Policy Planning in Health Care - Group 1 - DMD 1-1 - November 2024 PDF

POLICY PLANNING IN HEALTH CARE, ECONOMIC CONTEXT OF HEALTH, & REGULATION OF HEALTH POLICIES Submitted by: Group 1 DMD 1-1 Submitted to: Dr. David Fernandez November 2024 ...

POLICY PLANNING IN HEALTH CARE, ECONOMIC CONTEXT OF HEALTH, & REGULATION OF HEALTH POLICIES Submitted by: Group 1 DMD 1-1 Submitted to: Dr. David Fernandez November 2024  1 Overview This is a written report of the last discussion presented by Group 1. Additionally, the answer to the question asked after the presentation is provided in the very last part. This report includes the following: I. Policy Planning in Healthcare II. Economic Context in Health III. Regulation of Health Policy I. POLICY PLANNING IN HEALTHCARE Universal healthcare or Kalusugan Pangkalahatan This aims to provide all Filipinos with equitable access to quality healthcare. This is the primary goal of every country. Policy Formation It was initiated through DOH Administrative Order No. 2010-0036 titled "The Aquino Health Agenda: Achieving Universal Health Care for All Filipinos.” This has 3 Strategic Thrusts: Financial Risk Protection; Improved Access to Quality Health Services; and Health-Related Goals 1. Financial Risk Protection - through expansion of enrolment and benefit delivery of the NHIP 2. Improved Access to Quality Health Services 3. Health-Related Goals - including for NCDs and their health-related risk factors (Department of Health, 2010b). Six Critical Building Blocks a. Service Delivery - to address variations in health service utilization and health outcomes across socioeconomic variables. b. Health Workforce - to ensure that all Filipinos have access to professional health-care providers, capable of meeting their health needs at the appropriate level of care. c. Health Financing - to increase resources for health that will be effectively allocated and utilized to improve the financial protection of the poor and vulnerable sectors d. Health Information - to establish a modern information system that will provide evidence for policy and program development and support (Department of Health, 2010b).  2 e. Medicine and Technology - to ensure equitable access to health services, essential medicines, and technologies of assured quality, availability, and safety. f. Leadership and Governance - to establish the mechanisms for efficiency, transparency, and accountability and prevent opportunities for fraud Service Delivery Networks Administrative Order No. 2014–0046, promoting SDNs, was introduced by the DOH in 2014. These networks connect public and private health providers to deliver a core set of integrated health services. Further enhances the capacity to meet population health needs. Development Process Involves creating health policies at the national level extending to Local Government Units. Emphasizes the structured approach in formulating policies that affect service delivery among different levels of government. Health Planning Process Done through an Interactive Cycle that builds on achievements and lessons learned from the previous health plans. Involves the following stages: a. Situational Analysis b. Goal Setting c. Programming & Budgeting d. Implementation e. Monitoring & Evaluation Health Human Resource Planning Involves the development of strategic plans for the workforce. Ensures the necessary human resources meet the health care demands. Health Facility Planning Refers to planning for the development and improvements of health facilities. Philippine Hospital Development Plan (1995) - was implemented to enhance hospital services and was revised in 2000 along with the health sector reform.  3 II. ECONOMIC CONTEXT OF HEALTH Economic factors and conditions have a huge impact on the health outcomes of people, the working of healthcare systems, and the access to medical care. These factors include income level, employment, stable housing, and a more general socioeconomic environment in which an individual lives that determines his ability to pay for necessities such as good nutrition, safe housing, and healthcare services. For example, in less wealthy communities, the number of quality health facilities also could be limited, and so also affects how individuals might receive some treatment for chronic conditions and preventive care. Healthcare systems respond to economic conditions, which consist of funding sources of the government, insurance structures, and availability of resources. The influence of funding sources may lead to shortages of staff members, old equipment, or long wait times and thus deny access and quality of care. Economic policies on insurance coverage or pharmaceutical prices can establish who can afford essential drugs or treatments.  