HIS MT 102 LEC - Health Care System

Health System

consists of many parts, such as the community, department or ministries of health, health care providers, health service organizations, pharmaceutical companies, health financing bodies, and other organizations

Health System

functions such as governance, healthcare service provision, and managing resources serve as the interconnections

Roemer (1991) - Health System

the combination of resources, organization, financing and management that culminate in the delivery of health services to the population

World Health Organization (2000)

all the organizations, institutions and resources that are devoted to producing health actions

Improving the Health of Populations, Responsiveness to Population, Fairness in Financial Contribution

The three main goals for health systems identified by WHO

Improving the health of populations

Overarching goal of a health system. Health status should be measured over the entire population and across different socioeconomic groups.

Improving the health of populations

There should be preperations for resilience to future but still unknown health risks, striving for equity in health

Responsiveness to Population

represents the concept that health system provides services in the manner that people want or desire and engages people as active partners.

Responsiveness to Population

it embodies values of respectfulness, non-discrimination, humaneness, and confidentiality. Health systems have an obligation to respond to the legitimate non-health desires and expectations of the population.

Responsiveness to Population

Responsive health systems maximize people's autonomy and control, allowing them to make choices, placing them at the center of the health care system.

Fairness in Financial Contribution

An ideal health system will provide social and financial risk protection in health and be fairly financed.

Fairness in Financial Contribution

An ideal health system is one that does not deter individuals from receiving needed care due to payments required at the time of service and one in which each individuals pays approximately the same percentage of their income for needed services.

Health Service Provision, Health Service Inputs, Stewardship, Health Financing

Enumerate the four vital health system functions

Health Service Provision

most visible product of the health system, trying to avert illness through education and preventive measures, having to perform a wide range of activities

Health Service Inputs

is the assembling of essential resources such as human resources, medications, and medical equipment, for delivering health services.

Stewardship

overall system oversight that sets the context and policy framework for the overall health system. usually a governmental responsability.

Stewardship

identifying health priorities, the insitututional framework, activities that should be coordinated, and trend in health priorities

Stewardship

generating appropiate data for policymaking ranging from public health surveillance data to health system performance and providing the basis for assessing health status, regulating the sector, and tracking health system performance, efectiveness, and impact

Health Financing

Includes collecting revenues, pooling risk, and allocating revenue

Revenue Collection

Collection of money to pay for health care services through general taxation, donor financing, mandatory payroll contributions, household expenditures, and other forms of personal savings

general taxation

public health systems are typically financed through ______

mandatory contributions from workers and emplyers (Payroll contributions)

Social security organizations are usually financed through _____

Risk Pooling

collection and management of financial resources in a way that spreads financial risks from an individual to all pool members

Risk Pooling

core function of health insurance mechanisms, ensuring financial protection from participation

Risk Pooling

an essential to avoid payment at the moment of utilizing services

Bismarck Model and Beveridge Model

Enumerate the two types of risk pooling models

Bismarck Model

• Uses an insurance system "sickness fund" typically financed jointly by employers through payroll deduction

• "Sickness funds" have to cover everybody and do not make a profit

• Doctors and hospitals tend to be private

• Examples: Germany, France, Belgium, Netherlands, Japan, Switzerland

Prussian Chancellor Otto von Bismarck - invented the welfare state

Bismarck Model was name after

Beveridge Model

Healthcare is paid for mostly by government taxes, with a low cost per capita as the government can control what doctors can do and what they can be charged

William Beveridge - social reformer who designed Britains National Health Service

Beveridge Model was named after

Strategic Purchasing

the way most risk-pooling organizations or purchasers use collected and pooled financial resources to finance or buy health care services for their members

Strategic Purchasing

a key role in defining the substantial part of the external incntives for appropriate provider-user interaction and health service delivery models

Service deliver;

Health Workforce;

Information;

Medical products, vaccines and technologies;

financing;

leadership and governance

enumerate the six essential groups for strengthening health groups by WHO (2000)

Service Delivery

whose which deliver effective, safe, quality personal and non-personal health interventions to those who need them, when and where needed, with minimum waste of resources

Health Workforce

one which works in ways that are responsive, fair, and efficient to achieve the best health outcomes possible, given the available resources and circumstances

Information

One that ensures the production, analysis, dissemination, and use of reliable and timely information on health determinants, health systems performance, and health status

