Surian sa mga Pag-aaral Pangkaunlaran ng Pilipinas
Vol. XXVIII No.4
Editor's Notes Consider this scene: A long line of people — many coming from nearby towns and provinces — is seen queuing up for emergency treatment and admission in a government-sponsored hospital. Chances are, though, that not all of them will be attended to immediately nor be accepted for hospital admission. There are simply not enough medical personnel or space for hospital confinement that will be able to accommodate them. The ones to be served will mostly be those with the most critical condition. But almost every Filipino dreams of being able to access inexpensive (if not totally free) but adequate health care service from the government for his health needs, be they critical or not. This is true especially for those in the lower income strata. After all, to be poor is already difficult; and to suffer from illnesses without resources to hold on to nor services and facilities to access to makes it doubly aggravating for them. Traditionally, an ordinary citizen would go to a clinic or barangay health unit (BHU) for his immediate or primary health needs. If his health requirements call for more complicated solutions, then he would be referred to the next higher level of health care unit and so on. 16
What's Inside 8 Regional forum scores institutional problems in water service delivery
12 World report: low carbon economy key to global development
14 PIDS Corner launched in Butuan City 15 Philippines hosts annual conference on East Asia cooperation
DEVELOPMENT RESEARCH NEWS July - August 2010
ISSN 0115-9097
How are government hospitals performing?
http://www.doh.gov.ph/qmmc
PHILIPPI NE INSTITUTE FOR DEVELOPMENT STUDIES
H
ealth care service in the country is designed to be delivered under a referral network. It starts with the barangay health workers (BHWs) incharge of barangay health stations (BHS). The BHWs, in turn, report to city health offices (CHOs) in cities or rural health units (RHUs) in towns. The CHOs and RHUs employ doctors, nurses, midwives, and other relevant health workers who refer patients to primary hospitals which, on the average, are small and only have 25 beds. Consistent to its term, primary and noncritical conditions are to be attended at the primary hospitals. Secondary hospitals attend to acute cases while final referrals are brought to medical centers, regional, and specialty care hospitals, collectively called tertiary hospitals. However, with the passing of the Local Government Code in 1992, facilities were devolved to different LGUs, with BHS and RHUs being assigned to municipalities and cities, hospitals to provinces while specialized hospitals remain under the Department of Health(DOH). The consequence was the fragmentation of the referral network. In cases where primary healthcare facilities experience stock-outs and personnel shortages, households opt to go directly to hospitals for treatment. Patients with conditions ranging from stable up to critical prefer to visit tertiary hospitals for check-ups and treatments. The DOH-retained tertiary hospitals which are programmed to accommodate serious cases are compelled to cater to those that primary or secondary hospitals should handle. These DOH-retained tertiary hospitals thus need more financial resources to attend to all their patients as these become overcrowded with many patients who are waiting for check-ups, laboratory procedures, and admission. But how well do these hospitals spend their resources? While admittedly, DOH-retained hospitals play a key role in the health care sector and deserve to have respectable budgets for their needs, are they able to properly allocate and monitor their budgets so that the affordability and quality of their services are ensured?