health care in the philippines essay

Essay on Health Care System In The Philippines

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100 Words Essay on Health Care System In The Philippines

The basics of health care in the philippines.

The Philippines’ health care system is a set of health services provided by public and private providers. Public health care is managed by the Department of Health (DOH), while private health services are offered by various hospitals and clinics.

Public Health Care

Public health care is available to everyone. It is funded by taxes and contributions from workers. The Philippine Health Insurance Corporation (PhilHealth) is the main public health care provider. It gives Filipinos access to basic medical services.

Private Health Care

Private health care is offered by private hospitals and clinics. It’s usually more expensive than public health care. People who can afford it often choose private care for more personalized service and shorter waiting times.

Challenges in the Health Care System

The health care system in the Philippines faces many challenges. These include a lack of resources, unequal access to health services, and a high cost of care. The government is working on these issues to improve the health care system.

Future of Health Care in the Philippines

The government aims to improve the health care system through the Universal Health Care Act. This law aims to provide all Filipinos with access to quality health care. It’s a big step towards better health care in the Philippines.

250 Words Essay on Health Care System In The Philippines

Introduction.

The health care system in the Philippines is a mix of public and private providers. It aims to give medical help to all its citizens. The Department of Health (DOH) is the main body in charge of health care.

The government provides health care through public hospitals and clinics. These are usually free or cost very little. The Philippine Health Insurance Corporation (PhilHealth) is the national health insurance program. It helps people pay for medical services.

There are also private hospitals and clinics. These usually offer better facilities and shorter waiting times. But, they are more expensive. Many people have private health insurance to help cover these costs.

The health care system in the Philippines faces some issues. There are not enough doctors and nurses, especially in rural areas. Also, the quality of care can vary greatly. Some people can’t afford the cost of private health care but need it due to the lack of public facilities.

Improvements

The government is working to improve the health care system. One step is the Universal Health Care Act. This law aims to give all Filipinos access to quality health care, without causing financial hardship.

In conclusion, the health care system in the Philippines is a mix of public and private providers. It faces some challenges, but efforts are being made to improve it. Everyone in the Philippines deserves access to good health care.

500 Words Essay on Health Care System In The Philippines

The basics of the health care system in the philippines.

The health care system in the Philippines is a mix of public and private providers. The Department of Health (DOH) is the main public health agency. It sets policies, plans, and programs for health services. It also runs special health programs and research.

The Philippine Health Insurance Corporation (PhilHealth) is another important part of the public health system. It provides health insurance for Filipinos. This helps to make health care more affordable.

Public and Private Health Providers

There are both public and private health care providers in the Philippines. Public providers include hospitals, clinics, and health centers run by the government. These offer free or low-cost services. But sometimes, they may not have enough resources or staff.

Private providers include doctors, clinics, and hospitals that are not run by the government. They usually offer more services and shorter waiting times. But, their services cost more.

Health Care Challenges

The health care system in the Philippines faces several challenges. One is the uneven distribution of health services. More health services are available in urban areas than in rural areas. This means people living in rural areas may have to travel far to get health care.

Another challenge is the cost of health care. Even though PhilHealth helps, many Filipinos still find health care expensive. Some may not be able to afford the medicines or treatments they need.

Efforts to Improve Health Care

The government is working to improve the health care system. In 2019, it passed the Universal Health Care Law. This law aims to give all Filipinos access to quality health care. It also aims to make health care more affordable.

The government is also investing in health technology. This includes telemedicine, which allows people to consult with doctors online. This can help people in rural areas get health care more easily.

The health care system in the Philippines is a mix of public and private providers. It faces challenges like uneven distribution of services and high costs. But, the government is taking steps to improve it. It is working to provide universal health care and make health care more affordable. It is also investing in health technology to reach more people. Despite the challenges, the future of health care in the Philippines looks hopeful.

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Disease, Human Health, and Regional Growth and Development in Asia pp 163–174 Cite as

Health Inequity in the Philippines

• Miann S. Banaag 5 ,
• Manuel M. Dayrit 6 &
• Ronald U. Mendoza 7  
• First Online: 09 May 2019

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Part of the book series: New Frontiers in Regional Science: Asian Perspectives ((NFRSASIPER,volume 38))

Health is an important component of human development. A healthy and well-trained workforce attracts investments and spurs economic progress. For this reason, countries need to ensure that its health system provides adequate services to its population. Where the system relies on public and private providers, there must be effective synergy between the two sectors. In the case of the Philippines where inequity has been a major concern in health outcomes and service provision, policy makers face the following challenges: (1) reduce the discrepancy in the access to healthcare services among its socioeconomic classes; (2) reduce the discrepancy in the quality of health services between the public and private sectors; (3) increase the availability of services to geographically isolated and depressed areas; and (4) reduce out-of-pocket expenditures as a percentage of total health expenditure.

• Health inequity
• Health outcomes
• Out-of-pocket expenditures

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See http://www.doh.gov.ph/national-objectives-health

The focus is on differences that can be addressed using policy action. Disparities in biological and genetic conditions cannot be considered as inequities.

This section draws on earlier work by the author. See Mendoza ( 2008 ).

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Ronald U. Mendoza

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Banaag, M.S., Dayrit, M.M., Mendoza, R.U. (2019). Health Inequity in the Philippines. In: Batabyal, A., Higano, Y., Nijkamp, P. (eds) Disease, Human Health, and Regional Growth and Development in Asia. New Frontiers in Regional Science: Asian Perspectives, vol 38. Springer, Singapore. https://doi.org/10.1007/978-981-13-6268-2_8

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[OPINION] 5 thoughts about the Philippine healthcare system

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This is AI generated summarization, which may have errors. For context, always refer to the full article.

A two-week confinement recently and a longer one last year for COVID-19 got me thinking about the Philippine healthcare system and hospitalization costs, in particular. As I lay in bed waiting to heal, I had five thoughts about the medical system.

• One, it is expensive to get sick in this country and to be hospitalized – too expensive for many Filipinos of lower middle income and below.
• Two, doctors have their own specializations and coordination of multiple doctors with one patient is often not seamless and even fragmented.
• Three, nurses and nursing assistants are underpaid.
• Four, nurses are well trained but nursing assistants could receive better training.
• Five, the pricing of medicines based on the hospital room used is wrong.

The five thoughts discussed

One, confinement in hospital can add up in cost very quickly especially if lab work, procedures and operations need to be done. Such a situation can put many Filipino families in a huge financial dilemma.

Membership in HMOs (Health Maintenance Organizations) is advised to help manage the extraordinary cost that goes with hospitalization but this stops after 65 years of age, a time when seniors will need more health care, not less. PhilHealth is useful but limited. The senior discount was helpful in my case. Yet after all these deductions, the out-of-pocket was still substantial. Personal debt is resorted to and if through informal sources, could carry with it high if not exorbitant rates of interest. Many hospitals offer a deferred payment plan but this can affect a hospital’s cash flow position which could have an impact on its medical service.

In the last year, two individuals from working class families known to me have seen family members pass away from disease that crept up on them (non-COVID-19) that required hospital care but which they kept ignoring or postponing because of the cost until it was too late. No health insurance, no savings in their cases, and despite help from a call to friends, it was too late. This is a story oft-repeated among those with lesser means in life.

Two, in my confinement for over a month with COVID-19 in 2021, a number of doctor-specialists were assigned to me upon my check-in in the emergency unit – a cardiologist, a pulmonologist, an infectious disease specialist, on top of my nephrologist, endocrinologist, and neurologist, the last three from my previous history of diabetes, renal failure, and a stroke. I got the sense that they were not coordinating on my treatment given the conflicting instructions given to nurses on medications and procedures. I found myself having to call doctors to clarify these things before things were clarified and/or changed.

In a recent two-week confinement (non-COVID-19), the experience had thankfully improved for me. The 7 doctors – four from my COVID-19 confinement previously – were speaking to each other and sharing updates. A lead doctor – in this case the infectious disease specialist – set up a Viber group so that the 7 of them could share notes on a daily basis. This helped the nurses explain medications and procedures more clearly. The only issue was the process of getting clearance from each of them when it became clear that my blood infection had been arrested. Chasing all seven doctors to get their clearances for my discharge took numerous follow up calls by my wife (mostly) and myself until it was finally done. The longer wait, however, added an additional day in hospital including a long wait for accounting to itemize the final bill for payment. The additional waiting time comes with its concomitant costs.

Three, from my conversations with nurses and nursing assistants (caregivers), I came to find out that they are grossly underpaid. Nurses in the private hospital were paid a monthly salary of P22,000. They told me that nurses in government hospitals had a higher monthly salary of P36,000. When asked why they did not transfer, the answer was generally one of two: Government hospital working conditions were more difficult (more patients to look after per shift, little time to rest, poorer facilities), or the private hospital was JCI-accredited and this meant that nurses there had a better chance of working abroad (US, Canada, UK, Australia) when applying for overseas placement. A number of nurses had worked previously in Saudi Arabia and had experienced better pay and working conditions but were now looking for an immigration opportunity for a more permanent move.

