LEVEL OF KNOWLEDGE AND AWARENESS OF THE RESIDENTS IN SELECTED CITIES IN NEGROS

OCCIDENTAL ON THEIR HEALTHCARE RIGHTS

Alyssa Gwen M. Geroso

Colegio San-Agustin Bacolod
B. S. Aquino Drive, Bacolod City, Philippines

Arielle Ciara B. Bajada

Colegio San-Agustin Bacolod
B. S. Aquino Drive, Bacolod City, Philippines

Arturo Jr. D. Dejos

Colegio San-Agustin Bacolod
B. S. Aquino Drive, Bacolod City, Philippines

Ilah Marie M. Dignos

Colegio San-Agustin Bacolod
B. S. Aquino Drive, Bacolod City, Philippines

Jiah Lorren T. Buenconsejo

Colegio San-Agustin Bacolod
B. S. Aquino Drive, Bacolod City, Philippines

Kaiye Angela T. Espora

Colegio San-Agustin Bacolod
B. S. Aquino Drive, Bacolod City, Philippines

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 LEVEL OF KNOWLEDGE AND AWARENESS OF THE RESIDENTS IN SELECTED CITIES IN NEGROS
OCCIDENTAL ON THEIR HEALTHCARE RIGHTS

Alyssa Gwen M. Geroso1, Arielle Ciara B. Bajada1, Arturo Jr. D. Dejos1, Ilah Marie M. Dignos1,
Jiah Lorren T. Buenconsejo1 and Kaiye Angela T. Espora1

1
Colegio San Agustin – Bacolod, Philippines

Abstract:

Background and Aims: Determining one's level of awareness and knowledge towards Healthcare rights

is important throughout treatment as people often are unaware of their individual rights because such

rights are either not clearly stated or are contained in a bundle of paperwork that patients must sign

before registration. The study determined the extent of one’s level of awareness and knowledge

towards Healthcare rights in the three different cities namely: Bacolod City, Sagay City and Escalante City

considering variables such as the age group, sex, level of education, city of residence, if they have ever

been a patient or have visited a healthcare facility and monthly family income.

Methods: A total of 754 respondents male and female of ages 20 to 59 were qualified as the study’s

respondents. The survey questionnaires were analyzed with the use of the frequency and percentage,

median and median absolute deviation.

Results: Out of the supposed 1,150 respondents, only 754 were gathered and qualified to participate in

the study. From these 754 respondents, using median and absolute deviation, the study found out that

in terms of age group, those who are 25-29,30-34,35-30,40-44,45-49,50-54,55-59 are fully aware and

knowledgeable than ages 20-24. Based on sex, females are fully aware as well as fully knowledgeable of

their rights than men but when taken as a whole both are moderately aware and knowledgeable. On the

level of education, respondents who have completed their high school education, which includes college

undergraduates, are fully aware and knowledgeable of their healthcare rights than elementary and

college graduates. As for the city of residence, despite Sagay being a third-class component city, they

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are fully aware as well as fully knowledgeable compared to Escalante City and Bacolod City. Based on

whether the respondents have been a patient or has visited a healthcare facility, the study found that

those who did not experience being a patient or have visited a healthcare facility are more aware and

knowledgeable. Lastly, based on the monthly family income, those who belong to the upper-middle

class are fully aware and knowledgeable as compared to those who belong to other categories.

Conclusions: Considering variables such as the age group, sex, level of education, city of residence, if

they have ever been a patient or have visited a healthcare facility and monthly family income

contributes to one’s extent of level of awareness and knowledge.

Key Words: Awareness, Knowledge, Health Care Rights

Introduction:

According to the World Health Organization [14], health is an important aspect of our human

rights and our notion of what it means to live a dignified life. One of the fundamental rights of every

human being, regardless of ethnicity, religion, political belief, economic or social status, is to enjoy the

best possible standard of health. This means that every patient has the right to be treated properly and

without discrimination. The promotion and protection of patient rights have become an essential and

fundamental aspect of modern healthcare [2], emphasizing human rights [5].

