Topnotch Medical Board Prep Preventive Medicine and Public Health Main Handout April 2024 PDF

TOPNOTCH MEDICAL BOARD PREP PREVENTIVE MEDICINE AND PUBLIC HEALTH MAIN HANDOUT BY DR. MANN For inquiries visit www.topnotchboardprep.com.ph or https://www.facebook.com/topnotchmedicalboardprep/ This handout is only valid for April 2024 PLE batch. This will be rendered obsolete for the next batch sin...

TOPNOTCH MEDICAL BOARD PREP PREVENTIVE MEDICINE AND PUBLIC HEALTH MAIN HANDOUT BY DR. MANN For inquiries visit www.topnotchboardprep.com.ph or https://www.facebook.com/topnotchmedicalboardprep/ This handout is only valid for April 2024 PLE batch. This will be rendered obsolete for the next batch since we update our handouts regularly. GENERAL SYSTEMIC DISORDERS: • failed thermoregulatory center & HEAT suppression of sweating. STROKE • S/Sx: temp 40-43°C, disorientation, delirium, coma • deficiency of water/salt leading to HEAT circulatory insufficiency. EXHAUSTION • S/Sx: fatigue, clammy, moist skin, increase temperature, weak pulse, low BP • painful muscle spasms involving arms & HEAT legs or abdomen due to excessive sweat loss CRAMPS with high water intake, without adequate salt replacement • minor disorder characterized by fainting HEAT • standing erect & immobile in hot SYNCOPE environment due to pooling of blood in blood vessels of skin and lower body parts National Institute for Occupational Safety and Health (NIOSH) THRESHOLD LIMIT VALUE • Set for airborne concentrations of substances, represents conditions under which workers may be repeatedly exposed without adverse health effects for an 8-hours workday, total of 48 hours per week TLV categories: 1. Time weighted average (TWA)- amount of chemical that can be repetitively exposed to a person over a long duration without causing adverse effects; usually based on average concentration in a 40-hour workweek. 2. Short term exposure limits (STEL)- amount of chemical allowable for a short duration (15 mins) without causing tissue damage, irritation or adverse effects 3. Ceiling – amount of chemical or particles that should not be exceeded at any time with no exceptions PHYSICAL AGENTS NOISE • Intensity measured in decibels (dB) • Frequency- rate of vibration of sources in Hertz. Important Ranges for Permissible duration of intensity (dB) and exposure frequency (Hz) Sound level Hours/day Hearing in dB 0 dB Threshold 8 85-90 Audible 20 – 4 90-95 Range 20,000 Hz 2 95-100 Threshold 1 100-105 120 dB for pain ½ 105-110 Speech 500 – ¼ 110-115 Frequency 2000 Hz 1/8 115 NOISE INDUCED HEARING LOSS • Sensorineural deficit from chronic exposure to excessive sound levels • almost always bilateral • OSHA level: 85 dbA for an 8-hour workday • Permissible Exposure level: 90 dBA for 8 hours PREVENTION AND CONTROL • Hearing Conservation Program • Personal hearing protective devices • Annual hearing tests • enclosures, barriers, ear plugs, canal caps, ear muffs HEAT MECHANISM OF HEAT EXCHANGE CONDUCTION Direct contact without interposition of air CONVECTION Movement of fluid or gas particularly air RADIATION Transfer by wave motion independent of any conduction medium EVAPORATION Sweat evaporation is most important, only means to maintain body temperature Prickly heat (Miliaria Rubra) –from unrelieved exposure to humid heat; skin continually wet with unevaporated areas, imbibing water. plugs sweat duct orifices, resulting in inflammation of sweat gland Dr. Mann ATMOSPHERIC PRESSURE DISORDERS • DYSBARISM o Sudden shift to environment of lower ambient pressure, as in rapid ascension to surface from deep-sea diving or with loss of cabin pressure while flying at high altitudes, causes decompression sickness. Decrease atm pressure causes: Increase atm pressure causes: • Decompression sickness (Caisson disease) – sudden decrease to approximately 45% of pressure with which subject had been equilibrated • Hypoxia • Nitrogen narcosis- nitrogen has increased solubility in fatty tissues • O2 toxicity – retrolental fibroplasia • Cardiovascular strain TOP 10 WORK-RELATED ILLNESSES 1. Respiratory diseases 6. Reproductive disorders 2. Musculoskeletal diseases 7. Neurotoxic disorders 3. Cancers 8. Noise-induced hearing loss 4. Injuries 9. Dermatological disorders 5. CV diseases 10. Psychological disorders HEALTH EXAMINATION FOR WORKERS CLASSIFICATION OF HEALTH EXAMINATIONS: 1. Entrance/pre-employment examination • Patient classification after examination o Class A – physically fit for any work o Class B – physically underdeveloped or with correctible defects but otherwise fit for work o Class C – employable but owing to certain impairments or conditions requires special