Module 03: Universal Health Care Flashcards
It aims to accelerate the implementation of Universal Health Care (UHC) in the Philippines to ensure all Filipinos have access to quality health services without financial hardship.
DOH Arangkada Towards UHC
When was the Universal Health Care (UHC) law enacted in the Philippines?
The UHC law was enacted in 2019 under Republic Act No. 11223.
What is the focus of strengthening primary care under “DOH Arangkada Towards UHC”?
It focuses on enhancing local health systems and ensuring comprehensive primary care services are accessible to all at the community level.
How does “DOH Arangkada Towards UHC” address health financing reforms?
it expands PhilHealth coverage, particularly for vulnerable sectors, to reduce out-of-pocket expenses and make healthcare services more affordable.
Why is health human resources a key component of “DOH Arangkada Towards UHC”
Investing in health human resources is essential to increase the number of doctors, nurses, and other healthcare professionals, supporting local health systems effectively.
These are known to create networks of health facilities to provide seamless care across primary, secondary, and tertiary healthcare levels.
Service Delivery Networks (SDNs)
How is information and technology integration utilized in “DOH Arangkada Towards UHC”?
Digital health technologies are used to improve health data systems and streamline health services, making the system more efficient.
What types of public health programs are emphasized in “DOH Arangkada Towards UHC”?
(A) Immunizations
(B) Maternal and Child Cafe
(C) Chronic Disease Management
Why is Universal Health Care (UHC) important in community health nursing in the Philippines
UHC is vital in ensuring that all Filipinos have affordable, quality healthcare access, especially for primary and preventive care, directly impacting community health nursing.
This principle of Universality in Universal Health Care (UHC) Reform ensures that all Filipinos are covered under the health care system.
Universality
This principle of Universality in Universal Health Care (UHC) Reform prioritizes providing services to unserved or underserved populations to address disparities.
Equity
This principle of Universality in Universal Health Care (UHC) Reform involves clear role delineation, separation between purchaser and provider, and implementing management and organizational reforms.
Accountability
This principle of Universality in Universal Health Care (UHC) Reform shifts focus to health promotion, primary care, and strategic purchasing to maintain long-term healthcare effectiveness.
Sustainability
This principle in Universality in Universal Health Care (UHC) Reform aims to make health information accessible, encourage citizen engagement, and involve private providers in healthcare delivery.
Participation
This principle in Universality in Universal Health Care (UHC) Reform encourages pooling resources and mutual support for basic health services to create a united health care system.
Social Solidarity
This principle in Universality in Universal Health Care (UHC) Reform relates to taking responsibility for non-basic or additional services beyond essential healthcare.
Individual Responsibility
This principle in Universality in Universal Health Care (UHC) Reform advocates for fair and transparent priority-setting to achieve healthcare goals over time.
Progressive Realization
Under the Universal Health Care, the main benefit for these people is that they receive effective healthcare without facing financial hardship.
Patient
Under the Universal Health Care, these are known to influence the provider’s behavior toward efficiency and effectiveness ensuring that care is cost effective.
Prayer
Under the Universal Health Care, they should aim to earn a positive margin by treating patients efficiently and achieving good health outcomes.
Providers
What benefit do Physicians have under Universal Health Care?
Physicians can earn a predictable income, reducing the need to charge high price differentials for their services.
How are Suppliers of Drugs, Devices, and Diagnostic Tests involved in UHC?
Suppliers provide products that improve outcomes or reduce costs, which are then incorporated into treatments by effective and efficient healthcare providers.
How does Universal Health Care ensure appropriate services for every Filipino family?
Every Filipino family is matched to a primary care team that ensures they receive the appropriate services they need in the appropriate facility.
PhilHealth protects Filipino families from _________ making their health spending predictable.
Financial risks
What outpatient services are covered under Universal Health Care?
(A) Face to face and teloconsultations with the Primary Care Team
(B) Laboratory, diagnostic tests, and outpatient drugs as long as they are PRESCRIBED by the Primary Care Team
Is there a co-payment for outpatient services when the Primary Care Team is linked to the public system?
No, there are no co-payments when the Primary Care Team is linked to the public system.
What is the co-payment policy if the Primary Care Team is linked to a private system?
Co-payments apply based on allowable mark-ups, with prices made available and posted by providers.
Who is responsible for funding population-based services under UHC?
The Department of Health (DOH) and Local Government Units (LGUs)
Who provides funding for individual-based health services under UHC?
PhilHealth funds individual-based health services, with pooled funds from sources like the Sin Tax, PAGCOR, and PCSO.
How is membership in UHC simplified?
Membership is divided into two types: Direct and Indirect Contributory.
This is based on adherence to quality and co-payment standards, with third-party accreditation for verification.
Contracting
This in service delivery networks are institutionalized as a prerequisite for contracting by network, ensuring providers practice gatekeeping and referral within province-wide and city-wide service delivery networks.
Primary Care
What regulation mandates transparent pricing in UHC?
UHC mandates transparent pricing of health goods and medical services to ensure affordability and accountability.
What is the required bed ratio for government, specialty, and private hospitals?
(A) 90:10 for government hospitals
(B) 70:30 for specialty hospitals
(C) 10:90 for private hospitals
How does UHC support income retention for public providers?
Income retention is enabled for all public providers through a Special Health Fund, allowing them to reinvest earnings into service improvements.
How does UHC ensure benefit complementation between PhilHealth and private health insurance (PHIs) or Health Maintenance Organizations (HMOs)?
UHC ensures benefit complementation between PhilHealth and PHIs/HMOs to provide comprehensive coverage without duplicating benefits.