Many countries' healthcare systems have defined certain rights for patients, and healthcare

practitioners are required to respect these rights when providing services [9]. Several declarations and

professional ethical guidelines have also been developed to ensure that all patients' fundamental human

rights and humanitarian treatment are protected and promoted. Despite these attempts to establish

and disseminate charter of patient rights, multiple studies from various countries have revealed

concerns such as patient rights violations and a lack of awareness of the patient rights legislation and its

ethical and legal implications [15].

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 To protect patients' rights, the Philippines Magna Carta of Patient's Rights and Obligations of

2008, also known as Senate Bill 2371 [10], was enacted. The following rights are listed in this policy: (1)

Right to Appropriate Medical Care and Humane Treatment; (2) Right to Informed Consent; (3) Right to

Privacy and Confidentiality; (4) Right to Information; and (5) Right to Choose a Health Care Provider and

Facility.

The Universal Health Care Act [11] was signed into law in 2019 to ensure that all Filipinos have

fair access to high-quality, affordable healthcare goods and services and protection from financial risk. It

also assures that all Filipinos are health-literate, have access to suitable living environments, and are

safeguarded from health dangers and risks.

These rights that were implemented are beneficial to the people. However, regardless of how

excellent the law is, it will never be effective until people are aware of it. People should be aware that

they are protected from health discrimination under the law. If individuals continue to be unaware of

their rights, especially those from rural areas and those with limited education, they are at risk being

exploited.

Materials and Methods:

Inclusion / Exclusion Criteria

To be included in the study, the respondents must be an official resident of the three cities

included in the research locale. Such respondents shall only be between 20-59 years old. Excluded in this

study are indigenous people, those that are homeless or are considered as refugees or displaced,

individuals with incurable diseases, and individuals who are unemployed. The characteristic of

unemployed is based on the definition given by Virola [13] for the Philippine Statistics Authority. Self-

employed individuals such as public transportation drivers (i.e. tricycle drivers), street and market

vendors, and online sellers are also included in the study. Additionally, according to the Bureau of Labor

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and Statistics [4], Students are neither classified as employed or unemployed because they are not

currently looking for a job, which is why they fall under the category of ‘Persons not in the labor force’.

For this reason, people who are currently finishing a degree or a full-time student will be included in the

study, although they have no job as defined by Virola [13] and as long as they are within the designated

age bracket of the study are included.

Ethical Consideration

The study had undergone research review through the Ethics Committee of Colegio San Agustin-

Bacolod and are still awaiting the clearance from the Committee.

Statistical Analysis

The frequency distribution and percentage frequency distribution is utilized for the first objective

in the study to determine the distribution of the respondents between the variables in the study in

terms of their age group, sex, level of education, city of residence, if they have ever been a patient or

have visited a healthcare facility, and monthly family income which will be interpreted as their income

groups. The median and median absolute deviation (MAD) method was used to answer the second and

third objectives because the data set of the study is not normally distributed.

RESULTS:

A total of 754 collected respondents made up this study; 320 (42.4%) were from Bacolod City,

235 (31.2%) were from Escalante City and 199 (26.4%) were from Sagay. All respondents completed the

researchers' survey questionnaires, which are provided in three (3) different languages for ease of

comprehension. Tables 1-6 will represent the Level of Awareness and Knowledge on Health Care Rights

of the Respondents according to Age, Sex, Level of Education, City of Residence, Healthcare Visit and

Monthly Income respectively.

Table 1. Awareness and Knowledge on Health Care Rights of the Respondents according to Age Group

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 Awareness Knowledge

Median Abs- Median Abs-

Age N Median Interpretation Median Interpretation
Deviation Deviation

Moderately
20-24 443 4 0.4 Moderately Aware 3.73 0.53
Knowledgeable
Moderately
25-29 110 4.235 0.53 Fully Aware 4 0.47
Knowledgeable

