HEALTH CARE SYSTEM Flashcards
The combination of resources, organization, financing and
management that culminate in the delivery of health services
to the population (Roemer, 1991)
Health Care System
According to this organization, health system was defined as “all the organizations, institutions and resources that are devoted to producing health actions
World Health Organization Report in 2000
3 main goals for health systems
- Improving the health of populations
- Improving the responsiveness of the health system to the population it serves
- Fairness in financial contribution
Four (4) Vital Health System Functions
- Health Service Provision
- Health Service Inputs
- Stewardship
- Health Financing
Promoted participatory management of the local health care system.
1979: Adoption of Primary Health Care
Integrated public health and hospital services
1982: Reorganization of DOH
Prescriptions are written using the generic name of the drug.
1988: The Generics Act
Transfer of responsibility of health service provisions to the local government units.
1991: RA 7160 “Local Government Code”
Aims to provide all citizens a mechanism for financial protection with priority given to the poor.
1995: National Health Act
Major organizational restructuring of the DOH to improve the way health care is delivered, regulated and financed
1996: Health Sector Reform Agenda
Adoption of operational framework to undertake reforms with speed, precision, and effective coordination
2005: FOURmula One (F1) for Health
Promote and ensure access to affordable quality drugs andmedicines for all
2008: RA 9502 “Access to Cheaper and Quality Medicines Act”
Universal health coverage and access to quality health care for all Filipinos
Universal health coverage and access to quality health care for all Filipinos
Directions of the Philippine Health Sector
-The Philippine Health Agenda (DOH Administrative Order 2016-0038)
-The Philippine Developmental Plan 2017-2022
-NEDA AmBisyon Natin 2040
-Sustainable Developmental Goals 2030
17 Goals
- No Poverty
- No Hunger
- Good Health
- Quality Education
- Gender Equality
- Clean water and sanitation
- Renewable Energy
- Good Jobs and Economic Growth
- Innovation and Infrastructure
- Reduced Inequalities
- Sustainable Cities and Communities
- Responsible Consumption
- Climate Action
- Life Below Water
- Life on Land
- Peace and Justice
- Partnership For The Goals
17 Goals of Philippine Health System
1: End poverty in all its forms everywhere
#2: End hunger, achieve food security and improved nutrition and promote sustainable agriculture
#3: Ensure healthy lives and promote well-being for all at all ages
#4: Ensure inclusive and quality education for all and promote lifelong learning
#5: Achieve gender equality and empower women and girls
#6: Ensure access to water and sanitation for all
#7: Ensure access to affordable, reliable, sustainable and modern energy for all
#8: Promote inclusive and sustainable economic growth, employment and decent work for all
#9: Build resilient infrastructure, promote sustainable industrialization and foster innovation
#10: Reduce inequality within and among countries
#11: Make cities inclusive, safe, resilient and sustainable
#12: Ensure sustainable consumption and production patterns
#13: Take urgent action to combat climate change and its impacts
#14: Conserve and sustainably use the oceans, seas and marine
resources
#15: Sustainably manage forests, combat desertification, halt and
reverse land degradation, halt biodiversity loss
#16: Promote just, peaceful and inclusive societies
#17: Revitalize the global partnership for sustainable development
Each goal is important in itself
And they are all connected
Health System branch under provincial government
- Provincial Health Office
- Inter-local Health Zones
- Provincial Hospitals
- District Hospitals
Health System branch under city government
City Health Office (Chartered Cities)
- City Hospitals
- Health Centers
- Barangay Health Stations
City Health Office (Components City)
- City Hospitals
- Health Centers
- Barangay Health Stations
Pertains to the arrangement of parts and their interconnections
System
Health Care System includes: (8)
Community
Department of Health
Health Providers
Health Service Organization
Different pharmaceutical companies
Health financing bodies
Organization related to health
Governance
The department that are responsible for the policies for health, provision of health service, health promotion, education, and financing.
DOH (Department of Health )
Improvement of health ; It could be personal or public
Health Action
Health System should strive for equity in health ; People should be protected from existing and emerging health risk and ready to be resilient
Improving the Health of Population
Sources of inequitable disparity in health may include
Disparities are most effectively reduced when they are
recognized and their minimization is an explicit national goal
How to properly get rid of those disparities
Organize our healthcare system
GIDA
Geographically Isolated and Disadvantaged Areas
represents the concept that the health system provides services in the manner that people want or desire and engages people as active partners.
Responsiveness
Respectfulness
Dignity
Confidentiality
Autonomy,
and timeliness in the delivery of health services
Non- discriminative and human
Responsiveness represents the concept that the health system provides services in the manner that people want or desire and engages people as active partners.
