Quality and

Access to Public
Healthcare in the
Philippines
Group Members:
Alvior, Anel | Chua, Clariz |
Diongzon, Julia | Ko, Rica | Tin,
Jarrod
 According to the World Health Organization,
healthcare can provide human wellbeing while
simultaneously improving the economy. This
shows how healthcare is directly involved in
one’s well-being and happiness. Both of these
are also crucial elements as to how a nation can
progress and prosper (WHO, 2010).

Thus, this presentation aims to present studies

that can provide more insight into the
healthcare system.
 How We Proceeded With The
Review
1. Many of the studies found online were theory-based without much
substantial evidence to support it. Our group filtered our sources to mostly
ones with quantitative data and its ability to clearly show the condition and
solution to the lack of quality and access of public healthcare.

2. The matrix was helpful in helping us narrow down our search for our sources
since many of
the sources online were vague and sometimes multiple sources were saying
just about the same
thing. The focus of each source was also different in their approach,
because of this, we
3. Even though
specifically we picked
searched sourcesthat
for sources to specifically answer
will fit the guide certain in
questions guide
the
questions
matrix. in the matrix, we
also digged deeper on each source and if there were more than 1 guide
question the source can
answer, we would also write it in the matrix. We also analyze each source
with our topic in mind
 The Literature We Chose to
Review
1. Exhaustive - Chapter 33. Professional Communication and Team Collaboration
(O’Daniel &
Rosenstein, 2008).
2. Critical - Does Corruption Affect Health and Education Outcomes in the
Philippines? (Azfar &
Gurgur, 2008).
1. Out of all the sources included in our Exhaustive Literature Review, this
source has the most
unique solution to improving the quality of healthcare. It also makes use of
interdisciplinary
elements which makes this source really interesting and thus, we chose to
highlight this
2. With the Philippines being known for its corruption, this literature is very
literature.
interesting because it
shows the effect of health outcomes as a result of corruption. Out of all the
sources in the
Critical Literature Review, this one brings a fresh new take on the problem
at hand and is
Exhaustive
Literature
Review
 Chapter 33. Professional Communication and Team
Collaboration
Communication failure or misinterpretation ranks 5th of the Top 10 causes of
death. This means that human error could potentially affect the survival chances
of a patient.

93% of communication is more affected by body language, tone and delivery

and 7% is left for the actual words said.

Collaboration in healthcare involves healthcare professionals assuming

complementary rules, working together, sharing responsibility and making
decisions to carry out plans for patient care.

Barriers to effective communication involve culture, gender differences and

hierarchies.

Crew Resource Management (Aviation) includes team training, simulation,

interactive debriefings and measurement and improvement of aircrew
performance. This considers human performance limiters and the nature of
human error and defines behaviours that are countermeasures to error.

Examples of Application of Crew Resource Management in Healthcare.

 Chapter 33. Professional Communication and Team
Collaboration
SBAR Tool (Situation, Background, Assessment, Recommendation)- Patient
Safety Program
● Have I seen and assessed this patient myself before I call?
● Are there standing orders?
● Do I have at hand
○ The chart?
○ List of current meds, IV fluids, and labs?
○ Most recent vital signs?
○ If reporting lab work, date and time this test was done and results of previous tests
for comparisons?
○ Code status?
● Have I read the most recent MD progress notes and notes from the nurse who worked the
shift ahead of me?
● Have I discussed this call with my charge nurse?
● When ready to call,
○ Remember to identify self, unit, patient, room number.
○ Know the admitting diagnosis and date of admission.
○ Briefly state the problem, what it is, when it happened or started, and how severe it
is.
● What do I expect to happen as a result of this call?
● Document whom you spoke to, time of call, and summary of conversation.
● Engage and treat physician with respect.
 Chapter 33. Professional Communication and Team
Collaboration
STICC (Situation Task Intent Concern Calibrate)

Situation: Here's what I think we face.

Task: Here's what I think we should do.
Intent: Here's why.
Concern: Here's what we should keep our eye on.
Calibrate: Talk to me. Tell me if you don't understand, can't do it, or see
something I do not.
Chapter 33. Professional Communication and Team
Collaboration
● To improve the quality of public healthcare, the study
suggested not only to improve technology but the
behavioral aspect of the workers as well.
● This study shows that in order to solve this problem of
the quality and access of healthcare, interdisciplinary
elements must be in play.
● Healthcare needs the expertise of other disciplines such
as aviation in order to improve quality. The training of
pilots can be used to train medical workers as well.
Training of medical workers have to be more specialized
as there is no room for error in this field is where lives are
at stake.

