OBJECTIVE

This study assessed the level of health system responsiveness of Rural Health Units (RHUs) in Cagayan Valley Region along seven domains of responsiveness namely dignity, autonomy, confidentiality, choice of provider, prompt attention, communication, and quality of basic amenities, and five core components of the health system namely health governance, health human resource, health information system, access to medicines and technology, and service delivery.

A cross-sectional research design was adopted using survey as the primary means of data collection using a researcher-developed questionnaire. The study was conducted in RHUs of 15 identified municipalities in the region. The municipalities were chosen based on their low performance in the LGU health score cards for 2019. A total of 618 clients and 235 health workers were included in the study. Frequency, percentage, and mean were used to analyze the profile and level of health system responsiveness. T test and one-way ANOVA were used to test significant differences.

The results showed that the RHUs included in the study have very good level of health system responsiveness, with overall percentage scores ranging from 73.55 to 88.08, in all domains assessed. However, choice of providers within the facilities (62.71%) and access to medicine and technology (77.45%) were the least responsive among all the identified domains. Significant differences in the clients’ assessment of the responsiveness of the RHUs were seen when grouped according to their sex, age, educational attainment, income level, overall level of health, frequency of visits, and distance of home to facility. The RHUs’ location, whether in an urban or rural area, number of staff, and number of barangays catered also were found to determine the level of health system responsiveness. Moreover, not all RHUs were able to comply with basic requirements of the Department of Health specifically along the services offered.

It can be concluded therefore that the RHUs, despite the limitations in certain aspects are still able to meet the expectations of the clients and health workers in the delivery of health services. However, in order to maximize responsiveness of these facilities, DOH requirements for these facilities should be met.

This essay laid out the development of a nurse's identity from clinical practitioner to developing researcher, with a focus on the importance of patient-centered and nurse-centered care as the cornerstone pillars of nursing research. Through narrative and application of qualitative and participatory research approaches, the author showed the intersection of everyday experience, philosophical inquiry, and scholarly pursuit along the path toward becoming a nurse researcher. The article examined how emotional experiences within the perioperative environment have instigated research questions aimed at improving patient and nurse well-being. Through the incorporation of academic models and theoretical perspectives, the author presented an emerging investment in health equity, social determinants of health, and collective inquiry, framing this individual path within the greater nursing science mission.

Palliative care has emerged as a crucial component of healthcare, particularly in the context of an aging population and the increasing prevalence of chronic and life-limiting illnesses. In the Philippines, however, access to palliative care remains significantly limited, especially in rural and underserved areas. This disparity is primarily driven by systemic challenges such as inadequate healthcare infrastructure, a shortage of trained professionals, and insufficient public awareness. While the inclusion of palliative care in the Universal Health Care (UHC) Act of 2019 (Republic Act No. 11223) reflects a progressive step toward addressing these needs, the implementation of comprehensive palliative services continues to face considerable hurdles. This paper advocated for the stronger integration of palliative care into primary health care systems at the barangay level, emphasizing the need to strengthen policy frameworks, ensure adequate resource allocation, and actively engage communities in this endeavor. Such efforts are essential to guaranteeing equitable, compassionate, and dignified care for all individuals, regardless of their stage of life or even socioeconomic status.

BACKGROUND

The Universal Health Care (UHC) Act of 2019 aims to improve health outcomes by strengthening primary care. The Konsulta outpatient benefit package is a key component of this reform. However, package availability does not guarantee utilization. Factors such as awareness, perceptions, and attitudes influence benefit use.

This study aimed to determine the awareness, perceptions, and attitudes regarding the Konsulta outpatient benefit package among working-age Filipino adults consulting at a tertiary government hospital.

A cross-sectional study was conducted with 218 respondents. The questionnaire covered sociodemographic and clinical characteristics, awareness, perceptions, and attitudes regarding Konsulta package. Data was analyzed through descriptive statistics.

Twenty-one percent (45/218) of Filipino adults were familiar with Konsulta package. Respondents who were aware of Konsulta were generally aged 51-59, female, unemployed, completed secondary education, lived in Metro Manila, diagnosed with chronic disease, and had previous PhilHealth benefit use. Konsulta facilities were found to be moderately accessible, and the package was reported to reduce out-of-pocket healthcare expenses and to be easy to avail with short waiting times. However, there were limitations in coverage of health services. Negative attitudes predominated among those who were aware of the package (29/45, 64%), particularly concerning program value and effectiveness.

