Upload
ted-herbosa
View
66
Download
0
Tags:
Embed Size (px)
Citation preview
Healthcare Innovation Forum: Philippine Healthcare
Teodoro J. Herbosa MD FPCS College of Medicine, University of the Philippines, Manila Undersecretary, DOH (2010-2014)
ObjectivesHistory of the Philippine Health care system
Health Reforms: Universal Health Care
Health Financing
Health Systems Strengthening
Health Partnerships
Intended Health Outcomes
Philippine Health CarePrehispanic era
Spanish Era
American Era
Golden Era 50’s
Diaspora
Two Systems: Public vs Private
Health ReformsGovernment owned Corporate Hospitals
Local Government Code/decentralization/devolution
Reforms from private healthcare vs social protection scheme
National Health Insurance Act 1994 Philippine Health Insurance Corporation
Universal Health Care funded through Sin Tax
Governance Reform for Public Hospitals
Background
3
Universal Health Care Building Blocks
Governance
Financing
Health Goods and Materials
Health Services
Information System
Health Workforce
THE AQUINO HEALTH AGENDAUniversal Health Care or Kalusugan Pangkalahatan, has three
strategic thrusts:
Universal Health Care / Kalusugan Pangkalahatan
Improved Health especially for the
Poor and Vulnerable
Secure access to quality
care at facilities
Achieve the public health
MDGs
Provide financial risk
protection
INTERVENTIONS OF CARE
Prim
ary
Prev
entio
n an
d
Health
Pro
mot
ion Curative
Health Care
Secondary Prevention and Primary Care
Universal Health CareKalusugan Pangkalatan
Health Risk Financing and Payment schemes reforms
Access to quality and affordable health care - modernization
Improved Public Health Outcomes focused on Maternal and Child Health
eHealth National eHealth Strategic Plan and Framework
Health FinancingPremium based health insurance system
Targetting the poorest
Using Sin Tax revenues for sustainable financing
Increased Health expenditure by government
Catastrophic Illness packages
Primary Care Benefit
Case Payment scheme/Capitation payments
SUBSTANTIAL INCREASE IN THE DEPARTMENT OF HEALTH BUDGET
Budget (in billion pesos)
Billi
on P
esos
0
22.5
45
67.5
90
Year2008 2009 2010 2011 2012 2013 2014
Budget (in billion pesos)
18.91 23.67 24.65 31.83 42.08 50.44 89.7
23 Case Rates (No balance billing for Sponsored Program beneficiaries in
government hospitals)
Health Systems Strengthening
Health Leaders Program ZFF
MMCF Strategic Thinking for Hospital Directors
Hospital governance reform; ISO Certification
Hospital Accreditation Commission
Health Systems Strengthening
Focus on GIDA
Preventive Health approach expanding EPI, rotavirus, Pneumococcal vaccines
NCDs
Local health systems/Interlocal health zones
IMPROVED ACCESS TO QUALITY HOSPITALS AND FACILITIES
3,576:Total health facilities upgraded and rehabilitated as of Feb 2013
1,049 hospitals
Another 2,487 health facilities will be upgraded this 2013.2,751 (91%) came from the 609 priority municipalities listed by the National Anti-Poverty Commission
Result: Increase in deliveries of mothers in hospitals. 719,552 mothers (38.8%) (2009) vs 1,014,613 mothers (57.1%) (2011)
Health Partnerships
Public Private Partnerships PPPs
Social Marketing and buy in
Name calling by certain sectors
Success in Emergencies and Disasters
Protracted planning and feasibility studies
Performance Comparison: Existing & MPOC
EXISTING POC
MODERNIZED POC
534 beds utilized out of 700 sanctioned beds, sub capacity operation at 55%
-60% levels
Ideal Staff to Bed Ratio not being
effectively achieved
Lower than average period of Avg. Length
of Stay (ALOS) & discharge times for admitted patients
Only primary and secondary medical
services, Limited allied services, medical tourism & private patients due to
poor competitive advantage
Private sector efficiency in operations to
ensure atleast 70% capacity utilization
Expected Ideal Staff to Bed Ratio of 2.25 persons/
bed
Possible reduction in ALOS, discharge period to reduce from 22 days to 8
days
Super specialty tertiary care with increased private
patients, medical tourists, allied medicine due to
internationally competitive services & facilities
Criteria For Selection Of Pilot Hospitals
22
Health OutcomesLonger Life Span
Increase in Average height
Lower Maternal and Child Mortality
Correcting undernutrition
Decerease childhood obesity
Decrease smoking related mortalities NCDs
OUTCOMES
3
ATTAINMENT OF THE HEALTH-RELATED MILLENNIUM DEVELOPMENT GOALS
Disaster Risk Reduction
Capacity and Capability
Incident Command Systems
Emergency Operations Center
Communications and Coordination
Logistics management system
eHealthEnterprise architecture/Common platform
Standards and Nomeclature
Security and Privacy
Risk management
Health Information Exchange
Analytics and Big Data
eHealth Component Map (Based on the DOH Philippine eHealth Framework and
Development Plan 2013-2016)
Health Information ExchangeOPENHIE
Private Sector Health systems development: Corporate networks
Procure and Improve Model
Ambulatory services to a greater number
Market segment capture
HMO and Health Insurance
Health Industry; Pharma, Equipment, Supplies, Design and construction
Threats to UHC Sec. AG Romualdez
•Emphasis on profit in the private health sector •Health goods and services as commodities •*Globalization – ASEAN Harmonization of
Health Services •*Public-Private Partnerships •Medical Tourism •Two-tiered health care system
– Dr. S.T.Han, WHO Regional Director for the Western Pacific: Hiscock Memorial Lecture, University of Hawaii, 1991
““You may have the best infrastructures, the most modern and up to date technology, and the best management and finance systems, but without a
well-motivated and skilled workforce none of these will have beneficial impacts on the health of
people.””
–Randy Pausch, The Last Lecture
“The brick walls are there for a reason. The brick walls are not there to keep us out. The brick walls
are there to give us a chance to show how badly we want something. Because the brick walls are there to stop the people who don't want it badly enough.
They’re there to stop the other people.”