placement or limited duty in a specified or selected assignment requiring follow up treatment / periodic evaluation. o Class D – unfit or unsafe for any type of employment Mnemonic Class A: “Ayos!” Class B: “… But still employable. ” Class C: “Conditional” Class D: “Denied!” Dr. Mann 2. Periodic Annual Medical Examinations § Interval of < 1 year between 2 consecutive PE 3. Transfer examinations 4. Special exam o If with undue exposure to health hazards, e.g., lead, mercury, hydrogen sulfide, sulfur dioxide, nitro glycol 5. Return to work exam § (1) detect if still contagious § (2) whether worker is fit to return to work § (3) after prolonged absence for health reasons, to determine possible occupational causes 6. Separation from work exam § (1) if suffering from any occupational disease; § (2) whether suffering from injury not completely healed; § (3) whether he has sustained an injury DOLE OCCUPATIONAL SAFETY AND HEALTH STANDARDS (As Amended, 1989) TOPNOTCH MEDICAL BOARD PREP PREVENTIVE MEDICINE AND PUBLIC HEALTH MAIN HANDOUT BY DR. MANN For inquiries visit www.topnotchboardprep.com.ph or email us at [email protected] This handout is only valid for the April 2024 PLE batch. This will be rendered obsolete for the next batch since we update our handouts regularly. Page 36 of 77 TOPNOTCH MEDICAL BOARD PREP PREVENTIVE MEDICINE AND PUBLIC HEALTH MAIN HANDOUT BY DR. MANN For inquiries visit www.topnotchboardprep.com.ph or https://www.facebook.com/topnotchmedicalboardprep/ This handout is only valid for April 2024 PLE batch. This will be rendered obsolete for the next batch since we update our handouts regularly. • OSH standards – mandatory rules and standards set and enforced to eliminate or reduce hazards in the workplace • This is a general reference for occupational safety and health standards for every working condition, sobrang haba nito, so if you are curious regarding specific conditions you can refer to this. OCCUPATIONAL SAFETY AND HEALTH STANDARD https://qrs.ly/2zbpwxn HADDON MATRIX • Model to understand causal chain of events in injuries • Extends epidemiological approach (host, agent, environment), to produce a matrix where causal factors in injury can be better understood through interaction of multiple factors over time • Temporal notions of pre-event, event, post-event phases plotted against host, agent, environmental factors of epidemiological model. SMOKING CESSATION PROGRAM THE ROLE OF THE CLINICIAN • increases likelihood that patient will successfully quit smoking • routinely identify smokers, offer evidence-based help to quit THE “5A’S” APPROACH • Ask about tobacco use • Advise quitting • Assess readiness to quit • Assist smokers ready to quit • Arrange follow-up E-CIGARETTE OR VAPING PRODUCT USE ASSOCIATED LUNG INJURY (EVALI) • “Vaping”: inhaling aerosol created by heating liquid or wax containing nicotine, cannabinoids (e.g., tetrahydrocannabinol, cannabidiol), flavoring, additives (e.g., glycerol, propylene glycol) • EVALI (e-cigarette or vaping product use-associated lung injury): name by Centers for Disease Control and Prevention (CDC) to dangerous, newly identified lung disease linked to vaping SUPPLEMENT: PUBLIC HEALTH “Public health refers to all organized measures to prevent disease, promote health, and prolong life among the population as a whole…. Thus, public health is concerned with the total system and not only the eradication of a particular disease.” (WHO) • Definitions emphasize that it is both an art and a science, highlighting the organized efforts of the society to help promote health among the population as a whole. o Reduce inequalities in health o Best health for the greatest number o Mental + Physical health UNIVERSAL HEALTH CARE ACT Orientation on the Universal Health Care Law. DOH Academy E-Learning Platform. http://learn.doh.gov.ph • Republic Act No. 11223 a.k.a. The Universal Health Care Act of 2019 • Signed into law on February 20, 2019 by Philippine President Rodrigo Roa Duterte • “The UHC Act automatically enlists all Filipinos in the national Health Insurance Program and prescribes the necessary reforms in the health system to enable access to a wide range of health services, while protecting the people from financial hardship.” – DOH E-learning module on the Universal Health Care Act of 2019 • An act instituting universal health care for all Filipinos, prescribing reforms in the health care system and appropriating funds thereof. • Universal Health Care means: o bringing primary care closer to families and communities, supported by hospitals as part of a network. o making PhilHealth membership automatic for every Filipino MAIN OBJECTIVES