(P) Lesson 3: Primary Healthcare and UHC Flashcards
→ prevention, treatment, and management of illnesses
→ preservation of mental health through services offered by health professions
→ embraces all goods and services designed to promote health
Healthcare
An international conference in Primary Healthcare caused by existing gross inequality in health status of people; people have the right and duty to participate individually and collectively
Alma Ata Declaration
When was the Alma Ata Declaration held?
September 6-12, 1978
What were the two major organizations that held the Alma Ata Declaration?
WHO and UNICEF
Program that aims to reach an acceptable level of health for everyone by the year 2000
“Health for All by 2000”
“Health for All by 2000” was modified in 1994 into what?
“Health for All by 2000 and Beyond”
The Alma Ata Declaration was adopted into the Philippines through what?
Letter of Instruction 949 (LOI 949)
Under whose term was LOI 949 signed?
President Ferdinand Marcos
When did Ferdinand Marcos sign LOI 949?
October 19, 1979
LOI 949 is also known as?
“Health in the Hands of the People”
The Local Government Code of 1991 is known as RA what?
RA 7160
This law transferred power from the national to the local government in order to build self-reliant communities
RA 7160 (Local Government Code of 1991)
The vision for RA 7160 was set by DOH Secretary who?
Juan Flavier
The mission of RA 7160 brought about what movement?
Sentrong Sigla
This concept believes that all people, everywhere, from all walks of life, deserve the right care in their community in the most inclusive, equitable, and cost-efficient approach to enhance people’s well-being
Primary Healthcare (PHC)
Refers to trained community workers or volunteers
Village Workers (barangay health workers)
Refers to the healthcare professionals themselves
Intermediate PHC Worker
Refers to when every entity involved is given the same services and given the same resources
Equality
Refers to being fair and just depending on the situation to achieve similar health outcomes
Equity
This level of care is provided by center physicians, public health nurses, rural midwives, barangay health workers, and traditional healers
Primary
This level of care is given by physicians and other allied health professionals for the assessment and treatment of health problems (minor surgeries and simple laboratory procedures are included here)
Secondary
This level of care is rendered by specialists in health facilities where complicated and intensive care is provided and where major surgical procedures can now be performed
Tertiary
The state of complete physical, mental, and social well-being and not merely the absence of disease or injury (acc. to WHO)
Health
T or F: Health is one dimensional in nature
False (it is MULTI-dimensional)
This aspect of health refers to the condition to maintain a strong and healthy body
Physical
This aspect of health is how one perceives himself, control his emotions, and adjust to the environment
Mental
This aspect of health is how a person feels, thinks, and acts toward everybody around him
Social
Refers to bringing about social change that allows people to achieve their human potential as it is a process rather than an outcome and is regarded as something that is done by one group to another
Development
Who stated that “health is central to development”?
Gro Harlem Brundtland
T or F: The healthier the people, the more our economy deteriorates
False (healthy citizens = flourishing economy)
These are the two constituent components of development
Health and Healthcare
T or F: Good health enables individuals to be active agents of change in the development process
True
The Universal Healthcare Act is also known as RA what?
RA 11223
When was RA 11223 signed into law?
February 20, 2019
When were the IRR of RA11223 signed?
October 10, 2019
When were the IRR of RA11223 published?
November 6, 2019
When was the effectivity date of RA11223?
November 22, 2019
This principle ensures health literacy, healthy living, and hazard and risk protection as everyone has to move forward with the same goal
Integrated and Comprehensive Approach
This principle refers to the entirety of the system, government, and societal approach in the development of health policies
Everyone is actively participating
This principle is centered on people’s needs and well being
People are at the center
T or F: Individual-based services refer to services which can be accessed within health facilities or traced back to one recipient
True
T or F: DOH and LGUs will cover for individual-based services
False (PhilHealth shall cover for the individual-based services)
What are the three dimensions of UHC?
Population, Services, and Financial Protection
This states that there should be automatic inclusion to the NHIP as long as you are a Filipino citizen
Population Coverage (Sec. 5 of the IRR)
This states that everyone should be able to avail the following services:
→ immediate eligibility to benefits/benefit packages
→ comprehensive inpatient and outpatient benefits
→ provision of primary care providers (compensation)
→ registration of Filipinos to primary care provider networks
Service Coverage (Sec. 6 of the IRR)
This revolves around prospective payments, co-payments, and benefit complementations
Financial Coverage (Sec. 7 of the IRR)
Refers to people who have the capacity to pay for their premiums
Direct contributors
T or F: 21 year olds and above who don’t have a means to pay are considered direct contributors
False (Indirect Contributors)
T or F: Direct contributors are not considered as lifetime members
False (they are lifetime members)
Who shall subsidize the premiums of the indirect contributors?
National Government
This act indicates how much money the government has to pay to subsidize the premiums of the Indirect Contributors
General Appropriations Act (GAA)
T or F: Domestic helpers who gain a salary of more than 5k monthly are obligated to pay their contributions as they are considered as direct contributors now
True
PhilHealth shall coordinate with other national government agencies towards the inclusion of all Filipinos in this system at no cost
Membership Database
T of F: Contribution rates have a trend of decreasing over the years
False (they increase over the years)
T or F: Employers also have a share in paying the contribution in which they split the percentage between the employees
True
The Entitlement to Benefits and Benefit Availment fall under what IRR?
Rule 3 Section 9
This section states that every member shall be granted immediate eligibility for the health benefit package without requiring the PhilHealth Identification Card
Section 9.1
This section states that failure to pay premiums shall not deny any enjoyment of the programs
Section 9.2
This sub section states that employers and self-employed direct contributors are to pay all missed contributions with interest, compounded 3% monthly and 1.5% for self-earning, professional practitioners, OFWs, and dual-citizens
Section 9.2 a-b
This section states that no additional expenses are to be charged to all members admitted in any ward accommodation
Section 9.4
This section states that members in non-ward accommodations may be charged co-payments/co-insurance, professional fees, and amenities
Section 9.8
This section states that PhilHealth shall issue guidelines to operationalize the no co-payment policy
Section 9.9
This section states that existing benefit packages shall continue implementations unless otherwise recommended by the HTA process (Health Technology Assessment)
Section 9.13
This section states that PhilHealth shall issue guidelines on the additional benefits for direct contributors, where applicable
Section 9.14
Funding for UHC falls under what rule?
Rule 9: Appropriations
This section states that the sources of funds can be:
- premium member contributions
- 40% of the charity fund, net of documentary tax payments and mandatory contributions of PCSO
- 50% of the national government share from PAGCOR
- annual appropriations of the DOH
- national government subsidy to PhilHealth
- supplemental funding
- total incremental sin tax collections
Section 37.1
The Special Health Fund falls under what rule?
Rule 5
These sections state that the province or city-wide health system shall pool and manage through a Special Health Fund, all resources needed for health services provided that the DOH in cooperation with the DBM and LGUs shall develop guidelines for the use of said Special Health Fund
Sections 20.1-20.7
T or F: The legal proceedings of PhilHealth moved from penalties and fines to the revocation of accreditation or membership
False (it moved from revocation to simply just penalties and fines)
These are standards for clinical health practices
Clinical Practice Guidelines (CPG)
What is the non-basic accommodation bed ratio for government hospitals?
90:10
What is the non-basic accommodation bed ratio for specialty hospitals?
70:30
What is the non-basic accommodation bed ratio for private hospitals?
10:90
Scholarship programs require how many years worth of return service in underserved areas?
3 years
The PhilHealth board plans to streamline 17 members into how many?
13 members