1.Envisioning the Health Research System in the Philippines by 2040: A perspective inspired by Ambisyon Natin 2040.
Jaifred Christian F LOPEZ ; Chiqui M DE VEYRA ; Lester Sam A GEROY ; Reneepearl Kim P SALES ; Teddy S DIZON ; Eva Maria CUTIONGCO-DE LA PAZ
Acta Medica Philippina 2019;53(3):261-267
BACKGROUND AND OBJECTIVE: This paper aims to describe long-term visions for health research in the Philippines. Ambisyon Natin 2040, an overarching vision for a dynamic country by the year 2040, is its main inspiration as this enables innovation and sustainable development.
METHODS: The health research profile conceptual framework developed by Tugwell et al., (2006) was utilized to structure the articulation of these visions. Review of related literature, reports, and documents and in-depth interviews with key players in health research were conducted.
RESULTS: In view of economic and technological developments in the country, it is expected that in 2040, health research priorities shall be more trans-disciplinary and more advanced. Research on health regulation and ethics will continue to be of importance. A more enabling environment for health research is also envisioned, since majority of research funding is expected to come from government, in addition to more research-friendly laws. More innovative platforms will be utilized to disseminate research results. The increasing international exposure and impact of academic work in the Philippines is also envisaged.
CONCLUSION AND RECOMMENDATIONS: Health research in the Philippines has been benefitted by a lot of gains and advances in the past years. Thus, to create an enabling health research system in the Philippines by 2040, focusing on innovations in health research, increased number of funding sources, and crafting of better policies on health research should be pursued. Sustaining these gains and advancing health research in our country entail collective effort from different stakeholders, both public and private.
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2.The impact of covid-19 pandemic on urology residency training programs in the Philippines: A descriptive study.
Daryl K. Koa ; Alfredo Uy Jr. ; Eli Paul F. Madrona ; Rodney M. Del Rio ; Meliton Alpas III ; Karl Marvin M. Tan ; Romeo Lloyd T. Romero ; Ralph Rabanal ; Ryan Josef Tuazon ; Jan Ernest Guy G. Yadao
Philippine Journal of Urology 2021;31(1):49-54
OBJECTIVE:
To provide an overview on the impact of healthcare disruption by the COVID-19 pandemic to urology training programs in the Philippines.
METHODS:
A survey questionnaire was used in collaboration with the study done by Rosen, et al. last May 2020. Telephone survey of the study population was done determining the status of resident staffing, workload, health/wellness, and didactics. Numerical and categorical data were analyzed and descriptive statistics are provided.
RESULTS:
All the observations on resident time in the workplace, including assignment to teams (81%), redeployment responses (55-97%), and remote clinical work (65%) were significant. Fifty one percent of residents have decreased research load. Eighty one percent have didactics in small groups. Fifty-five percent have 1 to 2 Video-based learning/conferences per week (p=0.007) followed by those with 3-4 with 98% (p=0.120) and those with >5 with only 6% (p=0.729). For Resident health and wellness, 87% of the residents were exposed to COVID-positive patients, but only 8% of residents were COVID positive (p=0.591). Lastly, 59% of the participants do not have access to wellness programs.
CONCLUSION
Data from respondents revealed significant changes in the different aspects of the present study. Urology residents spent more time away from their specialties, and have been re-deployed to COVID-19 floors. Ambulatory services, conferences, educational lectures have mostly shifted to virtual platforms. Resident concerns for COVID-19 exposure have been addressed properly; however, wellness programs have not been widely available for residents. As a first national survey, the present study may give significant insights on program changes and may be used as preliminary data for future studies.
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3.Validation study of a psoriasis registry questionnaire.
Journal of the Philippine Medical Association 2019;98(1):1-14
INTRODUCTION:
Psoriasis affects 0.1-3% of the world's population. It is a chronic multifactorial disease with a
genetic basis and various triggering factors. In the Philippines, extrapolated data from 2004 reveals a 2%
prevalence. Thus it is important to develop a database with psoriasis patients' demographics, disease
characteristics, treatment and quality of life.