Results and Findings of the Study

● 44,000 to 98,000 people die in US hospitals because of
medical errors
● 65-70% of safety problems in anesthesiology were linked
to human error.
● An American non-profit healthcare system, Kaiser
Permanente adopted the use of CRM (Crew Resource
 Critical
Literature
Review
 Does Corruption Affect Health and Education Outcomes in the
Philippines?
The research conducted surveys in eighty municipalities, according to the seven
measures: immunization of children, delay in vaccination of children, waiting time of patients,
accessibility of health clinics for treatment, choosing public health clinics for vaccination, and
satisfaction with general health clinics. In each measure, there is substantial proof that
corruption hurts the quality of healthcare.

This study defines corruption as “abuse of office for personal gain”. In which corruption
can affect different parts of healthcare in various ways like bribery and embezzlement. It is also
stated that this corruption can be seen as the root cause of poverty in the Philippines.

Philippines was decentralized back in 1991 with the Local Government Code (LGC) which
resulted in a distribution of responsibility between elected local governments. Due to the
decentralization, expenditures and decisions on healthcare began to vary between different
localities. This resulted into mostly positive views due to the advances the Philippines was able
to make in the fight against malaria, TB, child health and etc.

All the surveys concluded that corruption has a substantial effect on the quality of
healthcare. In which corruption affects the rural and urban areas differently. Rural areas go
through a longer waiting period, delayed immunizations, and less satisfaction towards
healthcare. While urban areas are more “corruption-elastic”. The study also concludes that
Does Corruption Affect Health and Education Outcomes in
the Philippines?
● Corruption happens in the local level and majority of the
population goes to government hospitals where
corruption is at play.
● This study highlights corruption as a major contributor to
the lack of quality and access to public healthcare in the
Philippines.
● This is a social problem since government officials are the
ones making decisions on the enhancements on the public
healthcare system.
RESULTS FROM THE STUDY
● Immunization Coverage
● The communities with the highest corruption level
also have the least number of successful
immunization coverage.
● Immunization coverage gets negatively affected by
urbanization rate, unequal distribution of wealth, and
distance to health centers.
● As more people get immunize, the locals prosper
Does Corruption Affect Health and Education Outcomes in
the Philippines?
● Vaccination of Children
● The size of public health facilities in the area has a
negative impact on immunization.
● There are a lot of factors affecting the demand for
health service, two of the factors are the existence
of private health providers and distance to
alternative public health facilities.
● In government hospitals, it was discovered that the
number of immunization coverage increase when the
central government regularly audits.
● Delay in vaccination of children

● The time period when infants get vaccinated gets

slightly reduced with the existence of private health
centers.

● There is a direct relationship between the infant’s

age of getting vaccinated and the distance of the
Does Corruption Affect Health and Education Outcomes in
the Philippines?
● Choosing Public Health Facilities for Immunization
● The wealthier a household is, the more likely they are
to choose a private hospital and vice versa with the
poor.
● If the distribution of wealth in one municipality is not
equal and there are no private hospital near by, more
households are more likely to go to public hospitals.
● Corruption is a deciding factor for household whether
they would go to public health facilities or not.
● A households prior experience with immunization would
help them make their decision in choosing a public or
private health facility.

● Waiting Time In Public Health Clinics

● Corruption has an insignificant effect in the waiting
time in the rich and urban areas.
Does Corruption Affect Health and Education Outcomes in
the Philippines?
● With one standard deviation of corruption there is
increase of 28% in the waiting time in rural regions and
15% increase in poor municipality.

● Denied a vaccine from public health facilities

● The bigger a hospital the more likely a patient would be
denied a vaccine.
● The size of a hospital is positive correlated for the
demand for health services.
● If there is a private hospital or private clinic within the
vicinity, public health centers are less likely to deny
vaccines to patients.

● Household’s satisfaction with public health clinics

● The household satisfaction level can increase when the
improvement of corruption is one standard deviation.
the household satisfaction overall can grow to 29%,
33% in rural areas and 48% in poor municipality.
 Azfar, O., & Gurgur, T. (2008). Does Corruption Affect
Health and Education Outcomes in the
Philippines? Retrieved March 14, 2020 from
https://www.researchgate.net/profile/Tugrul_Gur
gur/publication/24054339_Does_Corruption_Affec
t_Health_and_Education_Outcomes_in_the_Philipp
ines/links/00b7d53be7d2341b6d000000.pdf

References Health and development. (2010, December 9).

Retrieved February 18, 2020, from
https://www.who.int/hdp/en/

O’Daniel, M. & Rosenstein, A. (2008). Chapter 33.

Professional communication and team
collaboration. Patient Safety and Quality: An
Evidence-Based Handbook for Nurses, 2, 271-
284. Retrieved March 27, 2020 from
https://www.ncbi.nlm.nih.gov/books/NBK2637/pd
f/Bookshelf_NBK2637.pdf