Risk Pooling in Health Systems
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Risk Pooling in Health Systems

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Questions and Answers

Which of the following is NOT a focus area for locally endemic disease prevention and control?

  • Treatment of Communicable and Non-communicable diseases
  • Nutrition: Adequate, safe and available
  • Expanded program for immunization
  • Genomic research (correct)
  • What type of facilities provide highly technological and sophisticated services?

  • Emergency Hospitals
  • Tertiary Level Medical Centers (correct)
  • Community Clinics
  • District Hospitals
  • What aspect of primary health care includes addressing maternal and child health along with responsible parenthood?

  • Nutritional Support
  • Specialized Medical Treatment
  • Environmental Health
  • Management of Primary Health Care (correct)
  • Which of the following is a critical component of safe water and sanitation in primary health care?

    <p>Effective waste disposal systems</p> Signup and view all the answers

    How does the management of primary health care relate to essential drugs?

    <p>Essential drugs are integral to treatment capabilities.</p> Signup and view all the answers

    What is the primary purpose of health financing?

    <p>To collect revenues, pool financial risk, and allocate resources</p> Signup and view all the answers

    Which of the following is NOT a method of revenue collection for health care services?

    <p>Corporate tax on large companies</p> Signup and view all the answers

    What does the Generics Act aim to achieve?

    <p>Encourage the use of generic drug names to reduce costs</p> Signup and view all the answers

    What was the significant outcome of the Adoption of Primary Health Care in the Philippine Health System?

    <p>Increased participation in local health management</p> Signup and view all the answers

    What legislation was introduced to ensure access to affordable quality medicines?

    <p>RA 9502</p> Signup and view all the answers

    What is the goal of AO 2010-0036?

    <p>To provide universal health coverage for all Filipinos</p> Signup and view all the answers

    How does the Sin Tax contribute to health financing?

    <p>By generating revenue through taxes on harmful products</p> Signup and view all the answers

    In what way did the reorganization of Primary Health Care impact public health?

    <p>It integrated public health with hospital services</p> Signup and view all the answers

    What is the primary aim of the National Health Insurance Act?

    <p>To provide financial protection to all citizens, especially the poor.</p> Signup and view all the answers

    What does the FOURmula One (F1) for Health framework emphasize?

    <p>Speed, precision, and effectiveness in health reforms.</p> Signup and view all the answers

    Which of the following best describes Primary Health Care?

    <p>It is an inclusive approach organizing health services for communities.</p> Signup and view all the answers

    What does accountability in health care management refer to?

    <p>Willingness to accept authority and responsibility for actions.</p> Signup and view all the answers

    How does the Universal Health Care Law benefit Filipino citizens?

    <p>It guarantees automatic enrollment in the National Health Insurance Program.</p> Signup and view all the answers

    What role do local governments play according to RA 7160?

    <p>They take on the responsibility of providing health services.</p> Signup and view all the answers

    Which characteristic best defines the Health Care System?

    <p>It is an organized plan of health services for a population.</p> Signup and view all the answers

    In the context of health services, the term 'authority' refers to what?

    <p>The legitimate right of a manager to make decisions and allocate resources.</p> Signup and view all the answers

    What is the primary focus of the health care delivery system?

    <p>People-centered service</p> Signup and view all the answers

    Which of the following is NOT a key element of better primary health care?

    <p>Enhanced Pharmaceutical Sales</p> Signup and view all the answers

    What type of health facilities are included in the primary level of health care?

    <p>Community hospitals</p> Signup and view all the answers

    Which aspect is emphasized through the leadership reforms in health care?

    <p>Enhanced managerial accountability</p> Signup and view all the answers

    What is the role of secondary-level health care?

    <p>Offers specialized treatment for referred patients</p> Signup and view all the answers

    Which listed option is a form of primary health care education?

    <p>Promoting healthy lifestyle choices</p> Signup and view all the answers

    What should the government prioritize for effective health care service delivery?