Most institutions still rely on paper-based methods of recording patient data. This is prone to error and
destruction. Further consolidation and analysis of this unsystematic data is problematic, making it difficult to assess real-time setbacks and develop programs.
OBJECTIVE:
To develop and assess the validity of a Psoriasis Questionnaire in the local setting, which will be
further utilized towards developing a Psoriasis Registry. The data from this can in turn be used to generate a Psoriasis Guideline.
METHODS:
This is a multicenter study. The Questionnaire was developed from Psoriasis literature and worldwide
registries, as well as local patient encounters. It was answered by Dermatologists and their patients. Cronbach's alpha (CA) was used to check for validity and internal consistency of the questionnaire.
RESULTS AND CONCLUSION
124 questionnaires were accomplished. Each part of the questionnaire was assessed
with CA. Some sections showed CA <0.70, indicating variability in the test response. To improve this, some
modifications in the Questionnaire were recommended. The overall CA score however was 0.8, indicating that in
totem the questionnaire is consistent and valid.
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4.Prevalence, epidemiology and clinical characteristics of melasma in Philippine dermatology patients: A multicenter, cross-sectional study.
Liezel A. Gener-Pangilinan ; Evangeline B. Handog ; Ma. Teresita Gabriel ; Benedicto D. Carpio ; Ma. Angela M. Lavadia ; Wilson Loginus
Journal of the Philippine Medical Association 2019;97(2):1-9
BACKGROUND:
Melasma is an acquired hyperpigmentary disorder occurring in the sun-exposed areas of the face and neck. There is little information on its prevalence, epidemiology and clinical characteristics in the Philippines.
OBJECTIVE:
To determine the prevalence, epidemiology and clinical characteristics of melasma in Philippine dermatology patients
METHODS:
This was a multicenter, cross-sectional study conducted from July to December 2013. The investigators determined the prevalence of melasma in 12,068 dermatology patients from 6 government hospitals and private centers in Metro Manila, Philippines. The melasma patients, aged 18 years and above were examined and given self-administered questionnaires to determine the epidemiological and clinical characteristics of their melasma.
RESULTS:
Of the 12,068 dermatology patients who were seen at the selected hospitals and private centers, 153 (1.26%) were clinically diagnosed with melasma. Majority of the melasma patients were Filipinos (73.20%), aged 41-50 years old (37.91%), with an average age of 42.40 + 9.68 years, and Fitzpatrick skin types III and IV (29.41% and 57.52%, respectively). Melasma was more prevalent in females (81.70%), wherein majority had a prior history of pregnancy (76.8% of the females). Oral contraceptive use was also reported in 37.6% of the female patients and 63.83% of those who have used OCP, have used it for only 1 year or less. Majority had no thyroid disease (75.16%) and daily sun exposure was limited to 1 hr or less for most patients (43.14%). Their melasma was mostly malar in distribution (60.13%), epidermal (61.44%), and mild (51.63%) to moderate (27.45%) in severity. The average mMASI score was 4.63 + 3.32.
CONCLUSION
Prevalence of melasma was low among the Philippine dermatology patients sampled. Majority of the melasma patients were Filipinos, aged 41-50 years old, with Fitzpatrick skin type IV, limited sun exposure and no thyroid disease. They were mostly females, with a prior history of pregnancy. Their melasma was mostly malar, epidermal, and mild in severity. These descriptive data can serve as baseline information for further studies on melasma in the Philippines.
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5.Patterns of resolved medical malpractice cases in the Philippines.
Journal of the Philippine Medical Association 2018;96(2):46-50
BACKGROUND:
Medical malpractice is an act or omission by a health care provider that deviates
from accepted standards of professional practice leading to injury to the patient. Tort actions of
negligence prevail when a plaintiff establishes in court that: (1} the physician had a duty to the
patient referred to as patient-physician relationship; (2} a dereliction or breach of that duty
occurred (3} the dereliction of duty resulted in damage to the patient, and (4} the patient was, in
fact, damaged (Brown, 1976).
