PH HCS Flashcards
BG
An archipelago in the South-East Asia Region
UYYYY?!??!?! PHILIPPINES !!!!🦅🦅
BG
PH population as of 2017
104.9 million
BG
Thirteenth most populous
country in the world (2017)
PHILIPPINES ULITT RAAA
BG
Predominant religion in PH?
PREDOMINANT?!
Roman Catholics constituting 87.4% of the Christian population
Demographics
Majority of Filipinos are?
religion
Christian Malays (92.2%)
BG
Minority groups?
Muslim minority groups comprising 5.6%
concentrated in Mindanao
BG
Adult literacy rate in the PH (2017)
96.5%
Demographics
Life expectancy at birth
69.1 yrs
(2016)
BG
GDP of the PH at the end of 2017
6.7%
one of Asia’s fastest growing economies
BG
TOF. The PH is categorized as a newly industrialized country
True
from agriculture to services and manufacturing.
BG
Contributing factor to the rising life expectancy among filipinos
- improvements in living conditions,
- better access to health services, and
- improved management and treatment of infectious diseases like pneumonia and tuberculosis (TB)
BG
What do you call these events experienced by Filipinos as a consequence of rising life expectancy:
* globalization and escalating climate change
* lifestyle related noncommunicable diseases (NCDs)
* persistence of infectious diseases like HIV, TB, and vaccine-preventable diseases
Triple Burden of Disease
BG (Triple Burden of Disease)
World ranking of PH in terms of exposure to disasters due to strong typhoons occuring with high irregularity
THIRD
sis aint good enuf
BG (Triple Burden of Diseases)
- diet,
- tobacco smoke,
- high systolic blood pressure (wc contribute to rising incidence of diseases of the cardiovascular system)
- malignant neoplasms,
- diabetes, and
- road traffic accidents
Changes in Lifestyle and prevalence of NCDs
BG (Triple Burden of Disease)
TOF. Effective interventions for HIV, TB, and VPDs are available
T
BUT despite the availability, peenoise continue to suffer
d minention why but ig CORRUPTION?!
BG (Triple Burden of Disease)
Measles and diptheria
Vaccine-preventable dse
Health service delivery
basic human right guaranteed by the Philippine Constitution
of 1987
Health
Health service delivery
Two sectors of the health delivery service in the Philippines
Public and Private sectors
Health service delivery
- largely financed through a tax-based budgeting system
- health services are delivered by government facilities under the national and local governments.
Public Sector
Health service delivery
supervises the government corporate hospitals, specialty and regional hospitals
Department of Health (DOH)
Health service delivery
consisting of for-profit and non-profit health-care providers, is largely market oriented, where health care is generally paid for through user fees at the point of service
Private Sector
Health service delivery
Roles of PhilHealth
provided financial risk protection and expanded health insurance coverage for the Filipino people since 1995
Health service delivery
the Philippine health sector has :
*1224 hospitals,
*2587 city/rural health centres and
*20, 216 village health stations
(2016 figures)
Health service delivery
in terms of physical infrastructure
read thru page xxii last paragraph for detailed breakdown
auq na magbreakdown
Health service delivery (infrasctructure)
64% of hospitals are Level 1 non-departmental hospitals with an average capacity of?
41 beds
Health service delivery (infrasctructure)
10% are Level 3 medical centres and teaching hospitals, with an average bed capacity of?
318 beds
bitch idefk if this is significant
Health service delivery (infrasctructure)
TOF. The geographical distribution of these resources are equal within the country.
F. varies
2/3s in Luzon (NCR); 23 hospital beds per 10k people
Rest of L —- 8.2 ; V—- 7.8 ; M —–8.3
Health service delivery (infrasctructure)
TOF. The average bed occupancy rate of private hospitals is significantly higher than for public medical centers
F (baliktad)
Health service delivery (infrasctructure)
On average, patients stay about two days
longer in public than in private medical centres.
yun lang.
Health service delivery
the top four cadres of institution-based health workers are:
* nurses (90 308),
* doctors (40 775),
* midwives (43 044) and
* medical technologists (13 413)
(2017 figures).