30-34 58 4.73 0.73 Fully Aware 4.33 0.7 Fully Knowledgeable

Moderately
35-39 36 4.435 0.6 Fully Aware 3.965 0.635
Knowledgeable
Moderately
40-44 37 4.4 0.53 Fully Aware 4.2 0.4
Knowledgeable
Moderately
45-49 23 4.6 0.8 Fully Aware 4 0.47
Knowledgeable
Moderately
50-54 27 4.53 0.6 Fully Aware 4.2 0.6
Knowledgeable
Moderately
55-59 20 4.435 0.4 Fully Aware 4 0.53
Knowledgeable
Moderately
Total 754 4.13 0.53 Moderately Aware 3.93 0.53
Knowledgeable

Those who are 25-29, 30-34, 35-30, 40-44, 45-49, 50-54, 55-59 are fully aware knowledgeable than

ages 20-24. Ages 30-34 are fully knowledgeable than other age groups. The age groups which have the

highest median of 4.73 is of ages 30-34 for the awareness and knowledge. While those ages 20-24 got

the lowest median of 4 for knowledge and ages 40-44 also got the lowest median of 0.4 for the

knowledge.

Table 2. Awareness and Knowledge on Health Care Rights of the Respondents according to Sex

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 Awareness Knowledge

Median Abs- Median Abs-

Sex N Median Interpretation Median Interpretation
Deviation Deviation

Moderately
Male 268 4.00 0.53 Moderately Aware 3.80 0.53
Knowledgeable

Moderately
Female 486 4.20 0.53 Moderately Aware 3.93 0.50
Knowledgeable

Moderately
Total 754 4.13 0.53 Moderately Aware 3.93 0.53
Knowledgeable

Females have a higher level of awareness with a median of 4.20 than males. But, males are

more knowledgeable with a median of 0.53 than females. When taken as a whole, both sexes showed

that they are moderately aware and knowledgeable of their rights as a patient.

Table 3. Awareness and Knowledge on Health Care Rights of the Respondents according to the Level
of Education

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 Awareness Knowledge

Median
Level of Median Abs-
N Median Abs- Interpretation Median Interpretation
Education Deviation
Deviation

Elementary Somewhat
4 3.73 0.53 Moderately Aware 3.00 0.47
Graduate Knowledgeable

Highschool Moderately
295 4.27 0.60 Fully Aware 3.80 0.47
Graduate Knowledgeable

College Moderately
401 4.07 0.47 Moderately Aware 3.93 0.53
Graduate Knowledgeable

None of the Moderately

54 3.93 0.47 Moderately Aware 3.73 0.37
above Knowledgeable

Moderately
Total 754 4.13 0.40 Moderately Aware 3.93 0.53
Knowledgeable

Respondents who have completed their high school education, which includes college

undergraduates, have the highest level of awareness and knowledge regarding healthcare rights. This

result is followed by college graduates, then elementary and those who have not completed any level of

education. Respondents who have completed their high school education got the highest median of 4.27

in awareness which is interpreted as fully aware while college graduates got the highest median of 3.93

and is interpreted as moderately aware. Moreover, respondents who have completed their elementary

education got the lowest median of 3.73, which is interpreted as moderately aware. College graduates

and respondents who have not completed any level of education have the most consistent responses

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with the Median Absolute Deviation value of 0.47, and the high school graduates have the most

inconsistent responses with a Median Absolute Deviation value of 0.60 in the awareness while college

graduates as well as those elementary and high school graduates have the most inconsistent responses.

Table 4. Awareness and Knowledge on Health Care Rights of the Respondents according to the City of
Residence

Awareness Knowledge

City of Median Abs- Median Abs-

N Median Interpretation Median Interpretation
Residence Deviation Deviation

Moderately Moderately
Bacolod City 320 4.13 0.53 3.80 0.50
Aware Knowledgeable

Moderately Moderately
Escalante City 235 4.07 0.47 3.87 0.53
Aware Knowledgeable

Moderately
Sagay City 199 4.27 0.47 Fully Aware 4.00 0.53
Knowledgeable

Moderately Moderately
Total 754 4.13 0.40 3.93 0.53
Aware Knowledgeable

Respondents who are residing in Sagay City are fully aware and knowledgeable regarding

patient’s rights than those who live in Bacolod and Escalante City who are both moderately aware of

their rights. Sagay City has a median of 4.27 in the awareness and 4.00 in knowledge. Also having an

absolute deviation of 0.47 in awareness however 0.53 in knowledge.

