PUBLIC CONSULTATION

Proposed Classification of Hospitals and Other Health Facilities

DEPARTMENT OF HEALTH
BUREAU OF HEALTH FACILITIES AND SERVICES
Atty. Nicolas B. Lutero III, CESO III March 2, 2012, Duque Hall, DOH

OBJECTIVE
To consult stakeholders on the Proposed Classification of Hospitals and Other Health Facilities.

Figure 1. Percent Distribution of DOH Licensed Hospitals as to Ownership n = 1,812

4%

DOH-Retained 36% Government Private

60%

Source: DOH BHFS 2010

Figure 2. Percentage of DOH Licensed Hospitals with PhilHealth Accreditation n = 1,812

12% PhilHealth Accredited Non-PhilHealth Accredited

88%

Source: DOH BHFS and PHIC, 2010

Figure 3. Percent Distribution of DOH Licensed Hospitals According to Scope of Services, n = 1, 812
5%

General Special

95%

Source: DOH BHFS 2010

Figure 4. Number of DOH Licensed Hospitals by Service Capacity, n = 1,812 (Year 2010)
Number of Hospitals

Figure 5. Percent Distribution of DOH Licensed Hospitals by Service Capacity n = 1,812

7% 13% Level 4 42% Level 2 Level 1 Level 3

38%
Source: DOH BHFS 2010

Figure 6. Percent Distribution of Authorized Beds of DOH Licensed Hospitals, n = 98,154

13%

37%

Level 4

Level 3

28%

Level 2

Level 1

22%

Source: DOH BHFS 2010

Legal Basis for Defining a Hospital Per R.A. 4226

Section 2 Beds or cribs or bassinets for 24 hour use or longer
Section 8 Bed space Laboratory OR X-ray Pharmacy OPD DR Isolation Morgue Section 16

Classify hospitals as to:

General or Special

Service Capacity
Size or bed capacity Training or not

Legal Basis for Defining a Hospital Per R.A. 4226

Section 2 Beds or cribs or bassinets for 24 hour use or longer

Section 8
Bed space Laboratory OR X-ray Pharmacy OPD DR Isolation Morgue

Section 16 Classify hospitals as to: General or Special Service Capacity Size or bed capacity Training or not

Legal Basis for Defining a Hospital Per R.A. 4226

Section 2 Beds or cribs or bassinets for 24 hour use or longer

Section 8
Bed space Laboratory OR X-ray Pharmacy OPD DR Isolation Morgue

Section 16 Classify hospitals

as to:

General or Special Service Capacity Size or bed capacity Training or not

Legal Basis for Defining a Hospital Per R.A. 4226

Section 2 Beds or cribs or bassinets for 24 hour use or longer Section 8 Bed space Laboratory OR X-ray Pharmacy OPD DR Isolation Morgue Section 16 Classify hospitals as to: General or Special Service Capacity Size or bed capacity Training or not

All 3 Sections of the Law have to be complied with to be classified as a hospital.

CURRENT CLASSIFICATION OF HOSPITALS PER DOH A.O. NO. 2005 0029

LEVEL 1 Primary care General Pediatrics Emergency and Out-patient Services General Obstetrics Non-surgical Gynecology Anesthesia LEVEL 2 LEVEL 3 LEVEL 4 Level 3 plus: Teaching and/or training with at least 1 accredited residency training program for physicians Department of Emergency Medicine Specialized and subspecialized forms of treatment, surgical procedure and intensive care Rehabilitation Service 2nd Level Radiology 3rd Level Radiology

Level 1 plus: Level 2 plus: Specialty Clinical Care with departmentalized clinical services General Dentistry Pharmacy Secondary Clinical Laboratory 1st Level Radiology Provision for ICU

General Medicine Surgery

Tertiary Clinical Laboratory

Minor Surgery

INCONSISTENCY OF CURRENT CLASSIFICATION VS. LAW

CATEGORY

Bed space

OR DR OPD
X X

Lab
X

X-ray
X

P
X

I M
X X

Consistent with Law

NO YES YES YES

Level 1 Level 2 Level 3 Level 4 Legend:

OR Operating Room DR Delivery Room OPD Out-patient Department Lab Clinical Laboratory

P Pharmacy I Isolation Facilities M Morgue Level 2 cadaver holding area Levels 3 and 4 mortuary

INCONSISTENCY OF CURRENT CLASSIFICATION VS. LAW

CATEGORY

Bed space

OR DR
X

OPD
X

Lab
X

X-ray
X

P
X

I M
X X

Consistent with Law

NO YES YES YES

Level 1 Level 2 Level 3 Level 4

Therefore, Level 1 does not qualify as a hospital and must be given a different category for licensure purposes.

