A Brief Overview of the Philippine Healthcare System
Summary
TLDRThis video offers an insightful look into the Philippine Healthcare System, exploring its six critical building blocks through the lens of a Filipino couple, Jacob and Althea. It delves into service delivery, healthcare workforce, essential medicines, health information, health financing, and government leadership. The video highlights the system's challenges, such as uneven distribution of healthcare facilities, shortages of healthcare workers, and issues with essential medicines availability. It also discusses the impact of government policies and devolution on healthcare services, providing a comprehensive yet concise overview of the current state of healthcare in the Philippines.
Takeaways
- π₯ The Philippines has a diverse healthcare system with both public and private providers, including over 22,000 public health stations and various levels of hospitals.
- π€° For expectant couples like Jacob and Althea, the Philippine healthcare system offers a range of services from prenatal care to birthing facilities, with over 1,900 licensed birthing homes and hundreds of thousands of hospital beds.
- π Hospital capacity in the Philippines is categorized into three levels based on the severity and complexity of conditions, with 750 level one hospitals for basic care, 327 level two hospitals for intensive care, and 120 tertiary hospitals for specialist treatment.
- π©ββοΈ The Philippine healthcare workforce is substantial, with over 90,000 nurses, 40,000 doctors, 43,000 midwives, and 13,000 medical technologists employed in institutions as of 2017.
- π Essential medicines and medical devices are generally available in public health centers, but there can be inconsistencies in supply, with private pharmacies and medical device resellers as alternatives.
- π The Philippine healthcare system tracks diseases like Dengue, Tuberculosis, and HIV to monitor and manage outbreaks, with various bureaus and institutions under the Department of Health (DoH) responsible for data collection.
- π» Health information systems in the Philippines are still developing, with efforts to modernize and digitize, though electronic medical record systems are not as widespread as in developed countries.
- π° Healthcare costs in the Philippines amount to 1.18 trillion pesos annually, roughly 6% of the GDP, with a significant portion (41.5%) being out-of-pocket expenses for individuals.
- π Government and leadership play a crucial role in the healthcare system, with devolution transferring power from the national to local governments, which can lead to conflicts and resource disparities.
- π Geographic disparities exist in healthcare service delivery, with urban areas having more facilities, leading to overutilization of larger hospitals and underutilization of rural health centers.
- πΌ There is a shortage of healthcare workers in the Philippines, with many trained professionals either concentrated in cities or choosing to work abroad or in other industries due to better pay and conditions.
Q & A
What are the six building blocks of a healthcare system as mentioned in the script?
-The six building blocks of a healthcare system are service delivery, healthcare workforce, availability of essential medicines and medical devices, health information, health financing, and government and leadership.
What types of healthcare providers are available in the Philippines according to the script?
-In the Philippines, there are public and private healthcare providers, including over 22,000 public barangay health stations, 2500 primary healthcare facilities, rural health units, outpatient departments of approximately 1200 hospitals, and private health clinics and teleconsultation services.
How does the script describe the hospital capacity and capability in the Philippines?
-The script describes three levels of hospital capacity and capability in the Philippines: Level one hospitals for simple cases, level two hospitals for intensive care or procedures, and tertiary level hospitals for severe or rare diseases, with 750, 327, and 120 hospitals at each level respectively.
What is the role of the barangay health stations in the healthcare system of the Philippines?
-Barangay health stations play a crucial role in the healthcare system of the Philippines by providing primary healthcare services, including well-baby care, to the community. However, they may not always have healthcare workers on duty, with only about 90 of the 22,000 stations having a nurse or midwife on duty.
How does the script address the issue of healthcare workforce in the Philippines?
-The script highlights that as of 2017, the Philippines had over 90,000 nurses, 40,000 doctors, 43,000 midwives, and 13,000 medical technologists employed in institutions. It also points out issues such as the concentration of healthcare workers in urban areas and the outmigration of trained professionals.
What challenges does the script mention regarding the availability of essential medicines and medical devices in the Philippines?
-The script mentions that while essential medicines and medical devices are often available, there can be variability in supply, with some primary health centers having essential medicines only about 57 to 76 percent of the time, and level 2 hospitals or higher at about 23 to 77 percent availability.