4 III. REGULATION OF HEALTH POLICIES At this part of the discussion, each section was discussed to provide much thorough explanation of how the policies are regulated and monitored. These are the regulations of the health policy included in this discussion: A. Safety and Quality (Section 27) B. Affordability and Pricing (Section 28) C. Equity and Accessibility (Section 29) A. Safety and Quality (Section 27) 1. PhilHealth Rating System: ○ Establishes incentives for health facilities based on quality, efficiency, and equity. ○ Measures include care quality, patient satisfaction, compliance with standards, and proper use of resources. 2. Licensing and Regulation of Health Facilities: ○ DOH will license and regulate health facilities (including mobile and digital services). ○ Licenses are valid for three years, with enforcement mechanisms extended to regional levels. 3. Clinical Practice Guidelines (CPGs): ○ DOH will develop and monitor CPGs with input from experts, ensuring care is evidence-based. B. Affordability and Pricing (Section 28) 1. Price Reference Indices: ○ DOH will maintain updated reference prices for drugs, medical devices, and supplies to prevent overpricing. ○ DOH and PhilHealth will monitor and enforce compliance with these indices. 2. Centralized Price Negotiation: ○ An independent board will negotiate prices for high-cost or single-source products to ensure affordability. 3. Mark-up Regulations: ○ DOH-owned facilities must adhere to set mark-ups on drugs and supplies to avoid excessive charges.  5 4. Public Price Transparency: ○ Health providers must disclose the prices of services and goods to the public and submit data to the DOH and PhilHealth. 5. Promotion of Generic Drugs: ○ Drug outlets must offer fairly priced generic alternatives and cannot withhold these from consumers. C. Equity and Accessibility (Section 29) 1. Preferential Licensing for Underserved Areas: ○ The DOH will prioritize licensing and contracting services in underserved or geographically isolated areas (GIDAs). ○ Incentives will be provided to facilities operating in these areas to maintain service sustainability. 2. Hospital Bed Capacity Requirements: ○ Government hospitals must allocate at least 90% of their bed capacity to basic ward accommodations. ○ Specialty hospitals must reserve at least 70% of their beds for wards, while private hospitals must allocate at least 10%. 3. Support for GIDAs: ○ LGUs, PhilHealth, and DOH will provide additional resources, infrastructure, and health workers in underserved areas to promote equitable service distribution. Standards by GIDAs to dictate which rural area should be prioritized Numerous factors are taken into consideration in order to guarantee equitable healthcare. Disparities in healthcare in such regions are being actively addressed by the Department of Health (DOH), indicating that several factors are probably taken into account when setting priorities. DOH guidelines state that geographic factors like difficult terrain (island, landlocked, or upland) and socioeconomic factors like high poverty, crisis susceptibility, and inadequate infrastructure characterize GIDAs. Access to medical facilities becomes more difficult because these regions are frequently far from the cities. Another important consideration is the availability of medical professionals, since programs such as the Doctor to the Barrios (DTTB) program may target underserved areas in terms of healthcare providers. Furthermore, determining areas of need may also be aided by community engagement, which includes feedback from regional leaders and organizations (Alzate 2024).  6 References Alzate, S. (2024, April 25). Healthcare for geographically isolated and disadvantaged areas (GIDAs). Medical Channel Asia. https://medicalchannelasia.com/healthcare-for-geographically-isolated-and-disadvantaged -areas-gidas/ Dayrit, M. et al. (2018). The Philippines Health System Review. Health Systems in Transition, Vol. 8 https://iris.who.int/bitstream/handle/10665/274 579/9789290226734-eng.pdf Department of Health & PhilHealth. (n.d.). IMPLEMENTING RULES AND REGULATIONS OF THE UNIVERSAL HEALTH CARE ACT. (REPUBLIC ACT NO. 11223). https://www.philhealth.gov.ph/about_us/UHC IRR_Signed.pdf Philippines - healthcare. (2024, January 23). International Trade Administration | Trade.gov. https://www.trade.gov/country-commercial guides/philippines-healthcare