Nursing assistants (caregivers) in this private hospital were in an even more precarious position. Their monthly salary was P12,000 and they were on 6-month contracts with no security of tenure.

In another private hospital, a dialysis nurse there who had a monthly salary of P14,000 said she chose to return after a two-year stint in Saudi Arabia to be with an 8-year old daughter. She has a second job for a second income to help her husband and family.

There was a also pattern I observed which I hope is not the normal thinking. In my hospital stay, I met two nurses who had been community nurses but who shifted to hospitals because of the better pay. Then, I met nurses in that private hospital looking to migrate in search of better opportunities.

This is an often-heard refrain: Nurses looking or actually migrating to greener pastures. In my dialysis center, four dialysis nurses have migrated to Canada, the US and Germany in the last two years. These are highly trained medical professionals that we lose to other countries. And there are more are in that pipeline.

Four, nurses are well trained but nursing assistants could receive better training. This is the difference between a four-year degree and a short certificate course. Caregivers take a short course TESDA (Technical Education And Skills Development Authority) training with certification but it perhaps could benefit from more hands-on medical training.

Five, the pricing of medicines based on the hospital room used is wrong. In my first hospital stay, all the medicines were given by the hospital. I was not allowed to use my available supply of maintenance medication including insulin. The price differential between the drugs I purchased myself versus the hospital-administered medication was higher by a factor of 2-4 adding significantly to my hospital bill.

A business school colleague now managing a hospital consulting group revealed that private hospitals follow differential pricing on services and supplies charged based on the room contracted. In the case of medicines which has a retail price in the publicly available drug stores and pharmacies, this pricing differential is akin to price-gouging.

What to do?

There is a lot that needs to be done with regard to our healthcare system. As a senior, I am increasingly having to use it more frequently, so I begin to see certain inefficiencies in the system that can lead to high healthcare and hospitalization costs.

The Universal Health Care Act (2019) was enacted “to realize universal coverage through a systematic approach and clear delineation of roles of key stakeholders towards better performance of key agencies and stakeholders in the healthcare system.”

Alvln Manalansan, a non-resident fellow of Stratbase CADR Institute and a convenor of CitizenWatch Philippines wrote an article in March 2021 whose title summed up the cause: “Urgency to transform fragmented health system.”

“Like any other health care system,” he wrote, “the vision of the UHC Act is remarkably outstanding, however, the main challenge is in its implementation. If the UHC Law is fully implemented, it will provide equitable access to quality and affordable healthcare services while protecting against financial risk for every Filipino. However, as frequently mentioned by the DOH, the law cannot be implemented instantly, but only progressively, mainly due to its high resource requirements at all levels.”

What can be done to bring more efficiency into the health care system?

We could start by appointing a secretary of health well-respected by the medical and health care establishment with knowledge ranging from community health care to hospital care, from pre-natal and maternal health care to gerontology (care for the elderly), and everything in between. The secretary need not be expert in all areas; he or she just needs to know the leading players in the each field and can assemble a first-rate team to look after and manage the system’s different parts.

In his column for the Philippine Daily Inquirer, business consultant Peter Wallace wrote , “In 2020, the country’s total health expenditure reached P1 trillion, 5.6% of GDP in that year. So, it should be the most important department in government, with the most competent, most highly experienced leader that can be found. From what we’ve heard, there are such leaders. The President only has to choose which one. Now.”

Let’s assemble the finest group of health economists, business managers, and public policy analysts to sit with the Department of Health leadership team and key medical practitioners to take apart the Universal Health Care Act to see how the entire system can be more integrated, more seamless, more efficient, and less costly to all Filipinos. Studying how certain countries have set up their national health programs (I.e. Canada, Europe) would be instructive. Congress has created an Education Commission II to overhaul the basic education system to improve system performance; a similar Health Commission should be considered.

A consolidation of small private hospitals with larger hospital groups will bring needed investment into this sub-sector, help modernize it, and generate the economies of scale that could drive costs down.

Health insurance should be made available to all with substantial benefits and a variant for senior citizens should be designed and implemented, including home care for the elderly and even hospice care for those nearing death. Incentives and tax breaks should be available to private health insurers providing health insurance and HMO coverage to seniors above age 65.

Most important, investment by Government in community health and preventive medicine should be increased. As in many cases in other fields, investing in prevention minimizes future risk and is less costly than clinical care.

Lastly, let’s pay our nurses and non-doctor medical personnel better wages. We need to provide better economic benefits to encourage them to stay in the country. – Rappler.com

Juan Miguel Luz was former Dean and Head of the School of Development Management at the Asian Institute of Management, and former Undersecretary, Department of Education.

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Totally agree with the writer. I am one of the Filipino nurses who migrated to the USA, 50 years ago. It saddens me that the conditions Mr. Luz describes was true back then, and that the system has not improved. Granted, the healthcare system is a complicated one. But all the suggestions for improvement that Mr. Luz proposes have been known even 50 years ago. The problem has always been in the implementation. That phase seems to be the thorniest of all phases. We have excellent thinkers, but the implementation phase is plagued by lack of resources, politics, lack of will, etc. Good luck to the next generation. May they get better at solving this great social need.

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Implementing Universal Health Care (UHC) in the Philippines: Is the Glass Half Full or Half Empty?

02 August 2021

This piece originally appeared in P4H here . It was written by Christian Edward Nuevo, Maria Eufemia Yap, Matt Boxshall, and Nirmala Ravishankar. 

Primary health care (PHC), first introduced through the Alma Ata Declaration of 1978, emphasizes that addressing health needs should be people-centered and multi-sectoral in approach. The recently passed Universal Health Care (UHC) Law in the Philippines puts PHC center stage through reforms aimed to improve health system performance. While the vision is laudable, making it happen is challenging. This article offers early learnings from the implementation of the UHC Law drawn from ThinkWell Philippines’ program of technical assistance and policy research to support the Department of Health (DOH) and the Philippine Health Insurance Corporation (PhilHealth)¹. We identified key opportunities and challenges created by the UHC Law against the three main pillars of strengthening PHC [1]. The UHC vision will have to be progressively realized through paradigm shifts, communication interventions, and a clear and strategic roll out plan.

Philippine Health Sector Reform: The UHC Law

Health sector reform in the Philippines has been accelerated by the passage of Republic Act 11223, more commonly known as the UHC Law [2]. This landmark piece of legislation seeks to revitalize health care through a whole-of-system, whole-of-government, whole-of-society, people-centered approach. It recognizes that health systems are naturally complex, dynamic, and adaptive. The legislation acknowledges that improving health system performance requires sustainable, wholesale changes [3]. The pillars of PHC underpin the entire UHC reform [1][2].

PHC and the UHC Law

The 2030 Agenda for Sustainable Development as well as other landmark resolutions [4] all champion the crucial role of PHC in achieving responsive and resilient country health systems [5]. The UHC Law is anchored on the three main pillars of PHC [6] in the following way:

• Primary care and essential public health functions as the core of integrated health services:  The UHC Law seeks to re-integrate the Philippines’ highly devolved governance system into province-wide health systems. These integrated provincial health systems promise more efficient use of resources and delivery of comprehensive care. Providers are encouraged to consolidate into health care provider networks, capable of delivering a range of services, grounded on a strong primary care base. PhilHealth is expanding its currently limited primary care benefit to a new package called “ Konsulta ”², with expanded rates and service inclusions, accessible to all membership types. Health care provider networks will be contracted by PhilHealth as one entity, aligning their incentives and accountabilities, and promoting continuity of care. Regrettably, the law does not mandate this re-integration. Resistance to change, and politics of intervening laws such as the Local Government Code stand in the way. Municipal mayors stand to lose authority over their health spending, personnel, and resources, and will only influence these as a member of the health board. Adequacy and supply-side readiness of health facilities, as well as financial constraints and the sustainability of PhilHealth are still prevailing realities [7][8][9].
• Empowered people and communities : With the UHC Law, all Filipinos are automatically members of PhilHealth, and are immediately entitled to benefits. Families and households are also given the freedom to choose the primary care provider they prefer and trust. Patient involvement in key decision areas is enhanced through representation in the Health Technology Assessment Committee that decides on benefit inclusions, and in the provincial health board that develops and monitors the province health plan. These opportunities for patients to directly influence matters concerning their own health contribute to a system that is truly responsive. However, patient knowledge is coming from a rather weak base. Data shows that for PhilHealth covered indigent families, only 53% knew of their entitlement for no balance billing, and around 39.6% are misinformed of their sponsorship [8]. This and other knowledge gaps present real challenges in affording people genuine participation even in institutionalized processes.
• Multi-sectoral policy action:  The UHC Law mandates the institutionalization of cooperative intergovernmental decision-making and implementation, particularly on areas such as health impact assessment, health professional education, and monitoring and evaluation of health system performance. The private sector is also enjoined to  respond to service delivery needs as health care provider networks, and to generate evidence together with the academe through data sharing and commissioning of relevant health policy and systems studies. Through these more inclusive and regular stakeholder engagement processes, strategic complementation with partners within and outside government is encouraged. Still, differences in perspectives and interests are among the greatest hurdles that affect cooperation and resource allocation. For one, adequacy of PhilHealth benefit package rates are continuously criticized [10], particularly by for-profit private facilities that do not enjoy the government subsidy afforded to public facilities. Even between government units, changes in processes meant to improve efficiency of one agency, may result to negative effects for another. When the Department of Budget and Management (DBM) transitioned to a new budgeting mechanism, it resulted to a 28% decrease in DOH appropriation from 2018 to 2019 [11].