Proposed Classification of Hospitals

According to Functional Capacity:
A. General Hospital
Provides medical and surgical care to the sick and injured and maternity care and shall have as minimum, the following clinical services: medicine, pediatrics, obstetrics and gynecology, surgery and anesthesia, emergency services, out-patient and ancillary services.

B. Specialty Hospital
Specializes in a particular disease or condition or in one type of patient.

C. Teaching/Research Hospitals
Teaching/training sites for physicians and other health professionals. It may be linked with medical school(s) or universities for medical research.

Classification of General Hospitals

CURRENT PROPOSED
RE-CLASSIFY TO PRIMARY CARE FACILITY LEVEL 1 LEVEL 2

LEVEL I
LEVEL 2 LEVEL 3

LEVEL 4

LEVEL 3

PROPOSED

LEVEL 1 Medicine Pediatrics OB-GYNE Surgery Anesthesia

LEVEL 2 Level 1 plus:

LEVEL 3 Level 2 plus:

Clinical Services for in-patients

Teaching with accredited residency Departmentalized training program in Clinical Services the 4 major clinical services

Emergency and OutRespiratory Unit patient Services

Maternity Facilities Isolation Facilities ICU Dental Unit

Department of Emergency Medicine

Rehabilitation unit Ambulatory Surgical Clinic Dialysis Clinic Tertiary lab with histopathology Blood Bank

Ancillary Services

Secondary Clinical Tertiary Clinical Laboratory Laboratory 2nd Level X-ray with mobile unit

1st

Level X-ray

3rd Level X-ray

Pharmacy

PROPOSED CLASSIFICATION OF OTHER HEALTH FACILITIES

A B C D

Primary Care Facility

Custodial Care Diagnostic Facility Facility

Laboratories: Clinical Lab/ HIV Blood Service Facilities Drug Test Lab NB Screening Lab Water Lab

Specialized Outpatient Facility

With in-patient Beds: Psychiatric Infirmary/ Care Facility Dispensary Birthing Home Without Beds: Medical Outpatient Clinics OFW Clinics Dental Clinics Drug Abuse Treatment and Rehabilitation Center (DATRC) Leprosarium

Dialysis Clinic (DC)

Radiologic Facility with Ambulatory X-ray, CT scan, Surgical Clinic mammography, etc. (ASC)

Biophysical Tests, Ultrasound, 2-D Echo, Stress Test, ECG, MRI

Nuclear Medicine

In-Vitro Fertilization (IVF) Centers Philippine Oncology Center

Nursing Home

PROPOSED CLASSIFICATION
HOSPITALS
General Level 1 Level 2 Level 3 Specialty Teaching/ Research

OTHER HEALTH FACILITIES

A. Primary Care Facility

B. Custodial Care Facility C. Diagnostic Facility

D. Specialized Out-patient Facility

DOH Website
www.doh.gov.ph

Doing Business
Licensing BHFS Requirements Hospitals and Other Health Facilities

BUREAU OF HEALTH FACILITIES AND SERVICES Division Standards Development Division Licensing and Accreditation Division Quality Assurance and Monitoring Division Chief Dr. Cynthia R. Rosuman Atty. Rodel C. Flores (OIC) Dr. Beauty A. Palongpalong Contact Number/ Email Address 6517800 local 2525 7119572 (direct) cyros88@gmail.com 6517800 local 2502-2504 7116982 (direct) ledor72@yahoo.com 6517800 local 2528 bapalongpalong@yahoo. com 6517800 local 2500

Administrative Unit

Ms. Teresa Salgado

Thank you.

SPECIALTY HOSPITALS
Particular Disease National Orthopedic Hospital National Center for Mental Health Particular Organ(s) Lung Center Philippine Heart Center Particular Group of Patients Philippine Childrens Medical Center Dr. Jose Fabella Memorial Hospital

San Lazaro Hospital

National Kidney and Transplant Institute

Philippine Geriatric Center