Table 5. Awareness and Knowledge on Health Care Rights of the Respondents in relation if the

respondents Have Visited or Was a Patient.

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 Awareness Knowledge

If the Respondents
have visited or was a Media Median Abs- Median Abs-
N Interpretation Median Interpretation
patient before in a n Deviation Deviation
healthcare facility

Moderately Moderately
Yes 570 4.07 0.53 3.90 .69693
Aware Knowledgeable

Moderately Moderately
No 184 4.20 0.40 4.00 .80851
Aware Knowledgeable

Moderately Moderately
Total 754 4.13 0.53 3.93 0.53
Aware Knowledgeable

Those who have not been a patient before or visited a healthcare facility has been found to be

more aware and knowledgeable with a median of 4.20 in awareness and 4.00 in knowledge than those

who have been a patient or visited a healthcare facility with a median of 4.07 in awareness and 3.90 in

knowledge.

Table 6. Awareness and Knowledge on Health Care Rights of the Respondents according to the

Monthly Family Income

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 Awareness Knowledge

Media Media
Monthly Family Media n Abs- Media n Abs-
Interpretation N Interpretation Interpretati
Income n Deviati n Devia
on tion

Below PhP 10,957 Moderately Moderate

Poor 43 3.93 0.53 3.73 0.53
per month Aware Knowledgea

Between PhP
Low income Moderately Moderate
10,957 - PhP 217 4.13 0.53 3.80 0.47
(but not poor) Aware Knowledgea
21,914 per month

Between PhP
Lower middle Moderately Moderate
21,915 - PhP 229 4.07 0.47 3.87 0.53
income Aware Knowledgea
43,828 per month

Between PhP
Middle middle Moderately Moderate
43,829 - PhP 119 4.20 0.60 4.00 0.53
class Aware Knowledgea
76,699 per month

Between PhP
Upper Middle Moderate
77,700 - PhP 66 4.30 0.47 Fully Aware 4.07 0.53
Class Knowledgea
131,484 per month

Between PhP
Upper Income Moderately Moderate
131,485 to PhP 35 4.13 0.53 3.87 0.40
(but not rich) Aware Knowledgea
219,140 per month

Atleast PhP Moderately Moderate

Rich 45 4.13 0.60 3.93 0.60
219,141 Aware Knowledgea
Moderately Moderate
Total 754 4.13 0.40 3.93 0.53
Aware Knowledgea

Those who belong to a monthly family income that ranges between PhP 77,700 -  PhP 131,484

per month are fully aware and moderately aware of their rights as patients than those who belong to

less than PhP 77,700, Between PhP 131,485 to PhP 219,140 and atleast PhP 219,141 per month.

Discussions

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 The study is focused on determining the level of awareness and knowledge of the residents of

Bacolod City, Sagay City and Escalante City. In this study, the researchers considered variables such as

the age group, sex, level of education, city of residence, if the respondents have ever been a patient or

have visited a healthcare facility, and monthly family income as determining factors for awareness and

knowledge. After an in-depth investigation, collection, and analysis of data for this study, the

researchers were able to come up with findings that can aid in answering the objectives of this study.

The knowledge and awareness data of the study was interpreted as skewed or not normally

distributed. The level of awareness of the respondents according to their age group showed that those

between the age group of 30-34 years old are observed to have the highest level of awareness with a

median of 4.73 and is considered as fully aware whereas those age group which falls between 20-24

years old have the lowest median of 4, which is deemed as moderately aware. For their Median

Absolute Deviation, the highest value is 0.8 which falls under the age group of 45-49 years old. This

result is considered as the one having the most inconsistent responses while those that are between the

age group of 20-24 years old and 55-59 years old are found to have the lowest Median Absolute