OF THE UHC ACT • 1) Progressively realize UHC through a systemic approach and clear delineation of roles of key agencies and stakeholders towards better performance in the health system; and • 2) Ensure that all Filipinos are guaranteed equitable access to quality and affordable health care goods and services, and protected against financial risk DECLARATION OF PRINCIPLES OF THE UHC ACT • Adoption of an integrated and comprehensive approach to ensure health literacy and healthy living conditions, and protection from hazards and risks • Development of a health care model that ensures access to a comprehensive set of quality and cost-effective health services without causing financial hardship to our citizens • Adherence to a people-oriented, people-centered approach for service delivery centered on people’s needs and well-being • A whole-of-system, whole-of-government, and whole-of society approach (integrated and comprehensive approach) in developing, implementing, and monitoring health policies, programs and plans The essence of the UHC is to give adequate safety nets for the people so that health care can be given by primary health care teams to individuals and families at the right place at the right time without the worry of financial ruin. Healthy home, school, or workplace = choosing a healthier lifestyle Dr. de la Rosa SOURCE OF FUNDING • Total incremental sin tax collections • National government subsidy to PhilHealth • Supplemental funding • Annual appropriations of DOH • Premium contributions of members • 50% of the National Government share from the Philippine Amusement and Gaming Corporation (PAGCOR) • 40% of the Charity Fund, net of Documentary Stamp Tax Payments and mandatory contributions of the Philippine Charity Sweepstakes Office (PCSO) FINANCING: KEY FEATURES POPULATION COVERAGE • Under the UHC Act, every Filipino citizen is automatically included in the National Health Insurance Program (NHIP) • Aside from ensuring automatic inclusion of every Filipino into the NHIP, the PHIC will also coordinate with other national government agencies towards inclusion of all Filipinos SERVICE COVERAGE • Immediate eligibility to benefits o preventive, promotive, curative, rehabilitative, and palliative • Comprehensive outpatient benefits o Drug benefit, emergency medical services o HCWs services, diagnostic, lab, dental, medical services, personal preventive services, prescription drugs and biologicals • Provision of Primary Care Providers o Every Filipino has a primary care provider • Registration of Filipinos to Primary Care Provider Networks o Every Filipino shall register with a public or private primary care provider § Considerations: proximity and ease of travel o Licensing of primary care providers FINANCIAL COVERAGE • Population-based o DOH, PhilHealth, DBM, DILG, other NGAs, LGUs ensure complementation in health financing • Individual-based o prepayment mechanisms (i.e., social health insurance, private health insurance, HMO) TOPNOTCH MEDICAL BOARD PREP PREVENTIVE MEDICINE AND PUBLIC HEALTH MAIN HANDOUT BY DR. MANN For inquiries visit www.topnotchboardprep.com.ph or email us at [email protected] This handout is only valid for the April 2024 PLE batch. This will be rendered obsolete for the next batch since we update our handouts regularly. Page 37 of 77 TOPNOTCH MEDICAL BOARD PREP PREVENTIVE MEDICINE AND PUBLIC HEALTH MAIN HANDOUT BY DR. MANN For inquiries visit www.topnotchboardprep.com.ph or https://www.facebook.com/topnotchmedicalboardprep/ This handout is only valid for April 2024 PLE batch. This will be rendered obsolete for the next batch since we update our handouts regularly. NHIP/PHILHEALTH Discussion under UHC Act • Program membership, with qualified dependents shall be simplified into 2 types: o Direct contributors – have the capacity to pay premiums § i.e., Gainfully employed or self-earning, professional practitioners, and migrant workers and their qualified dependents o Indirect contributors – do not have the capacity to pay premiums § Subsidized by the national government § i.e., indigents, families in critically poor condition (identified by gov’t) , senior citizens, Persons With Disability (PWD) o Qualified dependents § Legal spouse who is not an active member § Unmarried and unemployed legitimate, illegitimate, and legally adopted or stepchildren below 21 y/o § Foster children § Parents aged 60 y/o and above who are not enrolled • Entitlement to benefits o Every member has immediate eligibility for health benefit package. o No need to present PhilHealth ID o Failure to pay premiums shall not prevent enjoyment of benefits o Zero co-payment – co-payment to a flat fee or predetermined rate paid at the point of service PREMIUM CONTRIBUTIONS • For direct contributors, premium rates shall be in accordance with the following schedule, and monthly income floor and ceiling Year 2022 2023 2024 2025 Premium Rate 4.00% 4.50% 5.00% 5.00% Income Floor 10,000 10,000 10,000 10,000 Income Ceiling 80,000 90,000 100,000 100,000 HEALTH SERVICES DELIVERY • Population-based health services o Intended to be received by populations as a whole or identified groups of people of which outcomes contribute to general public health. o i.e., health promotion, disease surveillance, vector control, disaster management o also focus on social determinants of health o province- and city-wide health systems § Primary care provider network with patient records accessible throughout the health system § Accurate, sensitive, and timely epidemiologic surveillance systems § Proactive and effective health campaigns • Individual-based health services o can be definitively traced back to a single recipient o i.e., in-patient care, medicines, laboratory tests, procedures o Whether accessed through healthcare facilities or remotely via tech for health o Limited effect to population level o Healthcare provider networks will be developed and contracted by PhilHealth (collectively, not individual providers) ✓GUIDE QUESTIONS The following are examples of individual-based health services, except? A. Ambulatory care B. Health promotion C. Laboratory tests D. Medicine Examples are cancer awareness and HIV/STD prevention • The Provincial and City Health Boards shall oversee and coordinate health systems integration into province-wide and city-wide health systems o Coordinate and provide oversight o Administrative and technical supervision over the health facilities and health human resources in their territorial jurisdiction o Manages the Special Health Fund § province-wide and city-wide health system-pooled and manage fund for resources intended for health services § used to finance the population- and individual-based health services § health system operating costs and capital investments § remuneration of additional health workers and incentives for all health workers § PhilHealth payments income accrued to Special Health Fund to be allocated by LGU ✓GUIDE QUESTIONS Under RA 11223, Provincial and City Health Boards are mandated the following tasks, EXCEPT: A. Integrating health systems into province-wide and city-wide health systems B. Exercising administrative, technical supervision over health facilities and health workers within their territorial jurisdiction C. Managing Special Health Fund D. None of the above Answer: D HUMAN RESOURCES FOR HEALTH • National Health Human Resource Master Plan (NHHRMP) – it will provide policies and strategies for the generation, recruitment, retraining, retention, assessment and securing of permanent employment and competitive salaries for the health workforce. • National Health Workforce Support System – it will support local public health system in addressing their human resource need. o Geographically Isolated and Disadvantaged Areas (GIDA) are priority areas of deployment • Scholarship and Training Program o Includes undergraduate and post-graduate programs o Expanded existing and new allied and health-related degree training programs – regulated based on health need of population o Reorient curricula of allied medical and medical education towards developing competencies in providing primary care services • Return service agreement o Required for scholarship grant recipients o Priority areas in the public sector with compensation, and under the supervision of the DOH REGULATION • Licensing and regulatory system for stand-alone health facilities • Formulation of standards for clinical care in cooperation of DOH with professional societies and academe SAFETY AND QUALITY • Incentive scheme o PhilHealth to create a rating system to incentivize, acknowledge, or reward facilities providing health services at a set safety and quality standard • Third-party accreditation o Recognize established accreditors to monitor standards which will also be a basis for incentivization (e.g., International Organization for Standardization or ISO) • Licensing of standalone facilities and use of Clinical Practice Guidelines Answer: B ORGANIZATION OF LOCAL HEALTH SYSTEMS Inequities in the Philippine health system is present across municipalities du to variable prioritization for health services of local administration across different municipalities. The UHC Act will integrate province- and city-wide health systems to address this where the DOH, DILG, PhilHealth