The Philippines Health System Review - WHO Western Pacific ...

More documents

Recommendations

Info

At present, patients´ rights and safety are expressed under the purview ofthe Penal Code and Medical Act of 1959 and health professional practiceacts. The lack of a gatekeeping mechanism in the health system allowspatients to choose their physicians. Patient empowerment, on the otherhand, has remained more a concept than a practice. The relationshipof the health system with individuals, families and communities is stilllargely one of giver to recipient.Table 2-1 Principal Legislation in the Health SectorYearAct1954 Republic Act No. 1082 “Rural Health Act”.1957 Republic Act No. 1939 “Contributions for the Maintenance of Hospital Beds”.1959 Republic Act No. 2382 “Medical Act”.1979 Adoption of primary health care (PHC)1982 Executive Order 851 “Reorganizing the Ministry of Health, Integrating theComponents of Health Care Delivery into its Field Operations, and for OtherPurposes”.1987 Constitution of the Republic of the Philippines.1988 Republic Act No. 6675 “Generics Act”.1991 Republic Act No. 7160 “Local Government Code”.1994 Republic Act No. 7722 “Higher Education Act”.1995 Republic Act No. 7875 “National Health Insurance Act”.1997 Republic Act No. 8344 “An Act Prohibiting the Demand of Deposits or AdvancePayments for the Confinement or Treatment of Patients in Hospitals andMedical Clinics in Certain Cases”.1999 Republic Act No. 7305 “Magna Carta for Public Health Workers”.2003 Republic Act No. 9184 “Government Procurement reform Act”.2004 National Health Insurance Act of 1995 amended to Republic Act No. 9241.2008 1988 Generics Act– amended to Republic Act No. 9502 “Cheaper and QualityMedicines Act”.2010 Republic Act No. 7432 ‘Senior Citizens Act” – amended to Republic Act No. 9994“Expanded Senior Citizens Act”.2.2 Historical BackgroundTable 2-1 provides a list of principal legislation in the health sector. In1941, the Department of Health was carved out of the Department ofHealth and Public Welfare and established as a separate entity. From the1950s onwards, there was a steady improvement in patient care, medicaleducation, and public health comparable to other developing countries.The national public network of health centres had its roots in the 195414
Rural Health Act, which transformed the puericulture centres to ruralhealth units (RHUs) in municipalities and to city health centres in citiesall over the country (DOH, 1995). In 1983, EO 851 integrated public healthand hospital services under the integrated public health office (IPHO) andplaced the municipal health office under the supervision of the chief ofhospital of the district hospital.Private sector health services, organized around free-standing hospitals,physician-run individual clinics, and midwifery clinics, have largelyfollowed the North American models of independent institutionseconomically dependent on fee-for-service payments. They range in sizefrom small basic service units operated by individuals to sophisticatedtertiary care centres.To improve the poor’s access to health care, various reforms have beeninstituted over the past 30 years (DOH, 2005). Among these were: theadoption of primary health care (PHC) in 1979; the integration of publichealth and hospital services in 1983 (EO 851); the enactment of theGenerics Act of 1988 (RA 6675); the devolution of health services to LGUsas mandated by the Local Government Code of 1991 (RA 7160); and theenactment of the National Health Insurance Act of 1995 (RA 7875). In1999, the DOH launched the health sector reform agenda (HSRA) as amajor policy framework and strategy to improve the way health care isdelivered, regulated and financed.Among these reform efforts, the Local Government Code (RA 7160 of1991) changed the delivery of health services as it gave local governmentunits (LGUs) responsibility for and financial management of their ownhealth activities, with the DOH providing guidance and advice. After manyprotests and much criticism, this devolution was finally implemented in1993.Another key reform effort was the enactment of the National HealthInsurance Act of 1995 (RA 7875), which replaced the Medicare Act of 1969and established PhilHealth as the national health insurance corporation.It aimed to ensure universal coverage with financial access to quality andaffordable medical care for all Filipinos by 2010.15
