Research Work

a. What - Level 01 hospital as per DOH versus Level 2, Level 3 and so on.

Level 1 hospitals provide emergency care and treatment, general administrative and ancillary
services, primary care for locally prevalent diseases, and clinical services such as general
medicine, pediatrics, obstetrics and non-surgical gynecology, and minor surgery. Level 1
hospitals must have, at a minimum, an operating room, recovery room, maternity facility,
isolation facility, clinical laboratory, imaging facility and a pharmacy, all of which must be
licensed by the Department of Health (DOH). Level 2 hospitals, in addition to Level 1
requirements, must have a department and must have an intensive care unit, respiratory therapy
services, tertiary clinical laboratory and Level 2 imaging facility with mobile X-ray equipment.
Finally, Level 3 hospitals, in addition to Level 1 and Level 2 requirements, must also teach/train
hospitals with accredited residency training programs in four major specialties: medicine,
pediatrics, obstetrics and gynecology (OB - GYN), and surgery.Additionally, a Level 3 hospital
must have a blood bank, an ambulatory surgery clinic, a dialysis facility, and Level 3 imaging
and laboratory facilities.

b. Inter relationship from Barangay Health Unit to District Hospital to Different Hospital
Levels.

What Is a Barangay Health Unit?

A barangay health center is a community-based, Barangay Health Workers (BHWs)are among

the front-liners in primary health care, they provide assistance and support to physicians,
dentists, nutritionists, public health nurses, and midwives. Their role is indispensable to
community health and wellness,” he said in a statement.

The role of BHWs is to provide first aid, collect vital statistics, maintain records, and make
reports; participate in community meetings provide assistance to health center activities like
nutrition education, monitoring and feeding; immunization education, monitoring, and
dispensing family planning services, sanitation and hygiene promotion and education, and
disaster relief and rehabilitation, among others. They are volunteers that are risking life and limb
to save others so it is high time the government reward their sacrifices with higher allowances
and benefits,”
What Is a District Hospital?

Health systems are often organized in a “hub-and-spoke” arrangement, with large district
hospitals (the hub) having more and better staff and better equipment than more peripheral
clinics. The hospital district provides first referral -level care for both outpatients and inpatients.
District hospitals also, in theory, could serve a gatekeeping role for patients with less common
problems, where skills and resources are most effectively focused on the higher level of care
provided to a regional or national level.

The World Health Organization (WHO 1992) envisages that a district hospital should be able to
offer diagnostic, treatment, care, counseling, and rehabilitation services provided by
predominantly generalist practitioners spanning the following disciplines family medicine,
primary health care, medicine, obstetrics, mental health, eye care ,rehabilitation ,surgery
(including trauma and orthopedics) ,pediatrics and geriatrics.

Such hospitals will usually provide 24-hour care and be integrated into the district health system
at a wider level to provide or support a range of services:

• districtwide health information

• implementation of peripheral primary health care policies

• administrative and logistics support to primary health care efforts

• communication with the community

• curative and chronic care for patients referred from peripheral units

• district laboratory services

• training and continuing medical education of health workers and students

• links between health and other development agendas

• development of local solutions to local health problems.

Hospital Levels

First-level hospital

Few specialties—mainly internal medicine, obstetrics and gynecology, pediatrics, and general
surgery, Often only one general practice physician or a nonphysician clinician and Limited
laboratory services available for general analysis but not for specialized pathological analysis
Second-level hospital

More differentiated by function, with as many as 5 to 10 clinical specialties

Third-level hospital

Highly specialized staff and technical equipment—for example, cardiology, intensive care unit,
and specialized imaging units, Clinical services highly differentiated by function and Teaching
activities in some facilities

c. Is there a Need for more Medical Facilities in the Philippine and what Region in particular.

d. Issue of Doctors and Nurses Shortage.

MEDICAL WORKER SHORTAGE

Even before the current pandemic, the Philippines was already facing a serious shortage of
medical workers. Based on the most recent data from the DoH, there were 40,775 medical
doctors (in the health sector) in the country in 2017, which translates to a medical doctor-to-
population ratio of 0.4:1,000. The generally accepted standard is one doctor for every 1,000
population, which means the country was 63,710 doctors short, given its 2017 population of 104
million.