How does the script discuss the issue of health financing in the Philippines?
-The script discusses that the Philippines spends approximately 1.18 trillion pesos annually on healthcare costs, which is about 6% of the GDP. It also mentions that 41.5% of total health expenditure is out-of-pocket, with about 50.3% covered by government schemes and 8.2% by private health insurance.
What is the significance of the devolution in the Philippine healthcare system as mentioned in the script?
-Devolution in the Philippine healthcare system means the transfer of power from the national government to local governments, with the national government setting guidelines and standards. This has implications for the distribution of healthcare services and funding, and can lead to issues such as conflicts over politics and jurisdiction.
What are some of the problems with the healthcare infrastructure in the Philippines as described in the script?
-The script describes several problems with the healthcare infrastructure in the Philippines, including a shortage of hospital beds relative to the population, an uneven distribution of healthcare facilities with a concentration in urban areas, and a shortage of healthcare workers, especially in rural areas.
How does the script suggest the private healthcare sector complements the public sector in the Philippines?
-The script suggests that the private healthcare sector in the Philippines complements the public sector by providing services such as private pharmacies and medical device resellers, which can help alleviate gaps in the public healthcare sector, especially when there are deficiencies.
What is the role of telemedicine in the Philippine healthcare system as highlighted in the script?
-The script highlights that telemedicine has grown considerably in the Philippines since the start of the pandemic, offering an alternative means of healthcare delivery, especially in situations where physical access to healthcare facilities is limited.
Outlines
π₯ Introduction to the Philippine Healthcare System
The video introduces the Philippine Healthcare System through the lens of a Filipino couple, Jacob and Althea, who are planning to start a family. It outlines the six building blocks of any healthcare system and discusses the first block, Service Delivery. The Philippines has a dual healthcare system with both public and private providers, including over 22,000 public health stations, 1200 hospitals, and various private clinics. The video also touches on the availability of birthing homes and the three levels of hospital capacity and capability, which range from basic care to specialist treatment. It mentions the pre-pandemic numbers of various health facilities and the potential for seeking healthcare outside the Philippines.
π©ββοΈ Healthcare Workforce and Essential Medicines
The second building block discussed is the Philippine Healthcare Workforce. The video highlights the challenges of healthcare worker availability, with only about 90% of health stations having a nurse or midwife on duty, and less than 10% having a doctor. It also covers the statistics of healthcare professionals in the Philippines, including over 90,000 nurses, 40,000 doctors, and 43,000 midwives. The third building block is the availability of essential medicines and medical devices, which are sometimes inconsistently available in public health centers. The video contrasts this with the private sector, which has 29,000 pharmacies and numerous medical device resellers to help fill the gaps in public healthcare.
π Special Concerns, Health Information, and Financing
The video addresses the special public health concerns like Dengue, tuberculosis, and HIV, which are monitored by a network of facilities reporting to the Department of Health (DoH). It discusses the fifth building block, Health Information, and the challenges in modernizing and digitizing health information systems in the Philippines. The sixth and final building block, Health Financing, is also covered, detailing the annual healthcare costs for the Philippines, which amount to 1.18 trillion pesos or about 6% of the GDP. The video explains how healthcare is primarily funded through out-of-pocket payments and government subsidies, with a smaller portion funded by private health insurance. It also touches on the issues of healthcare infrastructure, such as the insufficient number of hospital beds and the urban concentration of healthcare facilities.
Mindmap
Keywords
π‘Archipelago
π‘Healthcare System
π‘Service Delivery
π‘Public Health
π‘Private Healthcare
π‘Healthcare Workforce
π‘Essential Medicines
π‘Telemedicine
π‘Health Information Systems
π‘Healthcare Finances
π‘Devolution
Highlights
The Philippines, an archipelago with over 7,000 islands, has a healthcare system serving more than 110 million people.
The Philippine Healthcare System is composed of six building blocks, each crucial for the system's functionality.
Service delivery includes both public and private healthcare providers, offering a range of services from barangay health stations to tertiary hospitals.
The country has over 22,000 public health stations and 1,900 licensed birthing homes, indicating a widespread service network.
Hospital beds are categorized into three levels based on the severity and complexity of care needed, with 750 level one hospitals, 327 level two, and 120 tertiary hospitals.