and the LGUs are the prime movers. Dr. de la Rosa AFFORDABILITY • Independent Price Negotiation Board to negotiate prices of drugs and devices in behalf of DOH o Members: Representatives from DOH, PhilHealth, Department of Trade and Industry (DTI), an economist, procurement specialist ician, health facility representative, citizen’s representative, LGU representative TOPNOTCH MEDICAL BOARD PREP PREVENTIVE MEDICINE AND PUBLIC HEALTH MAIN HANDOUT BY DR. MANN For inquiries visit www.topnotchboardprep.com.ph or email us at [email protected] This handout is only valid for the April 2024 PLE batch. This will be rendered obsolete for the next batch since we update our handouts regularly. Page 38 of 77 TOPNOTCH MEDICAL BOARD PREP PREVENTIVE MEDICINE AND PUBLIC HEALTH MAIN HANDOUT BY DR. MANN For inquiries visit www.topnotchboardprep.com.ph or https://www.facebook.com/topnotchmedicalboardprep/ This handout is only valid for April 2024 PLE batch. This will be rendered obsolete for the next batch since we update our handouts regularly. • Standardized prices of drugs and devices procured and sold guided by price reference indices and centrally negotiated prices • Public availability of prices of all. Health services and good offered • drug outlets required to carry generic equivalent of all drugs in the Primary Care Formulary and provide lists of therapeutic equivalents with prices • Health maintenance organizations (HMO) and life and non-life private health insurances to develop standard policies and plans that complement benefit packages of the NHIP to cover cost of amenities, good and amenities not covered by PhilHealth EQUITY • Preferential licensing of health facilities and contracting of health services in underserved areas • DOH to guarantee equitable distribution of health services and benefits; GIDA as priority • Prescribed allocation of authorized bed capacity for basic or ward accommodation: ≥90% in government hospitals, ≥70% in specialty hospitals, ≥10% in private hospitals GOVERNANCE AND ACCOUNTABILITY • Comprehensive and coordinated approach to health development with emphasis on scaling up health promotion and preventive care o Health Promotion Bureau: to improve health literacy and mainstream health promotion and protection § focus on reducing NCDs, implement population-wide health promotion programs and activities across social determinants of health o DepEd: schools are designated as healthy settings. § programs and modules on health literacy and rights to be integrated into the existing school curricula o LGU: to implement stricter policies: Strengthen and broaden existing policies, promote health literacy and healthy lifestyle, reduce prevalence of NCDs and their risk factors and lower incidence of new infectious diseases, and address mnental health issues and improve mental health indicators. • Submission of health and health-related data to PhilHealth as a requirement for all public and private, national and local health related entities to guide research and policymaking • Health Impact assessment as requisite for policies, programs and projects • Institutionalization of Health Technology Assessment (HTA) for development of policies and programs, regulation, and determination of range of entitlements, recommendatory to DOH and PhilHealth o Creation of Health Technology Assessment Council composed of health experts § facilitate recommendations, oversee HTA § review and assess existing DOH and PhilHealth benefit packages PENAL PROVISIONS • A health care provider contracted for the provision of individual-based health services who commits an unethical act, abuse of authority or fraud shall be punished by a fine of 200,000 pesos for each count, or suspension of contract up to three months. • The same shall constitute a criminal violation punishable by imprisonment for six (6) months and one (1) day up to six (6) years. HEALTH SECTOR STRATEGY • Country's vision, policy direction, and strategic objectives needed to accelerate the achievement of UHC • Build the health system’s resilience against future pandemics and health emergencies • Strategic thrusts o Enable Filipinos to be healthy o Protect Filipinos from health risks o Care for Filipinos’ health and wellness o Strengthen Health Institutions and Workforce Source: DOH PHILHEALTH • Philippine Health Insurance Corporation (PHIC), now also known as the National Health Insurance Program (NHIP) • Mandate: to provide health insurance coverage and ensure affordable, acceptable, available and accessible health care services for all citizens of the Philippines • Tax-exempt Government Corporation (attached to DOH) • Limited