Filipino adults consulting at the Philippine General Hospital-Family Medicine Clinic have low awareness level on PhilHealth Konsulta Package. It was perceived to reduce healthcare expenses and to be easy to avail with short waiting times, but limitations in accessibility and appropriateness were reported. Negative attitudes toward program value and effectiveness were identified.

Contraceptive Agents ; Health Personnel ; Primary Health Care ; Philippines

INTRODUCTION: Cancer patients attending emergency departments (EDs) often present with acute symptoms and are frequently admitted. This study aimed to characterise the profile of oncology patients who were discharged from the ED. METHODS: This was a retrospective audit of patients with cancer-related diagnoses who presented to the ED at the Singapore General Hospital (SGH) over a 6-month period from 1 October 2018 to 31 March 2019 and were directly discharged from the ED. Data was extracted from the hospital's electronic medical record system. RESULTS: Of the 492 participants included in the study, the majority were triaged as Priority 2 (61.4%), while 30.7% were triaged as Priority 3, 6.9% as Priority 1 and 1.0% as Priority 4. There was no statistical difference between the National Early Warning scores across the different triage categories in these patients. The most common complaint was (44.3%), followed by genitourinary symptoms (19.5%) and those related to devices, catheters or stomas (17.3%). More investigations of all types were done for patients being managed in Priority 1 (57.6%) than in the other triage categories (40.1% for Priority 2, 23.2% for Priority 3 and 12.0% for Priority 4). Treatment procedures carried out were mainly symptomatic (analgesics, antiemetics, proton pump inhibitors) for 79.8% of the patients. There were no significant differences in the proportion of patients requiring various treatment modalities among the triage categories. CONCLUSION Selected oncological patients may potentially be managed in an ambulatory setting.
Humans ; Emergency Service, Hospital/statistics & numerical data* ; Retrospective Studies ; Female ; Neoplasms/diagnosis* ; Male ; Singapore ; Patient Discharge/statistics & numerical data* ; Middle Aged ; Aged ; Triage ; Adult ; Emergencies ; Aged, 80 and over

INTRODUCTION: The study objective was to determine the levels of self-care and health literacy (HL) and their associations among patients with chronic kidney disease (CKD). METHODS: This was a cross-sectional, questionnaire-based study conducted in a public primary care setting in Singapore. A total of 289 participants aged 21-80 years with hypertension were recruited. Self-care profiles were measured using the Hypertension Self-Care Profile (HTN-SCP; range 0-240, domain range 0-80). Health literacy was measured using the Short-Form Health Literacy Scale (HLS-SF12; range 0-50, limited literacy ≤33). RESULTS: The mean self-care score was 182.7 (standard deviation [SD] 23.2). The median HL score was 34.7 (interquartile range [IQR] 31.9-40.3), and 31.1% of participants had limited HL. Self-care was not associated with age, CKD status, household income and education, but was associated with gender and HL score. In the final regression model, lower HL scores (adjusted β = 1.03, 95% confidence interval [CI] 0.7 to 1.36, P < 0.001) and male gender (adjusted β = -5.29, 95% CI -10.56 to -0.03, P = 0.049) were associated with lower self-care scores. The HL scores were associated with self-care domains of self-efficacy (HL: β = 0.30, 95% CI 0.17 to 0.42, P < 0.001), motivation (HL: β = 0.40, 95% CI 0.26 to 0.53, P < 0.001) and behaviour (HL: β = 0.38, 95% CI 0.26 to 0.50, P < 0.001). CONCLUSION Thirty-one percent of the participants had limited HL. Self-care was not associated with age, race, CKD status, household income or education. Male gender and limited HL were associated with lower self-care. Self-care was associated with self-efficacy, motivation and behaviour. Future research could focus on more targeted approaches to improve self-care and HL among patients with CKD.
Humans ; Male ; Female ; Health Literacy ; Middle Aged ; Self Care ; Cross-Sectional Studies ; Aged ; Adult ; Primary Health Care ; Renal Insufficiency, Chronic/therapy* ; Singapore ; Surveys and Questionnaires ; Aged, 80 and over ; Young Adult ; Hypertension/therapy*