Key areas for priority action

One of the biggest prerequisites in this reform process is a  shift in governance paradigms . The UHC reform requires provincial governments to be more accountable for care of their constituents and management of their health systems. They must reduce dependence on current national government support on personnel deployment, commodities, and infrastructure investments. Provincial governments must work to contextualize the benefits of integrating into province-wide health systems and health care provider networks, and rally support from people and providers within their jurisdiction. Central offices, on the other hand, should pivot back to their role of being technical stewards of the health sector, crafting strong policies, standards, and regulatory thrusts. These transitions from old to new ways need to be championed by the Department of Health, generating buy-in from other government agencies to ensure a genuine whole-of-government approach.

As new policies and guidelines are formulated,  strong communication and promotion interventions  must be pursued   by both the national and local governments. Patients need to be informed of all their entitlements, and the merits of living healthy lifestyles. Likewise, health care providers must understand the need for instituting strong gatekeeping mechanisms and facilitating synergistic relationships between primary and specialty practitioners. By engaging various stakeholders and communicating a compelling value proposition, key players will better understand their respective roles, leading to greater alignment with the UHC agenda.

Finally,  a clear, strategic, year-on-year rollout chronology  towards achieving the vision for UHC should be laid out in a transparent manner. Sequencing of reforms should start with generating clear demand for primary care through patient empowerment and incentive schemes for providers. This can drive the necessary motivation for the public sector to build capacity, and similarly attract the private sector to participate and coordinate. By committing to a clear plan of action, the Philippines DOH can build confidence amongst all stakeholders, public and private, local and national, and across government. Clarity of vision will be essential to deliver on the promise of UHC in the Philippines.

¹  These activities are part of the Strategic Purchasing for Primary Health Care project supported by the Bill & Melinda Gates Foundation and implemented by ThinkWell. For more information, please visit our website . For questions, please write to us at [email protected] l.

² An expanded primary care benefit package known as PhilHealth Konsulta (PhilHealth Konsultasyong Sulit at Tama) to cover all Filipinos and to ensure access to essential, preventive, promotive, and curative services.

• World Health Organization. 2019. Primary health care towards universal health coverage. In: Seventy-second World Health Assembly, 1 April 2019. Geneva: World Health Organization. Available from:  https://apps.who.int/gb/ebwha/pdf_files/WHA72/A72_12-en.pdf  [cited 2020 Feb 08].
• Republic of the Philippines. 2019. Republic Act 11223. An Act Instituting Universal Health Care for All Filipinos, Prescribing Reforms in the Health Care System, and Appropriating Funds Therefor.
• Fattore G, Tediosi F. 2013. The Importance of Values in Shaping How Health Systems Governance and Management Can Support Universal Health Coverage. Elsevier: Value in Health 16, S19-S23.  http://dx.doi.org/10.1016/j.jval.2012.10.008
• 2012 UN Resolution on Universal Health Coverage, 2018 Declaration of Astana, 2019 World Health Assembly
• World Health Organization. 1978. Declaration of Alma-Ata. International Conference on Primary Health Care, Alma-Ata, USSR.
• Kruk ME, Gage AD, Arsenault C, Jordan K, Leslie HH, Roder-DeWan S, et al. 2018. High-quality health systems in the Sustainable Development Goals era: time for a revolution. Lancet Glob Health. 11;6(11):e1196–252.  http://dx.doi.org/10.1016/S2214-109X(18)30386-3  pmid: 30196093
• Bredenkamp C, Gomez V, Bales S. 2017.  Pooling Health Risks to Protect People: An Assessment of Health Insurance Coverage in the Philippines.
• Dayrit MM, Lagrada LP, Picazo OF, Pons MC, Villaverde MC. 2018. The Philippines Health System Review. Vol. 8 No. 2. New Delhi: World Health Organization, Regional Office for SouthEast Asia. Available from:  http://apps.searo.who.int/PDS_DOCS/B5438.pdf  [cited 2020 Feb 10].
• Romualdez JR, Rosa J, Flavier J, Quimbo S, Hartigan-Go K, Lagrada L, et al. 2011. The Philippines Health System Review. Vol. 1 No. 2. Manila: World Health organization, Regional Office for the Western Pacific.
• Picazo OF et al. 2015. A Critical Analysis of Purchasing of Health Services in the Philippines: A Case Study of PhilHealth. Philippine Institute for Development Studies. Discussion Paper Series No 2015-54.
• Department of Health. 2019. Budget Briefer FY 2019. Health Policy Development and Planning Bureau. Available from:  https://www.doh.gov.ph/publication/serials/2019-Budget-Briefer  [cited 2020 Feb 10].

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COVID-19: an ongoing public health crisis in the Philippines

The Philippines is contending with one of the worst COVID-19 outbreaks in southeast Asia. As of April 18, 2021, there were 926 052 cases of SARS-CoV-2 infection and 15 810 deaths recorded. WHO has warned that the country's health-care system risks being overwhelmed. From March 29, 2021, a new round of lockdown was implemented in Manila and four surrounding provinces to suppress the new surge of infections. Although lockdown measures help control the spread of the virus, they only offer a short-term solution.

The pandemic has heavily hit the country in multiple ways. As an archipelagic country made up of more than 7000 islands, the Philippines is among the most vulnerable countries in the world to natural disasters. In addition, the longstanding battle with infectious diseases has been compounded with the rise in non-communicable diseases due to lifestyle changes and an increase in risk behaviours. These issues have predisposed the population to severe negative effects of the COVID-19 pandemic. The economy shrank almost 10% in 2020, which pushed more people into poverty. Besides the direct health losses due to the pandemic and the associated policy response, there are indirect health losses that are hard to estimate--for example, when health-care resources were reprioritised away from other important areas.

Case isolation, contact tracing, and physical distancing are recognised as the backbone of effective COVID-19 control. A prerequisite of successful implementation of these strategies is to have a robust public health system and sufficient workforce, which was inadequate and insufficient in the country even before the pandemic. The limited investment in health-care infrastructure and a shortage of health-care workers curtail the system, while inequalities in health-care delivery further jeopardise access to services. According to The Philippines Health System Review published by WHO in 2018, there were 23 beds per 10 000 individuals in the National Capital Region, and this number is less than ten per 10 000 individuals for the rest of the country. Public and privately owned health systems are supposed to be complementary in health-care service delivery, but no effective measure exists to regulate the expanding private sector, leading to a high amount of out-of-pocket expenses for health care; for example, more than half of total health spending was out-of-pocket in 2018. The COVID-19 pandemic puts further pressure on the fragmented public health system. Along with this fragmentation, the insufficient response from the government has resulted in a delay in contact tracing and mass testing, an overwhelmed medical system, and slow vaccine roll-out.

Parallel with public health policies, mass vaccination is another viable solution to this pandemic. There are 600 000 doses of the CoronaVac vaccine (Sinovac Life Sciences) donated from China and more than 525 600 doses of the ChAdOx1 nCoV-19 vaccine (Oxford--AstraZeneca) from the COVAX scheme arriving in the country. The shortage of COVID-19 vaccines and the slow vaccine roll-out has been criticised by the public; however, vaccine hesitancy is another public health issue that needs addressing. Public confidence in vaccines has dropped markedly since the Dengvaxia controversy and is likely to affect the willingness of people to accept COVID-19 vaccines. Concerns over data transparency, rare side-effects, and government accountability could further push people away from vaccination.

In February, 2019, the Philippines passed the Universal Health Care (UHC) law to ensure equitable access to quality and affordable health-care services for the entire population. The implementation of UHC can minimise the existing discrepancy in health-care systems. There is an urgent need for the country to gain control of the pandemic through mass testing, better contact tracing, and planning beyond vaccine acquisition and roll-out. These positive actions will not only help the country to recover from the pandemic, but also support UHC as a long-term goal to strengthen pandemic preparedness and response capability in the future.

