RUBRICS FOR PRESENTATION

Criteria 1 2 3 4 Score
Attention to Did not Little attempt Engage Engage audience
Audience attempt to to engage audience and and held their
engage with with audience held their attention
audience attention most throughout, with
of the time by creative
remaining on articulation,
topic and enthusiasm and
presenting clearly focused
facts with on the
enthusiasm presentation
Clarity No apparent Content is Sequence of Development of
logical order loosely information is the presentation
of connected, well organized is clear through
presentation, transitions for the most use of specific
unclear focus lack clarity part, but for and appropriate
more clarity examples,
with transitions transitions are
is needed clear and create
concise and even
flow
Content Presentation Presentation Information Exceptional use
is unclear is clear, but relates to a of material that
and supporting clear clearly relates to
information information is presentation, a focused
appears disconnected many relevant presentation,
randomly points, but they abundance of
chosen are somewhat various
unstructured supported
materials
Creativity Delivery is Materials Some apparent Exceptional
repetitive presented originality originality of
with little or with little displayed presented
no variety in interpretation through use of materials and
presentation or originality original interpretations
interpretation
of presented
materials
Presentation Greatly Exceeding or Remained close Presented within
Time exceeding or falling short of to the allotted the allotted time
falling short allotted time time
of allotted
time
Name: Bellarmine T. Millena
Level: II
Block: A
Topic: MEANING & SERVICE VALUE OF MEDICAL CARE;
ALLOCATION OF HEALTH RESOURCES; ISSUES INVOLVING
ACCESS TO CARE

MEANING AND SERVICE VALUE OF MEDICAL CARE

Michael E. Porter & Elizabeth O. Teisberg

- proposed a single unifying goal for health care: to deliver value for the patient.
- VALUE: defined as the outcomes that matter to patients and the costs to achieve
those outcomes.
- to achieve value for patients; health care delivery needed to be organized around
the medical conditions’ patients have, accurately measure the outcomes that matter
to patients, and measure the cost to achieve them.
VALUE-BASED HEALTHCARE

- Based on their work entitled: Redefining Health Care Creating Value-Based

Competition on Results (2006) by Harvard University Professor Michael E.
Porter and was co-authored by Elizabeth Teisberg
- Widely touted as critical to improving the health outcomes of patients
worldwide and controlling runaway health care costs
- Main Concept/Idea: This focus on prevention lowers the need for
expensive medical tests, ineffective medications and unnecessary
procedures.
How does value-based care reduce costs?

- providers such as hospitals and doctors are paid based on patient outcomes,
rather than the current “fee-for-service” model. In other words, the provider
is rewarded for helping patients become healthier.
- With the concept of value-based care, doctors and hospitals get paid based
on outcomes, not on numbers of procedures done, patients seen, or how
much they are charged. Rather than charging a patient for each individual
test or service, payments are bundled
- Electronic medical records for each patient eliminate repetitive and
unnecessary tests and procedures.
- Teams of doctors and healthcare professionals communicate with one
another through the help of care coordinators to treat patients with more
 efficiency and less wasted time and effort. Patients move through this
integrated system more quickly.
- The ideal result is fewer readmissions and less frequent hospitalizations and
trips to the emergency room. Value-based care is a long-term goal. It’s a
proactive concept to keep healthcare costs down, produce better healthcare
outcomes and most importantly, improve your overall health and wellbeing.
Priority Setting: involves a process of choice among alternative health care
programs and services that can be offered, and among the patients or groups of
patients who are to receive care
Rationing: refers to the conscious decision to exclude certain people from a
service or treatment that they need.
Rationing takes many forms.

- Rationing occurs when a state determines who is eligible for Medical

Assistance insurance.
- It also occurs when deciding which patient on the waiting list gets an organ
transplant.
- Rationing is also utilized when prices are set for health insurance and health
services that some people cannot afford

ALLOCATION OF RESOURCES
Health Care Resources: Defined as all materials, personnel, facilities, funds, and anything
else that can be used for providing health care services.
Resource Allocation
- Commonly viewed in terms of the use of equipment or other resources within the
institution
- the distribution of sources – usually financial - among competing groups of people
or programs.
- the process of identifying and managing resources
The fair and equitable division of scarce goods and services is usually considered an
issue of distributive justice.
Distributive Justice: refers to the fair, equitable, and appropriate distribution of health-
care resources determined by justified norms that structure the terms of social cooperation

Society has used a wide variety of criteria for the distribution of resources. But
certainly, does not exhaust the list of possible criteria.
 Common methods for Distribution of Goods and Resources
• to each person an equal share (equality)
• to each person according to need (individual need)
• to each person according to merit (
• to each person according to contribution
• to each person according to effort
• to each person according to social worth
Healthcare allocations are commonly classified in terms of two levels of decision making:
micro-allocation and macro-allocation.