METHODS:
The study was conducted to describe the patterns of the resolved medical malpractice
cases in the Philippines. Transcripts of records of resolved medical malpractice cases were
retrieved, analyzed and evaluated by 2 lawyers and the researcher.
RESULTS:
Negligence was established as the main cause of litigation among the 6 resolved
medical malpractice cases. Eight physicians were found liable while 4 were acquitted. The
litigation process was protracted, lasting 13-24 years.
CONCLUSION
The results of the study serve to provide an overview of medical malpractice
cases in the Philippines. It is hoped to increase the awareness of health care providers
regarding medical malpractice.
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6.‘I am who I am’: A phenomenology of strategic roles portrayed by creatively insubordinate Filipino medical academic leaders
Maria Minerva P CALIMAG ; Allan B DE GUZMAN
Journal of Medicine University of Santo Tomas 2018;2(1):224-236
Background
Organizational life is a drama in
which all are actors playing different roles, hence it
is made relevant by its contextually-embedded focus
on role enactment.
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7.Impact of COVID-19 pandemic in Filipino occupational therapy practice across regions.
Rod Charlie Delos Reyes ; Karla Czarina Tolentino ; Wendy Sy
Philippine Journal of Allied Health Sciences 2021;4(2):22-28
The Philippine Government has implemented community quarantine throughout the country to respond to the COVID-19 pandemic that has since
profoundly affected the lives, health, and well-being of individuals, families, and communities. This has also created an impact on the practice of
occupational therapy in the country as the pandemic presents occupational disruptions in the new normal. This paper summarizes the current
conditions of the practice of occupational therapy in times of the unprecedented disaster highlighted by the COVID-19 crisis and the situation of
practitioners and recipients of service across the regions of the country. Findings conclude that there are: (1) emerging delivery service patterns,
(2) consequences of COVID-19 to therapists, and (3) insights moving forward.
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8.A rapid literature review on the strategies for collaboration between occupational therapists and speech-language therapists in the field of augmentative and alternative communication.
Daryl Patrick Yao ; Ghislynne Dei-Anne Andaya ; Kaoru Inoue
Philippine Journal of Allied Health Sciences 2021;4(2):35-41
An alternative and augmentative communication (AAC) device replaces or supplements a person’s natural speech. Speech-Language Pathologists
(SLPs) collaborate with a team of healthcare professionals in the process of identification and use of the right AAC device for a person with complex
communication needs (CCN). In the Philippines, occupational therapists (OTs) and SLPs are more likely to collaborate in the treatment of their
clients due to their interprofessional education (IPE) experience. However, most Filipino SLPs do not engage in interprofessional collaboration
(IPC) when rendering AAC services. Thus, there is a need to identify existing literature that tackles collaborative practices to raise the quality of
service and care. Hence, this study aimed to identify and discuss existing literature that documented IPE and IPC strategies between OTs and SLPs
in the field of AAC. The structure of this literature review was guided and adapted from the topics outlined in the preferred reporting items for
systematic reviews and meta-analyses (PRISMA). Literature archived in two databases (Pubmed and Scopus) were reviewed. Two articles out of
five studies were included in this review. Strategies found were “case based learning approach” for post-graduate students and the “Beyond Access
model” in supporting practitioners. In conclusion, there is a dearth of literature on IPC practices among OTs and SLPs in the field of AAC. There is a
need to report IPE and IPC efforts in the Philippines to provide applicable strategies to the local healthcare landscape.
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9.The application of the ADDIE model and the training cycle in the development, implementation and evaluation of training program on data use for decision-making among end-users of electronic health information system in geographically isolated and disadvantaged areas.
