scholarly journals Return Service Agreement in the Context of the Universal Health Care Act: Using International and Local Experiences to Guide Application of the RSA

2020 ◽  
Vol 54 (6) ◽  
Author(s):  
Theo Prudencio Juhani Z. Capeding ◽  
Ma-Ann M. Zarsuelo ◽  
Michael Antonio F. Mendoza ◽  
Leonardo R. Estacio Jr. ◽  
Ma. Esmeralda C. Silva
Keyword(s):  
Health Care ◽  
Health Workforce ◽  
Health Professionals ◽  
System Level ◽  
Universal Health Care ◽  
Policy Reforms ◽  
Local Literature ◽  
The Government ◽  
Service Agreement ◽  
Universal Health

Background. Philippines is in a constant struggle to address shortage and maldistribution of health professionals, affecting equity in service delivery. The government endeavors to generate adequate supply of health workforce through scholarship and training programs which have been further expanded with the enactment of the Universal Health Care (UHC) Act. This article aimed to give a background for discussion on the application of return service agreement (RSA) provisions in the light of attaining universal health care. Methods. A modified systematic review of literature was conducted guided by the key issues determined by the Department of Health with focus on the extent of scholarship grants and on number of recipients. Results. The Philippine government enacted policy reforms through implementing RSA in response to the progressive decline of the net flow of health professionals. However, the criticisms lie in that RSA is not a long-term solution. With the RSA provisions in the UHC Law, metrics on determining the under-produced and maldistributed professional cadre must be created. These should be responsive in addressing facility-level and health system-level gaps. Conclusion and Recommendation. Paucity of current local literature impedes attaining a conclusive body of evidence, therefore, further research is needed. Operationalization of RSA should not be viewed as a singular means to solve the health workforce gaps, but as part of holistic assessment, taking into consideration epidemiological, geographical, political, and social determinants. Stakeholders must ingress in collaborative intersectoral policy actions to warrant bottom-up support. Activities related to mapping, monitoring, and incentivizing medical and health-related professionals must be established to support a system conducive for workforce retention.

scholarly journals Status and effects of health workforce related factors on implementation of universal health care in Nakuru West Sub County, Nakuru, Kenya

2020 ◽  
Vol 8 (1) ◽  
pp. 90
Author(s):  
Jackline Mokeira Selvester ◽  
Moses Otiati Esilaba ◽  
Oscar Omondi Donde
Keyword(s):  
Health Care ◽  
Health Workforce ◽  
Cross Sectional Study ◽  
Health Care Facilities ◽  
County Government ◽  
Universal Health Care ◽  
Related Factors ◽  
Cross Sectional ◽  
Health Officer ◽  
Universal Health

Background: Globally, due to low health care coverage, there have been continued efforts to ensure that there is increased accessibility to quality, affordable and equitable universal health care (UHC) services in most parts of developing countries, such as within Nakuru county in Kenya.Methods: The study focused on determining health workforce gaps in health care facilities that affect the implementation of UHC in Nakuru West Sub County. Cross-sectional study design was applied, data was collected using structured questionnaires, analyzed using statistical package for social sciences 23rd version and presented in charts for ease comparison.Results: The findings of this study indicated that there was shortage of HWCs. This implies that the staffing in the facilities located in Nakuru West Sub-County is inadequate for the implementation of the Kenyan government UHC and it was evident that the mostly affected sections were the nursing, public health officer (PHO), pharmacy, clinical officers and laboratory in that order. Most alarmingly, majority of the HCWs (58.2%) were not being appreciated for good work, despite the fact that they play a key role in the implementation of UHC.Conclusions: It is therefore imperative for the county government which is the arm of the Kenyan government to ensure that they recruit adequate health care workers in all cadres to serve the continuously rising population and HCWs should have adequate level of education, acceptable training skills and be well- motivated.