The Lancet Regional Health – Western Pacific

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The Philippine Health Care Delivery Essay

This chapter discusses the related topics, the literature and studies reviewed as well; it also showed the theoretical, conceptual and analytical frameworks. Literature cited was bridged in the present study. Likewise, literatures cited were synthesized. Terms used in the study were defined for easy reference.

Review of Related Literature and Studies

Health care delivery.

The Philippine Health Care Delivery. Health care system is an organized plan of health services. The rendering of health care services to the people is called health care delivery system. Thus, health care delivery system is the network of health facilities and personnel which carries out the task of rendering health care to the people. In the Philippines health care system is complex set of organizations interacting to provide an array of health services. (www.freewebs.com/…/…).

In the Philippines the components of the health care delivery system as mandate of the Department of Health (DOH) is to be responsible for the following: formulation and development of national health policies, guidelines, standards and manual of operations for health services and programs; issuance of rules and regulations, licenses and accreditations; promulgation of national health standards, goals, priorities and indicators; development of special health programs and projects and advocacy for legislation on health policies and programs.The Philippine Health Care Delivery Essay.  The primary function of the Department of Health is the promotion, protection, preservation or restoration of the health of the people through the provision and delivery of health services and through the regulation and encouragement of providers of health goods and services (E.O. No. 119, Sec. 3).

The DOH vision is “Health as a right. Health for All Filipinos by the year 2000 and Health in the Hands of the People by the year 2020.” While its mission is “DOH, in partnership with the people to ensure equity, quality and access to health care by: making services available; arousing community awareness; mobilizing resources; and promoting the means to better health. (www.freewebs.com/…/…).

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In the Philippine healthcare setting health care facilities are level as Level I, Level II, and Level III. Level I (Primary Level of Health Care Facility) are the rural health units, their sub-centers, chest clinics, malaria eradication units, and schistosomiasis control units are directly operated by the DOH; puericulture centers operated by League of Puericulture Centers; tuberculosis clinics and hospitals of the Philippine Tuberculosis Society; 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.

The Level II (Secondary Level of Health Care Facilities) is the smaller, non-departmentalized hospitals including emergency and regional hospitals. The services offered to patients with symptomatic stages of disease, which require moderately specialized knowledge and technical resources for adequate treatment. While the Level III (Tertiary Level of Health Care Facilities) are the highly technological and sophisticated services offered by medical centers and large hospitals. These are the 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 effectively. (www.freewebs.com/…/…). The Philippine Health Care Delivery Essay.

Health care workers are also classified. There are three levels of health workers in the Philippine. These are: the village or grassroots health workers; the intermediate level of health workers; and the first line hospital personnel. The village or grassroots health workers are the first contacts of the community and initial links of health care. They provide simple curative and preventive health care measures promoting healthy environment and participate in activities geared towards the improvement of the socio-economic level of the community like food production program. These are the barangay health worker, volunteers or traditional birth attendants or hilot.

The intermediate level of health workers represents the first source of professional health care. They attend to health problems beyond the competence of village workers and provide support to front-line health workers in terms of supervision, training, supplies, and services. These are the medical practitioners, nurses and midwives. While the first line hospital personnel provide backup health services for cases that require hospitalization and establish close contact with intermediate level health workers or village health workers. These are the physicians with specialty, nurses, dentist, pharmacists, and other health professionals. (www.freewebs.com/…/…).

Parts of the healthcare setting are patients. A patient is any recipient of healthcare services. According to Wikipedia, the patient is most often ill or injured and in need of treatment by a physician, advanced practice registered nurse, veterinarian, or other health care provider. The word patient originally meant “one who suffers”. This English noun comes from the Latin word patiens, the present participle of the deponent verb, patior, meaning ‘I am suffering,’ and akin to theGreek verb πάσχειν (= paskhein, to suffer) and its cognate noun πάθος (= pathos) (en.wikipedia.org/wiki/Patient).

Patients’ satisfaction with an encounter with health care service is mainly dependent on the duration and efficiency of care, and how empathetic and communicable the health care providers are. It is favored by a good doctor-patient relationship. Also, patients that are well informed of the necessary procedures in a clinical encounter, and the time it is expected to take, are generally more satisfied even if there is a longer waiting time. (Pulia, 2011)

Patient Satisfaction

Patient satisfaction represents a complex mixture of perceived need, expectations and experience of care. “Quality healthcare” can cover a wide spectrum. It may be structural quality which relates to dimensions such as continuity of care, costs, accommodation and accessibility; while process quality involves the dimensions of courtesy, information, autonomy and competence. The terms “service quality” refer to a set of issues including communication, sign posting, information provision and staff interaction with patients. Interpersonal aspects of quality and amenities of care together with the technical aspects of quality to be the three components of health care quality. The interpersonal component of quality is defined as the quality of interaction between the patient and provider or the responsiveness, friendliness, and attentiveness of the healthcare provider.

Patient satisfaction focuses on clinical interaction in specific healthcare settings whereas responsiveness evaluates the health system as a whole. Patient satisfaction generally covers both medical and non-medical aspects of care while responsiveness focuses only on the non-health enhancing aspects of the health system. Patient satisfaction represents a complex mixture of perceived need, individually determined expectations and experience of care.

Satisfaction is a relative judgment. It is a comparison between perceived performance and aspiration. The basic point to asses’ satisfaction is to measure the extent to which aspirations are met given the self perceived performance level. Both the level of aspiration and of perceived performance has to be measured. The Philippine Health Care Delivery Essay. This is necessary because aspirations may be unrealistic given the level of available resources while evaluation of performance levels by individuals may differ widely from the actual or objective levels of achievement.

Patient-related factors. A citied in the study of Thiedke (2007) patients’ demographic and social factors are a minor factor in patient satisfaction, while others concluded that majority of the demographics represent the variance in rates of satisfaction. On the other hand, the literature does shed some light on how particular demographic factors affect patient satisfaction. The most consistent result was the finding of Haviland, et. al., (2006), which was older patients tend to be more satisfied with their health care. Studies that have looked at ethnicity have generally held that being a member of a minority group is associated with lower rates of satisfaction. Most studies have found that individuals of lower socio economic status and less education tend to be less satisfied with their health care. However, the study of Kersnik, et, al, (2001) found that frequent visitors to a family practice had lower educational status, lower perceived quality of life, and higher anxiety and depression scores and were more satisfied with their family physician. Other studies have shown that poorer satisfaction with care is associated with experiencing worry, depression, fear or hopelessness (Frostholm, 2005), and having a psychiatric diagnosis such as schizophrenia, post-traumatic stress disorder or drug abuse (Desai 2005).

Physician-related factors. According to literature physicians can promote higher rates of satisfaction by improving the way they interact with their patients. Possibly the most important characteristics of a physicians is to take the time and effort to elicit patients’ expectations. A study of Rao, et. al., (2005) shows that when physicians recognize and address patient expectations, satisfaction is higher not only for the patient but also for the physician; it may help to remember that patients often show up at a visit desiring information more than they desire a specific action. In addition, Bell, et. al. (2001) found out that approximately few patients had one or more unvoiced desires in a visit with their physician. The desire for a referral or for physical therapy was the most common. Young and undereducated patients were more likely to experience unmet needs at their visit, and they demonstrated less symptom improvement and evaluated their visit less positively. The Philippine Health Care Delivery Essay.

Communication. Shaw, and his colleague (2005) presented that doctor-patient communication can also affect rates of satisfaction. When patients who presented to their family physician for work-related, low-back pain felt that communication with the physician was positive (i.e., the physician took the problem seriously, explained the condition clearly, tried to understand the patient’s job and gave advice to prevent re-injury), their rates of satisfaction were higher than could be explained by symptom relief. As cited by Thiedke, (2007) in his study physicians can also improve patient satisfaction by relinquishing some control over the encounter. Studies have found that when physicians exhibited less dominance by encouraging patients to express their ideas, concerns and expectations, patients were more satisfied with their visits and more likely to adhere to physicians’ advice. Thus, Patient satisfaction can also be influenced by physicians’ medical decision making. Patients expressed a preference for physicians who recognized the importance of their social and mental functioning as much as their physical functioning.

The Webster’s Dictionary defines communication as “the imparting or interchange of thoughts, opinions, or information by speech, writing, or signs.” Whereas the spoken words contain the crucial content, their meaning can be influenced by the style of delivery, which includes the way speakers stand, speak, and look at a person (Joint Commission Resources; 2005). The collaboration in health care is defined as health care professionals assuming complementary roles and cooperatively working together, sharing responsibility for problem-solving and making decisions to formulate and carry out plans for patient care.

