Policy analysis on establishing criteria for population versus individual-based health services towards achieving Universal Health Care

Leonardo Jr R Estacio; Ma-ann M Zarsuelo; Christine Mae S Avila; Ma Esmeralda C Silva; Michael Antonio F Mendoza; Carmencita D Padilla

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Policy analysis on establishing criteria for population versus individual-based health services towards achieving Universal Health Care

Author: Leonardo Jr. R. Estacio ^{1
,

2} ; Ma-Ann M. Zarsuelo ^{1
,

3} ; Christine Mae S. Avila ¹ ; Ma. Esmeralda C. Silva ^{1
,

4} ; Michael Antonio F. Mendoza ^{1
,

5} ; Carmencita D. Padilla ⁶
Author Information

1. University of the Philippines Manila Health Policy Development Hub
2. College of Arts and Sciences, University of the Philippines Manila
3. Institute of Health Policy and Development Studies, National Institutes of Health, University of the Philippines Manila
4. College of Public Health, University of the Philippines Manila
5. College of Dentistry, University of the Philippines Manila
6. University of the Philippines Manila
Publication Type:Journal Article
Keywords: Delivery of Health Care
MeSH: Healthcare Financing; Health Services Accessibility
From: Acta Medica Philippina 2020;54(6):677-685
CountryPhilippines
Language:English
Abstract: Background:The enactment of the Universal Health Care Act is anticipated to bring wider coverage and accessibility of quality healthcare services as stipulated in its objectives. With the integration of the healthcare system at the provincial level, determining population- and individual-based services is crucial in mapping the managerial and financial roles. Hence, this study aimed to establish the criteria for identifying population-based and individualbased health services in the Philippines.
Methods:A systematic review of literature was conducted to generate evidence for the policy brief and discussion points on the roundtable discussion spearheaded by the UP Manila Health Policy Development Hub in collaboration with the Department of Health. Key stakeholders of the policy issue convened to share expertise and insights in determining criteria for population- and individual-based services, intending to generate consensus policy recommendations.
Results:The general scope of individual-based health services stipulated in the Law are to be financed under the benefit packages of PHIC and HMOs. Meanwhile, population-based services are those that address public health issues such as health promotion and disease surveillance. Several services considered as ‘grey areas’ are those that fall in the overlap of the individual- and population-based services. These services may be examined through an outcome-based algorithm that examines fragmentation issues both in the supply and demand side of service delivery.
Conclusion and Recommendation:Proposed criteria in identifying individual- and population-based services include the number of recipient/s, the effectivity of service delivery and utilization, and source of funding. Health programs that are in the grey areas can be examined through an outcome-based algorithm.
Full text:2584-Article Text-14167-1-10-20201226.pdf