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HEALTH SERVICE

DELIVERY

Philippine Health Sector Performance

October 28, 2014

Cebu City

48 36 40 42 63 62

37 45 61 59 49 23 35

7 24 34 19

127

16

75 46

125 137

25 48 24 44

26 33

71

36

69 24

9

31 28 52 42 36

53 41 48 31 46 43

26 46

19 55 40

18

62

19

38 38

112 99

18 27

37 34

22 22

38

5

23

11

10

23

3

22 7

30 42

3

15 9

13 7

7

20

14

12

7

0

59

2

3

1

10 5

0

3 9

10

3 1

3

5

3

0

0

Private 57%

Government 43%

Level 1 655 40%

Level 2 615 38%

Level 3 234 14%

Level 4 117 7%

Philippine Hospitals in 2011

17.10

48.30

16.00

92.10

18.50

48.6

106.4

46.7

120

52.8

88.6

400

112.1

100

93.9

194.2

214.2

154.6

635.7

221.4

0 100 200 300 400 500 600 700

Private

DOH-retained

LGU hospitals

Other government

All Hospitals

Average Number of Hospital Beds

Level 4 Level 3 Level 2 Level 1

52.8

265.6

38.7

132.2

59.3

110.4

240.2

104.5

285.2

122.7

0 50 100 150 200 250 300

Private

DOH-retained

LGU hospitals

Other government

All Hospitals

"True" Hospitals

Levels 2, 3 and 4 Hospitals All Hospitals

Source: Hospital Statistical Report

Source: Hospital Statistical Report 2011

Number of Beds per 1,000 Population

2.48

0.96 0.97

0.8 0.72 0.75 0.73

0.65

0.93

0.66 0.6

1.31

0.49

0.65

1.33

0.31

0.76 0.83

NC

R

RE

GIO

N I

RE

GIO

N I

I

RE

GIO

N I

II

RE

GIO

N I

VA

RE

GIO

N I

VB

RE

GIO

N V

RE

GIO

N V

I

RE

GIO

N V

II

RE

GIO

N V

III

RE

GIO

N I

X

RE

GIO

N X

RE

GIO

N X

I

RE

GIO

N X

II

CA

R

AR

MM

CA

RA

GA

PH

ILIP

PIN

ES

All "Hospitals", 966

Med,

Surg

, P

edia

, O

bG

842

Pulm

onolo

gy,

496

Op

hth

alm

olo

gy,

471

Card

iolo

gy,

456

Rehab M

ed,

367

On

colo

gy,

299

Th

ora

cic

an

d C

ard

iova

scu

lar

Su

rge

ry,

24

4

Dia

beto

logy,

172

Str

oke U

nit,

88

Ort

hopedic

s,

55 N

UM

BE

R O

F H

OS

PIT

AL

S

Source: Survey of Available Services and Equipment in Hospitals 2011

Services Available in

Philippine Hospitals 2011

0% 50% 100%

ARMM

CAR

CARAGA

NCR

I

II

III

IV-A

IV-B

V

VI

VII

VIII

IX

X

XI

XII

PHILIPPINES

Complete ER Equipment

85% 90% 95% 100%

ARMM

CAR

CARAGA

NCR

I

II

III

IV-A

IV-B

V

VI

VII

VIII

IX

X

XI

XII

PHILIPPINES

Complete Basic Lab Equipment

0% 20% 40% 60% 80%

ARMM

CAR

CARAGA

NCR

I

II

III

IV-A

IV-B

V

VI

VII

VIII

IX

X

XI

XII

PHILIPPINES

Complete Critical Care Equipment

Government

Private

Source: Survey of Equipment and Facilities, BHFS

Source: Survey of Equipment and Facilities, BHFS

72

.6

32

.9

28

.4

27

25

.4

24

.5

21

.4

20

.8

17

.7

17

.1

16

.3

15

.1

14

.3

14

.1

13

.2

10

.3

9.8

4.3

ALL DOCTORS