Deviation which is 0.4 and is found to have the most consistent responses. In terms of level of

knowledge according to their age group, the results of the study showed similarities found in its

awareness counterpart, wherein the age group that has the highest level of knowledge belong to those

that are between ages 30-34 years old with a median value of 4.33. The age group that got the lowest

level of awareness are those that belong between the age group of 20-24 years old which got the

median value of 3.73. For their Median Absolute deviation, the age group that got the highest value of

0.7 are those that are between the age group of 30-34 years old which is considered to have the most

inconsistent responses and those that got the lowest value of 0.13 are those age group that are

between 40-44 years old which is deemed to have the most consistent responses. According to the

study of Agrawal et al. [1], younger adults were more aware than any other age groups. In the said

Page 12 of 19
study, the younger adults are those that are 18-35 years old, 107 participated and got the percentage of

30.6%. Same as true with the study of Yaghobian et al. [16] where age affects the level of awareness of

the respondents.

The level of awareness of the respondents according to their sex showed that females have a

higher level of awareness followed by males. When taken as a whole, both sexes showed that they are

moderately aware of their rights as a patient. In terms of knowledge, females are observed in the study

to be more knowledgeable with the median value of 3.93 than males who have the median value of

3.80. Moreover, females also have more consistent responses with a Median Absolute Deviation value

of 0.50 than males who have 0.53. The study of Agrawal et al. [1] also shows that females are more

aware of their rights. This also does holds true with the study of Ebrahimi et al. [6] in terms in the level

of knowledge.

The level of awareness according to the level of education of respondents showed that

respondents who have completed high school education, which includes college undergraduates, are

fully aware about their healthcare rights. It is followed by elementary and college graduates, and those

who have not completed any level of education are interpreted as moderately aware of healthcare

rights. While respondents who have completed their elementary education got the lowest median with

3.73 that is interpreted as least aware. College graduates are the most knowledgeable about their

healthcare rights with the median value of 3.93 and Elementary graduates are the least knowledgeable

about their healthcare rights with a median value of 3.00. According to Gallego & Vázquez-Navarrete [8],

Bateni et al. [3], and Tabassum et al. [12], respondents with low educational attainment are interpreted

as the least likely to be aware of their healthcare rights. Similarly, in this study, the respondents with

two of the lowest educational attainment are the least aware of their healthcare rights.

The level of awareness according to the city of residence showed that the respondents who are

residing in Sagay City are fully aware regarding patient’s rights than those who live in Bacolod and

Page 13 of 19
Escalante City who are both moderately aware of their rights. Sagay City has a median value of 4.27 and

a median absolute deviation of 0.47 compared to the cities of Escalante and Bacolod which has a median

of 4.07 and 4.13 respectively, and a median absolute deviation of 0.47 and 0.53 respectively. Moreover,

those who live in Bacolod City had more samples compared to Escalante City which had 235 samples

and Sagay City which had 199 samples. In this study, all three cities demonstrated a moderate

knowledge regarding patient’s rights with Sagay City being the highest among the three and Bacolod

City being the lowest.  In contrast with the results of this study, Fotaki [7] showed that respondents from

an urban city are the best and well-informed when it comes to their rights, which does not hold true in

this study as Sagay City have the most aware respondents, even if it is only considered as a 3 rd class-

component city.

The level of awareness in relation to if the respondents have visited a healthcare center or was a

patient showed that the extent of awareness of respondents in relation to having visited a healthcare

facility or experienced being a patient in such facilities. It shows that people who have not experienced

being a patient or have never visited a healthcare facility have a higher median of 4.20 and lower

median absolute deviation of 0.40 than patients who have visited a healthcare facility or experienced

being a patient. In their study, they have used frequency to show the results while in this study, the

researchers used the median and abs-deviation in presenting the data. Moreover, it shows that there

are more people who have visited a healthcare facility or experienced being a patient than those who do

not.  Those who have not visited a healthcare facility or experienced being a patient are more

knowledgeable than those who experienced being a patient or have visited a healthcare facility. 