The Philippine Healthcare Workforce comprises over 90,000 nurses, 40,000 doctors, and 43,000 midwives as of 2017.
Essential medicines and medical devices are sometimes available inconsistently, with public health centers having essential medicines about 57-76% of the time.
The Philippines has a robust private sector with 29,000 private pharmacies to supplement public healthcare deficiencies.
Disease surveillance is a key aspect of the healthcare system, with a network for monitoring and reporting diseases like Dengue, tuberculosis, and HIV.
Healthcare financing in the Philippines accounts for 6% of the GDP, with significant personal out-of-pocket expenses.
Government schemes like PhilHealth cover a portion of healthcare costs, but out-of-pocket payments remain high at 41.5% of total health expenditure.
Healthcare infrastructure faces challenges with an average of 1.2 hospital beds per 1,000 people, leading to potential shortages.
Healthcare workers are in short supply, with many trained professionals choosing to work abroad or in non-medical sectors due to better pay and conditions.
The devolution of the healthcare system has led to a distribution of power from the national to local governments, with mixed outcomes.
Conflicts between politics and jurisdiction can affect the quality and accessibility of healthcare services.
The Philippine Healthcare System faces issues of funding, healthcare workforce, and leadership that impact the quality of care provided.
Transcripts
in an archipelago with over 7 000
Islands somewhere in Southeast Asia with
more than 110 million people we have the
Philippines and this video is about the
Philippine Healthcare System there are
six building blocks in any Healthcare
System and we will briefly discuss them
one by one but first let me introduce
you to a Filipino couple let us name
them
Jacob and Althea let's say Jacob and
Althea are planning to start a family
and just want to ask a professional how
reproductive Health Works what should
they do what to expect in the next
couple of months depending on the
severity and urgency of their Healthcare
concerns Jacob and Althea have several
providers to choose from this is where
the first building block in the
Philippine Healthcare System comes in
Service delivery the Philippines has
both public and private healthcare
providers functioning in parallel and
most of the time working together Gekko
Ben Althea could go to more than 22 000
Public barangay Health stations in 2500
Primary Healthcare facilities rural
Health units or barangay health centers
are issues and bhcs there are also
outpatient Departments of approximately
1200 hospitals of various capacity and
of course there are also Private health
clinics and private and public
teleconsultation services available in
the country after a couple of months and
Althea is already 38 weeks pregnant and
needed to give birth the Philippines has
over 1 900 licensed birthing homes that
could help her deliver her beef B if her
case was more complicated then she must
go to a hospital to give birth if Jacob
suddenly became sick for some reason
probably unrelated to the baby and he
needed to be hospitalized the
Philippines have hundreds of thousands
of hospital beds divided in three levels
of Hospital capacity and capability the
choice of level of hospitals depends on
the severity and complexity of Jacob's
condition for simple cases that only
require short-term admission and basic
care the Philippines have 750 level one
hospitals if Jacob needed intensive care
or procedures we have 327 level 2
hospitals and if he developed a really
severe or rare disease that would
require prologue or specialist treatment
the Philippines have 120 tertiary level
hospitals this is your end referral
facilities and the last option if Jacob
requires that level of care and of
course he could always go to another
country like Singapore if he wants to
get health care outside of the
Philippines
other important numbers in the
Philippine Health Services we have 30
psychiatric facilities 499 dialysis
centers 2000 general clinic Laboratories
or diagnostic Centers 1000 x-rays 400 CT
scans and 109 MRIs MRIs whatever eyes
these are the pre-pandemic numbers and
of course we're going to talk about
issues of the healthcare service
delivery in the Philippines and the
entire Philippine Healthcare System in
general but for now let's talk about the
second building block the Philippine
Healthcare Workforce
so going back Althea gave birth to a
baby let's name her baby Corona and both
mom and baby were healthy that's good
news they decided to bring baby Corona
to a barangay health station for a
well-chat visit because that's what
you're supposed to do even if you have a
normal delivery you still have to do a
well-child visit unfortunately not all
Health stations have healthcare workers
on duty only about 90 of the 22 000
Health stations have either a nurse or a
midwife on duty less than 10 percent of
them have an accompanying Doctors on
Duty our nurses and midwives on duty in
this barangay health stations can still
provide well baby care because they are
trained to provide them but if the
family wants baby Corona to be seen by a
doctor then they have to bring the baby
to the nearest bhcs or rhus this each
season are shoes have doctors specialist
nurses midwives medical technologists