18

.8

9.7

9.1

8.4

7

6.6

6.6

6.4

5.9

5.4

4.2

4.1

3.8

3.3

2.5

2.4

2.1

1.1

MEDICINE

4.3

2.6

1.1

1

1

1

0.9

0.9

0.8

0.7

0.7

0.6

0.4

0.4

0.3

0.2

0.2

0

SURGEON

32

.3

16

.1

12

12

11

.8

11

.3

11

10

.4

10

.2

10

.2

9

8.1

7.6

7.4

6.9

6.2

6

2.9

GP/FAMILY MEDICINE

5.3

4

1.7

1.7

1.4

1.2

1.2

1.2

0.9

0.8

0.7

0.6

0.5

0.5

0.5

0.2

0.2

0.1

OB-GYN

4.4

3.1

1.8

1.6

1.6

1.5

1.5

1.4

1.3

1

1

0.8

0.8

0.6

0.5

0.4

0.4

0.1

PEDIATRICIAN

Where are our doctors? PhilHealth Accredited Physicians : 100,000 population

1.9

1.7

0.7

0.6

0.6

0.6

0.6

0.5

0.5

0.5

0.3

0.3

0.3

0.2

0.2

0.2

0.1

0

ANESTHESIA

0.5

0.4

0.3

0.3

0.2

0.2

0.2

0.2

0.1

0.1

0.1

0.1

0.1

0.1

0.1

0.1

0

0

PATHO/RADIO

Do the equipment and services

correspond to demand?

Data shows that there is no

correspondence between the

mortality rate of leading diseases

and the level of service availability

in the regions.

0

20

40

60

80

100

120

140

160

0

5

10

15

20

25

30

35

40

45

50

AR

MM

Reg

XII

CA

R

CA

RA

GA

Reg

IV-B

Reg

IX

Reg

XI

Reg

VIII

Reg

X

Reg

II

Reg

VII

Reg

VI

Reg

V

Reg

IV-A

Reg

I

NC

R

Reg

III

Rat

e p

er 1

00,0

00

Nu

mb

er o

f h

osp

ital

s

Diseases of the Heart

No. of Hospitals Rate per 100,000

0

1

2

3

4

5

6

7

8

9

10

0

5

10

15

20

25

30

AR

MM

Reg

IV-B

Reg

VIII

CA

RA

GA

CA

R

Reg

II

Reg

IX

Reg

XII

Reg

V

Reg

XI

Reg

X

Reg

VI

Reg

I

Reg

VII

Reg

III

Reg

IV-A

NC

R

Rat

e p

er 1

00,0

00

Nu

mb

er o

f H

osp

ital

s

Malignant Neoplasm


0

10

20

30

40

50

60

70

80

90

0

5

10

15

20

25

30

35

AR

MM

Reg

IX

Reg

XII

Reg

IV-B

Reg

VIII

Reg

X

Reg

II

CA

R

CA

RA

GA

NC

R

Reg

VI

Reg

VII

Reg

IV-A

Reg

XI

Reg

III

Reg

V

Reg

I

Rat

e p

er 1

00,0

00

Nu

mb

er o

f H

osp

ital

s

Cerebrovascular Diseases


0

5

10

15

20

25

30

35

40

0

5

10

15

20

25

30

35

40

45

50

AR

MM

Reg

XII

Reg

IX

CA

R

Reg

XI

Reg

X

CA

RA

GA

Reg

VII

Reg

VIII

NC

R

Reg

IV-B

Reg

IV-A

Reg

V

Reg

VI

Reg

II

Reg

III

Reg

I

Rat

e p

er 1

00,0

00

Nu

mb

er o

f H

osp

ital

s

Chronic Lower Respiratory Disease


Source: 2011 Survey of Equipment and Facilities, BHFS; 2011 Philippine Health Statistics

Bed Occupancy Rate

A hospital operates efficiently if it has a BOR of 85-95%.

DOH-Retained Hospitals

LEVEL Bed Occupancy Rate

Level 1 (n=4) 70%

Level 2 (n=13) 103%

Level 3 (n=9) 114%

Level 4 (n=25) 108%

All DOH-retained (n=51) 105%

Average length of stay (ALOS) is longer for Surgery and

Medicine cases, while DOH-retained hospitals seem to

have longer ALOS than other hospitals.