to paying for the utilization of health services • Enabling laws: o RA 7875 or National Health Insurance Act of 1995, as amended by RA 9241 and 10606 and IRRs o RA 11223 or UHC Act o IRR or RA 11228 or Act providing for mandatory PhilHealth Coverage for all PWDs HISTORY • Early 60s: The Philippine Medical Association introduced the MARIA Project, prioritizing aid to communities in need of medical assistance. o valuable precursor to the Medicare program, from which a medical care plan for the entire Philippines was created • 1969: Republic Act 6111 or the Philippine Medical Act was signed by President Ferdinand E. Marcos. • 1990s: vision for a better, more responsive government health care program was prompted by the passage of several bills with implications on health financing o The public's clamor for a health insurance that is more comprehensive in terms of covered population and benefits led to development of House Bill 14225 and Senate Bill 01738 which became The National Health Insurance Act of 1995 or Republic Act 7875 § Law paved the way for the creation of the Philippine Health Insurance Corporation (PhilHealth), mandated to provide social health insurance coverage to all Filipinos in 15 years' time. • PhilHealth assumed the responsibility of administering the former Medicare program for government and private sector employees from the GSIS, SSS, and OWWA Past board exam question: Some controversies and issues faced by PhilHealth: • allegations of fund mismanagement and overpricing • delayed payments to hospitals Dr. Tan MEMBERSHIP • Formal Economy: with formal contracts and fixed terms of employment, premium shared by employee and employer • Informal Economy o Migrant Workers o Informal sector o Self-Earning Individuals o Filipinos With Dual Citizenship o Naturalized Filipino Citizens o Citizens of other countries working and/or residing in the Philippines • Indigent: person who has no visible means of income, or whose income is insufficient for family subsistence, as identified by the DSWD based on specific criteria • Sponsored Member: member whose contribution is being paid by another individual, government agency, or private entity • Lifetime Member: member who has reached the age of retirement under the law and has paid at least 120 monthly premium contributions TOPNOTCH MEDICAL BOARD PREP PREVENTIVE MEDICINE AND PUBLIC HEALTH MAIN HANDOUT BY DR. MANN For inquiries visit www.topnotchboardprep.com.ph or email us at [email protected] This handout is only valid for the April 2024 PLE batch. This will be rendered obsolete for the next batch since we update our handouts regularly. Page 39 of 77 TOPNOTCH MEDICAL BOARD PREP PREVENTIVE MEDICINE AND PUBLIC HEALTH MAIN HANDOUT BY DR. MANN For inquiries visit www.topnotchboardprep.com.ph or https://www.facebook.com/topnotchmedicalboardprep/ This handout is only valid for April 2024 PLE batch. This will be rendered obsolete for the next batch since we update our handouts regularly. PhilHealth Membership Programs DIRECT CONTRIBUTORS Informal Formal Economy Economy Employees in the government, military or police force, political subdivisions, agencies or instrumentalities, constitutional commissions and is occupying either an elective or an appointive position. Private employee including corporations, partnerships or single proprietorships, NGOs, cooperatives, non-profit organizations, social civic or professional or charitable institutions based in the Philippines. Foreign governments or international organizations with quasi-state status. Foreign business organization based abroad with agreement with the corporation to cover their Filipino employees in Philhealth. Migrant workers (documented or undocumented Overseas Filipino Workers who are engaged in a remunerated activity in another country of which they are not citizens Informal sectorincludes street hawkers, market vendors, pedicab and tricycle drivers, small construction workers, and homebased industries and services Owners of micro enterprises Self-Earning individuals (Professionals: including doctors, lawyers, engineers, artists, architects and the like, businessmen, entrepreneurs, actors, actresses and other performers, news correspondents, professional athletes, coaches, trainers, and such other individuals) Owners of small, medium and large enterprises Filipinos with dual citizenship Household helpers Naturalized Filipino citizens (Commonwealth Act No. 473 or the Revised Naturalization Law) All other workers rendering services, whether in government or private offices such as job order contractors, project-based contractor Family Drivers Lifetime Members Individuals