Page 1: Health Systems in TransitionVol. 1
Page 5 and 6: ContentsPreface....................
Page 7 and 8: List of TablesTable 1-1 Population/
Page 9 and 10: Figure 4-2 Number of beds in govern
Page 11 and 12: A standardized profile has certain
Page 13 and 14: Peer Reviewers on behalf of the Asi
Page 15 and 16: CPRDALEDBMDHSDILGDODOFDOHDOLEDOSTDT
Page 17 and 18: OOPOut-of-pocketOPBOutpatient Benef
Page 19 and 20: AbstractHealth status has improved
Page 21 and 22: the principle governing agency of t
Page 23 and 24: Hospital admissions data from PhilH
Page 25 and 26: 1. Introduction1.1 Geography and So
Page 27 and 28: Indicator 1970 1980 1990 2000 2005
Page 29 and 30: Table 1-2 Economic indicators, 1970
Page 31 and 32: Women tend to live longer than men
Page 33 and 34: Rate per 100 000 population (Rank)R
Page 35 and 36: Table 1-7 Maternal and child health
Page 37: 2. Organization and Governance2.1 S
Page 41 and 42: that supplement PhilHealth coverage
Page 43 and 44: plan, covering all government emplo
Page 45 and 46: The DOH has attempted to address th
Page 47 and 48: 2.7 Regulation2.7.1 Overview and hi
Page 49 and 50: through the institutionalization of
Page 51 and 52: Figure 2-3 Nursing Licensure Examin
Page 53 and 54: epresent another level of regulatio
Page 55 and 56: The law stresses the need for a hig
Page 57: coverage of the population vary, th
Page 60 and 61: Figure 3-1Health expenditure as a s
Page 62 and 63: Figure 3-2Financial FlowsOut-of-poc
Page 64 and 65: the results are promising. As of Ap
Page 66 and 67: Table 3-6 PhilHealth Special Benefi
Page 68 and 69: Taxes or contributions pooled by a
Page 70 and 71: Table 3-8 Allotments, obligations &
Page 72 and 73: LGUs procure all commodities throug
Page 74 and 75: payment of salaries and other allow
Page 76 and 77: Accreditation contracts are renewed
Page 78 and 79: 3.6 Voluntary Health InsuranceBased
Page 80 and 81: pricing in local hospitals, observe
Page 82 and 83: 4. Physical and Human Resources4.1
Page 84 and 85: Figure 4-1 Number of government and
Page 86 and 87: Table 4-2 Beds in government and pr
Page 88 and 89:
Table 4-4 Patient care utilization
Page 90 and 91:
Figure 4-3DOH total appropriations
Page 92 and 93:
4.2.3 Medical Equipment, Devices an
Page 94 and 95:
attempted to document the number of
Page 96 and 97:
Health Worker DistributionSince dat
Page 98 and 99:
(Figure 4-6). As for the nurse-to-p
Page 100 and 101:
Figure 4-9 Ratio of pharmacists per
Page 102 and 103:
of 2002. While CNS is essentially a
Page 104 and 105:
To manage migration flows of health
Page 106 and 107:
5.2 Public HealthImproving access t
Page 108 and 109:
• The prevention of cardiovascula
Page 110 and 111:
Private sector health professionals
Page 112 and 113:
Access to essential drugs is constr
Page 114 and 115:
5.9 Palliative CareIn 1991, the Phi
Page 116 and 117:
5.12 Alternative/Complementary Medi
Page 118 and 119:
drug stores. Later in 2009, the DOH
Page 120 and 121:
Year Reform Brief description2005 F
Page 122 and 123:
health care approach of putting hea
Page 124 and 125:
asic health packages. To this end,
Page 126 and 127:
The Generics Act of 1988 aims to pr
Page 128 and 129:
know the generics of oral/suspensio
Page 130 and 131:
As a result of these strategies, th
Page 132 and 133:
Improvements in the delivery of key
Page 134 and 135:
7.4 Allocative and Technical Effici
Page 136 and 137:
8. ConclusionsAs measured by standa
Page 138 and 139:
Further elaboration of the Human re
Page 140 and 141:
De Rosas-Valera M (2009). Health te
Page 142 and 143:
Gonzaga E, Navarra D (2004). The Re
Page 144 and 145:
National Statistics Office (2006).
Page 146 and 147:
Taguiwalo M (2004). Strategy for Lo
Page 148 and 149:
9.2 Useful websitesAvailable in Eng
Page 150 and 151:
The World Bankhttp://www.worldbank.
Page 152 and 153:
Jennifer Frances E. dela Rosa is a
Page 155:
The Asia Pacific Observatory on Hea
show all

The Philippines Health System Review - WHO Western Pacific ...

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?