2.2

2.5

2.1

2.4

2.4

2.9

4.2

3.6

4.3

3.1

3.2

4.3

2.5

3.3

2.3

2.9

3.2

3.4

2.5

3

2.2

2.7

2.8

3.2

0 0.5 1 1.5 2 2.5 3 3.5 4 4.5 5

All cases

Medicine

OB

GYN

Pedia

Surgery

All Hospitals LGU hospitals DOH-retained Private Hospital

Source: Hospital Statistical Reports, 2011

Ave. outpatient Ave. inpatient Ratio of OP/IP

Level 1 8,188 1,902 5

Level 2 16,805 5,533 5

Level 3 72,565 18,962 4

Level 4 86,775 20,490 7

Total 60,681 14,960 6

Ave. no. of

minor operations

Ave. no. of

major operations

Ratio of

minor/major

Level 1 320 . .

Level 2 803 381 9

Level 3 5,474 2,097 4

Level 4 3,787 3,657 1

Total 3,064 2,594 4

Source: Hospital Statistical Reports, 2011

Pabo Lasso Technique

Assessment of hospital

performance by mixing three

indicators:

1. Bed Turnover Rate (BTR)

2. Occupancy Rate (OCC)

3. Average Length of Stay

(ALOS)

DOH Hospitals (58)

CONNER

TALISAY

LABUAN

S.ISABELA

SANLOWOMEN

BICONSANWESVISSAN

DJRMH

SCHISTO

LHMRH

ECSANMARGOSA

ASTMMC

FNLGH

PALAWAN

STANTHONY

AMAIPAK

BATANESGH

DJSMMC

CARAGA

ITRMC

LASPINAS

SPMC

VET

BATAANGH

LCP

VLZMCPHC

POC

MMMHMC

BAGUIOGH

CLMMRH

ARMC

DRH

BRTTHREGION1

PCMC

JBLMCWESVISMC

COTREGIONAL

NCH

DPJGMRMC

ZCMC

QMMC

NCMH

GCGMH

CVMCTONDO

RITM

NMMC

NKTI

EVRMC

EAMC

VSMMC

SANLZRO

JRRMMC

BICOLMC

BATANGASGH

0

100

200

300

Be

d T

urn

ove

r R

ate

(B

TR

)

0 1 2 3Bed Occupancy Rate (BOR x100)

Zone Hospital Zone Hospital

1 EVERSLEY CHILDS SANITARIUM 3 TALISAY DISTRICT HOSPITAL

1 LABUAN PUBLIC HOSPITAL 4 AMAI PAKPAK MEDICAL CENTER

1 MARGOSATUBIG REGIONAL HOSPITAL 4 AMANG RODRIGUEZ MEDICAL CENTER

1 ZAMBOANGA CITY MEDICAL CENTER 4 BAGUIO GENERAL HOSPITAL A MEDICAL CENTER

2 BATANES GENERAL HOSPITAL 4 BATAAN GENERAL HOSPITAL

2 BICOL SANITARIUM 4 BATANGAS REGIONAL HOSPITAL

2 CONNER DISTRICT HOSPITAL 4 BICOL MEDICAL CENTER

2 DR. JOSE RIZAL MEMORIAL HOSPITAL 4 BICOL REGIONAL TRAINING A TEACHING HOSP.

2 JOSE R. REYES MEMORIAL MEDICAL CTR. 4 CAGAYAN VALLEY MEDICAL CENTER

2 LAS PINAS GEN. HOSP. & SATELLITE TRAUMA

CENTER

4 CORAZON LOCSIN MONTELIBANO MEMORIAL REGIONAL

HOSP.

