PH HCS Flashcards by Martin Andrei Loyola

An archipelago in the South-East Asia Region

UYYYY?!??!?! PHILIPPINES !!!!🦅🦅

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PH population as of 2017

104.9 million

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Thirteenth most populous
country in the world (2017)

PHILIPPINES ULITT RAAA

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Predominant religion in PH?

PREDOMINANT?!

Roman Catholics constituting 87.4% of the Christian population

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Demographics

Majority of Filipinos are?

religion

Christian Malays (92.2%)

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Minority groups?

Muslim minority groups comprising 5.6%

concentrated in Mindanao

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Adult literacy rate in the PH (2017)

96.5%

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Demographics

Life expectancy at birth

69.1 yrs

(2016)

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GDP of the PH at the end of 2017

6.7%

one of Asia’s fastest growing economies

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TOF. The PH is categorized as a newly industrialized country

True

from agriculture to services and manufacturing.

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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)

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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

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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

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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

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BG (Triple Burden of Disease)

TOF. Effective interventions for HIV, TB, and VPDs are available

BUT despite the availability, peenoise continue to suffer

d minention why but ig CORRUPTION?!

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BG (Triple Burden of Disease)

Measles and diptheria

Vaccine-preventable dse

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Health service delivery

basic human right guaranteed by the Philippine Constitution
of 1987

Health

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Health service delivery

Two sectors of the health delivery service in the Philippines

Public and Private sectors

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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

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Health service delivery

supervises the government corporate hospitals, specialty and regional hospitals

Department of Health (DOH)

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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

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Health service delivery

Roles of PhilHealth

provided financial risk protection and expanded health insurance coverage for the Filipino people since 1995

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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

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Health service delivery (infrasctructure)

64% of hospitals are Level 1 non-departmental hospitals with an average capacity of?

41 beds

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# 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 ## Footnote 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 ## Footnote 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 ## Footnote 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.

# 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

# 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.

# 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 ## Footnote 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

# 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

PH HCS Flashcards

(105 cards)