Collaboration between physicians, nurses, and other health care professionals increases team members’ awareness of each others’ type of knowledge and skills, leading to continued improvement in decision making. Effective teams are characterized by trust, respect, and collaboration, one of the greatest proponents of teamwork. Teamwork, is believes, to be endemic to a system in which all employees are working for the good of a goal, who have a common aim, and who work together to achieve that aim. When considering a teamwork model in health care, an interdisciplinary approach should be applied. Unlike a multidisciplinary approach, in which each team member is responsible only for the activities related to his or her own discipline and formulates separate goals for the patient, an interdisciplinary approach combine a joint effort on behalf of the patient with a common goal from all disciplines involved in the care plan.

The pooling of specialized services leads to integrated interventions. The plan of care takes into accounts the multiple assessments and treatment regimens, and it packages these services to create an individualized care program that best addresses the needs of the patient. The Philippine Health Care Delivery Essay. The patient finds that communication is easier with the cohesive team, rather than with numerous professionals who do not know what others are doing to manage the patient.

It is important to point out that fostering a team collaboration environment may have hurdles to overcome: additional time; perceived loss of autonomy; lack of confidence or trust in decisions of others; clashing perceptions; territorialism; and lack of awareness of one provider of the education, knowledge, and skills held by colleagues from other disciplines and professions. However, most of these hurdles can be overcome with an open attitude and feelings of mutual respect and trust. A study determined that improved teamwork and communication are described by health care workers as among the most important factors in improving clinical effectiveness and job satisfaction. (Flin, et. al., 2003)

Extensive review of the literature shows that communication, collaboration, and teamwork do not always occur in clinical settings. For example, a study by Sutcliff, Lewton, and Rosenthal (2004) reveals that social, relational, and organizational structures contribute to communication failures that have been implicated as a large contributor to adverse clinical events and outcomes. Another study shows that the priorities of patient care differed between members of the health care team, and that verbal communication between team members was inconsistent (Flin, 2003). Other evidence shows that more than one-fifth of patients hospitalized in the United States reported hospital system problems, including staff providing conflicting information and staff not knowing which physician is in charge of their care (Cleary, et. al., 2003).

Over the past several years, we have been conducting original research on the impact of physician and nurse disruptive behaviors (defined as any inappropriate behavior, confrontation, or conflict, ranging from verbal abuse to physical or sexual harassment) and its effect on staff relationships, staff satisfaction and turnover, and patient outcomes of care, including adverse events, medical errors, compromises in patient safety, poor quality care, and links to preventable patient mortality. Many of these unwanted effects can be traced back to poor communication and collaboration, and ineffective teamwork (Rosenstein, et. al., 2005).

Unhappily, many health care workers are used to poor communication and teamwork, as a result of a culture of low expectations that has developed in many health care settings. This culture, in which health care workers have come to expect faulty and incomplete exchange of information, leads to errors because even conscientious professionals tend to ignore potential red flags and clinical discrepancies. They view these warning signals as indicators of routine repetitions of poor communication rather than unusual, worrisome indicators. (Chassin, 2002) The Philippine Health Care Delivery Essay.

Although poor communication can lead to tragic consequences, a review of the literature also shows that effective communication can lead to the following positive outcomes: improved information flow, more effective interventions, improved safety, enhanced employee morale, increased patient and family satisfaction, and decreased lengths of stay. (Joint Commission Resources, 2005). Gittell and others (2000) show that implementing systems to facilitate team communication can substantially improve quality. Effective communication among staff encourages effective teamwork and promotes continuity and clarity within the patient care team. At its best, good communication encourages collaboration, fosters teamwork, and helps prevent errors.

In health care environments characterized by a hierarchical culture, physicians are at the top of that hierarchy. Consequently, they may feel that the environment is collaborative and that communication is open while nurses and other direct care staff perceive communication problems. Hierarchy differences can come into play and diminish the collaborative interactions necessary to ensure that the proper treatments are delivered appropriately. When hierarchy differences exist, people on the lower end of the hierarchy tend to be uncomfortable speaking up about problems or concerns. Intimidating behavior by individuals at the top of a hierarchy can hinder communication and give the impression that the individual is unapproachable (Joint Commission Resources, 2005; Weick, 2002 ) .

Staff who witness poor performance in their peers may be hesitant to speak up because of fear of retaliation or the impression that speaking up will not do any good. Relationships between the individuals providing patient care can have a powerful influence on how and even if important information is communicated. Research has shown that delays in patient care and recurring problems from unresolved disputes are often the by-product of physician-nurse disagreement. Several results of research has identified a common trend in which nurses are either reluctant or refuse to call physicians, even in the face of a deteriorating status in patient care. Reasons for this include intimidation, fear of getting into a confrontational or antagonistic discussion, lack of confidentiality, fear of retaliation, and the fact that nothing ever seems to change. Many of these issues have to deal more with personality and communication style (Rosenstein. 2002). The major concern about disruptive behaviors is how frequently they occur and the potential negative impact they can have on patient care. Our research has shown that 17 percent of respondents to our survey research in 2004-2006 knew of a specific adverse event that occurred as a result of disruptive behavior.The Philippine Health Care Delivery Essay.  A quote from one of the respondents illustrates this point: “Poor communication” postop because of disruptive reputation of physician resulted in delayed treatment, aspiration, and eventual demise.” (Rosenstein, 2005)

Time spent. Time spent during a visit plays a role in patient satisfaction, with satisfaction rates improving as visit length increases. Time spent chatting during the visit was also related to higher rates of satisfaction. Physicians with high-volume practices were more efficient with their time but had lower rates of patient satisfaction, offered fewer preventive services and were viewed as less sensitive in the doctor-patient relationship (as cited by Thiedke, 2007). Interestingly, one study showed that while physicians felt rushed 10 percent of the time, patients felt that way only 3 percent of the time. Patient satisfaction was identical whether the physician did or did not feel rushed. This suggests that physicians may be more sensitive to feelings of being rushed and their feelings may not reflect the actual time spent during the visit. (Lin, et. al., 2001)

Technical skills/quality. In the healthcare delivery, healthcare quality has two distinct facets: technical quality (also called quality in fact) and functional quality. Technical quality refers to the accuracy of medical diagnoses and procedures, and is generally comprehensible to the professional community, but not to patients. Study conducted by Jaipul (2003) patient perceives functional quality as the manner in which the service is delivered. Functional quality perceptions may influence future decisions to return to a facility for service. Some empirical evidence suggests that patients’ quality judgment may be positively associated with technical quality, as reflected in outcomes such as risk-adjusted mortality among hospitalized patients for medical conditions (Lin, et. al., 2002).

Technical quality cannot be attained without the technical skills of the health care personnel. The study conducted by Chang, et. al. (2006) has looked at patients’ assessment of their physicians’ technical skills and the effect on satisfaction, but the findings are contradictory. However, Fung, et. al., (2005) study found that when forced to make a trade-off, participants expressed a strong preference for physicians who have high technical skills. Otani, et. al., (2005) findings revealed that patients also indicated that a physician’s ability to make the correct diagnosis and craft an effective treatment plan were more important than his or her “bedside manner.”

System-related factors. Patient satisfaction is not simply a product of the patient’s demographics and the physician’s skills. It is also affected by the system in which care is provided. Otani’s (2005) findings disclosed that although it is clear that patients’ first concern is their doctor, but they also value the team with which the doctor works with. One study (Wolosin, et, al., 2005) found that while physician care was most influential to patients’ satisfaction, the compassion, willingness to help and promptness of the physician’s staff were next in importance. In another large database of surveys, nurses were the next most important source of satisfaction, ahead of access-to-care issue. Patients who had remained in a practice for more than 15 years attributed their loyalty to their physician first and to the “team concept” second as cited by Thiedke (2007). Effective referrals play a role in patient satisfaction (Roseanne et. al., 2006) . One study looked at referrals from the standpoint of the family physician, the referral physician and the patient, and found that satisfaction with the referral’s outcome was higher when the family physician initiated the referral (Bekkelund , et. al., 2005). Similarly, a study of patients treated for recurring headaches revealed that those who self-referred to a neurologist were less satisfied than those whose primary doctor had referred them. A survey of cancer patients found that they valued their family physician highly and wanted to maintain contact with him or her, even when they were receiving cancer care elsewhere (cited by Thiedke 2007). The Philippine Health Care Delivery Essay.

