HEALTH SYSTEM
consists of all organizations, people, and actions whose primary intent is to promote, restore, or maintain health.
Health System has 6 building blocks or components
Service delivery
Health workforce
Information
Medical products, vaccines, and technologies
Financing
Leadership and governance or stewardship
HEALTH CARE DELIVERY SYSTEM
refers to the network of health facilities and personnel which carries out the task of rendering health care to the people.
WORLD HEALTH ORGANIZATION (WHO)
specialized agency of the United Nations (UN)
Provides global leadership on health matters
WHO Constitution:
Its objective is the attainment by all people of the highest possible level of health
WHO Constitution Core Functions
provide leadership
shaping the research agenda
setting norms and standards and promoting and monitoring their implementation
Articulating ethical and evidence-based policy options
Providing technical support, catalyzing change, and building sustainable institutional capacity.
SDG Goal 3
DEPARTMENT OF HEALTH (DOH)
The main governing body of health services in the country
DEPARTMENT OF HEALTH (DOH)
Provides guidance and technical assistance to LGUs through the Center for Health Development in each of the 17 regions
DEPARTMENT OF HEALTH (DOH)
holds the overall technical authority on health as it is a national health policy-maker and regulatory institution.
DOH’s 3 MAJOR ROLES
leadership in health;
enabler and capacity builder;
administrator of specific services
private sector
Composed of for-profit and nonprofit agencies
Provides all levels of services and accounts for a large segment of health service providers in the country
Financing of Health Services (3 major groups):
Government (National and Local)
Private Sources
Social Health Insurance
PHILIPPINE HEALTH INSURANCE CORPORATION
Tax-exempt government corporation attached to the DOH for policy coordination and guidance
DOH Administrative Order 2012-0012
Rules and Regulations Governing the New Classification of Hospitals and Other Health Facilities in the Philippines
ENUMERATE HOSPITALS
General
Level 1
Level 2
Level 3(teach/train)
Specialty
enumerate other health facilities (4)
Primary Care Facility
Custodial Care Facility
Diagnostic and \n Therapeutic Facility
Specialized Outpatient Facility
General Hospitals
Provides services for all kinds of illnesses, injuries or deformities
Specialty Hospitals
Offers services for a specific disease or condition or type of patient (children, elderly or women)
Primary Care Facility
First-contact health facility that offers basic services including emergency services and provision for normal deliveries
Custodial Care Facility
Provides long-term care to patients with chronic conditions requiring ongoing health and nursing care due to impairment and a reduced degree of independence in ADLs, and patients in need of rehabilitation.
Diagnostic/Therapeutic Facility
for the examination of the human body, specimens from the human body for the diagnosis, sometimes treatment of disease, or water for drinking water analysis
Specialized Outpatient Facility
performs highly specialized procedures on an outpatient basis
LEVEL 1 HOSPITAL
Most basic
Cater to patients who need minor care and supervision
LEVEL 1 HOSPITAL
Must include:
operating room
post-operative recovery room
maternity facilities
Isolation facilities
Dental Clinic
Blood Station
Clinical Laboratory
Level 1 - Imaging facility
X-ray
Pharmacy
LEVEL 2 HOSPITAL
Need for a referral from Level 1
Contains all the facilities of Level 1
LEVEL 2 HOSPITAL
Additional Facilities:
ICU for critically ill patients
NICU (Neonatal intensive care unit)
HRPU (high risk pregnancy unit)
Respiratory therapy services
Specialist doctors for OB-Gyne, pediatric services, medicine, surgery, their subspecialty and ancillary services
Clinical Laboratory
Level 2 - Imaging facilities (mobile X-Ray and contrast examination)
LEVEL 3 HOSPITAL
Teaching and/or training hospital
Contains all the facilities of Level 2
LEVEL 3 HOSPITAL
Specialized Facilities:
Physical Medicine and Rehabilitation Unit
Ambulatory Surgical clinic
Dialysis facility
Respiratory therapy services
Blood bank
Clinical Laboratory
Level 3 Imaging facility (interventional radiology)
Level of Hospital
defined as the service capabilities of hospitals reflected in the 2020 license to operate.
