Health Systems and Healthcare Facilities

• A health system is all resources, actors, and institutions related to financing, regulation, and activities to improve/maintain health, according to the WHO in 2000.
• Healthcare delivery refers to the resources a population or society distributes in the organization/delivery of health services, according to Stanhope in 2001.
• A health system facilitates documentation of data, diagnosis, plans, client responses, and evaluation.
• A health system evaluates care efficiency and effectiveness.
• A health system gives directions, guidance, and planning to healthcare.
• A health system provides care continuity and reduces omissions.
• A health system individualizes client participation in care.
• A health system promotes creativity and flexibility in healthcare practices.

Health Care Facilities

• Primary care facilities, secondary care facilities, and tertiary healthcare facilities

Primary Level of Health Care Facilities

• Rural health units
• Sub-centers
• Chest clinics
• Malaria eradication units
• Schistosomiasis control units operated by the Department of Health
• Puericulture centers operated by League of Puericulture Centers
• Tuberculosis clinics/hospitals of the Philippine Tuberculosis Society.
• Private clinics operated by the Philippine Medical Association
• Clinics by large industrial firms for their employees
• Community hospitals/health centers operated by the Philippine Medicare Care Commission

Secondary Level of Health Care Facilities

• Smaller, non-departmentalized hospitals including emergency and regional hospitals
• Services for patients with disease symptoms which require moderately specialized knowledge/technical resources

Tertiary Level of Health Care Facilities

• Highly technological/sophisticated services by medical centers and large hospitals
• Specialized national hospitals
• Services rendered at this level are for clients afflicted with diseases that seriously threaten their health/require technical and specialized knowledge

Primary Level of Health Care Facilities; A Pyramidal Health Structure

• Tertiary: National health services, care regional health services
• Secondary: District health services; care rural (local hospital) services
• Primary: Rural health units; Barangay health stations care

Different Healthcare services

• Operation Theatre (O.T.)
• OPD
• Blood Bank
• Casualty
• Radiology Department
• ICU
• Physiotherapy
• Pathology

Healthcare Providers

• Doctors
• Physician Assistants
• Nurses
• Pharmacists
• Dentists
• Technologists and technicians
• Therapists and rehabilitation specialists
• Emotional, social, and spiritual support providers
• Administrative and support staff
• Community health workers and patient navigators

Health Care Provider Roles

• Administrative staff schedules appointments/finds medical records/ sends reminders/greets patients.
• Nurses record patient weight and vital signs/escort to exam rooms/record the visit reason.
• PCP such as a doctor, physician's assistant or nurse practitioner examines and talks with the patient to develop a diagnosis/plan of care.
• Technicians perform lab or radiology tests and administrative staff ships out samples.
• A lab performs the analysis and writes up the test results.
• The technician, nurse, or doctor discusses the results with the patient.
• A pharmacist fills the prescription if treatment is prescribed.
• Medical billing experts bill the patient's insurance for office visits and tests or medication.

Components of the Healthcare System

• Patients
• Healthcare Human Resources
• Healthcare Systems
• Healthcare Facilities & Equipment
• Healthcare Supplies
• Healthcare Processes
• Healthcare Partners

Essential Components of Healthcare

• Health Education
• India Ki Pharmacy
• Netmeds.com
• Treatment of Common Diseases and Injuries
• Essential Drugs Supply
• Safe Water and Sanitation
• Disease Control
• Nutrition
• Maternal and Child Health Care
• Immunization

Concept of PHC

• To provide the rural population in developing countries with at least the basic minimum level of healthcare services
• Inverse Care
• Unsafe Care
• Impoverishing care
• Fragmented and Fragmenting care
• Misdirected Care

Five Common Shortcomings of Healthcare Delivery

• Inverse care is a healthcare paradox where the most needful populations, often the poor or those with severe illnesses, receive the least quality care, while the wealthier or healthier populations benefit.
• Unsafe care refers to healthcare practices or conditions that cause harm to patients due to errors, negligence, or preventable adverse events.
• Impoverishing care refers to situations where individuals or families are pushed into financial hardship or poverty due to the high costs of accessing healthcare services.
• Fragmented and Fragmenting care refers to a lack of coordination between healthcare providers leads to disjointed care.
• Misdirected care refers to healthcare systems or services that focus on inappropriate priorities, leading to inefficiencies and suboptimal outcomes.

Basic Requirements for Sound PHC (The 8 A's and 3 C's)

• Accessibility: Health services should be physically and economically accessible to everyone, especially in rural and underserved areas.
• Affordability: Costs of care must not prevent individuals from seeking or receiving necessary services.
• Acceptability: Services should respect cultural, social, and religious values, meeting the expectations of the community.
• Availability: Sufficient healthcare resources, including facilities, medications, and personnel, must be present to meet the population's needs.
• Appropriateness: Care provided should be relevant to the specific health needs/conditions of the community.
• Accountability: Healthcare providers/systems are accountable to the communities they serve, ensuring quality/ethical standards.
• Awareness: Communities informed about available services, health risks, and prevention measures.
• Acceptability of Care Providers: Providers trusted/respected, which ensures a good provider-patient relationship.
• Comprehensiveness addresses a wide range of health needs: prevention/promotion to treatment, rehabilitation, and palliative care.
• Continuity: Patients receive coordinated care across different levels/over time, fostering long-term relationships with providers.
• Coordination: PHC integrates services across different sectors/levels of care, ensuring seamless transitions for patients.

Strategies of PHC

• PHC must ensure access to health services for the most disadvantaged populations and focus on interventions which will impact the major causes of mortality, morbidity, and disability for those populations.
• PHC, through its preventative/health promotion roles, addresses known risk factors, which are the major determinants of health outcomes for local populations
• PHC as a component of health systems must develop in ways that are financially sustainable, supported by political leaders, and by populations served.
• PHC policy must integrate with other policy domains/play its part in wider social, economic, environmental + development policy.

Philippine Health Care Delivery System

• A complex set of organizations interacting to provide an array of health services
• Public: Largely financed through tax-based system.
• National: DOH (specialty, regional hospitals, medical centers, DOH representatives)
• Local: LGU (provincial + district hospitals, RHUs (Rural Health Unit), BHSS ( Barangay Health Stations)
• Private- Largely market-oriented.
• Profit: Commercial, market orientation. (Private practitioners, private clinics/laboratories).
• Non-profit: Non-commercial + service orientation- (Socio-civic groups, religious organizations/foundations)