Health service delivery
in terms of human resources for health
xxii ulit for breakdown huhu
no need to memorize numbers :))
Human resources for Health
TOF. Public sector engages a lesser proportion of nurses, midwives, and medical technologists.
F (higher proportion)
Human Resources for Health
Highest engagement in the public sectors
90k
Nors
gcing n sha
nurse yan ha wag kayong anek
Human Resources for Health
TOF. There is a marked differences in the number of institution-employed health workers available to serve area population, Visayas with varying densities of nurses per 10,000 population across regions.
T
Health financing
Consistently increased since 2005
Total health expenditure (THE)
Health financing
Government health expenditure has increased significantly in nominal terms, but it has been
eclipsed by?
private sector funding sources
grown rapidly with the economy
Health Financing
TOF. With the private sector eclipsing government expenditure, public spending is now more sufficient in terms of covering the needs of the population
F (still insufficient)
Health Financing
a social health insurance program, covers 92% of the population, with 40% of which being poor and subsidized by the government for premium payments.
PhilHealth
Health Financing
Challenges related to health financing
- Overlap between funding sources (DOH,LGU,PHILHEALTH)
- limited financial protection
- out-of-pocket-payments (OOPs)
Health Financing
Financial protection is limited, resulting in a high level of ?
household out-of-pocket (OOP) payment
OOP expenditure in PH is >50%
Health Financing
TOF. PhilHealth’s payment system is dominated by free-for-all
F (still dominated by fee-for-service)
Health Financing
Effect of PhilHealth’s payment system
NO technical efficiency or financial protection
Health Governance
The national technical authority on health, providing policy direction, strategic plans, regulatory services, standards, and guidelines for health.
The Department of Health (DOH)
Health Governance
responsible for managing and implementing local health programs and services.
Local government units (LGUs)
Health Governance
serves as an advisory body to the local chief executives and the local legislative council members on the local health system.
local chief executive (governor or mayor)
Health Governance
represented in LGUs through either a DOH representative or Development Management Officer.
The DOH Regional Health Office
Health Governance and Regulation
Has its own regional Department of Health that is directly responsible to the ARMM Regional Governor.
Autonomous Region in Muslim Mindanao (ARMM)
HEALTH GOVERNANCE AND REGULATION
The Philippines is divided into how many regions
(legal age x 0) + 38 - 22 -1
17
Health Governance and regulation
directly administers provincial, city, and municipal health offices, and provincial and district hospitals within the autonomous region.
ARMM
Key health reforms
the country’s Universal Health Care (UHC) policy initiated in 2010.
Kalusugan Pangkalahatan (KP)
Key Health Reforms
This policy aims to:
* achieve universal and sustainable PhilHealth membership
* upgrade and modernize government health facilities
* fortify efforts to achieve Millennium Development Goal (MDG) targets.
KP
Regulation
under the Department of Finance regulates and supervises the operations of private insurance companies, including health insurance and pre-need companies as well as mutual benefit associations
The Insurance Commission (IC)
Regulation
exempted and is regulated through a Board of Directors, chaired by the Secretary of Health.
PhilHealth
DOH oversees licensing hospitals, laboratories, other health facilities, and health products through which buraeus?
2
Health Facilities and Service Regulatory Bureau (licensing of Labs, Hosps, and HFs)
Food and Drug Administration (health products).
Regulation
Any health facility that is accredited by DOH Regional Offices is automatically accredited by?
PhilHealth
HEALTH SYSTEM PERFORMANCE key Challenges
Uneven progress towards national objectives for health due to?
devolved health financing and service delivery.
HEALTH SYSTEM PERFORMANCE key Challenges
maldistribution of facilities, health staff, and specialists.
Inequitable access to health service
HEALTH SYSTEM PERFORMANCE key Challenges
Limited financial support from PhilHealth, mainly for?
inpatient care
HEALTH SYSTEM PERFORMANCE key Challenges
TOF. there are still factors that hinders Patient satisfaction and user experience of health services
T
there are improvements but sis just ain’t good enough
HEALTH SYSTEM PERFORMANCE key Challenges
2 events that continue to impoverish patients.