• MACRO-ALLOCATION
- Macro-allocation decisions include how particular health-related institutions
such as hospitals or government agencies budget their spending (sometimes
referred to as meso-allocation).
- encompasses the decisions a nation makes concerning what resources to devote
to particular institutions or, more broadly, to high-technology curative medicine
as opposed to.
- Determine how much should be expended and what kinds of goods and services
will be made available.
- Macro-allocations problems are demonstrated in such questions as:
✓ What kinds of health care will be available?
✓ Who will get it, and on what basis?
✓ How will the costs be distributed?
✓ Who will deliver the services?
✓ Who controls these issues?
Two-Tier System and the Decent Minimum

- Under this approach, everyone would be guaranteed coverage for basic care
and catastrophic health needs. This coverage of a decent minimum of care
would be distributed on the basis of need, with everyone being ensured
equal access.
- The second-tier, based on the ability to pay, would provide expanded and
perhaps better care at private expense.

MICRO-ALLOCATION

• Focuses on decisions regarding particular persons.

• It often involves "patient selection": determining which patients among those who
need a particular scarce resource, such as a heart transplant, should receive
treatment.
 • More personal determination of who will receive scarce resources, such as
intensive-care beds, advanced technology, or organ transplants.

Triage: refers to the sorting of injured or sick people according to their need for
emergency medical attention. It is a method of determining priority for who gets
care first.
Responses and attempted solutions to the problem of limited healthcare resources:

Since health is valued very highly, there have been many attempts to reform the system.
These reforms have attempted to either increase the financial resources directed to
healthcare or to use limited resources in the best way possible. Reform attempts have
included efforts to:
1. Increase efficiency: By curtailing waste and unnecessary care, providers can be
more efficient.
- Methods include evaluating health technologies and expanding prevention
programs.
2. Distribute resources equitably: The basis of distribution is value-based and can
take many forms: strict equality, access to a determined level of care, access to an
equal opportunity for care, limiting access to people responsible for their health
problems, and access based on age or other factors.
3. Adopt managed care plans: Managed care has been offered as an organizational
structure that hopes to distribute healthcare resources more efficiently and wisely
by having physicians review policies that balance the healthcare of the individual
patient (and the cost of caring for that patient) with the goals and costs of providing
healthcare to the entire group.

ISSUES INVOLVING ACCESS TO CARE

Health care access: is the ability to obtain healthcare services such as prevention,
diagnosis, treatment, and management of diseases, illness, disorders, and other health-
impacting conditions.
For healthcare to be accessible it must be affordable and convenient.

1. POVERTY
- if you have plenty of money you usually have better access to healthcare
than others do. You will be able to afford insurance or have enough money
to pay for care privately.
- PhilHealth implements the National Health Insurance Program that aims to
provide Filipinos with financial assistance and access to affordable health
 services. It covers hospital costs, subsidy for room and boarding, medicine,
and professional services

2. BARRIERS TO ACCESS
Examples:
➢ Not enough donor organs for transplant
➢ Not enough primary care physicians
➢ Country lacks healthcare professionals and facilities
➢ Limited hours, long waiting times, and limited afterhours care
➢ Insurance not available at affordable rates to certain populations
➢ Drug prices too high
➢ Patients already with high medical debts

3. HEALTHCARE RESOURCE ISSUES

- can be macro-allocation issues, micro-allocation issues, or somewhere in-
between.
• Macro-allocation issue: When the decisions are about large-scale
allocation within society or government.
▪ One broad macro-allocation issue is what priority the government
should place on healthcare amidst other areas competing for funding,
laws, and policies, for example, defense, education, and commerce.
▪ Slightly less broad issues concern how much to spend or focus on
prevention, treatment, and research
▪ to the level of individual institutions or healthcare systems, what
spending decisions should a hospital make about various healthcare
programs, building facilities, buying technology, outreach to the
community, etc.? Where should new clinics be stationed?
• Micro-allocation issues: When they are at the level of healthcare
professionals allocating time to specific patients.
▪ These issues arise in the delivery of healthcare from provider and staff
to patient.
▪ What new equipment should be purchased?
▪ How much staffing should the practice have, and at what level?
▪ For specific patients, how much time should the physicians and nurses
spend in the exam room, in patient education, in obtaining tests?