Donahue, et. al. (2005) states that continuity of care, one of the pillars of family medicine, is felt to have suffered under managed care Norman, et. al., (2001). While it is unclear to what degree patients in general value continuity of care, it is clear that patients who have been followed by their physician for more than two years are more satisfied with their care – particularly when they are able to see their own physician (Gary, et. al, (2005). Beach et. al.. (2005) exposed that patients who reported being treated with dignity and who were involved in decisions were more satisfied and more adherent to their doctor’s recommendations. Stelfox, et. al, (2005) exposed that patient satisfaction surveys of inpatient physician performance showed an inverse relationship between satisfaction and risk management episodes. In addition, physicians can find practical take-away lessons in the literature, such as the following: treat patients with dignity and include them in decision making; work with a team; elicit patients’ concerns; and dress in semiformal attire and always smiling. Lastly, while it may not be as easy as the above lessons, find pleasure in what you do. Physicians who report high professional satisfaction have patients who are more satisfied with their care. (Haas, et. al., 2000).

Synthesis of the Arts

Studies of Thiedke (2007), Haviland, et. al., (2006), Haviland, et. al., (2006), Frostholm (2005), and Desai (2005) studied if there is significant relationship between demographic profile and patient’s satisfaction. Studies of Rao, et. al., (2005), and Bell, et. al. (2001) focused on the physician-related factors of patient satisfaction. This patient satisfaction was attributed in recognizing and addressing patient expectations while Bell, et. al. (2001) looked into the desire for a referral or for physical therapy as the reason for patient satisfaction.

Shaw, and his colleague (2005), Thiedke (2007), Flin, et. al., 2003, Sutcliff, Lewton and Rosenthal (2004), Chassin (2002), and Rosenstein, et. al., 2005 presented that doctor-patient communication can also affect rates of satisfaction. Extensive review of the literature shows that communication, collaboration, and teamwork do not always occur in clinical settings. An example was the study by Sutcliff, Lewton, and Rosenthal (2004) reveals that social, relational, and organizational structures contribute to communication failures that have been implicated as a large contributor to adverse clinical events and outcomes.

Jaipul (2003) and Lin, et. al., (2002) studied on the technical quality (also called quality in fact) and functional quality. While the study conducted by Chang, et. al. (2006), and Fung, et. al., (2005), and Otani (2005) has looked at technical skills of the health workers. The Philippine Health Care Delivery Essay.The study of Otani (2005) also center on system related factor such as teamwork of other health professional, Wolosin, et. al., (2005) stress that compassion and willingness to help of the health care professions, Bekkelund, et. al., (2005) and Roseanne et. al., 2006 disclosed referrals as factors that persuade patient satisfaction. Donahue, et. al. (2005), Norman, et. al. (2001) states that continuity of care are factors that offer patient satisfaction. (Gary, et. al, (2005), Beach et. al.. (2005), Stelfox, et. al., (2005), and (Haas, et. al., 2000), exposed that patients who reported being treated with dignity, as factors that influence patient’s satisfaction.

Gaps Bridged by the Study

While most of the literature cited which had been reviewed concerned whether there is relationship between demographic profile and patient’s satisfaction, physician-related factors addressing patient expectations the desire for a referral or for physical therapy was the reason for patient satisfaction. Extensive review of the literature shows that communication, collaboration, and teamwork do not always occur in clinical settings. Technical quality, technical skills of the health workers, communication and teamwork of other health professional, compassion and willingness to help, patients who reported being treated with dignity as factors that influence patient’s satisfaction were also studied. However, there is no research yet conducted on the same topic and on the recommendations to have quality management program of the healthcare services at Dr. Fernando B. Duran Sr. Memorial Hospital (DFDMH).

Theoretical Framework

This study will be anchor to Expectation Fulfillment Theory by Linder-Pelz (1982). Expectations, which are central to the consumer model, play in determining satisfaction with healthcare. The work of Linder-Peltz on the interaction between patient expectations and perceptions is seen to be particularly influential in this respect. Linder-Peltz’s viewed expectations have an effect on satisfaction independent of other variables (i.e., irrespective of their fulfillment) leading to conclude that this is not to say that expressions of satisfaction have little to do with the qualities of the service provided or the care offered and clearly “engendering positive expectations’ must not be confused with raising false hopes which deliberately mislead patients. The Philippine Health Care Delivery Essay. Even so, the assumption that satisfaction is entirely the product of an evaluation by itself but it may not apply in all situations.

In this regard Zeithaml, et. al., (1990) have noted that while consumers ultimately judge the quality of services on their perceptions of the technical outcome provided and how that outcome was delivered (process quality), many professional services are highly complex and a clear outcome is not always evident. This is certainly true of many healthcare scenarios where the technical quality of the service- the actual competence of the provider or effectiveness of the outcome – is not easy to judge. The patient may never know for sure whether the service was performed correctly or even if it was needed in the first place. Williams (1994) has observed that the greater the perceived unexplained or technical nature of treatment the more likely it is that many service users will not believe in the legitimacy of holding their own expectations, or of their evaluations (Zelthaml, et. al., 1990).

In addition, if a service user is coming into contact with the system for the first time then expectations, which for many have been formed through past experience, might be waiting formation. In both cases a patient might wish for the health professional to adopt a paternalistic role in the relationship (‘doctor knows best’) while they themselves remain a passive partner. Donabedian (1980) sees quality of healthcare as a trilogy comprising ‘structure, process and outcome'( Zeithaml, et. al., 1990). However, Shaw (1984) argue that service users who cannot judge the technical quality of the outcome effectively will base their quality judgments on structure and process dimensions such as physical settings, the ability to solve problems, to empathies, time-keeping, courtesy and so on.

This study is also anchored on Lydia Hall’s Care, Core and Cure theory. The CARE focuses on hands-on bodily care and the belief that a caring touch and thorough assessment is therapeutic. This nurturing component which is also referred to as “mothering” the patient, is done with the goal of comforting the patient and helping them meet their needs. The “motherly” care provided by nurses and the medical staff may include, but is not limited to provision of comfort measures, provision of patient teaching activities and helping the patient meet their needs where help is needed. The members of the staff help the patient or the family in accepting and adapting to the emotional and other stresses the condition may bring. It also opens channels of communication to allow expression of feelings and help the patient/family work out through it.The Philippine Health Care Delivery Essay.  Thus, it is utilized when patient is provided with care and teachings at each phase of the nursing process, providing him/her with comfort both physiologically and psychosocially.

According to the theory, the CORE is the person or patient to whom nursing care is directed and needed. The core (patient) has goals set by him/herself and not by any other person, and that these goals need to be achieved. The “core”, in addition, behaved according to his feelings, and value system. In Hall’s theory, “core” refers to using therapeutic communication to help the patient understand not only his condition, but also his life. The goal is to help patients learn their roles in the healing process. Thus, it is realized when the patient is able to express his/her feelings about the procedure and participates in exploring these feelings, helping him/her towards a faster recovery.

The CURE, on the other hand is the attention given to patients by the medical professionals. It refers to the medical staff applying their knowledge of the disease to assist with a plan of care. Their function is to assist the patient and her family in coping with treatment. When the care, core and cure exhibit harmony and balance, the patient will be the one to benefit from it all since his/her needs are being put into priority.

The nursing care model of Virginia Henderson was also used as basis of the study. Using the Henderson’s model of the concept of nursing provides the understanding that nursing care should be holistic and contemplate the patient as a whole with his/her physical aspects as well as psychical, emotional, cultural and spiritual ones. According to Henderson, the person as whole has 14 basic activities or requisites to be satisfied in order to maintain a person’s health and well being, and develop all his/her capacities. These 14 components are: Breathe normally, Eat and Drink Adequately, Eliminate Body Waste, Maintain Desirable Positions, Sleep and Rest, Wear Suitable Clothes, Maintain Body Temperature by adjusting clothes and modifying environment, Keep the Body clean and well-groomed, Avoid Dangers and Injuring Others, Communicate with others, express emotions, needs and fears, Worship according to one’s faith, Work to have a sense of Accomplishment, Play and Participate in various forms of Recreation, Learn, discover and Satisfy Curiosity. According to this model, everybody is capable of carrying out these basic activities by themselves, and if they don’t, it is because of lack of the knowledge, will, or strength to do so.

According to this model, nursing care should be centered on the individual and based on a dynamic relationship between patient and nurse, as well as having a teaching function (George, 2000). Although each individual is unique, the fundamental needs of every human being are of a similar nature. The task of the nurse is to assist patients in articulating their needs, interests and wishes. The nurse should help each patient to carry out the measures to satisfy his/her needs which are important for his/her health.The Philippine Health Care Delivery Essay.  Since the patient is the best judge of his/her own needs and often has clear wishes and expectations about how nursing care should be provided, he/she should, therefore, be considered as an active and responsible participant in his/her own nursing care. In order to achieve the objective of nursing interventions, that is satisfying patients’ needs and maximizing their ability to look after themselves, nurses should create a personal and constructive relationship with the patients. This requires the nurse to be sensitive, to have the capacity for insight and to provide emotional support. In addition, nursing and medical care overlaps and complements each other. Nurses therefore should support the patient and show him/her how to carry out the doctor’s orders. It is important that the nurse gives the patient advice and that he/she performs medical interventions correctly. In this regard, the nurse should possess knowledge about the patient and his/her treatment. The nurse and patient should work together towards satisfying patient’s needs and helping the patient attain the greatest possible degree of self-efficacy. In order to achieve this objective, the nurse must continuously evaluate the nursing care plan in order to maintain or improve the level of care.