and some even have pharmacies and
dentists on board and again there are
always hospitals and medical clinics if
that's what you prefer my point is as of
2017 the Philippines has over 90 000
nurses 40 000 doctors 43 000 midwives
and 13 000 med techs that are employed
in an institution there are more
healthcare workers that are not employed
in any institutions working in private
and these statistics are from five years
ago so the numbers probably changed and
practicing professionals probably
changed by then and of course the
healthcare workers in the Philippine
Health System have issues let's not talk
about it right now let's jump to the
next building block availability of
essential medicine and medical devices
or baby Corona would require medications
the public health service providers in
the Philippines sometimes have all the
essential medicines and medical devices
available sometimes there is this study
from a couple of years ago that states
majority of the primary health centers
have essential medicines available of
about 57 to 76 percent of the time for
level 2 hospitals or higher essential
drug availability was only about 23 to
77 percent if you ever work at a public
Hospital you would feel like sometimes
there are days when almost all medicines
are available and there are days where
no medicines are available at all like
literally nothing the hospital is just
like a building with no supplies
of course if Jacob and Althea cannot
obtain their medication or medical
devices from the public health sector
they can always purchase from the 29 000
private pharmacies and thousands of
medical device resellers in the country
I hope you are seeing a pattern here
whenever there is a deficiency in the
Philippine Public Health sector there is
usually a private provider that could at
least to some extent help alleviate that
Gap so remember when Jacob got sick
let's say he was diagnosed with Dengue
because of course it's Dengue and
there's a freaking Dengue outbreak in
the Philippines while I was researching
this video and nobody seems to be
talking about it Dengue some diseases
like Dengue tuberculosis HIV among
others are of special particular public
health concerns that the Philippine
Healthcare System have a network of
collecting statistics and reporting to
the local government the Doh and the
national government this is in theory to
monitor the possible outbreaks of
diseases epidemics and pandemics so the
public health officials can formulate an
early enough response to prevent and
manage the spread of these illnesses
this is where the care information comes
in the Port building block of the
Philippine Healthcare System we have
several bureaus under the Doh and
independent institutions to collect this
data the Philippines have several
attempts to modernize and digitize the
health information systems such as
ehealth Solutions and pillow Health's
electronic insurance claims
unfortunately electronic medical record
system in the Philippines are still
primitive and not as ubiquitous as those
in developed countries
telemedicine however has grown
considerably since the start of the
pandemic so that's a good thing maybe I
don't know
when it comes to health finances the
Philippines is spending 1.18 trillion
with a t trillion pesos every year for
its healthcare costs that is
approximately six percent of the
Philippines GTP and each Filipino spends
over 9800 every year for their personal
health care costs so how does Jacob and
Althea pay for their Family Healthcare
most likely from their own wallets with
subsidies from the government which is
basically taxes that is also from your
wallet 41.5 of Total Health expenditure
in the Philippines is out of pocket that
is easy to understand
then about 50.3 percent are government
schemes including peel Health where the
government takes money in the productive
members of society pulls it in a fund
and use it to reimburse healthcare
providers for service are built by Phil
Health members included in the
government schemes are the 270 billion
pesos of funding for the Department of
Health of the Philippines yes 270
billion with a B that is how much money
is allocated for the Department of
Health of the Philippines of course they
need to spend a lot of money because we
are still in the pandemic and they need
to buy their laptops and they need to
hire a new health secretary you know
Healthcare is really expensive a small
portion about 8.2 percent are funded by
Private health insurance that is if you
ask me has its own issues but let's talk
about it in another video so all these
numbers I had mentioned are used by the
Philippine government to make Jacob
ataya and baby Corona's Health promoted
restore and maintained because the
government are nice and good people and
it's mandated in the Philippine
Constitution or something okay that's
already five of the six building blocks
before we continue let's talk about some
of the problems with the health
infrastructure in the Philippines
you may think over 100 000 beds are a
lot but considering there are over 100
million Filipinos already that's only
approximately 1.2 beds per 1000 possible
patients are available so if Jacob and
Althea live in a bronchi of 1000 people
and both of them got sick the
unfortunate reality is they are going to
have to share the hospital bed along
with everyone else in the barangay that