    <p>Allocating sufficient budget and resources</p> Signup and view all the answers

    Which of the following is true about health care service delivery reforms?

    <p>They aim to improve the quality and efficiency of services.</p> Signup and view all the answers

    What is the primary goal of a health system in improving health equity?

    <p>Minimizing inequitable disparities in the community</p> Signup and view all the answers

    Which model funds healthcare through tax payments?

    <p>Beveridge Model</p> Signup and view all the answers

    What does risk pooling aim to achieve in health systems?

    <p>To distribute the financial burden of healthcare costs</p> Signup and view all the answers

    Which of the following is NOT one of the building blocks of the WHO Health System Framework?

    <p>Health Outcomes</p> Signup and view all the answers

    How should a health system improve its responsiveness?

    <p>By placing patients at the center and responding to their expectations</p> Signup and view all the answers

    Which aspect of health financing is essential for a health system?

    <p>Adequately funding essential services for all citizens</p> Signup and view all the answers

    What role does strategic purchasing play in health systems?

    <p>It involves financing or buying health care services for members.</p> Signup and view all the answers

    What is one of the goals of health systems regarding service delivery?

    <p>Ensuring timely delivery of quality and cost-effective health services</p> Signup and view all the answers

    Study Notes

    Risk Pooling and Health Systems

    • Risk pooling involves collecting and managing financial resources to distribute the financial risks of healthcare among all members of a health system.
    • Aims to minimize the individual financial burden of healthcare costs through collective coverage.

    Goals of Health Systems

    • Improve population health equity by addressing health disparities in communities.
    • Enhance the responsiveness of health systems by empowering individuals and aligning with their expectations.
    • Ensure fair health financing that protects against catastrophic health expenses.

    Building Blocks of WHO Health System Framework

    • Service Delivery: Ensures effective, safe, quality personal and non-personal health interventions.
    • Health Workforce: Essential for quality service delivery and requires sufficient training and support.
    • Leadership/Governance: Establishes strategic policies supporting an effective health system structure.

    Health Financing

    • Revenue collection methods for healthcare include taxation, out-of-pocket expenditures, and sin taxes (taxes on harmful substances).
    • Risk pooling is fundamental for protecting citizens against the financial impacts of health emergencies.

    Philippine Health System Characteristics

    • Developed a largely centralized and government-funded health care system focused on equitable access.
    • Implemented universal health coverage through initiatives like the Kalusugang Pangkalahatan act, aimed at providing quality health care for all Filipinos.

    Key Health Laws and Acts in the Philippines

    • RA 9502: Access to Cheaper and Quality Medicines Act ensures affordable drug access.
    • RA 7160: Local Government Code transfers health service responsibilities to local units.
    • National Health Insurance Act: Provides financial protection for all citizens with a focus on vulnerable populations.

    Primary Health Care (PHC) Concept

    • A whole-of-society approach promoting accessible health services to enhance health and well-being in communities.
    • Based on community participation and affordability, ensuring health as a basic human right.

    Health Care Delivery System

    • Organizes and delivers health services to the population, ensuring that systems are effectively budgeted and managed.

    Levels of Health Care Facilities

    • Primary Level: First contact health care focused on basic needs, offered through community health stations and clinics.
    • Secondary Level: Specialized treatment provided by healthcare professionals for referred patients in regional hospitals.
    • Tertiary Level: Advanced medical care in large hospitals offering high-tech services for complex health conditions.

    Essential Elements for Better Primary Health Care

    • Include education for health, endemic disease control, immunization, maternal and child health, nutrition, and access to essential drugs and services.

    Management and Engagement in Primary Health Care

    • Key management aspects include leadership, public policy reforms, and increasing stakeholder participation for better health outcomes.

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    Description

    Explore the concept of risk pooling within health systems, emphasizing the collection and management of financial resources. Understand how financial risks are spread from individuals to a collective pool to ensure equitable health service delivery. This quiz will delve into theoretical underpinnings and practical implications as highlighted by Roemer in 1991.

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