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    Hospital issues in the 21st century

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    arniemoldogo

    Posts : 4
    Join date : 2010-04-21

    Hospital issues in the 21st century

    Post  arniemoldogo on Thu 22 Apr 2010, 1:36 am

    Hospital Issues

    • Uprising Cost of Health Care in the Philippines
    Inequalities in access to quality of health care among Filipino patients are glaring. While few health care facilities in the country boast meeting world class standards on quality care, while others suffer from dire lack of equipment and inadequate staff.

    Such inequity is an extension of the imbalance on the country’s socio-economic development which favors the high income and urban sector of the population. Equity in health care has worsened during the period under consideration: the non-poor who are less burdened by illness or diseases receive more health care services while the poor who bear a greater burden of illnesses receive less health care.

    The poor endure a greater burden of major diseases such as diabetes, cancer, heart disease, disability and epilepsy and thus “…need to seek quality health care that is largely provided by public and private hospitals and private clinics in the Philippines,”

    “However, what is observed in the Philippine case is that there is inequity: the poor are not getting treatment according to their needs.”
    Financial difficulties may have forced the poor to postpone seeking care until more severe stages of the illness, thus resulting in the bypass of primary basic health facilities, the Manila-based lender pointed out.

    The failure of health care supply to keep pace with population growth also posed a constraint.“The population of the Philippines has been increasing at an annual rate of 2.3%, so if supply of services is not keeping up with the population growth there will be a decline in the utilization rate of the services,” the DOH paper read.

    Health care utilization has declined at a faster rate than population growth, which could be attributed either to a decline either in the supply of services or in the demand or both, it added. The decline in supply could be due to scarcity of materials as well as lack of staff and equipment, which may have forced people to go to tertiary or private health care facilities that are better equipped and staffed, even for basic and primary health care. The lack of supply of hospital beds and physicians as well as the uneven distribution of health personnel across the regions are among the reasons cited for the differences.

    • Understaffed
    Ironic that there are thousands of licensed nurses in the Philippines but hospitals are still understaffed. This is related to inadequate budget allotted for health. Migration is the cause of understaffed, nurses and doctors are leaving the country driven by low compensation. This migration leads to reduction of skilled and efficient health workers in our country that will results to poor quality of care. Though one of the solutions that hospitals are doing is to accept volunteers or trainees to compliment lack of manpower in the hospitals. Sad to say, it has been a business for funding supplies and facilities.

    • Waste management
    There was no adequate teaching or pre-service or in-service training program on health care waste management for health personnel, including medical doctors, health inspectors, nurses, and technicians in the hospital that makes everyone susceptible with infections and hospital acquired diseases and can be a threat in environmental health especially places near the hospitals.

    Recommendations:

    • Uprising cost of health.
    To address these problems, our group proposed that the government evaluate the databases of the state-owned Social Insurance System and Philippine Health Insurance Corp. (PhilHealth) to study the scope for expansion in health care services and facilities. PhilHealth should continue to promote its services to provinces and municipalities where coverage rates are low.

    • Understaffed.
    Migration and lack of fund in the hospital leads to understaffed. Migration is somehow personal and we don’t have the control for that, but the fund that our government is allotting to the health is really not sufficient to make out health workers stay. Recommendations to aide this issue will be a proposal to LGU to establish sources of fund or give funds/budget in hospitals under their jurisdictions to help this hospitals comply with the needs. Example will be the Ospital ng Makati, where the LGU is funding the institution and giving a lot of benefits to the people.

    • Waste management.

    In the Philippines, HCWH-Southeast Asia launched its Health Care Waste Assessment Project (HWAP). The first step is to put in place a rigorous segregation program. Sorting healthcare waste once it has been mixed is extremely hazardous and should never be attempted.
    Another important step that healthcare facilities can take is to reduce the number of unnecessary injections. Many patients have an unfounded belief that injections are better than pills. However, the used syringes are capable of spreading infections like HIV and hepatitis. Wherever a treatment can be given orally, that should be the preferred method. This act should be strictly implemented in hospitals to reduce the case of infections and diseases, this will also promote environmental health sanitation program. Hospitals should have a dedicated Health Care Waste Management Committee responsible for developing the health care facility's waste management plan which includes policies and guidelines on proper waste management, training and education, and monitoring. The committee schedules a monthly meeting to discuss problems related to waste management and find new ways to recycle and reuse products. Different hospitals found a variety of ways to utilise the money saved or earned from their new waste management practices — in one case there was enough to pay the salary of the waste manager, making the whole system self-sustaining.

    arniemoldogo

    Posts : 4
    Join date : 2010-04-21

    in addtion to the hospital issue

    Post  arniemoldogo on Thu 22 Apr 2010, 1:59 am

    guys we posted macro recommendations for the issues. for micro recommendations in the issue of understaffed, we will be proposing a managerial trainings for nurses and for all the staff of the institution that will empowered them to be more independent in decision making and be more skilled and efficient in delivering health care so promote quality of care. For the waste management, we focus here cause it will create a certain problem in the environment, so our recommendations will be the hospital have a dedicated Health Care Waste Management Committee responsible for developing the health care facility's waste management plan which includes policies and guidelines on proper waste management, training and education, and monitoring.

