HEALTHCARE INFORMATION REGULATIONS, LAWS, AND STANDARDS Flashcards
● The main drivers of the healthcare system are essential for the efficient management and operation of the public health system.
HEALTH HUMAN RESOURCE
● They are the health educators and providers of health services.
HEALTH HUMAN RESOURCE
● Find the most efficient way on how to deliver HC services
HEALTH HUMAN RESOURCE
● Pertains to the effect, patient-centered care through activation and engagement,
HEALTH OUTCOMES
● Changes in health that result from specific health interventions
HEALTH OUTCOMES
● Measuring how well a patient responds to treatment, how satisfied patients are with the care that they receiving
HEALTH OUTCOMES
● Average number of years of life expected hypothetically for individuals
LIFE EXPECTANCY
● Subject throughout their lives to the mortality rate at a given period expressed in years
LIFE EXPECTANCY
● No of years a newborn or infant could live if prevailing mortality during its birth would stay throughout its life
● Influences involved: sex, lifestyle (diet, smoking, alcohol, etc)
LIFE EXPECTANCY
Measured to determine the status of health and particular dynamics of an area
DEATHS AND BIRTHS
no. of death occurring during the year per 1000 pop, mid year
● Crude death rate
the rate of natural increase, which is equal to the population change in the absence of migration
○ Crude: di kasama mga nanganak sa bahay, undocumented birth
● Crude birth minus crude death
○ Refers to decisions, plans, and actions that are undertaken to achieve specific health care goals within a society.
Health policy
○ It outlines priorities and the expected roles of different groups; and it builds consensus and informs people
Health policy
provides national policy, direction, and strategic plans, regulatory guidelines for health in highly specialized and specific tertiary level hospitals
○ DOH
○ Kalusugan Pangkalahatan - continued health reform through three key strategies
Universal Health Care (UHC) Bill into Law (RA 11223)
RA 11223
Universal Health Care law (UHC)
three key strategies
■ Achieving universal sustainable Philhealth membership
■ Upgrading and modernizing government health facilities
■ Fortifying efforts to achieve millennium development goals
○ Every Filipino, including overseas Filipino workers, are eligible for preventive, promotive, curative, rehabilitative, and palliative care upon automatic enrollment to the government’s health insurance program.
UHC
○ The Philippine Health Insurance Company (PhilHealth) will have expanded coverage to include
free consultation fees, laboratory tests and other diagnostic services.
○ To improve doctor-to-patient ratio, upgrade hospital bed capacities and equipment and establish more hospitals in remote areas.
UHC
The process that gives a facility a legal approval to operate
● Licensure
Licensure for health facilities
DOH and Health Facilities and Services Regulatory Bureau
Licensure for professionals
Professional Regulation Commission
gives a healthcare organization the authority to participate in several programs
● Certification
○ An external review process that an organization elects to undergo.
● Accreditation
○ Legal documents and health human resources that will review the operations of any health institution
Accreditation
● All facilities must have this and it is generally the state department of health or a similar agency that carries this out
Licensure for Health facilities
○ tend to emphasize areas such as physical plan standards, fire safety, space allocations, and sanitation
Licensure regulation
is required before it operates and give service
Initial license
Licensure renewal for health facilities
annual
● Usually granted after some form of examination or proof of education and may be renewed periodically through payment of a fee and/or proof of continuing education or professional competence.
LICENSURE TO INDIVIDUALS/PROFESSIONALS
○ Renew every 3 years
LICENSURE TO INDIVIDUALS/PROFESSIONALS
○ Professionals working abroad shall not be covered by the CPD requirement during the period of their employment abroad.
● IRR of the Republic Act 10912 (March 1, 2019)
○ CPD Act of 2016
○ Initially 45 credit units - conventions, seminars, webinars
- As of now 15 gradually tinataas
● RA10912
○ Amendments to the Revised Guidelines on CPD Program for All Registered and Licensed Professionals
○ Initially 45 Credit units required for every 3 years
● PRC Resolution No. 2016-990
Newly licensed professionals shall be exempted from CPD requirements for their first renewal
True
Minimum CPD units
15
● Granted following an on-site inspection to determine if minimum health and safety standards have been met.
Organizational licensure
● Maintenance of licensure is an ongoing requirement for the
Organizational licensure
implies that the individual has received additional education and training, and demonstrated competence in a specialty area beyond the minimum requirements set for licensure.
Certification for individual practitioners
usually implies that the organization has additional services, technology, or capacity beyond those found in similar organizations
Certification for organizations
● External quality assurance program of DOH through NRLS (National Reference Laboratory)
Accreditation
○ To ensure quality operation/equipment etc
Accreditation
● Often a voluntary process in which organizations choose to participate, rather than one required by law and regulation.
Accreditation
○ Usually regarded as optimal and achievable, and are designed to encourage continuous improvement efforts within accredited organizations.
● Accreditation standards
○ Is made following a periodic on-site evaluation by a team of peer reviewers, typically conducted every two to three years.
● Accreditation decision
● An independent, non-profit organization, dedicated to improve and promote quality and safety in the delivery of healthcare in the Philippines through continuing review of performance, assessment and accreditation.
PHILIPPINE TRIPARTITE ACCREDITATION FOR HEALTH FACILITIES, INC. (PTAHF, INC.)
are eligible for the reimbursement of hospital expenses and professional fees
● PhilHealth’s Benchbook Standards
○ Established by DOH to accredit hospitals in the PH
Hospital Accreditation Commission (HAC)
● Before HAC was created __ did the accreditation of hospitals through surveys
Philhealth
○ addresses broader determinants of health and focuses on the comprehensive and inter-related aspects of mental, social health, and the holistic health of a patient.
Primary Health care
○ An approach to help and wellbeing centered to the needs/preference of individuals,
Primary Health care
○ assures people receive comprehensive care ranging from promotion of care, prevention and treatment, rehabilitation
Primary Health care
○ Essential health care is made universally acceptable to individuals and families in the community by means acceptable to them through their full participation and at a cost that the community and country can afford at every stage of development.
● WHO
Two types of primary HCW
Barangay health workers
Intermediate
Volunteers who undergo formal training to provide HC
Barangay health workers
FOUR PILLARS OF PRIMARY HEALTH CARE
Community participation
Intersectoral coordination
Appropriate technologies
Support mechanism made available
multidisciplinary group of health and social care professionals who work together to deliver local and accessible services and social care services
Primary health care
Pillar of PHC - Social and proven approach to address HC needs of the people in a community
● Involvement of the community is important,
● Representative ng barangay for analysis, decision making, and planning for effective social action and program implementation.
Community participation
● Collective actions involving more than one specialized agency performing different roles for a common purpose
Intersectoral coordination
● Must be implemented and other applications to fasten the healthcare delivery system and services.
Appropriate technologies
● Main target of PHC is the availability and accessibility of essential HC and to the first level referral facilities in our area
- Support mechanism made available