The level of awareness according to monthly income showed that those who belong to a

monthly family income that ranges between PhP 77,700 - PhP 131,484 per month are more fully aware

of their rights as patients than those who belong to less than PhP 77,700. A descriptive study by Gallego

& Vázquez-Navarrete [8] in Colombia that compared two cross-sectional studies in 2000 and 2010,

Page 14 of 19
showed that the most disadvantaged groups are those of low socioeconomic status and are the least

likely to be aware of their rights. In their study, the researchers used a univariate analysis, frequencies

and percentages estimated for each year. Their sample also comprised male and female users but of

different ages ranging from 13 to more than 65 years of age. While in this study, the data was collected

within two weeks, and the age group is between 20-59 years old, male and female. Moreover, it shows

that those who belong to a monthly family income interpreted as poor had the lowest knowledge on

their healthcare rights as compared to the upper middle class with 4.07 showing that they are more

knowledgeable.

Conclusion

Taking everything into account, the study discovered that in terms of age group, when it comes

to their healthcare rights, those between the ages of 20 and 24 are the least aware and knowledgeable,

while those between the ages of 30 and 34 are the most aware and knowledgeable. Females are more

aware and informed about their rights than males, yet both are relatively aware and knowledgeable

when viewed as a whole. On the basis of the level of education, college graduates are shown to be more

aware and knowledgeable than individuals who have completed less than a bachelor's degree. As for the

city of residence, despite being classified as a third-class component city, Sagay City was discovered to

be fully aware and knowledgeable when compared to Escalante City and Bacolod City. Based on

whether the respondent has been a patient or has visited a healthcare facility, the study found that

those who have done neither are fully aware and knowledgeable, higher than their counterpart. Lastly,

based on the monthly family income, those who belong to the upper-middle class are fully aware and

knowledgeable as compared to those who belong to other income classes.

Overall, the residents' total awareness of their patient rights was found to be moderate in this

study. The same is also true in terms of knowledge, with data indicating that residents as a whole had a

moderate knowledge of patient rights. When compared to the outcomes of most research concerning

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patient rights awareness and knowledge, these findings are satisfactory. Despite this, there should still

be efforts made for future improvement, as there are still numerous areas identified in this survey that

appear to reveal individuals still having insufficient knowledge of their patients' rights.

Acknowledgements

The completion of the work could not have been possible without the assistance of people

whose names may not all be mentioned. Their contributions were very-well appreciated and

acknowledged. The group would like to express their deepest gratitude particularly to the following: Mr.

Alain P. Juayang, Ms. Desiree Diel; and Mr. Paolo Hilado for their kind and understanding spirit and for

providing invaluable guidance throughout this research. It is the researchers’ privilege to work on the

research under their guidance. Secondly, the researchers would like to acknowledge the guidance of Mr.

Eduardo Bacodio Jr. as the statistician of the paper, without whom interpretation of the data would not

have been possible. The researchers are also grateful to their parents, relatives and friends who shared

their love, prayer and support either morally and emotionally. Above all, praise and thank God, the

Almighty, the source of their knowledge and wisdom, for his shower of blessings throughout the

research process.

Conflict of Interest or Funding

The researchers declare no conflict of interest or funding from any institution or agency.

Data Availability

The researchers declare that the data supporting the findings of this study are available within

the study.

Authors’ Contribution

The study was carried out in collaboration with all authors. AGMG, ADD, IMMD and JLTB did

Chapter 1. AGMG, ACBB, IMMD and JLTB did Chapter 2. AGMG and ACBB did Chapter 3. ACBB , ADD.

IMMD, JLTB and KATE did the interpretation and analysis of data. AGMG has contributed to the journal

Page 16 of 19
contents, action plan, questionnaire and made the PowerPoint presentations. ACBB has contributed on

the research instrument, appendices, supervised the overall research process and revisions and editing

of the manuscript. ADD has contributed to the statistical tools, acknowledgment, journal contents and

questionnaire. IMMD has contributed to the ethical clearance and recommendations. JLTB has

contributed to the questionnaire, research locale, recommendations, action plan, summary and

managed the journal and poster contents. KATE corrected the study’s tenses and grammar. All the

authors did the data collection, helped in the REC assessment forms and editing the manuscript.

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