UD Philippine Health Care Delivery System Flashcards
a fundamental human right
Health
is a most important world-wide social goal that requires
the action of many other social and economic sectors in addition to the
health sector
Attainment of the highest possible level of health
the current situation of the health care system of Philippines
gross inequality in the health status
essential health care based on scientifically sound and socially acceptable methods
Primary Health Care
universally accessible to individuals and families with their full participation at a cost that the community
and country can afford in a spirit of self-reliance and self-determination
Primary Health Care
An organized plan of health services
Health Care System (Miller-Keane, 1987)
Rendering health care services to people
Health Care Delivery (Williams-Tungpalan, 1981)
The network of health facilities and personnel which carries out the task of rendering health care to the people
Health Care Delivery System (Williams-Tungpalan, 1981)
It is a complex set of organizations interacting to provide an array of health services (Dizon, 1977)
Philippine Health Care System
Philippine Health Care System: Health service delivery was devolved to___________ it has not completely surmounted the fragmentation issue
Local Government Units (LGUs) in 1991
Philippine Health Care System: Health human resource struggles with the problems of
underemployment, scarcity and skewed distribution
Philippine Health Care System: Strong involvement of the private sector comprising how many percent
of the health system but regulatory functions of the government have yet to be fully maximized
50%
Essential Elements of Primary Health Care (Philippines)
- Education concerning prevailing health problems and the methods of identifying, preventing and controlling them
- Locally endemic disease prevention and control
- Expanded program of immunization against major infectious diseases
- Maternal and child health care including family planning
- Essential drugs arrangement
- Nutritional food supplement, an adequate supply of safe and basic nutrition
- Treatment of communicable and noncommunicable disease and promotion of mental health
- Safe water and sanitation
Essential Elements of Primary Health Care (5)
- universal coverage to reduce exclusion and social disparities in health
- service delivery organized around people’s needs and expectations
- public policy that integrates health into all sectors
- leadership that enhances collaborative models of policy dialogue
- Increased stakeholder participation
Other elements of primary health care (6)
- Expanded options of immunizations
- Reproductive health needs
- Provision of essential technologies for health
- Health promotion
- Prevention and control of non-communicable diseases
- Food safety and provision of selected food supplements
Principle of PHC: (5)
- Built on Alma-Ata principles
- Take account broader population health issues, reflecting and reinforcing public health functions
- Create the conditions for effective provision of services to poor and excluded groups
- Organize integrated and seamless care, linking prevention, acute care and chronic care across all components of the health system
- Continuously evaluate and strive to improve performance
Alma-Ata principles (4)
equity, universal access, community participation, intersectoral approach
Basic Objectives of Philippine Health care (8)
- Improvement in the level of health care of the community
- Favorable population growth structure
- Reduction in the prevalence of preventable, communicable and other disease
- Reduction in morbidity and mortality rates especially among infants and children
- Extension of essential health services with priority given to the undeserved sectors
- Improvement in basic sanitation
- Development of the capability of the community aimed at self-reliance
- Maximizing the contribution of the other sectors for the social and economic development of the community
primary care and other services to meet the main health problems in a community must be provided equally to all individuals irrespective of their gender, age, and caste, urban/rural and social class
Equitable distribution of health care
adequate number and distribution of trained physicians, nurses, allied health professions, community health workers and others working as a health team and supported at the local and referral levels
Community participation
recognition that health cannot be improved by intervention within just the formal health sector; other sectors are equally important in promoting the health and self- reliance of communities
Multi-sectoral approach
accessible, affordable, feasible and culturally acceptable to the community
Use of appropriate technology
Management of Primary Health Care (5)
- Planning
- Organizing
- Staffing
- Controlling
- Directing
Sets direction and determines what needs to be accomplished
- Setting priorities and determining performance targets
Planning
Designing the organization or the specific division, unit, or service
- Designating reporting relationships and intentional patterns of interaction
- Determining positions, teamwork assignments, and distribution of authority and responsibility
Organizing
Organizing have six domain
- Authority
- Responsibility
- Accountability
- Centralization
- Decentralization
- Formalization
a manager’s formal and legitimate right to make decisions, issue orders, and allocate resources to achieve organizationally desired outcomes
Authority
means an employee’s duty to perform assigned task or activities
Responsibility
means that those with authority and responsibility must report and justify task
outcomes to those above them in the chain of command
Accountabilty
Types of Authority
- Line Authority
- Functional Authority
- Staff Authority
managers have the formal power to direct and control immediate subordinates; Superior issues orders and is responsible for the result—the subordinate obeys and is responsible only for executing the order according to instructions
Line Authority
where managers have formal power over a specific subset of activities
Functional Authority
granted to staff specialists in their areas of expertise; • not a real authority in the sense that a staff manager does not order or instruct but simply advises, recommends, and counsels in the staff specialists’ area of expertise
Staff Authority
The location of decision making authority near top organizational levels
The location of decision making authority near lower organizational levels
Decentralization
The written documentation used to direct and control employees
Formalization
- Acquiring and retaining human resources
- Developing and maintaining the workforce through various strategies and tactics
- Refers to assignment of individuals to responsible positions identified in a management plan
- Determines the competencies required
- Assigning/recruiting staff
Staffing
Monitoring staff activities and performance and taking the appropriate actions for corrective action to increase performance
Controlling
Focuses in the initiation of action in the organization through effective leadership and
motivation of, and communication with, subordinates
Directing
How to determine the competencies required
- Identifying KRAs
- Determining qualifications and competencies required
Managers are usually required to set a direction and determine what needs to be accomplished. It means setting priorities and determining performance targets.
Planning
This refers to the management function on designing the organization or the specific division, unit, or service for which the manager is responsible. Further, it means designating reporting relationships and intentional patterns of interaction. Determining positions, teamwork assignments, and distribution of authority and responsibility.
