New primary care benefits may now be availed of at the University Health Service (UHS) in UP Diliman. These health care benefits are given as part of a pilot study, “Philippine Studies in Primary Care”, which was launched on October 2016 to run for a year until September 30, 2017, unless otherwise extended. Jointly funded by UP System and Philhealth, the study aims to test the effectiveness of a primary care health delivery system in a corporate setting. “Our target beneficiaries are employees, which in the pilot study would refer to university staff of various categories. Since they are part of the mandated clientele of the University Health Service, the health benefit package and the Primary Care health delivery system under study are in that sense, within a ‘corporate setting’,” according to UHS Acting Director Jesusa Catabui.
If found effective, the system may be adopted on a national scale and may be made the basis of an appropriate Outpatient Benefit Package by Philhealth, as well.
In an interview, UHS Acting Director Jesusa Catabui explained the significance of primary care and its important aspects.
Primary Care defined
“Primary Care is a health care system that provides for comprehensive first contact care by trained providers, which in the UHS setting, are its staff physicians. As primary care providers, they should be well trained to diagnose and treat patients through a wide range of diseases, and to judiciously refer patients for specialty care when needed. Even after referring patients to medical specialists, they should be able to coordinate and provide for continuing patient care,” Dr. Catabui explained. According to her, the ideal is to have a primary care provider for each Filipino family that will assist them in navigating through the health care system, and avoiding unnecessary expensive tests or a fragmented medical care.
Primary Care beneficiaries
Although all mandated clients of the University Health Service are entitled to certain health privileges, only the University staff and their dependents (as defined by Philhealth) may avail of the added benefit package under the study. Eligible clients include: faculty members and their dependents, and bona fide non-faculty University staff, whether permanent, UP or non-UP contractual employees, together with their dependents as well. Outsourced University personnel such as our security guards and custodial workers, and students are not included in the study. Aside from free consultation, each eligible patient may avail of free medicines and laboratory tests up to a total of PHP 2000 in one year, as long as: these are prescribed by their primary care provider; the medicines are available at UHS Pharmacy; or the tests are being done at our hospital, according to Dr. Catabui.
For example, a non-UP contractual employee can now bring his/her sick spouse, any of his/her 6 children below 21 years of age, or either of his/her parents aged 60 and above, and himself, in the event any of them get sick. Eeach is entitled to the benefits mentioned above. On the other hand, Dr. Catabui added, of course it is better that nobody in the family gets sick at all. They get to enjoy the benefits of good health and Philhealth money is spent on those who really need it.
Electronic Medical Records (EMR)
In order to track Philhealth expenses for each eligible client who come for consultation, it is vital that patient medical records be now in electronic form. Outpatients consulting at the University Health Service for non-urgent illness will have to line up first at the Records Section for data entry, after which they proceed to the triage nurse where their vital signs, such as body temperature or blood pressure, are taken and recorded on the computer. At the same time, the system queues them to an available doctor assigned at the General Out Patient Department (OPD) for final assessment and treatment. Prescriptions and requests for necessary laboratory tests including ECG and X-ray examinations are electronically generated and then presented to the billing section or to the pharmacist, as the case may be.
The customized EMR system also allows for the accurate generation of reports and secure and efficient records management.
Primary Care on a national scale
“Hopefully, depending on the results of the study, primary care may be adopted nationwide for more accessible and affordable health care services. Proper training and giving enough incentives to our primary care providers are also vital for such a system to work,” Catabui concluded.