Values: respectfulness, dignity, confidentiality, autonomy, and timeliness in the delivery of health services
Maximizes people’s autonomy and control
Improving the Responsiveness of the Health System to the Population it serves
can provide financial and social assistance to give the people a essential health services that they need
Ideal Healthcare System
Paying for health care should not impoverish individuals or families
All systems must be financed, and there must be adequate funding in the system to provide essential services
WHO definition - fairly financed health system is one that does not deter individuals from receiving needed care due to payments required at the same time of service;
One in which each individual pays approximately the same percentage of their income for needed services
Fairness in Financial Contribution
Most visible product of the health care
Public and Private Hospitals
Most visible product of the health care (public and private hospitals)
Promote health and try to avert illness through education and preventive measure
“ Delivering health services is thus an essential part of what the system does- but it is not what the system is’ (WHO 2000)
Health Service Provision
“ Delivering health services is thus an essential part of what the system does- but it is not what the system is’
WHO, 2000
Management of resources
Assembling of essential resources for delivering health services
Human resources, medication, and medical equipment
Health Service Inputs
Overall system oversight sets the context and policy framework for the overall health system
Public health surveillance and health system performance - Data - Health status
Government responsibility
Stewardship
Stewardship Core Function:
- Identifying health priorities for allocation of public resources
- Identifying an institutional framework
- Coordinating activities with other system related to external health care
- Analyzing health priorities and resource generation trends and their implications
- Generating appropriate data effective decision-making and policy-making on health matters
refers to how financial resources are used to ensure that the health system can adequately cover the collective health needs of every person
Health Financing
Different mechanism of health financing
Revenue Collection
Risk Pooling
Strategic Purchasing
Collection of money to pay for health care services
General taxation, donor financing, mandatory payroll contributions, mandatory or voluntary risk-rated contributions, direct household out-of-pocket expenditures, and other forms of personal savings
Revenue Collection
Collection and management of financial resources in a way that spreads financial risks from an individual to all pool members
Risk Pooling
Way most risk-pooling organizations or purchasers use collected and pooled financial resources to finance or buy health care services for their members
Strategic purchasing
Two main model of Risk Pooling
Bismarck Model
Beveridge model
It uses an insurance system usually financed jointly by employers and employees through payroll deduction; Insurance system- sickness fund- Private sector
Bismarck Model ( Bismarck’s Law on Health Insurance of 1883 )
Bismarck Model, who made this model
Otto von Bismarck
A type health insurance plans have to cover everybody, and they don’t make a profit
Bismarck-type health insurance
The Bismarck model is found in what places
Germany
France
Belgium
Netherlands
Japan
Switzerland
and, to a degree, in Latin America
social reformer who designed Britain’s National Health Service
William Beveridge
Health care is provided and financed by the government through tax payments, just like the police force or the public library
Hospitals and Clinics are owned by the government; some doctors are government employees, but there are also private doctors who collect their fees from the government
Beveridge model
Beveridge model
Great Britain
Spain,
most of Scandinavia and New Zealand,
Hongkong and Cuba
mandated to provide national policy direction and develop national plans, technical standards, and guidelines of health.
Department of Health (DOH)
Department of Health is mandated to provide national policy direction and develop national plans, technical standards, and guidelines of health.
Provides technical assistance, capacity building and advisory service for disease prevention and control and supplies medicines and vaccines
Devolution/ Decentralized - LGUs were granted autonomy and responsibility for their own health services
National Health programs are coordinated by the DOH through the LGUs
Leadership and Governance
LGUs were granted autonomy and responsibility for their own health services
Devolution/ Decentralized
programs are coordinated by the DOH through the LGUs
National Health Programs
national health system consisted of a three-tiered system under the direct control of the DOH: tertiary hospitals at the national and regional levels; provincial and district hospitals and city and municipal health centers; and barangay (village) health centers
Centralized
The DOH, LGUs and the private sector participate, cooperate and collaborate in the care of the population
Decentralized
DOH functions
- Developing health policies and programs;
- Enhancing partners’ capacity through technical assistance;
- Leveraging performance for priority health programs among these partners;
- Developing and enforcing regulatory policies and standards;
- Providing specific programs that affect large segments of the population;
- Providing specialized and tertiary level care
“ All for Health Towards Health For All”
The Philippine Health Agenda (DOH Administrative Order 2016-0038)
“ matatag, maginhawa, at panatag na buhay”
The Philippine Development Plan 2017-2022
Building a prosperous, predominantly middle-class society where no one is poor
Promoting a long and health life
Becoming smarter and more innovative
Building a high-trust society
NEDA AmBisyon Natin 2040
all Filipinos are guaranteed equitable access to quality and affordable health care goods and services, and protected against financial risk. President Duterte
R.A. 11223 or the Universal Health Care Law
What is the risk pooling of the Philippines
It has multiple risk pooling model
LGUs have to give
- basic health service
- health promo
- preventive units
Example of free nationalize center
PGH Philippine General Hospital
3 health system guarantes
- individual level interest for all stages
- access to health information
- financial through UHL
