CPH LEC MODULE 8

• The health system, also referred to as health care system, comprises all organizations, institutions and resources that produce actions whose primary purpose is to improve health. It includes efforts to influence determinants of health as well as more direct health-improving activities.

  
• Philippine health care delivery system

  Dual health system composed of the public sector and the private sector
• Public sector


  Largely financed through a tax-based budgeting system, where health services are delivered by government facilities run by the national and local governments
• Private sector


  Largely market-oriented where health care is generally paid for through user fees at the point of service or "out-of-pocket" payments
• Timetable of selected events in the history of the Philippine health care system


  • Traditional health care (herbs and rituals)
  • Dispensary for indigent patients of Manila
  • Medicus Titulares: medical doctors during the late 19th century
  • Superior Board of Health and Charity, 1888
  • Creation of Department of Public Works, Education and Hygiene
  • Creation of a Board of Health for the City of Manila
  • Act No. 157: Establishment of a Board of Health for the Philippine Islands
  • Act No. 1407: Establishment of the Bureau of Health
  • Act No. 2156: known as Fajardo Act
  • Act No. 2568: from Bureau of Health to the Philippine Health Service
  • Act No. 2711: included the Philippine Health Law of 1917
  • Act No. 4007: Reorganization Act of 1932
  • Commonwealth Act No. 430: Creation of the Department of Public Health and Welfare
  • E.O. No. 94: Post war reorganization of the Department of Health and Public Welfare
  • Conversion of Sanitary District into Rural Health Units (RHU)
  • Conceptualization of the Restructured Health Care Delivery System
  • P.D. 1937: the Department of Health was transformed into the Ministry of Health
  • E.O. No. 851 reorganized the Ministry of Health
  • E.O No. 119: the Ministry of Health was renamed back to Department of Health
  • RA 7160: known as Local Government Code of 1991
  • E.O. No. 102: Redirecting the Functions and Operations of the DOH
  • Development of the Health Sector Reform Agenda
  • Development of a plan to rationalize the bureaucracy in an attempt to scale down including the DOH
• Levels of health care delivery


  • Public Health Practice
  • Primary Care
  • Secondary Care
  • Acute Care
  • Subacute Care
  • Tertiary Care
  • Restorative Care
  • Long-Term Care or Chronic Care
  • End-of-Life Practice
• Types of health care providers


  • Independent Providers
  • Limited Care Providers
  • Nurses
  • Nonphysician Practitioners
  • Allied Health Care Professionals
  • Public Health Professionals
• Independent Providers


  Those health care workers (HCWs) who have the specialized education and legal authority to treat any health problem or disease that an individual has
• Independent Providers


  • Allopathic Providers
  • Osteopathic Providers
  • Nonallopathic Providers
• Allopathic Providers


  Those who use a system of medical practice in which specific remedies for illnesses, often in the form of drugs or medication, are used to produce effects different from those of diseases
• Osteopathic Providers


  Those whose remedies emphasize the interrelationships of the body's systems in prevention, diagnosis and treatment
• Nonallopathic Providers


  Those who provide nontraditional forms of health care, often referred to as complementary/alternative medicine (CAM) or complementary/integrative medicine
• Nonallopathic Providers


  • Chiropractors
  • Acupuncturists
  • Naturopaths
  • Herbalists
  • Homeopaths
• Limited Care Providers


  Also referred to as RESTRICTED CARE PROVIDERS, those who have advanced training, usually a doctoral degree, in a health care specialty, who provide care for a specific part of the body
• Limited Care Providers


  • Dentists
  • Optometrists
  • Podiatrists
  • Audiologists
  • Psychologists
• Nonphysician Practitioners


  Also referred to as PHYSCIAN ASSISTANTS, PHYSICIAN EXTENDERS or NONPHYSICIAN CLINICIANS (NPCs), those who practice medicine with physician supervision; midlevel providers with training and skills beyond those of nurses and less than those of physicians
• Allied Health Care Professionals


  Those HCWs who provide services that assist, facilitate, and complement the work of physicians and other health care specialists
• Allied Health Care Professionals


  • Laboratory technologists and technicians
  • Therapeutic science practitioners
  • Behavioral scientists
  • Support services
• Public Health Professionals


