Background: In order to financially sustain the participation of the private sector in the UHC, there is a need to find reasonable balance of accountability in the costing of health services. The costing must be based on actual resources used from the perspective of the private health service provider. Objective: The objective of this paper was to determine the cost of primary care services from the framework of the UHC reform in the private sector. Method: This is a multi-method approach to cost-identification in establishing and providing primary care health service in the UHC. The approaches used by the authors included review of published literature, laws and policies from DOH and other regulatory agencies. From this review, they develop the minimum facility requirement for basic primary care facility and primary care facility with ancillary services. They used the actual expenditures of existing primary care clinics, 2021 quotations from equipment and supplies companies, published construction rates and consensus approach to establish the cost. Based on 2021 value of Philippine Peso, they estimated the cost of constructing and operating a primary care facility. Results: The total estimated cost of building a primary health care facility based on the DOH licensing standard was estimated to be around PhP2,490,000. The cost of furniture and equipment as required in the DOH AO was PhP474,685. Thus, the total cost of the construction and equipment for a basic primary care facility setup is PhP2,964,685. We estimated the annual operating cost with the building estimated to depreciate in 20 years and the furniture and equipment in 5 years, the annualized cost for the building is PhP124,500 and for the furniture and equipment PhP94,937. The total annual salary of the staff based on government standards was PhP2,381,962. The maintenance, operating and overhead expenses (MOOE) which included water and electricity, repair and maintenance, waste disposal, supplies and other fees was PhP451,190. The total annual operating cost of a basic primary care facility is PhP3,052,590. This facility can provide basic services such as outpatient consultation and minor surgeries. Using the same approach for the basic facility, the total annual operating cost of a basic primary care facility with ancillary service is PhP11,023,670. This facility can provide outpatient consultation, minor surgeries and primary care services such as health education and preventive care plus the ancillary services like pharmacy, clinical laboratory and x-ray. For patients with diabetes, the total annual cost is PhP8,986. The significant cost driver is the clinical assessment and non-pharmacologic intervention. The researchers found the same cost pattern for the annual cost care of patients with hypertension but with a slightly higher annual total with PhP9,963. Their sensitivity analysis based on inflation, construction, equipment and operating expense may increase these cost estimates by 20% in the next 5 years. Conclusion Based on their findings, the current per capita support from PHIC Konsulta package is not adequate in the private sector both for wellness and care of patients with chronic condition. PHIC needs to consider adjusting per capita rates and consider case rate payment as it is currently doing for hospital care. Without this proposed adjustment, only those patients in the higher socioeconomic status will be capable of consulting the private sector. This scenario defeats the equity issue that is a primary concern in the UHC.
Universal Health Care

Readiness of Health Care Staff: Statement 1. Family physicians and their staff should prepare themselves mentally, physically and emotionally before resuming clinic services. Prior to starting every clinic day, physicians and their staff should take their temperature and note respiratory symptoms. Statement 2. All clinical staff should be properly trained on proper use of PPEs, clinic disinfection, infection control and other safety procedures. Statement 3. Family Physicians should design an office management and operations plan that includes triage, patient flow, treatment and other patient care protocols including strict implementation of infection prevention and control procedures, management of PPE supplies and potential staff shortages. Statement 4. The clinic staff must inform their patients of the changes that may result from the new management and operations plan that will be made in the facility Clinic Procedures, Disinfection and Infection Control: Statement 5. After undergoing proper triage, non-COVID 19 patients entering the clinic should use a hand sanitizer, step on a foot bath or pad soaked in chlorine or any approved disinfectant solution at the entrance. All clinic staff, patients and accompanying persons should be wearing at least a mask inside the clinic. They should be instructed to avoid touching their face or mask and perform hand hygiene immediately before and after if cannot be avoided. Statement 6. Appropriate visual alerts or educational posters regarding infection control, proper handwashing, cough or sneezing etiquette should be visible inside the clinic. Statement 7. The clinic facility must have infection prevention and control measures that adhere to international and local standards. Statement 8. After appropriate triaging, a family physician when attending to a patient shall wear mask, single use gloves and eye protection while apron or gown is optional. It is up to the discretion of the family physician to use higher level of protection based on his risk assessment of the clinic environment and if resources are available. Clinical Services Statement 9. As much as possible, family physicians should continue all primary care services in the clinics. However, it is advisable to first limit the service to non-COVID-19 (suspect or diagnosed) patients. Patients needing COVID-19 assessment and management should be referred to appropriate facilities and follow the guidelines set forth by the Department of Health. Statement 10. A patient who consulted and whose symptoms were resolved may choose not come back for follow-up. Patients with chronic diseases may be followed-up at longer intervals if their illness is stable. Statement 11. Referrals for further assessment, diagnostic tests, or other procedures not available in the clinic must first be coordinated with the referral center/site
Personal Protective Equipment ; Triage ; Disinfection