted to
alcohol drugs or alcohol