Organizing
This function refers to acquiring and retaining human resources. It also refers to developing and maintaining the workforce through various strategies and tactics.
Staffing
This function refers to monitoring staff activities and performance and taking the appropriate actions for corrective action to increase performance.
Controlling
Its focus in to initiate action in the organization through effective leadership and motivation of, and communication with, subordinates.
Directing
an unwanted problem where the memory blocks cannot be allocated to the processes due to their small size and the blocks remain unused
Fragmentation Issue
SMART means
S - Specific
M - Measurable
A - Attainable
R - Realistic
T - Time-bound
KRA stands for
K - Key
R - results
A - Area
3 classification of health facilities
- According to ownership
- According to scope of services
- According to functional capacity
2 classification according to ownership
Government
Private
2 classification of according to scope of services
General Facilities / Hospitals
Specialty Centers / Hospitals
Example of general facilities / hospitals
Philippine General Hospital
Jose Reyes Memorial Medical center
Example of specialty centers / hospitals
Philippine Heart Center
National Kidney and Transplant Institute
classification according to functional capacity
Hospitals: General or Specialty
Other health facilities
how many levels are there in general hospitals
Level 1
Level 2
Level 3
other health facilities (4)
Primary Care Facility
Custodial Care Facility
Diagnostic / Therapeutic Facility
Specialized Out-Patient Facility
rural health units, their sub-centers, chest clinics, malaria eradication units, schistosomiasis control units operated by the DOH; Puericulture centers operated by League of Puericulture Centers; Tuberculosis clinics and hospitals of the Philippine Medical Association
Primary Level of Health Care Facilities
Private clinics, clinics operated by the Philippine Medical Association; clinics operated by large industrial firms for their employees; community hospitals and health centers operated by the Philippine Medicare care Commission and other health facilities operated by voluntary religious and civic groups ( Williams-Tungpalan, 1981)
Primary Level of Health Care Facilities
Primary Level of Health Care Facilities: clinical services and facilities for in-patients
- consulting specialist in:
- Medicine
- Pediatrics
- OB-Gyne
- surgery - Emergency and Out-Patient Services
- Isolation facilities
- Surgical / Maternity Facilities
- Dental Clinic
Primary Level of Health Care Facilities: ancillary services
- Secondary Clinical Laboratory
- Blood station
- 1st level X-ray
- Pharmacy
these are the smaller, non-departmentalized hospitals including: emergency and regional hospitals in which services to patients with symptomatic stages of diseases, which require moderately specialized knowledge and technical resources for adequate treatment are offered
The secondary level of health care facilities
The Secondary Level of Health Care Facilities: Clinical services and facilities for In-patients
- All level 1
- Departmentalized Clinical Services
- Respiratory unit
- General ICU
- High Risk Pregnancy Unit
- NICU
The Secondary Level of Health Care Facilities: ancillary services
Tertiary Clinical Laboratory
Blood Station
2nd Level X-Ray
these are the highly technological and sophisticated services offered by medical centers and large hospitals; these are specialized national hospitals; the services rendered at this level are for clients afflicted with diseases which seriously threaten their health and which require highly technical and specialized knowledge, facilities, and personnel to treat effective (Williams - Tungpalan, 1981)
The Tertiary Level of Health Care Facilities
The Tertiary Level of Health Care Facilities: Clinical services and facilities for In-patients
- All level 2
- Teaching/Training with accredited residency training program in the major clinical services
- Physical Medicine and Rehabilitation Unit
- Ambulatory Surgical Unit
- Dialysis Clinic
The Tertiary Level of Health Care Facilities: ancillary services
Tertiary Clinical Laboratory
Blood bank
3rd Level X-ray
with In-patient beds;
- infirmary/Dispensary
- Birthing Home
without beds:
- medical out-patient clinics
- OFW clinics
- dental clinics
Primary Care Facility
Psychiatric Care Facility
Drug Abuse Treatment and Rehabilitation center
Sanitarium and Leprosarium
Nursing Home
Custodial Care Facility
Dialysis Clinic
Ambulatory Surgical Clinic
In-Vitro fertilization Centers
Radiation Oncology Facility
Oncology Center/Unit
Specialized Out-Patient Facility
Laborities:
- Clinical Lab/ HIV
- Blood Service Facilities
- Drug Test Lab
- NB Screening Lab
- Water Lab
Ionizing Machines ( X-ray, CT scan, etc) non ionizing machines ( MRI, Ultrasound, etc)
Nuclear Medicine
Diagnostic / Therapeutic Facility
Factors on the various categories of health workers among countries and communities
Available Health Manpower Resources
Local Health Needs And Problems
Political And Financial Feasibility
Three levels of primary health care workers
- Village or Grassroot Healthworkers
- Intermediate Level Healthworkers
- First Line Hospital Personnel
first contact of the community and initial links of health care; provide simple curative and preventive health care measures promoting healthy environment
Villageb or Grassroot Healthworkers
participate in activities geared towards the improvement of the socio-economic level of the community like production program; community health worker, volunteers or traditional birth attendants
Village or Grassroots Healthworkers
represent the first source of professional health care; attends to health problems beyond the competence of village workers
Intermediate Level Healthworkers
provide support to front-line health workers in terms of supervision, training, supplies, and services; medical practitioners, nurses, and midwives.
Intermediate Level Healthworkers
provide backup health services for cases that require hospitalization; establish close contact with intermediate level health workers or village health workers; physicians with specialty, nurses, dentist, pharmacist, other health professional
First Line Hospital Personnel
Attainment of the highest possible level of health is a most important world-wide social goal requires the action of many other social and economic sectors in addition to the health sector
Alma Ata Declaration (1998)