DOH
responsible for leveling different hospitals
bones
Treatment of a particular type of illness \n government owned
Philippine Orthopedic Center (FOR WHAT)
Communicable Diseases
Treatment of a particular type of illness \n government owned
San Lazaro Hospital (FOR WHAT)
Cancer
Treatment of a particular type of illness \n government owned
Benavides Cancer Institute (FOR WHAT)
Treatment of patients belonging to a particular group
Philippine Children’s Medical Center
National Children’s Hospital
National Center for Geriatric Health
Dr. Jose Fabella Memorial Hospital
THE MANILA HEALTH DEPARTMENT
The Department is concerned mainly on promotion of health and prevention of diseases to the Manila constituents with special focus on poor families.
Maternal and Child Health
Communicable Disease Control
Non Communicable Disease Control
Health Centers Thrust Program
Communicable Disease Control
Tuberculosis
Communicable Disease Control
Leprosy
communicable disease control
std
communicable disease control
dengue prevention and control program
non communicable disease control
National Voluntary Blood Donation
RURAL HEALTH UNIT
Commonly known as a health center
RHU
Primary level health care facility in the municipality
RA 7160
This will enable local governments to attain their fullest development as self-reliant communities and make them more effective partners in the attainment of national goals.
LOCAL HEALTH BOARD
Creations of the:
Provincial Health Board
City/Municipal Health Board
Provincial Governments
Responsible for administration of provincial and district hospitals
Municipal and City Governments
In charge of the Primary Care
Rural Health Centers (RHU)
Satellite Outposts - Barangay Health Stations (BHS)
Devolution
Act by which the national government confers power and authority upon the various LGUs to perform specific functions and responsibilities.
Devolution
Advantage: allowed local leaders to have a greater hand in the future of communities
Devolution
Disadvantage: fragmentation of the health care delivery system in the Philippines
REFERRAL
Set of activities undertaken by a healthcare provider or facility in response to its inability to provide the necessary health intervention to satisfy a patient’s need
Functional Referral System
Ensures the continuity and completion of health and medical services
Comprehensive, encompassing, promotive, preventive, curative and rehabilitative care
Engages all health facilities from the lowest to the highest
Two-way referral system
Movement of a patient from the health center of first contact and the hospital at first referral level.
When hospital intervention has been completed, the patient is referred back to the health center
Internal Referral
Occur within the health facility, from one health personnel to another
External Referral
Movement of a patient from one health facility to another
Vertical
patient referral may be from a lower to a higher level of health facility or other way round
Horizontal
patient is referred between similar facilities in different catchment areas
COMMUNITY
collection of people who interact with one another
group of people who share something in common and interact with one another
Community Immersion
Implementation of intervention program to that identified problems in the community setting
REHABILITATION SETTING
The world class and state of the art laboratory and classroom designed for Speech-Language
Autism (person will special needs, person with disability)
Psychosocial
past experiences
Neurologic
dysfunction
RIGHTS
what is just, reasonable, what is due, what ought to be, or what is justifiable
a moral power or claim to do, to possess or receive from others as belonging or due to a moral agent
a moral claim over something that has basis in the nature of a man that is, his being rational being called to pursue a higher vocation
PATIENT’S RIGHTS
claims that patients may demand in order to promote their natural striving or advancement to health for as long as they are essentially life-saving
RIGHT TO APPROPRIATE MEDICAL CARE AND HUMANE TREATMENT
without any discrimination and within the limits of the resources, manpower and competence available for health and medical care at the relevant time.
RIGHT TO APPROPRIATE MEDICAL CARE AND HUMANE TREATMENT
If immediate treatment cannot be given, the patient needs to be referred or sent for treatment elsewhere, where the appropriate care can be provided.
RIGHT TO APPROPRIATE MEDICAL CARE AND HUMANE TREATMENT
No deposit, pledge, mortgage or any form of advance payment for treatment during an emergency situation.
hindi dapat nauuna ang pera kesa sa service.
. RIGHT TO INFORMED CONSENT
The right to a clear, truthful and substantial explanation, in a manner and language understandable to the patient the ff:
proposed procedures, whether diagnostic, preventive curative, rehabilitative or therapeutic.
the person who will perform the said procedure shall provide his name and credentials to the patient.
possibilities of any risk of mortality or serious side effects
problems related to recuperation and probability of success and reasonable risks involved.
Nature of Treatment
Alternatives
Plan A, Plan B
Benefits
Opportunity for questions
Risks
Key aspects of informed consent
RIGHT TO PRIVACY AND CONFIDENTIALITY
freedom from unwarranted public exposure, except in the following cases:
when his mental or physical condition is in controversy and the appropriate court, in its discretion, order him to submit to a physical or mental examination by a physician;
when the public health and safety so demand; and
when the patient waives this right in writing.
will benefit public health and safety;
when it is in the interest of justice and upon the order of a competent court; and
when the patients waives in writing the confidential nature of such information;
when it is needed for continued medical treatment or advancement of medical science subject to de-identification of patient and shared medical confidentiality for those who have access to the information
When to disclose information?