Conceptual Framework

Dr. Fernando B. Duran Sr. Memorial Hospital formerly Sorsogon Provincial Hospital envisions to provide health care facility to an enlightened, health-seeking target populace combating disease, as well as promoting wellness, through adequate, timely, quality care by compassionate health care workers.

The human resources as well as the physical resources of the hospital are very vital in the healthcare delivery. Thus, this study conceptualized that the healthcare delivery system of the hospital would lead to patient satisfaction in terms of general satisfaction, technical quality, interpersonal aspects, communication, financial aspects, time spent with doctor, accessibility.

Factors which may influence the patient satisfaction such as patient-related factors which include, interaction with the staff, staff patient communication (clear explaining by staff on the procedure and care), care and concern shown by the doctor, doctors-patients ratio, nurses-patients ratio, knowledge and skill of the staff, and the time spend by doctor to attend to the patient.

The system-related factors which comprises of clinical team compassion and willingness to help, care condition, referrals, continuity of care, availability of care facility, food service, and cleanliness of the entire hospital. Base from the results of the study recommendations will be utilize to have Quality Management Program for Hospital services at Dr. Fernando B. Duran Sr. Memorial Hospital. The Philippine Health Care Delivery Essay.

Analytical Framework

The study will determined the patient satisfaction of the health care delivery of Dr. Fenrnado B. Duran Sr. Memorial Hospital. Using a validation questionnaire checklist, the data will be gathered, tabulated and analyzed in order to determine the profile of the respondents along age, sex, socio-economic (monthly family income), and educational attainment. An appropriate statistical treatment will be used to test the research hypothesis at 0.05 level of significance that there is a significant difference in the demographic profile of the patients with their level of satisfaction. From the analysis and interpretation of the data provided by the respondents, quality management programs will me proposed to have satisfied patients as healthcare delivered by the said hospital.

HEALTH CARE DELIVERY

The following terms used in this study are defined conceptually and operationally:

Drugs. These are substances that have a curative effect when ingested or introduced into the body. In this study, this refers to the substances or other preparation used for the treatment or prevention of disease usually prescribed by the health professionals for the treatment or prevention of disease.

Equipment. This term refers to set of tools, devices, kit, etc., assembled for a specific purpose. In this study this refers to machine uses in the hospital such as ECG machine, BP apparatus, Suction apparatus, Ambu bag, Nebulizer, Oxygen gauge, etc. use to deliver the health care services of the hospital

Facility. These are thing created to serve a particular function (www.thefreedictionary.com/facility). In this study, this term refers to the building and its amenities such as water and lights to serve the delivery of health services to the patients.

Factors. This is a Latin word which means “who/which acts” (en.wikipedia.org/wiki/Factor). In this study, this refers to the facilities, services, drugs, medicine, supplies, equipment and the interpersonal relationship of the health professionals to the patients. The Philippine Health Care Delivery Essay.

Health Care Service Delivery. This is the network of health facilities and personnel which carries out the task of rendering health care to the people as a complex set of organizations interacting to provide an array of health services (www.freewebs.com/…/…). In this study, this refers to the transferring of the healthcare service to the patient in the province of Sorsogon.

Health Care Service. This refers to the complete network of agencies, facilities, and all providers of health care in a specified geographic area. (medical dictionary.thefreedictionary.com/health+care+system). In this study, this refers to the healthcare services rendered by Dr. Fernando B. Duran Sr. Memorial Hospital to the people of the province of Sorsogon.

Health Care. This refers to the prevention, treatment, and management of illness and the preservation of mental and physical well-being through the services offered by the medical and allied health professions (medical-dictionary.thefreedictionary.com/health+care). In this study, this refers to combating disease as well as promoting wellness, through adequate, timely, quality care by compassionate health care workers.

Health Care Delivery. This refers to the process by which the prevention, treatment, and management of illness and the preservation of mental and physical well-being is offered by the medical and allied health professions (medical-dictionary.thefreedictionary.com). In this study, it refers to the avoidance, action, and administration of illness and protection of mental and physical well-being through the health services by the health professionals.

Hospital. This refers to the health care institution that provides patient treatment by specialized staff and equipment. Hospitals often, but not always, provide for inpatient care or longer-term patient stays (en.wikipedia.org/wiki/Hospital). In this study, it refers to Dr. Fernando B. Duran Sr. Memorial Hospital.

Interpersonal Relationship. This refers to the association between two or more people that may range from brief to continuing bond (en.wikipedia.org/wiki/Interpersonal_relationship). In this study, it refers to the connection between the health professionals and patients to meet the common objectives that is to treat and prevent diseases.

Level of Satisfaction. This refers to the stage of approval when comparing service or product’s performance with the personal expectations(www.businessdictionary.com/definition/satisfaction.html#ixzz25fCBSAIe). In this study, it refers to the point where in patients are pleased due to the service rendered by the health professional based on his/her expectations to treat or prevent diseases.

Level of Patient Satisfaction. This refers to the stage of approval when comparing service or product’s performance with the patients expectations In this study, it refers to the degree of congruency between the patient’s satisfaction along technical quality, interpersonal manner, communication, financial aspects, time spent with doctor and accessibility of care.

Measures. The Philippine Health Care Delivery Essay. This refers to the plans or courses of action taken to achieve a particular purpose (Webster Dictionary). In this study, it refers to the provisions for affordable medicine, facilities, and the maintenance of cleanliness of the health care facilities.

Medicines. This is the science or practice of the diagnosis, treatment, and prevention of disease in technical use often taken to exclude surgery (Merriam Dictionary). In this study, it refers to the knowledge and skills of health professionals which relates to the prevention, treat, or lessening of disease.

Patient satisfaction. Is the degree of congruency between a patient’s expectations of ideal care and his /her perception of the real care him /her receives. In this study this refers to the happiness with one’s situation in life one feels when one has fulfilled a desire, need, or expectation.

Patient-related Factors. In this study, this refers to staff interaction with patients, staff-patient communication; care concern shown by the doctors; doctor’s dominance over patients’ idea, concerns and expectations; knowledge and skills of doctors, nurses and other allied health professionals; time spent by doctor to the patients, staff appearance, care and concern shown by the doctors, nurses and other allied health professionals.

Patients. This term refers to any persons who is recipient of healthcare services, ill or injured and in need of treatment by a doctor, nurse, or other health care provider. In this study, the term refers to any person who avails of the services of Dr. Fernando B. Duran Sr. Memorial Hospital during the duration of the study.

Satisfaction. This term refers to a psychological state resulting when the emotion surrounding disconfirmed expectations is coupled with consumer’s prior feelings about the consumption experience (Webster Dictionary). In this study, this term refers to the pleasure obtained by the patient from the services of the healthcare facility and health care providers in the study.

Service. The term refers to the action of helping or doing work for someone (Merriam Dictionary). In this study, this term refers to effort done by health professionals to the patients to treat or prevent diseases.

Supplies. This term refers to the stocks of a resources from which a person or place can be provided with the necessary amount of that reserve (Webster Dictionary). In this study, this term refers to the patients’ needs which the health professional necessitated to treat or prevent diseases which exclude drugs and medicines. The Philippine Health Care Delivery Essay.

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Improving Healthcare in the Philippines with Affordable Equipment from the USA

Kary Van Arsdale, Ed.D.

Certified International Commerce Specialist and Director of International Operations, Avante Health Solutions

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There is a critical need for economical, dependable medical equipment in the Philippines. With a growing population that exceeded 100 million in 2016, the Philippines is our world's twelfth most populated country. In spite of continued growth the Philippines healthcare delivery system suffers from a variety of deficiencies.

Healthcare in the Philippines: In Need of Medical Equipment and Care Providers

In addition to a shortage of healthcare providers, there is a lack of hospital beds and medical equipment in the Philippines. In particular, there is a shortage of doctors and equipment in rural areas and poorer provinces. Of the 17 key regions of the Philippines, only 4 regions meet the minimum standards of hospital beds per 1,000 residents. And with a shortage of high quality operating room equipment in the Philippines, many patients are unable to receive the surgical care that they require.

How a Shortage of Medical Care Affects Life Expectancy in the Philippines

As a partial result of deficiencies in the healthcare delivery system, the average life expectancy for the Philippines in 2014 was 68.2, which is significantly below the world average and other East Asian countries. Men and residents of impoverished regions of the Philippines are at particular risk of premature death. In 2014, the average life expectancy of men in the Philippines was just under 65 years of age and the lifespan of residents in poorer regions of the Philippines was nearly 10 years shorter than the average life expectancy in richer areas.