Balance billing and outside-hospital purchases
under to ng patient satisfaction and user experience… but
HEALTH SYSTEM PERFORMANCE key Challenges
Limited number of health facilities relative to the growing population
yes sister yan na
d ko alam pano icard
pero under to ng patient satisfaction and user experience… but
PhilHealth Coverage
PhilHealth membership coverage has expanded, but benefit coverage remains mainly for ?
inpatient care
HEALTH SYSTEM PERFORMANCE key Challenges
- Overprovision of physicians,
- under provision of care, and
- poor physician adherence to clinical practice guidelines
contribute to?
LOW QUALITY OF CARE
PhilHealth Coverage
Limited financial support from PhilHealth, mainly for ?
inpatient care
wtf?
Deployment programs
Deployment programs are easing maldistribution problems somewhat, but:
list 2 probems that remain
- Monitoring and sustainability problems remain.
- strategies may not be sustainable in the long term.
QoC
Limited number of health facilities relative to the growing population.
Key challenge of Health system performance
naulit lang to idk kay maam
QoC
Health adherence to clinical practice guidelines contribute to low quality of care.
Key challenge of Health System Performance
HISTORICAL BACKGROUND
developed a largely centralized government-funded and operated health care system
1970: Primary Health Care for All
HISTORICAL BACKGROUND
promoted participatory management of the local health system
1979: Adoption of Primary Health care
HISTORICAL BACKGROUND
Integrated public health and hospital services
1982: Reorganization of DOH
HISTORICAL BACKGROUND
Prevention and nutrition to promote breastfeeding.
1986: Milk Code 1986
HISTORICAL BACKGROUND
Prescription are written using the generic name of the drug in attempt to lower expenditure on drugs by promoting and purchasing the branded medicines.
1988: The Generic Act
HISTORICAL BACKGROUND
transfer of responsibility of health service provisions to the local government
1991: RA 7160 “Local Government Code”
HISTORICAL BACKGROUND
aims to provide all citizens a mechanism for financial protection with priority given to the poor.
1995: National Health Act
HISTORICAL BACKGROUND
major organizational restructuring of the DOH to improve the way health care is delivered, regulated and financed.
1996: Health Sector Reform Agenda
HISTORICAL BACKGROUND
Adoption of operational framework to undertake reforms with speed, precision, and effective coordination.
2005: FOURmula One (F1) for Health
HISTORICAL BACKGROUND
promotes and ensures access to affordable quality drugs and medicines for all.
2008: RA 9502 “Access to cheaper and Quality Medicines Act”
HISTORICAL BACKGROUND
Universal health coverage and access to quality health care for all Filipinos.
2010: AO 2010-0036 “Kalusugang Pangkahalatan”
dapat alam niyo na to
HISTORICAL BACKGROUND
generating extra revenue for the Department of Health by discouraging harmful consumption of alcohol and tobacco
2013: Sin Taxes for Health
aka Sin-Tax Law
Historical Background
Enrolling all Filipino citizen automatically in National Health Insurance Program administered by PhilHealth.
2019: Universal Health Care Law
issued administrative order 2012-0012 (Rules and Regulations Governing the new Classification of Hospitals and Other Health Facilities in the Philippines) that provides for a new classification scheme of health facilities
DOH
Classification of Hospitals and Health Facilities:
According to Ownership
- Government
- Private
Classification of Hospitals and Health Facilities Acc. to Ownership
Created by law
Government
Classification of Hospitals and Health Facilities Acc. to Ownership
- national government,
- DOH,
- Local Government Unit (LGU),
- Department of National Defense (DND),
- Philippine National Police (PNP),
- Department of Justice (DOJ)
- State Universities and Colleges,
- Government owned and Controlled Corporations (GOCC) and others.
Government health facility
Classification of Hospitals and Health Facilities Acc. to Ownership
owned, established and operated with funds through donation, principal, investment or other means by any individual corporation, association or organization.
Private
Classification of Hospitals and Health Facilities Acc. to Ownership
may be a single, religious, non-government organization and others.
Private health facilities
Classification of Hospitals and Health Facilities: Acc. to scope of serv
a hospital that provides services for all kinds of illnesses, diseases, injuries or deformities.