2 LUIS HORA MEMORIAL REGIONAL HOSPITAL 4 COTABATO REGIONAL A MEDICAL CENTER

2 LUNG CENTER OF THE PHILIPPINES 4 DR. PAULINO J. GARCIA MEMORIAL RESEARCH A MEDICAL

CENTER

2 NATIONAL KIDNEY AND TRANSPLANT INSTITUTE 4 EAST AVENUE MEDICAL CENTER

2 PHILIPPINE CHILDREN'S MEDICAL CENTER 4 EASTERN VISAYAS REGIONAL MEDICAL CTR.

2 PHILIPPINE HEART CENTER 4 FAR NORTH LUZON GEN. HOSP. A TRAINING CENTER

2 PHILIPPINE ORTHOPEDIC CENTER 4 GOV. CELESTINO GALLARES MEMO. HOSP.

2 RESEARCH INSTITUTE FOR TROPICAL MEDICINE 4 ILOCOS TRAINING A REGIONAL MEDICAL CENTER

2 SAN LAZARO HOSPITAL 4 JOSE B. LINGAD MEMORIAL REGIONAL HOSPITAL

2 TONDO MEDICAL CENTER 4 MARIANO MARCOS MEMORIAL HOSPITAL A MEDICAL

CENTER

2 WESTERN VISAYAS SANITARIUM 4 NATIONAL CENTER FOR MENTAL HEALTH

3 ADELA SERRA TY MEMORIAL MEDICAL CENTER 4 NATIONAL CHILDREN'S HOSPITAL

3 CARAGA REGIONAL HOSPITAL 4 NORTHERN MINDANAO MEDICAL CENTER

3 DAVAO REGIONAL HOSPITAL 4 QUIRINO MEMORIAL MEDICAL CENTER

3 DON JOSE S. MONFORT MEDICAL CENTER EXT.

HOSP.

4 REGION I MEDICAL CENTER

3 OSPITAL NG PALAWAN 4 SCHISTOSOMIASIS CONTROL AND RESEARCH HOSPITAL

3 SAN LORENZO RUIZ WOMEN'S HOSPITAL 4 VALENZUELA MEDICAL CENTER

3 SOUTHERN ISABELA GENERAL HOSPITAL 4 VETERANS REGIONAL HOSPITAL

3 SOUTHERN PHILIPPINES MEDICAL CENTER

(former DAVAO MEDICAL CENTER)

4 VICENTE SOTTO MEMORIAL MEDICAL CENTER

3 ST. ANTHONY MOTHER AND CHILD HOSPITAL 4 WESTERN VISAYAS MEDICAL CENTER

Hospital quality (2011 data)

85% 89%

0% 20% 40% 60% 80% 100%

ARMM

CAR

CARAGA

NCR

REGION I

REGION II

REGION III

REGION IVA

REGION IVB

REGION IX

REGION V

REGION VI

REGION VII

REGION VIII

REGION X

REGION XI

REGION XII

Philippines

PhilHealth-Accredited

6%

3%

2%

1%

8%

3%

4%

3%

3%

5%

3%

18%

2%

4%

1%

6%

4%

0% 5% 10% 15% 20%

ARMM

CAR

CARAGA

NCR

REGION I

REGION II

REGION III

REGION IVA

REGION IVB

REGION IX

REGION V

REGION VI

REGION VII

REGION VIII

REGION X

REGION XI

REGION XII

Philippines

ISO Certification

Government Private

6%

1%

2%

2%

5%

1%

0% 2% 4% 6% 8%

ARMM

CAR

CARAGA

NCR

REGION I

REGION II

REGION III

REGION IVA

REGION IVB

REGION IX

REGION V

REGION VI

REGION VII

REGION VIII

REGION X

REGION XI

REGION XII

Philippines

International Accreditation

Government Private

10.3

21.0

16.9

8.8

13.4

0.0

5.0

10.0

15.0

20.0

25.0

Private DOH-retained LGU-owned Other government ALL

DEATHS PER 1,000 ADMISSIONS

Source: Hospital Statistical Report

Sources of Funds

GOVERNMENT PRIVATE

Income from User Fees

Insurance Reimbursements

Direct Government Subsidies

Donations

Other Government Agencies

User Fees

Social and Private Insurance

Reimbursements

Other Forms

How much is PhilHealth’s share in

hospital financing?

7.90%

12.40%

28.20%

18.50% 17.70%

26.50%

38.40%

45.80%

41.60% 40.70%

LEVEL 1 LEVEL 2 LEVEL 3 LEVEL 4 ALL HOSPITALS

Share of PHIC income to total revenue* Share of PHIC income to total income**

*total revenue is the sum of non-PHIC income, PHIC income and appropriated budget from the national government **total income is the sum of PHIC and income from other sources (excluding appropriations)

PhilHealth income and quantified free service per

admission, DOH-retained hospitals, Philippines, 2011

Average PHIC

income

PHIC income per

inpatient

Ave value of free

service

Ave free service

per patient

Level 1 1,552,560 729.27 1,500,000 1,340

Level 2 4,944,846 1,006.26 11,600,000 1,409

Level 3 37,100,000 2,152.31 72,400,000 3,698

Level 4 57,300,000 2,200.83 89,100,000 5,064

Total 39,500,000 1,858.94 69,900,000 4,084

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