The Role of Access to Hospitals and Quality Medical Equipment in the Philippines

The shortage of hospitals and surgical equipment are the primary barriers to quality healthcare in the Philippines. Half of the people who live in the Philippines reside in rural areas of the country where there are sometimes no licensed medical doctors and ill-equipped facilities with broken medical devices. Most of the best clinics and hospitals are located in larger cities such as Manila, Cebu City, Quezon City and Davao City. However, even residents of the country's capital face healthcare challenges. Staffing shortages, combined with a lack of sufficient hospital beds and poorly functioning medical equipment pose problems for city residents as well.

The Challenge of Finding Affordable Medical Equipment in the Philippines

Public and private hospitals in the Philippines face a great challenge in sourcing medical equipment that is both reliable and affordable. As a result of an extremely limited local medical device production, over 95% of medical devices are imported from other countries. Notably, many hospital owners and doctors are reluctant to buy equipment from other countries. Others worry that they will not be able to afford high quality equipment. Many doctors and clinic owners have no idea where to go to source dependable medical devices at a fair price.

How Doctors in the Philippines Find Affordable Surgical Equipment from the USA

Surgeons, doctors and hospital owners are often not aware that they can safely buy hospital equipment from trustworthy medical equipment companies in the USA. The United States leads all other countries in medical device manufacturing with approximately 43% of all medical devices being produced in the USA in 2015. Filipino hospital owners often do not realize that they can also save money by purchasing professionally refurbished medical equipment from the USA. Doctors and surgeons are delighted to find out that they can save 50% or more when they buy refurbished medical equipment. Some of the best refurbishing companies can even provide all hospital equipment needed by a facility. Purchasing from these companies leads to additional discounts and lower shipping costs.

How to Find the Best Medical Equipment Supplier for the Philippines

When choosing a medical equipment supplier, there are four key points to consider: Experience, product quality, accreditation, and references. You should select a company with decades of industry experience and registration with the USA FDA. Additionally, you should seek a company that has a long list of customers in the Philippines. Please contact us to find out how we have supplied affordable medical equipment to the Philippines since 1984. We look forward to working with you!

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April 2, 2024

Eclipse Psychology: When the Sun and Moon Align, So Do We

How a total solar eclipse creates connection, unity and caring among the people watching

By Katie Weeman

Students observing a partial solar eclipse on June 21, 2020, in Lhokseumawe, Aceh Province, Indonesia.

NurPhoto/Getty Images

This article is part of a special report on the total solar eclipse that will be visible from parts of the U.S., Mexico and Canada on April 8, 2024.

It was 11:45 A.M. on August 21, 2017. I was in a grassy field in Glendo, Wyo., where I was surrounded by strangers turned friends, more than I could count—and far more people than had ever flocked to this town, population 210 or so. Golden sunlight blanketed thousands of cars parked in haphazard rows all over the rolling hills. The shadows were quickly growing longer, the air was still, and all of our faces pointed to the sky. As the moon progressively covered the sun, the light melted away, the sky blackened, and the temperature dropped. At the moment of totality, when the moon completely covered the sun , some people around me suddenly gasped. Some cheered; some cried; others laughed in disbelief.

Exactly 53 minutes later, in a downtown park in Greenville, S.C., the person who edited this story and the many individuals around him reacted in exactly the same ways.

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When a total solar eclipse descends—as one will across Mexico, the U.S. and Canada on April 8—everyone and everything in the path of totality are engulfed by deep shadow. Unlike the New Year’s Eve countdown that lurches across the globe one blocky time zone after another, the shadow of totality is a dark spot on Earth that measures about 100 miles wide and cruises steadily along a path, covering several thousand miles in four to five hours. The human experiences along that path are not isolated events any more than individual dominoes are isolated pillars in a formation. Once that first domino is tipped, we are all linked into something bigger—and unstoppable. We all experience the momentum and the awe together.

When this phenomenon progresses from Mexico through Texas, the Great Lakes and Canada on April 8, many observers will describe the event as life-changing, well beyond expectations. “You feel a sense of wrongness in those moments before totality , when your surroundings change so rapidly,” says Kate Russo, an author, psychologist and eclipse chaser. “Our initial response is to ask ourselves, ‘Is this an opportunity or a threat?’ When the light changes and the temperature drops, that triggers primal fear. When we have that threat response, our whole body is tuned in to taking in as much information as possible.”

Russo, who has witnessed 13 total eclipses and counting, has interviewed eclipse viewers from around the world. She continues to notice the same emotions felt by all. They begin with that sense of wrongness and primal fear as totality approaches. When totality starts, we feel powerful awe and connection to the world around us. A sense of euphoria develops as we continue watching, and when it’s over, we have a strong desire to seek out the next eclipse.

“The awe we feel during a total eclipse makes us think outside our sense of self. It makes you more attuned to things outside of you,” says Sean Goldy, a postdoctoral fellow at the department of psychiatry and behavioral sciences at Johns Hopkins University.

Goldy and his team analyzed Twitter data from nearly 2.9 million people during the 2017 total solar eclipse. They found that people within the path of totality were more likely to use not only language that expressed awe but also language that conveyed being unified and affiliated with others. That meant using more “we” words (“us” instead of “me”) and more humble words (“maybe” instead of “always”).

“During an eclipse, people have a broader, more collective focus,” Goldy says. “We also found that the more people expressed awe, the more likely they were to use those ‘we’ words, indicating that people who experience this emotion feel more connected with others.”

This connectivity ties into a sociological concept known as “collective effervescence,” Russo and Goldy say. When groups of humans come together over a shared experience, the energy is greater than the sum of its parts. If you’ve ever been to a large concert or sporting event, you’ve felt the electricity generated by a hive of humans. It magnifies our emotions.

I felt exactly that unified feeling in the open field in Glendo, as if thousands of us were breathing as one. But that’s not the only way people can experience a total eclipse.

During the 2008 total eclipse in Mongolia “I was up on a peak,” Russo recounts. “I was with only my husband and a close friend. We had left the rest of our 25-person tour group at the bottom of the hill. From that vantage point, when the shadow came sweeping in, there was not one man-made thing I could see: no power lines, no buildings or structures. Nothing tethered me to time: It could have been thousands of years ago or long into the future. In that moment, it was as if time didn’t exist.”

Giving us the ability to unhitch ourselves from time—to stop dwelling on time is a unique superpower of a total eclipse. In Russo’s work as a clinical psychologist, she notices patterns in our modern-day mentality. “People with anxiety tend to spend a lot of time in the future. And people with depression spend a lot of time in the past,” she says. An eclipse, time and time again, has the ability to snap us back into the present, at least for a few minutes. “And when you’re less anxious and worried, it opens you up to be more attuned to other people, feel more connected, care for others and be more compassionate,” Goldy says.

Russo, who founded Being in the Shadow , an organization that provides information about total solar eclipses and organizes eclipse events around the world, has experienced this firsthand. Venue managers regularly tell her that eclipse crowds are among the most polite and humble: they follow the rules; they pick up their garbage—they care.

Eclipses remind us that we are part of something bigger, that we are connected with something vast. In the hours before and after totality you have to wear protective glasses to look at the sun, to prevent damage to your eyes. But during the brief time when the moon blocks the last of the sun’s rays, you can finally lower your glasses and look directly at the eclipse. It’s like making eye contact with the universe.

“In my practice, usually if someone says, ‘I feel insignificant,’ that’s a negative thing. But the meaning shifts during an eclipse,” Russo says. To feel insignificant in the moon’s shadow instead means that your sense of self shrinks, that your ego shrinks, she says.

The scale of our “big picture” often changes after witnessing the awe of totality, too. “When you zoom out—really zoom out—it blows away our differences,” Goldy says. When you sit in the shadow of a celestial rock blocking the light of a star 400 times its size that burns at 10,000 degrees Fahrenheit on its surface, suddenly that argument with your partner, that bill sitting on your counter or even the differences among people’s beliefs, origins or politics feel insignificant. When we shift our perspective, connection becomes boundless.

You don’t need to wait for the next eclipse to feel this way. As we travel through life, we lose our relationship with everyday awe. Remember what that feels like? It’s the way a dog looks at a treat or the way my toddler points to the “blue sky!” outside his car window in the middle of rush hour traffic. To find awe, we have to surrender our full attention to the beauty around us. During an eclipse, that comes easily. In everyday life, we may need to be more intentional.

“Totality kick-starts our ability to experience wonder,” Russo says. And with that kick start, maybe we can all use our wonderment faculties more—whether that means pausing for a moment during a morning walk, a hug or a random sunset on a Tuesday. In the continental U.S., we won’t experience another total eclipse until 2044. Let’s not wait until then to seek awe and connection.