According to the DoH, the Philippines had 90,308 practicing nurses and 43,044 practicing
midwives in public and private health facilities in 2017, equivalent to a nurses and midwives-to-
population ratio of 1.3:1,000. There is no clear recommended standard for the number of nurses
and midwives, but the average for low middle income countries, to which the Philippines
belongs, is 1.7:1,000, according to the World Health Organization (WHO). Even by this modest
standard, the country was short by 44,273 nurses and midwives in 2017

There is also the fact that Philippine hospitals are understaffed. According to a national study
published in 2018, as many as three out of four local government units lack health workers.

The Philippines’ average nurse to population ratio is one to 5,000. But in some geographically
isolated areas, it is one to 20,000. Conditions only got worse when the pandemic hit and COVID-
positive nurses needed to be quarantined.

“We projected that we’d be short-handed because the quarantine period is 14 days,” said
Pretchell Tolentino, the director of the Department of Health’s Health Human Resource
Development Bureau.

e. Global Ranking of the Philippines with Health Care System.

What is the rank of Philippines in health care system?

Country Comparison

Overall Health

Philippines 47.6 38.2

Healthcare in the Philippines is considered to be of good quality by international standards. For

instance, the World Health Organization ranks the efficiency of the Filipino healthcare system
60th in the world. Meanwhile, the Bill and Melinda Gates Foundation, using medical access and
quality as their criteria, ranks the Philippines 124th in the world. Regardless of the assessment
criteria, the healthcare system in the Philippines is steadily improving. Above all, this is thanks
to government reforms that are moving the country closer to a universal system. As such, all
Filipino citizens are entitled to free medical care through the Philippine Health Insurance
Corporation, known as PhilHealth. And in early 2019, the country reached a major milestone
with the Universal Healthcare Act. After that, the scope of PhilHealth’s coverage expanded to
include free medical consultations and laboratory tests. Furthermore, going forward all Filipino
citizens will be automatically enrolled in the national program.

f. Typical common problem experienced by Patient visiting Hospitals.

· The WHO refers to the Filipino Healthcare System as "fragmented." There is a history of
unfair and unequal access to health services that significantly affects the poor.

· million people living in the Philippines, many do not have access to primary care. The
country has high maternal and newborn mortality rates, and high fertility rates. This creates
problems for those with particularly limited access to this primary care or for those living with
generally poor health conditions.

· Healthcare in the Philippines suffers from a shortage of human medical resources, especially
doctors. This makes the system run slower and less efficiently.

· Filipino families who can afford to buy private health facilities often choose them as their
primary option. Private facilities provide better quality of care than public facilities typically
visited by low -income families.

· Public facilities are usually in less rural areas. These facilities have fewer medical staff and
lower supplies.
· Only 30 percent of health professionals working in government meet the health needs of the
majority. Healthcare in the Philippines suffers because the remaining 70 percent of health
professionals work in the more expensive private sector.

g. Standard dimensions for Critical areas with illustration.

● Medical Intensive Care unit

Intensive care units (ICUs) are areas of the hospital where seriously ill patients receive
specialized care such as intensive monitoring and advanced life support. These units
are also called critical care units, intensive therapy units, or intensive treatment units.

The intensive care unit is planned and configured for seven individual intensive care
rooms. The rooms are arranged in a row, and are surrounded by the necessary supply
rooms

● Intermediate Medical Care Unit

An Intermediate Care Unit (IMCU) is logistically situated between the Intensive

Care Unit (ICU) and the general ward. It can act as a “step-up” or “step-down”
unit between the general ward and the ICU but can also be used to admit
patients from the Emergency Department or Recovery ward.

What is the difference of Intermediate care unit to Intensive care unit?

 Intermediate care units (IMCUs) are suitable for patients needing a level of care
lower and is intended to be a unit where those patients are treated that do not
require the resources of intensive care unit (ICU).

· Surgical and Obstetrical Service

Obstetrics is the field of study concentrated on pregnancy, childbirth and the

postpartum period. As a medical specialty, obstetrics is combined with gynecology
under the discipline known as obstetrics and gynecology (OB/GYN), which is a surgical
field

What kind of surgery does an obstetrician do?

Obstetrical procedures include cervical cerclage, dilation and curretage, amniocentesis,

Cesarean section, circumcision, and forceps and vacuum deliveries.

What does obstetrical patient mean?

of or relating to the care and treatment of women in childbirth and during the period
before and after delivery.