General
Classification of Hospitals and Health Facilities: Acc. to scope of serv
shall provide medical and surgical care and it shall equipped with service capabilities needed to support medical physician or specialist
General Hospital
Classification of Hospitals and Health Facilities: Acc. to scope of serv
- Clinical Services
1. Family Medicine
1. Pediatrics
1. Internal Medicine
1. Obstetrics and Gynecology
1. Surgery - Emergency Services
- Out-patient Services
- Ancillary And support Services such as Clinical laboratory, Imaging facility, and Pharmacy.
General hospital provisions/service capabilities
Classification of Hospitals and Health Facilities: Acc. to scope of serv
a hospital that specializes in a particular disease or condition or in one type of patient.
Specialty
Classification of Hospitals and Health Facilities: Acc. to scope of serv
Type of hospital that may be devoted to treatment of any of the following:
* Treatment of a particular type of illness or condition requiring a range of treatment.
* Treatment of patients suffering from disease of a particular organ or group of organs.
Specialty
Specialty Hospitals
Identify the devoted specialty of the following hospitals:
* Philippine Orthopedic Center,
* National Center for Mental Health,
* San Lazaro cancer.
Treatment of a particular type of illness or condition requiring a range of treatment.
Specialty Hospitals
Identify the devoted specialty of the following hospitals:
* Lung Center of the Philippines,
* Philippine Heart Center,
* National Kidney and Transplant Institute,
* A hospital dedicated to treatment of eye disorders.
Treatment of patients suffering from disease of a particular organ or group of organs.
Classification of Hospitals and Health Facilities: Acc. - Func. capacity
must have at the minimum:
* an operating room,
* maternity facilities, isolation facilities,
* a clinical laboratory,
* an imaging facility and Pharmacy
all of which should be licensed by the Department of Health
Lvl 1 General Hospital
Classification of Hospitals and Health Facilities: Acc. - Func. capacity
contains all the elements of level 1as well as additional facilities like ICU for critically ill patients and specialist doctors for gynecology and pediatric services.
Level 2 General hospital
Classification of Hospitals and Health Facilities: Acc. - Func. capacity
are considered tertiary hospitals that can provide all kinds of health services.
Level 3 General Hospitals
Classification of Hospitals and Health Facilities: Acc. - Func. capacity
TOF. Specialty hospitals are NOT under this classfication
F
Classification of Hospitals and Health Facilities: Acc. - Func. capacity
shall be assessed in accordance with the guidelines formulated by Philippine College of Surgeons (PCS).
Trauma Capability of Hospital
Classification of Hospitals and Health Facilities: Acc. - Func. capacity
a DOH licensed hospital designed as a Trauma Center
Trauma - Capable Facility
Classification of Hospitals and Health Facilities: Acc. - Func. capacity
a DOH licensed hospital within trauma service area which receives trauma patients for transport to point of care or a trauma center.
Trauma – Receiving Facility
LEVEL OF HEALTH CARE IN THE PHILIPPINES
This includes rural health units, their sub-centers, chest clinics, malarial eradication units and schistosomiasis control units operated by the DOH.
Primary Level of Care
LEVEL OF HEALTH CARE IN THE PHILIPPINES
Typically, this is the first point of contact for community members with other levels of the health center
Primary Level of Care
LEVEL OF HEALTH CARE IN THE PHILIPPINES
Traditional healers, center physicians, public health, nurses, rural health midwives
Primary Level of Care
LEVEL OF HEALTH CARE IN THE PHILIPPINES
- These are the smaller, non-departmentalized hospitals, including emergency hospitals
Secondary Level of Care
LEVEL OF HEALTH CARE IN THE PHILIPPINES
Infirmaries, municipal, district hospital and out-patient departments are all examples of out-patient departments.
Secondary Level of Care
LEVEL OF HEALTH CARE IN THE PHILIPPINES
Specialists in health-care facilities provide this service
Secondary Level of Care
LEVEL OF HEALTH CARE IN THE PHILIPPINES
These are medical centers, regional, provincial hospitals, and large hospitals that offer highly technological and sophisticated services.
Tertiary Level Health Care Facilities
