Health Care System Flashcards
Is a complex network of organizations, institutions, resources, and people whose primary purpose is to improve health
health System
he defined health system as “The combination of resources, organization, financing and management that culminates in the delivery of health services to the population.”
Milton I. Roemer 1883
Defined health system as “All the organizations, institutions, resources and people whose primary purpose is to improve health”
WHO, 2000
Roemer Model of Health Services System
Organization of Programs (PriMoVo)
Management (HALeR)
Economic Support (PeChaI ni SoGo Fo)
Resource Production ( MaFaCK)
Delivery of Services (Primary, Secondary, Tertiary)
WHO 3 Main Goals of Health System
- Improve the health of the population
- Improve health care system’s responsiveness
- Provide Fair Health Financing
FOUR VITAL HEALTH SYSTEM FUNCTIONS (DOH)
Health Service Provision
Health Service Input
Stewardship
Health Financing
Any service, not limited to clinical services, aimed at improving the health of populations
Health Service
Preventive measures as well as promotion of a healthy way of living to avoid illnesses are also part of the best system.
Health Service Provision
Generating the essential physical resources for the delivery of health services ▪ ○ Medications, human resources, and medical equipment
Health Service Inputs / Managing Resources
Sets the direction, context, and policy framework
Stewardship
Raising and pooling resources to pay for health services
Health Financing
Health Financing Components
Revenue Collection
Risk Pooling
Strategic Purchasing
2 components of Revenue Collection
Public health system- tax payments
Social Security organization - mandatory contributions from workers and employers
objective of Risk Pooling
Manage these revenues to
equitably and efficiently pool health risks
Objective of Strategic purchasing
Assure the purchase of
health services in an allocatively and technically efficient manner.
Spread financial risks from an individual to all pool members
● Core function of health insurance companies
Risk Pooling
2 models of Risk pooling
Beveridge Model (Beveridge Report 1942)
Bismarck Model (Bismarck’s Law on health insurace of 1883)
Risk pooling organizations use collected funds and pooled financial resources to finance health care services for the members.
Strategic Purchasing
SYSTEM BUILDING BLOCKS
Service Delivery
Leadership and Governance
Information
Financing
Health Products, Vaccines
Healthcare Workforce
Mandated to provide the appropriate direction for the nation’s health care industry
Department of Health
What is The Philippine Health Agenda 2016-2022
“All for health towards health for all” rally point by 2020
What is The Philippine Development Plan 2017-2022
Includes 4 key medium- term plans to translate the vision of aspirations for the Filipinos and the country
What is Sustainable Development Goals 2030
Compilation of 17 developmental goals
What is NEDA AmBisyon Natin 2040
This is a collective long- term plan which envisions e better life in the next 25 years
Enumerate the Historical background
1970- Primary health Care for All
1979- Adoption of :Primary Health care l (LOI 949)
1982- Reorganization of DOH (EO 851)
1986- The Milk Code
1988- The Generics Act (RA 6675)
1991- The Local Government Code (RA 7150)
1995- National Health Insurance Act (RA78750
1999- Health Sector Reform Agenda
2005- FOURmula 1
2008- Access to Cheaper and Quality Medicines Act (RA9502)
2010 - Kalusugang Pangkalahatan (AO 2010- 0036)
2013- Sin Taxes for Health
2019- Universal Health Care Law
Developed a largely centralized government- funded and operated health care system
Primary health Care for All 1970
Promoted participatory management of the local health care system
Adoption of Primary Health care 1979 (LOI949)
Integrated public health and hospital services
Reorganization of DOH 1982 (EO851)
Prevention and nutrition to promote breastfeeding
Milk Code 1986
Prescriptions are written using the generic name of the drug
Generics Act (RA 6675) 1988
Transfer of responsibility of health services provisions to local government units
Local Government Code (RA 7160) 1991
Aims to provide all citizens a mechanism for financial protection with priority given to the poor
National Health Insurance Act (RA 7875) 1995
Major organizational restructing of the DOH to improve the way health care is delivered
Health Sector Reform Agenda 1999
Adoption of operational framework to undertake reforms with speed, precision, and effective coordination
FOURmula One (F1) for Health 2005
Promotes and ensures access to affordable quality drugs and medicines for all
Access to Cheaper and Quality Medicines act (RA9502) 2008
Universal health coverage and access to quality health care for all Filipinos
Kalusugang Pangkalahatan (AO2010- 0036) 2010
Generating extra revenue for DOH by discouraging harmful consumption of alcohol and tobacco
Sin Taxes for Health
Enrolling all Filipino citizens automatically in the National Health insurance program administered by PhilHealth
Universal Health Care Law
Stats in the PH
78 provinces
138 cities
1496 municipalities
42025 barangays
LGUs are grouped into
17 regions
Take care of their own health services and are given autonomy under the LGC of 1991 (RA 7160)
LGU’s
formal statements produced and supported by senior management
Policies
mandatory actions or rules that give formal policies,
support, and direction
Standards
recommendations to users when specific standards do not apply
Guidelines
Health outcomes
Improved Efficiency
● Social & Financial Risk Protection
● Improved Equality of Health
● Responsiveness
Uses an insurance system where he sickness funcd finances both the
employers and the employees
Bismarck Model (1883) by Otto von Bismarck
Health care is provided and funded by the government through tax payments
Beveridge Model(1942) by William Beveridge
Collection of money to pay for health care services
Revenue Collection
Collection and management of financial resources in a way that spread financial risks from an individual to all pool members
Risk Pooling
Risk-pooling organizations use collected funds and pooled financial resources to finance health care services for the members
Strategic Purchasing
Involve the oversight, policy making, and strategic direction necessary to guide the health system and ensure its accountability and responsiveness
● Main responsibility of the government
Stewardship