  Those HCWs who work in a public health organization, who provide unique health care services to the community
• Public Health Professionals


  • Environmental health workers
  • Public health administrators
  • Epidemiologists
  • Health education specialists
  • Public health nurses and physicians
  • Biostatisticians and research scientists

  
• Health care workers are projected to be the fastest growing occupational group during the 2014 to 2024 projections decade. Due to the continuing geographic maldistribution of health care workers, the need will be greater in some settings than in others. The settings of greatest need will continue to be the rural and inner-city areas.
• Classification of hospitals according to ownership


  • Government
  • Private
• Classification of hospitals according to scope of services


  • General
  • Specialty
• General hospital


  A hospital that provides services for all kinds of illnesses, diseases, injuries or deformities. A general hospital shall provide medical and surgical care to the sick and injured, maternity, newborn and child care. It shall be equipped with the service capabilities needed to support board certified/eligible medical specialists and other licensed physicians rendering services in, but not limited to, clinical services, emergency services, outpatient services, and ancillary and support services.
• Specialty hospital


  A hospital that specializes in a particular disease or condition or in one type of patient. A specialized hospital may be devoted to treatment of a particular type of illness or for a particular condition requiring a range of treatment, treatment of patients suffering from diseases of a particular organ or groups of organs, or treatment of patients belonging to a particular age group.
• Clinical Services


  • Family Medicine
  • Pediatrics
  • Internal Medicine
  • Obstetrics and Gynecology
  • Surgery
• Emergency Services


  Services provided in an emergency setting
• Outpatient Services


  Services provided to patients who are not admitted to a hospital
• Ancillary and Support Services


  • Clinical laboratory
  • Imaging facility
  • Pharmacy
• Specialty hospital


  A hospital that specializes in a particular disease or condition or in one type of patient
• Types of specialty hospitals


  • Hospitals devoted to treatment of a particular type of illness or condition
  • Hospitals devoted to treatment of diseases of a particular organ or groups of organs
  • Hospitals devoted to treatment of patients belonging to a particular group such as children, women, elderly
• Classification of General Hospitals


  • Level 1
  • Level 2
  • Level 3
• Clinical Services for in-patients in General Hospitals

  • Consulting Specialists in Medicine, Pediatrics, OB-GYNE, Surgery
  • Departmentalized Clinical Services
  • Teaching/training with accredited residency training program in the 4 major clinical services
• Emergency and Out-patient services in General Hospitals

  • Respiratory Unit
  • Physical Medicine and Rehabilitation Unit
  • Isolation Facilities
  • General ICU
  • Surgical/Maternity Facilities
  • High Risk Pregnancy Unit
  • Ambulatory Surgical Clinic
  • Dental Clinic
  • NICU
  • Dialysis Clinic
• Ancillary Services in General Hospitals

  • Secondary Clinical Laboratory
  • Tertiary Clinical Laboratory with Histopathology
  • Blood Station
  • Blood Bank
  • 1st Level X-ray
  • 2nd Level X-ray with mobile unit
  • 3rd Level X-ray
  • Pharmacy
• Trauma-Capable Facility


  A DOH licensed hospital designated as Trauma Center
• Trauma-Receiving Facility


  A DOH licensed hospital within the trauma service area which receives trauma patients for transport to the point of care or a trauma center
• Categories of Primary Care Facilities


  • With In-patient beds (Infirmary, Birthing Home)
  • Without beds (Medical Out-patient Clinic, Medical Facility for Overseas Workers and Seafarers, Dental Clinic)
• Examples of Custodial Care Facilities


  • Custodial Psychiatric Care Facility
  • Substance/Drug Abuse Treatment and Rehabilitation Center
  • Sanitarium/Leprosarium
  • Nursing Home
• Examples of Diagnostic/Therapeutic Facilities


  • Clinical Laboratory, HIV Testing Laboratory, Blood Service Facility, Drug Testing Laboratory, Newborn Screening Laboratory, Laboratory for Drinking Water Analysis
  • Ionizing Machines (X-ray, CT scan, mammography), Non-ionizing Machines (MRI, ultrasound)
  • Nuclear Medicine Facility