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OP174 Development Of A Formal Priority-Setting For The Philippine Government
- John Wong, Katherine Ann Reyes, Beverly Lorraine Ho
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- Journal:
- International Journal of Technology Assessment in Health Care / Volume 34 / Issue S1 / 2018
- Published online by Cambridge University Press:
- 03 January 2019, p. 64
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- Article
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Introduction:
The lack of institutional mechanisms in the Philippine Health Insurance Corporation (PhilHealth) for rationalizing spending has led to a less than optimal allocation of financial resources. The study's objective is an explicit and systematic priority setting process of selecting new interventions for PhilHealth through identification of relevant literature evidence on the themes under study, then subjecting these to stakeholder and expert consultations.
Methods:The qualitative study followed a problem solving approach to policy analysis. Bardach's Eightfold Path, supplemented by a World Health Organization (WHO) guideline on policy analysis, provided the framework. Eightfold path recommends that the analysis proceed by (i) defining the problem, (ii) assembling the evidence, (iii) constructing the alternatives, (iv) selecting the criteria for identifying the best alternative, (v) projecting the outcomes, (vi) confronting the tradeoffs, (vii) making the decision, and (viii) disseminating the results.
Results:A six-step priority setting process to facilitate the assessment of new interventions for PhilHealth coverage was developed. The process is governed by seven accountability-based principles and four explicit criteria to evaluate interventions. Additionally, the study provided proof-of-concept for conducting local cost-effectiveness and budget impact analyses as key inputs to a national systematic priority-setting process.
Conclusions:This study recommended four criteria and a seven-step process for priority setting to be adopted and an overarching set of principles that will guide the conduct of such activities. The proposed priority-setting process was approved by the PhilHealth. The same process was adopted by the Department of Health in the draft administrative order for health technology assessment. This study stimulated research projects for economic evaluations of health interventions.
5 - Universal Health Coverage, Health Security and Resilient Health Systems
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- By Eduardo Banzon, University of the Philippines, Beverly Lorraine Ho, University of the Philippines
- Edited by Ramon L. Clarete, Emmanuel F. Esguerra, Hal Hill
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- Book:
- The Philippine Economy
- Published by:
- ISEAS–Yusof Ishak Institute
- Published online:
- 12 February 2019
- Print publication:
- 10 September 2018, pp 190-230
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Summary
No one wants to be sick. Yet, those who fall ill are punished with the high cost of accessing healthcare. While one cannot totally prevent it, conditions where an individual is born, grows, works, lives and ages contribute to the likelihood of falling ill. For example, population groups residing near development projects are unnecessarily exposed to hazards, thus increasing their vulnerability. Residents of disasterprone areas cannot rely on their health system in the aftermath of a shock, even after a few years, for them to live the way they used to.
This chapter argues why the government should sustain its ongoing investments in health, and proposes where and how these investments should be channelled in order to ensure that (1) the system is designed as one which promotes health or makes it easy for people to choose the healthier option; (2) those who fall sick are not driven to impoverishment; and (3) the system remains dependable in the event of shocks/disasters.
Box 5.1. A Typical Case of a Filipino Family in 2016 Jose and Alicia, are minimum wage earners. They live in Cavite but work in a factory in Mandaluyong City, Metro Manila. Commuting to work means losing four hours daily to travel. Because they are home late and have to leave early the next day, they are unable to prepare lunch. They are suki (frequent patrons) to Aling Nene's ration consisting of one-fourth serving of viand and three-fourth serving of rice — food with little nutritional value and that is often salty. At work they are exposed to high heat, with the factory having little ventilation.
One day Jose had a bad case of diarrhoea requiring admission. They chose to go to the nearest government hospital. Since Jose, a PhilHealth insurance member, was confined in the “charity ward”, where one nurse takes care of eighteen patients simultaneously, Alicia had to stay as a watcher to make sure all of Jose's needs were being met. Moreover, the attending physician tasked Alicia to purchase medicines in a drug outlet a few kilometres away, as the hospital pharmacy had run out of stock.
After three days in the hospital, both Jose and Alicia had lost three days of work and had spent most of their savings. Jose will also need to start allocating a portion of his salary for maintenance medications.