    that's all. Smile
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    Tet Soriano

    Posts : 63
    Join date : 2010-04-20
    Age : 28
    Location : Quezon City

    Re

    Post  Tet Soriano on Thu 22 Apr 2010, 6:26 am

    I agree to your recommendation about the promotion of PhilHealth. But what about those people who are not covered with these health benefits? I agree to your recommendation about the waste managament in hospital. I suggest there should be an ACTIVE Sanitary Inspector to make sure that all the hospitals are adhering to the waste management law.

    cpenuliar

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    Join date : 2010-04-20
    Age : 29

    Re: Hospital issues in the 21st century

    Post  cpenuliar on Thu 22 Apr 2010, 9:35 am

    I also agree to your recommendation on hospital waste management; however, the need still exists for education and behavior changes at the sites where regulated medical waste is generated. Health care personnel also need a better understanding of which items should and should not be designated as infectious/hazardous waste to reduce the volume and cost of disposal.

    Mercury-containing products is one of the hazardous waste found/used in all hospitals. Mercury is another significant environmental health hazard. Absorption of this volatile metal in sufficient quantities causes poisoning, which is characterized by salivation, loose teeth, spongy gums, cheek ulceration, necrotic jaws, marked emaciation, neuritis, and tremors. As health care personnel, we must be more aware on how our facilities dispose of mercury-containing products (eg, thermometers, sphygmomanometers, batteries), which may be burned in medical waste incinerators. When mercury is incinerated at high temperatures, it becomes a gas and settles on land and water, where both wildlife and humans can ingest it. The DOH sets guidelines for the gradual phasing out of mercury in all health care facilities. Right now medical instruments and equipment made without mercury are available, and we should use them as alternatives to mercury-containing products.

    zacedieh12

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    Join date : 2010-04-20

    hospital issues in 21st century

    Post  zacedieh12 on Thu 22 Apr 2010, 11:41 am

    I agree with the two comments, although hospitals implement waste segregation and management their regulations are not consistently followed by the many patients’ watchers. There is a need for continuous information dissemination and most especially behavior change in the proper disposal of infectious materials (ex. Oral and nasal secretion). There should have political will in the part of the sanitary inspectors to implement the regulations set by the hospital regarding waste management.
    I also agree with the gradual phasing out of the mercury-containing products in the hospitals, digital thermometers are more expensive than the mercurial ones but it is not prone to breakage and exposure to mercury that is harmful to health.
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    Tet Soriano

    Posts : 63
    Join date : 2010-04-20
    Age : 28
    Location : Quezon City

    Re

    Post  Tet Soriano on Thu 22 Apr 2010, 12:15 pm

    I agree that even in the hospital, there should be behavioral change among patients and all other health personnel.I believe that if the hospital will become firm with the policies, change is possible. You are right that political will has also a big impact on this.

    nina_vil
    Guest

    Re: Hospital issues in the 21st century

    Post  nina_vil on Thu 22 Apr 2010, 1:06 pm

    Thank you for your feedbacks, we all know that there are standards and policies that needs to be imlemented right? we nurses, we always do our part to advocate and educate in our full power and competence to address such issues. regarding your feedbacks about proper education and awareness promotion, i dont think that we lack capabilities nor neglected that issue. the main problem is that, CHANGE should begin in oneself right? change is inevitable.it is hard to change a person's belief, it will take a lot of time and I believe that it is still possible. Smile

    kecs72
    Guest

    Re: Hospital issues in the 21st century

    Post  kecs72 on Thu 22 Apr 2010, 1:15 pm

    I firmly believe in behavioral change, and this should begin within ourselves. And by doing do one can apply this at work. Simple measures like advocating the non-use of disposables (utensils, plates...)or a policy that all plastics brought in should be limited by the patient / family. There are numerous ways that we can use to reduce the amount of wastes. A big percentage of waste produced are non-hazardous wastes and this something we can address at our level. Others have imposed on giving fines for violations for both the patients and staff. We nurses need to be that spark that will eventually lead to the light.

    kimmina

    Posts : 9
    Join date : 2010-04-20

    Re: Hospital issues in the 21st century

    Post  kimmina on Thu 22 Apr 2010, 2:36 pm

    I strongly agree with the behavioral change. Change should always come from within ourselves. This is very essential in voicing out what we really have to advocate as health care workers. As for the policies and guidelines, it is saddening that the government and even the hospitals itself cannot fully implement the standard measures that must be followed in order to achieve optimum health intervention. More than the financial matter, i think this is also the reason why some nurses choose to go abroad than stay here in the Philippine health care setting. They cannot anymore take the unchanging and even worsening problem in our field-- understaffing because of scarcity in budget, poor health care delivery to poor people, improper waste disposal, and so on.

    zentan

    Posts : 5
    Join date : 2010-04-21

    Re: Hospital issues in the 21st century

    Post  zentan on Thu 22 Apr 2010, 7:15 pm

    It is ironic how there are hundreds of thousands of registered nurses in the country but hospitals are saying that they do not have enough nurses in their institutions. Most hospitals are too cheap and refuses to pay for more staff that is why they resort to having volunteers. And volunteers, i strongly believe, are being taken advantage of they work just hard as any staff do yet most hospitals don't even give them any sort of compensation.

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