Jonathan P. Guevarra ; Arturo M. Ongkeko Jr. ; Carl Abelardo T. Antonio ; Amiel Nazer C. Bermudez ; Portia H. Fernandez&ndash ; Marcelo
Acta Medica Philippina 2021;55(4):398-405
OBJECTIVE:
This paper describes the process utilized in developing a training program on data use for decision-
making tailored for real-time monitoring of maternal and child health indicators through Community Health
Information Tracking System (rCHITS) end-users in selected areas in the Philippines.
METHODS:
Guided by the ADDIE (Analysis, Design, Development, Implementation and Evaluation) model and
the training cycle, existing records and reports lodged with the National Telehealth Center (NTHC) pertaining to
rCHITS were reviewed, supplemented by interviews with the technical staff of the NTHC and discussion with
healthcare workers. Training design was developed, training modules and materials were prepared, critiqued, revised
and finalized. The training was implemented and evaluated using an evaluation tool designed for this specific
capability-building endeavors.
RESULTS:
A tailored training program on data use for decision-making was designed for rCHITS end-users in select
areas in the Philippines. The process of developing the training program was guided by the ADDIE Model and the
Training Cycle. Training was delivered to a total of 128 public health workers. Majority of the participants gave high
evaluation on the clarity and relevance of objectives, discussion of topics, methods of delivery, and time devoted
in addressing issues (range 3.5-3.8 out of highest possible score of 4)
CONCLUSION
This paper demonstrates the utility of the ADDIE Model and the Training Cycle in developing a training
program aimed at enhancing the capability of the field personnel in utilizing the data generated from rCHITS in
decision-making. Training participants must also be monitored and evaluated in their workplace setting in order to
determine if the concepts and principles covered during the training program are put into practice.
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10.Impact analysis of regulatory regime options for integrated health care provider networks in the Philippines
Katherine Ann V. Reyes ; Reneepearl Kim P. Sales ; Julienne Lechuga ; Jemar Anne Sigua
Philippine Journal of Health Research and Development 2024;28(1):1-9
Background:
The enactment of the Philippine Universal Health Care (UHC) Act mandates the formation of Integrated Health Care Provider Networks (IHCPN), linking hospitals and health facilities, which includes government and privately-owned primary care providers. While hospitals and some health facilities are already under government regulation, primary care providers have not been subjected to formal licensing requirements. In this changing service delivery model, the possible impact of three regulatory policy options being considered need to be assessed according to the goal of ensuring that health services remain affordable and are of high quality.
Methodology:
A multi-method approach to regulatory impact analysis (RIA) systematically assessed three regulatory options: 1) one Department of Health (DOH) license per hospital and health facility (status quo); 2) one DOH license for all public hospitals and health facilities within an IHCPN and another for individual private hospitals and health facilities; and 3) one DOH license per individual hospital and health facility, and one DOH certification issued to individual hospitals and health facilities as part of an IHCPN. Information from literature, documents, focus group discussions, and cost analyses were triangulated.
Results:
Regulators are faced with two main risks: there is no standard for networked health care delivery that could provide a foundation for regulation, and provider participation is voluntary, which could lower the interest of private providers to integrate. The three regulatory options considered these risks. Option 1 requires the least change in regulatory policy, but is expected to increase costs to regulators due to the expansion of licensing and enforcement work covering primary care providers. Option 2 requires the most change in regulatory policy, but may be the least expensive to enforce, especially if all facilities join a network. This can also be preferred in a setting with existing interlocal health zones, and participation in the network by private providers poses the most challenge. Option 3 is a tiered regulatory set up that projects the highest cost to regulators as a result of both establishing new certification standards and guidelines on top of a wider scope for enforcement.
Conclusion
This is the first RIA conducted for the Philippine health system, with challenges similar to those experienced in developing countries. Across the three pre-determined regulatory models, the least costly option may not be the easiest to mount and enforce. Implementability appears to be a stronger consideration which seems to be hinged to the option requiring incremental rather than large form of changes.
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