Catholic Church Advocacy and the Affordable Care Act

2019 ◽  
Author(s):  
Jeanine Kraybill
Keyword(s):  
United States ◽  
Health Care ◽  
Affordable Care Act ◽  
Catholic Church ◽  
Health Care Policy ◽  
Common Ground ◽  
The United States ◽  
Universal Health Care ◽  
The Government ◽  
Universal Health

The American Catholic Church has a long history in health care. At the turn of 19th century, Catholic nuns began developing the United States’ first hospital and health care systems, amassing a high level of professionalization and expertise in the field. The bishops also have a well-established record advocating for healthcare, stemming back to 1919 with the Bishops’ Program for Social Reconstruction, which called for affordable and comprehensive care, particularly for the poor and vulnerable. Moving into the latter part of the 20th century, the bishops continued to push for health care reform. However, in the aftermath of Roe v. Wade (1973), the American bishops insisted that any reform or form of universal health care be consistent with the Church’s teaching against abortion, contraception, and euthanasia. The bishops were also adamant that health care policy respect religious liberty and freedom of conscience. In 1993, these concerns caused the bishops to pull their support for the Clinton Administration’s Health Security Act, since the bill covered abortion as a medical and pregnancy-related service. The debate over health care in the 1990s served as a precursor for the United States Conference of Catholic Bishops’ (USCCB) opposition to the Obama Administration’s Affordable Care Act (ACA) and the Department of Health and Human Services’ (HHS) contraception mandate. The ACA also highlighted a divide within the Church on health care among religious leaders. For example, progressive female religious leadership organizations, such as the Leadership Conference of Women Religious (LCWR) and their affiliate NETWORK (a Catholic social justice lobby), took a different position than the bishops and supported the ACA, believing it had enough protections against federally funded abortion. Though some argue this divide lead to institutional scrutiny of the sisters affiliated with the LCWR and NETWORK, both the bishops and the nuns have held common ground on lobbying the government for affordable, comprehensive, and universal health care.

Exploring Health Services With the Help of a Work Systems Lens

2018 ◽  
Vol 5 (1) ◽  
pp. 28-44
Author(s):  
Christine Welch
Keyword(s):  
Health Care ◽  
Health Professionals ◽  
Open Systems ◽  
Modern Society ◽  
Wicked Problem ◽  
Universal Health Care ◽  
Optimal Solutions ◽  
Work Systems ◽  
Problematic Situations ◽  
Universal Health

The challenges of providing universal health care in modern society is a subject of concern among citizens, patients and health professionals alike. It is discussed among politicians of every persuasion. While there may be little agreement on the way forward, there is at least agreement that this is a ‘wicked' problem that defies a simple solution. Optimal solutions to many separate problematic situations will probably not result in a satisfactory dissolution of the ‘mess.' Open systems approaches are required, recognizing that organizations subsists from moment to moment as a reflection of interactions among people and technologies. As part of such an inquiry, work systems methods may be useful as a vehicle for reflection and comparison.

scholarly journals Addressing Primary Care Inequities in Underserved Areas of the Philippines: A Review

2020 ◽  
Vol 54 (6) ◽  
Author(s):  
Marianne Joy N. Naria-Maritana ◽  
Gabriel R. Borlongan ◽  
Ma-Ann M. Zarsuelo ◽  
Ara Karizza G. Buan ◽  
Frances Karen A. Nuestro ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Workers ◽  
Human Resources For Health ◽  
The Philippines ◽  
Universal Health Care ◽  
Publication Date ◽  
Quality Health Care ◽  
The Government ◽  
Universal Health

Background. Inequities in health care exist in the Philippines due to various modifiable and non-modifiable determinants. Through the years, different interventions were undertaken by the government and various stakeholders to address these inequities in primary care. However, inequities still continue to persist. The enactment of the Universal Health Care (UHC) Act aims to ensure that every Filipino will have equitable access to comprehensive and quality health care services by strengthening primary care. As a step towards UHC, the government endeavors to guarantee equity by prioritizing assistance and support to underserved areas in the country. This paper aims to review different interventions to promote equity in the underserved areas that could aid in needs assessment. Methods. A search through PUBMED and Google Scholar was conducted using the keywords, “inequity,” “primary care” and “Philippines.” The search yielded more than 10,000 articles which were further filtered to publication date, relevance to the topic, and credibility of source. A total of 58 full-text records were included in the review. Results and Discussion. In the Philippines, inequities in primary care exist in the context of health programs, facilities, human health resources, finances, and training. These were recognized by various stakeholders, from government and private sector, and nongovernment organizations, taking actions to address inequities, applying different strategies and approaches but with a shared goal of improving primary care. On another end, social accountability must also be instilled among Filipinos to address identified social and behavioral barriers in seeking primary care. With political commitment, improvement in primary care towards health equity can be achieved. Conclusion and Recommendation. To address inequities in primary care, there is a need to ensure adequate human resources for health, facilities, supplies such as medications, vaccination, clean water, and sources of funds. Moreover, regular conduct of training on healthcare services and delivery are needed. These will capacitate health workers and government leaders with continuous advancement in knowledge and skills, to be effective providers of primary care. Institutionalizing advocacy in equity through policies in healthcare provision would help realize the aims of the Universal Health Care Act.