will get sick especially in a pandemic a
hundred thousands of hospital beds are
not enough hospital beds for the
Philippines other issues about Health
Service delivery majority of our
facilities are found in the urban areas
especially in the cities of the national
capital region and adjacent provinces so
what usually happens is when a patient
from a remote region in the country
requires Health Service and they have to
travel more than 30 minutes to the
nearest facility they usually decide to
ignore the barangay health stations and
health centers and go straight to the
big hospital so you will see scenes like
this and this and this overwhelming the
secondary and tertiary level Hospital
girls and everyone suppers and since
this setup makes it so hard for some
people to seek professional help many
often decide not to get a consult or
seek help until they are already really
really sick or Worse sometimes they just
die without being seen by any Healthcare
professional like zero consult since
birth
okay about human resource side there is
a petrol shortage of healthcare workers
in the Philippines therefore it is in my
opinion that the Philippines has among
the best trained healthcare workers in
the world especially our nurses their
top tier well-trained export quality
they are sought after by many developed
countries because of reasons but the
problem is still there healthcare
workers are at a constant shortage we
train a lot of nurses and doctors and
other Allied health professionals but
most of them are either concentrated in
cities like in the Health Service
delivery problem all over again or the
trained professionals don't stay in the
Philippine healthcare industry they
would rather either go outside of the
country to practice their profession or
go to a BPO company because it makes
sense for them pay is higher work hours
are better I don't know if it's less
stressful or less toxic than being in a
hospital or not but if it's more
stressful and more toxic why are you
staying in that company
when it comes to essential medicines and
medical devices majority of the time
they are readily available like I
mentioned earlier except that one time
when there was a paracetamol shortage in
the Philippines because Filipinos are
humans that make human decision you
might also encounter issues for The
Uncommon medications especially the
breaded ones but if you make an effort
you're probably going to be able to get
the medications you might need
when it comes to prices I know it is
expensive but the Philippines already
have among the better price controls
compared to other countries maybe I
don't have evidence for this the main
problem is since the medication expense
are usually shouldered out of pocket by
the patients accumulating cost becomes
really really expensive really really
fast
with all the complexities and numbers
and issues we discussed that lead us to
the six building block of the Philippine
Healthcare System that is supposed to
solve majority of these issues
government and Leadership
since the Devolution of the Philippine
Healthcare System the structure of
leadership and power are distributed
more in the local side with guidelines
and standards set by the national
government Revolution does not
necessarily mean things are getting
better or worse Devolution in this
context just means the power is
transferred from the national government
to the local government and there are
several issues about that the Doh
Philippines only handles a few tertiary
level and Specialty hospitals while the
provincial government handles the
regional and District hospitals certain
cities in the Philippines have become so
large that they manage their own
independent city hospitals and the rural
Health units at barangay Health Centers
and stations are managed by the mayors
of municipalities concerns of this type
of leadership structure is that there is
often conflicts with politics and
jurisdiction why would the patient from
Imus Cavite go to a public Hospital in
Metro Manila for Health Services when
there is already public health
facilities in Imus those are just minor
issues publicly health workers would
still provide services to every patient
wherever they come from the problem is
certain facilities are over utilized and
under resource while other facilities
are underutilized and over resource
another possible issue that might arise
in this kind of system is that the
responsibility of providing healthcare
service to citizens are being
transferred to the lgu but the funding
is not being transferred to the lgu so
lack of funding lack of healthcare
Workforce means less healthcare for the
people
each building block probably deserves a
bit of its own if you want an in-depth
explanation maybe as some other content
creator could do a video about it or
wait maybe I'll do a video about it in
the future I don't know I guess that's
it a brief overview of the healthcare
system of the Philippines hope you like
it if you have any questions write it
down in the comment section if you have
ideas on how to fix the issues of the
Philippine Healthcare System maybe you
should be the health secretary or
something or run for the president maybe
I don't know you do you I'll just do me
thanks for watching goodbye
[Music]
we beat
it so congratulations Philippines
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