INTRODUCTION: As the population ages, patient complexity is increasing, intensifying the demand for well-resourced, coordinated care. A deeper understanding of the factors contributing to this complexity is essential for optimising resource allocation. This study evaluates the prevalence of complex care needs in Singapore's primary care settings and identifies the factors associated with these needs. METHOD: Using a qualitative study design, we developed a patient complexity questionnaire to assess how Singapore family physicians recognise patient complexity. Sixty-nine experienced primary care physicians applied this tool to assess patient encounters, categorising each as "routine care" (RC), "medically challenging" (MC), or "complex care" (CC). We compared the care needs across these categories and used mixed-effects multinomial logistic regression to determine the independent predictors of complexity. RESULTS: Of the 4327 encounters evaluated, 15.0% were classified as CC, 18.5% as MC, and 66.4% as RC. In both CC and MC encounters, the most common medical challenges were polypharmacy (66.2% in CC, 44.9% in MC); poorly controlled chronic conditions (41.3% in CC, 24.5% in MC); and treatment interactions (34.4% in CC, 26.0% in MC). Non-medical issues frequently identified included low health literacy (32.6% in CC, 20.8% in MC); limited motivation for healthy lifestyle behaviours (27.2% in CC, 16.6% in MC); and the need for coordinated care with hospital specialists (24.7% in CC, 17.1% in MC). The top 3 independent predictors of complexity included mobility limitations requiring assistance (odds ratio [OR] for requiring wheelchair/trolley: 7.14 for CC vs RC, 95% confidence interval [CI] 4.74-10.74); longer consultation times with physicians (OR for taking >20 minutes for doctor's consultation: 3.96 for CC vs RC, 95% CI 2.86-5.48); and low socioeconomic status (OR for living in 1- or 2-room HDB flats: 2.98 for CC vs RC, 95% CI 1.74-5.13). CONCLUSION High care needs, encompassing both CC and MC encounters, were prevalent in primary care interactions. These findings highlight that relying solely on chronic disease count is insufficient to capture the full spectrum of patient complexity.
Singapore/epidemiology* ; Humans ; Primary Health Care/statistics & numerical data* ; Male ; Female ; Middle Aged ; Aged ; Adult ; Surveys and Questionnaires ; Prevalence ; Polypharmacy ; Qualitative Research ; Chronic Disease/therapy* ; Logistic Models

Obesity is a significant public health problem in China. The development of a proactive and effective model to combat the obesity epidemic could alleviate the disease burden, improve population health, and ultimately support the achievement of the Healthy China goals. Obesity research has made significant progress domestically and internationally, resulting in continuous improvements in basic public health services within primary care. Therefore, the National Office of Basic Public Health Service Program for Primary Diabetes Care has organized experts to issue the National Guidelines for the Integrated Management of Obesity in Primary Care (2025). The aim of this guide is to assist primary care physicians with evidence-based recommendations for diagnosing and evaluating obesity, promoting standardized and integrated management for patients with obesity. It includes essential guidelines for patient management, an overview of obesity, diagnostic and evaluation criteria, integrated management strategies, and protocols for follow-up and referral.
Humans ; Primary Health Care ; Obesity/therapy* ; China ; Practice Guidelines as Topic

In China, the prevalence of diabetes has increased significantly, and rigorous challenges exist in diabetes prevention and glycemic control, especially in primary medical care. Under the guidance of the National Health Commission of the People's Republic of China and the Chinese Medical Association, the Office for Primary Diabetes Care of the National Basic Public Health Service Program issued the "National guidelines for the prevention and control of diabetes in primary care (2018)" in 2018. The present guideline, which incorporates the latest advances in diabetes research and practice from the 2018 and 2022 editions, aims to improve primary health facilities and provide standardized basic public health and medical services throughout China. It applies to healthcare providers who provide primary care to patients with type 2 diabetes aged 18 or older. It primarily includes basic management requirements; workflow of health management; diagnosis; classification; monitoring, screening, and assessment; treatment; identification and management of diabetic acute and chronic complications; traditional Chinese medicine; referral; health management; and health education.
Humans ; Primary Health Care ; China ; Diabetes Mellitus, Type 2/therapy* ; Diabetes Mellitus/prevention & control* ; Practice Guidelines as Topic