aged 60 years and above * Uniformed personnel (AFP, PNP, BJMP and BFP) aged 56 years and above* SSS underground miner-retirees aged 55 years above* SSS and GSIS Disability Pensioners prior to March 4, 1995 *Which and have paid at least 120 monthly contributions with PhilHealth and the former Medicare Programs of SSS and GSIS INDIRECT CONTRIBUTORS Indigent Sponsored Members Senior Citizen Members Members of the informal economy from the lower income segment who do not qualify for full subsidy under the means test rule of the DSWD, whose premium contribution shall be subsidized by the LGUs or shall be through cost-sharing mechanisms between/among LGUs, and/or legislative sponsors, and/or other sponsors and/or the member, including the National Government Persons who have no visible means of income, or whose income is insufficient for family subsidence, as identified by the DSWD based on specific criteria Orphans, abandoned (children who have no known family willing and capable to take care of them and are under the care of the DSWD, orphanages, churches and other institutions) and abused minors, out-of-school youths, street children, persons with disability (PWD), senior citizens and battered women under the care of the DSWD, or any of its accredited institutions run by NGOs or any non-profit private organizations, whose premium contributions shall be paid for by the DSWD Barangay health workers, nutrition scholars, barangay tanods, SK Officials, and other barangay workers and volunteers, whose premium contributions shall be fully borne by the LGUs concerned Filipino citizens who are residents of the Philippines, aged sixty (60) years or above and are not currently covered by any membership category of PhilHealth; Qualified dependents of senior citizen members who are also senior citizen themselves Qualified dependents of members belonging to other membership categories, with or without coverage who are senior citizens themselves Senior Citizens who are gainfully employed or who remain to have regular sources of income shall continue to pay their premium contributions to PhilHealth under the applicable membership categories Un-enrolled women who are about to give birth, whose premium contributions shall be fully borne by the National Government and/or LGUs and/or legislative sponsors or the DSWD if such woman is an indigent as determined by it through the means test. Citizens of other countries and/or residing in the Philippines All Filipinos aged 21 years and above with capacity to pay. Beneficiaries of Pantawid Pamilyang Pilipino Program All Filipinos aged 21 years old and above without capacity to pay premiums. https://www.philhealth.gov.ph/circulars/2014/circ33_2014.pdf https://www.philhealth.gov.ph/members/#gsc.tab=0 ✓GUIDE QUESTIONS Aling Myrna, 69/F working as a BHW in a small city of Kalayaan, Palawan. As of this moment, she already paid 123 monthly contributions to PhilHealth. What category does she belong to? A. Direct ; Formal Economy B. Direct ; Lifetime Member C. Indirect ; Sponsored Member D. Indirect ; Senior Citizen Answer: B Senior citizens who are still working and contributing to PhilHealth can continue contributing until able, and are categorized as a LIFETIME MEMBER kung meron kang at least 120 monthly contributions. Comparing it to the SENIOR CITIZEN category which is granted to everyone ≥60 years old on the basis of age. Do not confuse LIFETIME MEMBERSHIP VS SENIOR CITIZEN MEMBERSHIP. Yung lifetime membership na earn mo as a contributor; Senior Citizen membership, binigay sayo ng Batas which is RA 10645 (An act providing for the Mandatory Philhealth Coverage for all Senior Citizens) Dr. Virata and Dr. de la Rosa BENEFIT ENTITLEMENTS Z BENEFITS • Benefit packages focused on providing relevant financial risk protection against illnesses perceived as medically and economically catastrophic. o Acute Lymphocytic / Lymphoblastic Leukemia (standard risk) o Breast Cancer (Stage 0 to IIIA) o Prostate Cancer (low-to-immediate risk) o End-stage renal disease eligible for requiring kidney transplantation o Coronary Artery Bypass Graft Surgery o Surgery for Tetralogy of Fallot in Children o Surgery for Ventricular Septal Defect in Children o Z- MORPH § Mobility § Orthosis § Rehabilitation § Prosthesis Help o Expanded Z- MORPH (Orthopedic Implants) TOPNOTCH MEDICAL BOARD PREP PREVENTIVE MEDICINE AND PUBLIC HEALTH MAIN HANDOUT BY DR. MANN For inquiries visit www.topnotchboardprep.com.ph or email us at [email protected] This handout is only valid for the April 2024 PLE batch. This will be rendered obsolete for the next batch since we update our handouts regularly. Page 40 of 77