scholarly journals Creating universal health care in Ireland: A legal context

Health Policy ◽  
2021 ◽  
Author(s):  
Manfred Lau ◽  
Charles Larkin ◽  
Michael Harty ◽  
Shaen Corbet
Keyword(s):  
Health Care ◽  
Universal Health Care ◽  
Legal Context ◽  
Universal Health

scholarly journals P1490MONTHLY TREND AND SEASONALITY IN ACUTE AND CHRONIC HEMODIALYSIS; RESULT FROM NATIONWIDE DATABASE OF MEDICAL BILLS OF UNIVERSAL HEALTH CARE INSURANCE SYSTEM IN JAPAN

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Ryoya Tsunoda ◽  
Hirayasu Kai ◽  
Masahide Kondo ◽  
Naohiro Mitsutake ◽  
Kunihiro Yamagata
Keyword(s):  
Health Care ◽  
Seasonal Variation ◽  
Chronic Hemodialysis ◽  
Universal Health Care ◽  
Health Care Insurance ◽  
Individual Data ◽  
Insurance System ◽  
Number Of Patients ◽  
Medical Bills ◽  
Universal Health

Abstract Background and Aims Although knowing the accurate number of patients of hemodialysis important, data collection is a hard task. Establishing a simplified and prompt method of data collection for perspective hemodialysis is strongly needed. In Japan, there is a universal health care insurance system that covers almost all population. This study aimed to know a seasonal variation of hemodialysis patients using the big database of medical bills in Japan. Method Japanese Ministry of Health, Labour and Welfare established a big database named National Database (NDB), that consists of medical bills data in Japan. All bills data were sent to the data server from The Examination and Payment Agency, the organization that receives all medical bills from each medical institution and judge validity for payment. Each record of the database consists of bill data of one patient of a month for each medical institution. All data were anonymized before saved in the server and gave virtual patient identification number (VPID) that is unique for each patient. VPID is a hash value calculated by patient’s individual data such as name, date of birth, so that the value cannot be duplicate. Calculation of VPID is executed by an irreversible way to make it difficult to decrypt VPID into patient’s individual data. This database includes all information about medical care of whole population in Japan except for patients not under the insurance system (patients under public assistance system, victims of the war, or any other specified people under the public medical expense). Using this database, we investigated monthly number of patients who were recorded to be undergone hemodialysis (HD, includes hemodiafiltration). We searched chronic HD patients who have undergone HD on the month and continued it for 3 months, and acute HD patients who have discontinued HD within 3 months. Results In NDB, the number of chronic HD patients under public insurance system who confirmed to have undergone HD in December 2014 was 284 433. In contrast, the number of HD patients identified from the year-end survey by Japanese Society of Dialysis Therapy in the same year was of 311 193, but this number includes patients not under insurance system. Incidence rate of acute HD in Japan was persisted at 30-39 per million per month. There is a reproducible seasonal variation in number of acute HD patients, that increases in every winter and decreasing in every summer. The significantly highest frequency was observed in February(38.5/million/month) compared with September(30.6/million/month), the lowest month of the year (p<0.01). Conclusion We could show the trend in number of HD patients using nationwide bills data. Seasonality in some clinical factors in patients under chronic hemodialysis such as blood pressure, intradialytic body weight gain, morbidity of congestive heart failure, and, mortality, has been reported in many observational studies. Also, there are a few former reports about seasonality in AKI. However, a report about acute RRT is few. From our knowledge, this is the first report that revealed monthly dynamics of HD in a whole nation and rising risk of acute HD in winter. The true mechanism of this seasonality remains unclear. We have to establish a method to collect clinical data such as prevalence of CKD, causative diseases of AKI, kinds of precedent operations, and medications in connection with billing data.

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