Medical products, vaccines, and technologies

ensures equitabke access to essential medical products, vaccines, and technologies of assured quality, safety, efficacy and effectiveness, and their scientifically sound and cost-effective use

Financing

raises adequate funds for health, in ways that ensures people can use needed services and are protected from financial catastrophe when having to pay for them

Leadership and Governance

involves ensuring strategic policy frameworks exist and are combined wih effective stewardship, coalition-building, provision of regulations and incentives, attention to system-design, and accountability

1970 - Primary Health Care for All

Developed a largely centralized government-funded and operated health care system

1979 - Adoption of Primary Health Care

Promoted participatory management of the local health care system

1982 - Reorganization of DOH

Integrated public health and hospital services

1986 - Milk Code 1986

Prevention and nutrition to promote breastfeeding

1988 - The Generics Act

Prescriptions are written using the generic name of the drug in an attempt to lower expenditure on drugs by promoting and purchasing non-branded medicines

1991 - RA 7160 "Local Government Code"

Transfer of responsibility of health service provisions to the local government units

1995 - National Health Insurance Act

Aims to provide all citizens a mechanism for financial protection with priority given to the poor

1996 - Health Sector Reform Agenda

Major organizational restructuring of the DOH to improve the way health care is delivered, regulated, and financed

2005 - FOURmula One (F1) for Health

Adoption of operational framework to undertake reforms with speed, precision, and effective condition

2008 - RA 9502 "Access to Cheaper and Quality Medicines Act"

Promotes and ensures access to affordable quality drugs and medicines for all

2010 - AO 2010-0036 "Kalusugang Pangkalahatan"

Universal health coverage and access to quality health care for all Filipinos

2013 - Sin Taxes for Health

Generating extra revenue for the Department of Health by discouraging harmful consumption of alcohol and tobacco

2019 - Universal Health Care Law

Enrolling all Filipino citizens automatically in the National Health Insurance Program administered by PhilHealth. All Filipinos are guaranteed equitable access to quality and affordable health care services

Department of Health

mandated to provide national policy direction and develop national plans, technical standards, guidelines of health, technical assistance, capacity-buildingm abd advisory services for disease prevention and control and supplies medicines and vaccines

Local Govenment Code (1991)

under the ____________, LGUS are granted the autonomy and responsability for their own health services. National health programs are coordinated by DOH through LGU

78 provinces headed by governers

138 cities and 1496 munincipalities headed by mayors

42025 barangays headed by chair persons(NSCB, 2010)

the philippines is divided into ____ provinces headed by governers, ____cities and _____munincipalities headed by mayors, _______barangays headed by chairpersons (NSCB, 2010)

Decentralized or Devolved Structure

state is represented by national offices and the LGUS, who provincial, city, munincipal, and barangar or village offices

1) tertiary hospitals at national and regional levels

2) provincial and district hospitals and city nf manunicipal health centers

3) barangay health cented

before devolution, the national health system consisted of a three-tiered system under the direct control of DOH:

1991 Local Government Code

since the _________, the government health system now consists of basic health services (health promotion and preventive units provided by cities, municipals, provincial and district hospitals, tertiary medical centers)

1. devleoping policies and programs

2. enhancing partners capacity through technical assistance

3. leveraging performance for priority health programs among partnets

4. developing and enforcing policies and standards

5. providing specific programs that affect large segment of population

6. providing specialized and tertiary level care

the department of health, as mandated, has the duty in

Philippine Health Agenda, Philippine Devlopment Plan 2017-2022, NEDA Ambisyon Natin 2040, SDG 2030

enumertae the driections of the philippine health sector

Philippine Health Agenda

"All for Health Towards Health For All" is the rally point for its vision of a healthy Philippines by 2020.

Philippine Health Agenda

has three key health system guarantees:

a. population and individual-level interventions that promote health and wellness, prevent and treat triple burden disease, delay complications, rehab

b. access to health interventions through Service Delivery Networks

c. financial risk protection when accessing interventions through Universal Health Insurance

Primary Development Plan of 2017-2022

This includes the four key medium-term plans to translate the vision of aspirations for the filipinos and the country

NEDA Ambisyon Natin 2040

This is a collective long-term plan which envisions a better life for the Filipinos and the country in the next 25 years.

SDG 2030

a compilation of 17 developmental goals that targets to end poverty, fight inequality and injustice, and confront issues involving climate change and its effects