OBJECTIVE: Medical trainees have increased burnout compared to the general population. This may be attributed to physiological stress, increased workload, work demands, and the training culture. This study evaluated the association between the current training culture of the residents and fellows and prevalence of burnout at the Philippine Children‘s Medical Center. MATERIALS AND METHODS: Two validated survey instruments were utilized in this study: the Organizational Culture Assessment Instrument (OCAI) to assess the current and preferred training culture among the trainees, and the Maslach Burnout Inventory (MBI) to evaluate the prevalence of burnout among participants. RESULTS: Ninety-two (pediatric residents = 50; fellows = 42) trainees were included in the study. Whereas the current identified training culture in the institution was the market or compete culture, respondents preferred the clan or collaborative culture. Majority of trainees scored high among the 3 domains of burnout: 72% for emotional exhaustion, 64% for depersonalization, and 57% in personal accomplishment. Market culture was significantly associated with emotional exhaustion and depersonalization. CONCLUSION The prevalence of burnout among medical trainees is a significant issue that requires attention. It is essential to implement programs to decrease burnout and shift towards a supportive training culture. This study suggests a gradual shift towards a clan culture, which can help promote collaboration, mentorship, and mutual support among trainees. Such changes will not only improve the well-being of trainees, but also enhance the quality of patient care.
Burnout, Psychological

BACKGROUND: Philhealth, the national health insurance program, aims to reduce out-of-pocket expenditures by subsidizing hospital admission expenses. A possible determinant of its success is the timeliness of management and prevention of discharge delay. OBJECTIVES: To determine the effect of Philhealth enrollment on the timeliness of discharge of patients with acute illness in a government tertiary hospital. METHODS: A retrospective cohort study involving 98 patients (49 Philhealth members and 49 nonPhilhealth members) was done. Data including age, sex, admitting diagnosis, social service classification, and type of Philhealth membership, were collated from the database of patients from the admitting section. Reasons for delay in discharge and number of days delayed from discharge point were obtained. Comparison of baseline characteristics was analyzed using independent t-test for quantitative variables, and Fisher’s exact test for qualitative variables. Association between PhilHealth coverage and hospital delay was analyzed using logistic regression analysis. RESULTS: Discharge delay is 3 times more likely to occur among non-Philhealth members as compared to the Philhealth group. Other variables were not significantly associated with discharge delay. CONCLUSIONS Discharge delay is significantly associated with non-membership to Philhealth. Further investigation through focus group discussions with patients’ families may be done to uncover other possible causes for discharge delay.

INTRODUCTION: There is an increasing interest and funding for the use of Information and Communication Technologies in the field of health. However, studies have shown conflicting results of Short Messaging Service (SMS) or Text reminder in the improvement of health care services such as immunization. This paper aims to determine the effect of SMS reminder on the immunization rate, which includes the dropout, delayed and prompt immunization rate. METHODS: Newly registered children for immunization at Barangay Pinyahan Health Center were enrolled in randomized controlled double blind field trial. 144 subjects were exposed to treatment 1 (regular follow-up with no SMS reminder; treatment 2 (with SMS reminder); and treatment 3 (with blank SMS reminder). Immunization rate which included dropout, delayed and prompt immunization rates were determined. The effects of the confounding factors such as family income, barangay location, and number of children, parental education and immunization status of siblings were also determined. RESULTS: The prompt immunization rate is inversely proportional to the dropout and delayed immunization rates. As the subjects progress to the third dose of the immunization, the dropout rate increases. The dropout rate is highest on the third dose of Hepatitis B and Measles vaccination which are given at a later age of a child. Only 6% of the total subjects were classified as Fully Immunized Child. This data is in contrast to the national data of Fully Immunized Child coverage at 80%. SMS reminder has no significant effect on the immunization rate for DPT, OPV, HPV and Measles in Barangay Pinyahan Health Center in comparison to the regular follow-up. However, in Treatment Group 3 (SMS Reminder), the dropout rates per type of vaccine are significantly different from each other. The dropout of DPT and OPV which is expected to be equal or higher than Hepatitis B and Measles vaccine is lower. Variation in immunization rates among different income groups and geographic barangay location is particularly evident. Low income families and living distant from the health center have a significant propensity to dropout from immunization. CONCLUSION SMS reminder and regular follow-up have no significant difference on the immunization rate. Information communications technologies such as SMS reminder are more likely to affect immunization rate when health systems offer a supportive environment of consistently available vaccine such as DPT and OPV, and confounding barriers such as low family income, which affects HPV immunization rate, and distance to the health center, which affects measles immunization rate, are at the minimum.

BACKGROUND: Philhealth, the national health insurance program, aims to reduce out-of-pocket expenditure to eradicate blockage to healthcare access by subsidizing expenses during admission. A possible determinant of its success is the timeliness of management and prevention of discharge delay. OBJECTIVE: To determine the association of Philhealth enrollment with the timeliness of patient discharge in a government tertiary hospital. METHODS: A retrospective cohort study involving 98 patients (49 Philhealth members and 49 nonPhilhealth members) was done. Data including age, sex, admitting diagnosis, social service classification, and type of Philhealth membership were collated from the admitting section. Reasons for delay in discharge and number of days delayed was obtained from discharge clearance list of the social service unit. Association between PhilHealth coverage and hospital delay was analyzed using logistic regression analysis. RESULTS: Discharge delay is 3 times more likely to occur among non-Philhealth members as compared to the Philhealth group. Other variables were not significantly associated with discharge delay. CONCLUSIONS Discharge delay is significantly associated with non-membership to Philhealth.Further investigation through focus group discussions with patients’ families may be done to uncover other possible causes for discharge delay.

OBJECTIVES: Healthcare workers are at the center of the pandemic, dealing with cases while being at risk of acquiring the infection themselves, causing work-related stress. Despite this, they continue reporting for duty. This paper aims to determine the factors that affect resilience of pediatric healthcare-workers in close contact with patients suspected with COVID infection and its association to sleeping disturbance during the first two years of COVID – 19 pandemic in a tertiary hospital in the Philippines. METHODOLOGY: This is a cross-sectional study. Healthcare-workers who render bedside patient care for those suspected or with COVID-19 infection, not diagnosed with any mental health illness, and fit the inclusion criteria were chosen through purposive sampling and asked to answer questionnaires with demographic survey, BRS and PSQI tool. RESULTS: Among 89 participants, females were predominant (60.67% ). Majority were in the 30- 39 age group (44.94%) and are nurses (40.45%) or doctors (39.33%) who were single (76.40%). Many have normal resilience as measured from their BRS scores with an average PSQI per category equal to or exceeded 5.00. The correlation coefficient was at -0.338 (p-value 0.001) between the BRS and PSQI scores, indicating that a significant negative correlation exists between the two scores. CONCLUSION Normal resilience was reported in the majority of the healthcare workers. All study participants had poor sleep quality as determined in the overall average PSQI score. A negative correlation between resilience and sleep quality was observed, denoting that poor sleep quality can be associated with lower resilience, and vice versa. However, temporality cannot be assumed with this study.
COVID-19