RIGHT TO INFORMATION
RIGHT TO INFORMATION
result of the evaluation of the nature and extent of his/her disease,
any other additional or further contemplated medical treatment on surgical procedure/s;
including any other additional medicines to be administered and their generic counterpart including the possible complications and other pertinent facts;
statistics or studies regarding his/her illness;
any change in the plan of care before the change is made
RIGHT TO INFORMATION
the person’s participation in the plan of care and necessary changes before its implementation;
The extent to which payment may be expected from Philhealth or any payor and any charges for which the patient may be liable;
RIGHT TO CHOOSE HEALTH CARE PROVIDER AND FACILITY
freedom to choose the health care provider to serve him as well as the facility, except when he is under the care of a service facility or when public health and safety so demands or when the patient expressly waives this right in writing.
RIGHT TO CHOOSE HEALTH CARE PROVIDER AND FACILITY
the right to seek a second opinion and subsequent opinions, if appropriate, from another health care provider/practitioner
RIGHT TO SELF-DETERMINATION
The right to avail of any recommended diagnostic and treatment procedures
Any person of legal age and of sound mind may make an advance written directive for physicians to administer terminal care when he/she suffers from the terminal phase of a terminal illness.
RIGHT TO RELIGIOUS BELIEF
right to refuse medical treatment or procedures which may be contrary to his religious beliefs, subject to the limitations such as:
\n
Provided, that such a right shall not be imposed by parents upon their children who have not reached the legal age in a life threatening situation as determined by the attending physician or the medical director of the facility.
RIGHT TO MEDICAL RECORDS
Entitled to a summary of his medical history and condition.
RIGHT TO LEAVE
Right to leave the hospital or any other health care institution regardless of his physical condition
INFORMED OF THE MEDICAL CONSEQUENCES
Releases those involved in his/her care from any obligation relative to the consequences of his decision;
his decision will not prejudice public health and safety (ex. COVID - walang right to leave)
Right to leave the hospital or any other health care institution regardless of his physical condition, provided that:
RIGHT TO REFUSE PARTICIPATION IN MEDICAL RESEARCH
right to be advised if the health care provider plans to involve him in medical research, including but not limited to human experimentation which may be performed only with the written informed consent of the patient
RIGHT TO CORRESPONDENCE AND RECEIVE VISITORS
The right to communicate with relatives and other persons and to receive visitors subject to reasonable limits prescribed by the rules and regulations of the health care institution.
RIGHT TO EXPRESS GRIEVANCES
The right to express complaints and grievances about the care and services received without fear of discrimination or reprisal and to know about the disposition of such complaints.
COMMUNICATION
Any means of exchanging information or feelings between two or more people. It is a basic component of human relationships, including health professions and other disciplines
SENDER
a person or group who wishes to communicate a message to another, can be considered the source-encoder.
MESSAGE
What is actually said or written
RECEIVER
The third component of the communication process, is the listener, who must listen, observe and attend
DECODER
FEEDBACK
can be either verbal, nonverbal, or both.
allows the sender to correct or reword a message.
VERBAL
uses the spoken or written word;
Nonverbal
communication uses other forms, such as gestures or facial expressions, and touch.
Nonverbal
sometimes called body language, includes gestures, body movements, use of touch, and physical appearance, including adornment.
requires a systematic assessment of the person’s overall physical appearance, posture, gait, facial expressions, and gestures.
To observe nonverbal behavior efficiently
PERSONAL APPEARANCE
Clothing and adornments can be sources of information about a person.
Although choice of apparel is highly personal, it may convey social and financial status, culture, religion, group association, and self-concept.
POSTURE AND GAIT
The ways people walk and carry themselves are often reliable indicators of self-concept, current mood, and health
FACIAL EXPRESSION
No part of the body is as expressive as the face.
Feelings of surprise, fear, anger, disgust, happiness, and sadness
GESTURES
Hand and body gestures may emphasize and clarify the spoken word, or they may occur without words to indicate a particular feeling or to give a sign.
GESTURES
A father awaiting information about his daughter in surgery may wring his hands, tap his foot, pick at his nails, or pace back and forth.
THERAPEUTIC COMMUNICATION
Requires the use of verbal and non verbal techniques that are focused on client needs.