Hospitals and Economics

Hospitals and Economics

Survival

Middle Ages hospitals served as

almshouses for the poor, hostels for
pilgrims, or hospital schools.
Latin hospes, signifying a stranger or
foreigner, hence a guest.
Another noun derived from this,
hospitium came to signify hospitality,
that is the relation between guest and
shelterer, hospitality, friendliness,
hospitable reception.
Hospes is thus the root for the English
words host(where the p was dropped
for convenience of pronunciation)
hospitality,hospice, hostel and hotel..

HISTORY

Ancient Egyptian Temples

(Asclepius) 291 BC : it
functiones as centers for
medical advice, prognosis
and healing: Tiber Rome
India: Fa Xian (chinese
Buddhist Monk : The heads
of the Vaisya families in
them establish in the cities
houses for dispensing
charity and medicine

Lying In
:Pandukabhaya of
Sri Lanka (437BC
to 367 BC
Mihintale Hospital
Anuradhapura
Medirigiriya

Hospitals

With the rapid

growth of the
population during
the 18th and 19th
centuries it was
obvious that local
charities and the
workhouse system
could not provide
sufficient medical
care for the poor.
6

PHYSICAL ASPECT OF
HOSPITALS
Architecture:
a) space minimizing effort of
medical personnel while
maximizing of the whole system
b) Sturdy and strong to
accommodate heavy
departments
c) Provision of space for
maintenance and waste disposal
d) New designs provides fresh air,
better views and more pleasant
colour schemes

Considerations:
psychological needs of the
patient, healing power of
nature,, reduction of nurses
fatigue and stress

Hospital Departments

Emergency
Cardiology
Intensive Care Unit
: Pediatric ICU,
Neonatal ICU,
Cardiovascular ICU
Neurology
Oncology
Obstetrics and
Gynaecology

Outpatient
Behavioural Health
Dentistry
Dermatology
Psychiatric Ward
Rehabilitation
Services
Physical Therapy
8

Support Units of Hospitals

Pharmacy
Laboratory
Pathology
Radiology

Non-Medical :
Medical Records
Department
Information
Management
Clinical Engineering
Facilities Management
Plant Operation
Dining Services
Security Departments

12

HOSPITALS
Medical Tourism to the Philippines
is currently on the rise
High-end private hospitals may charge
an arm and a leg for medical procedures
but the prices are still affordable when
you compare them to the rates charged
by top-notch facilities in first-world
countries.

13

14

DEMAND AND SUPPLY OF HOSPITALS

FACTORS AFFECTING
DEMAND FOR HOSPITALS

NEED > Demand

Nature of Goods
Level of Income :Engels Law
Third Party
Resource Allocation of
Government on Health
Lifestyle and Health
Conditions

FACTORS AFFECTING
SUPPLY OF HOSPITALS
Market : Demand
Production Inputs
Income
Profitability

15

Pricing Mechanism

1.
2.
3.
4.
5.
6.

FACTORS AFFECTING THE

PRICING MECHANISM OF
HOSPITALS
Resource Allocation :
Production Cost
Derived Demand
Supply
Nature of Goods
Level of Income
Government Laws

St. Lukes Medical Center : Triple

Cardiac Bypass Surgery normally
cost an average of US $ 250,000 in
the US would cost about P 900,000 (US
$21, 428.60 at the exchange rate of US
$ 1= Php 42)
Philippine Heart Center : Triple
Cardiac Bypass Surgery The same
medical procedure can be done for less
than P 900,000 in the, a specialist
hospital that is operated by the
government.
St. Lukes Medical Center or in the other
top-notch private hospitals in the
country: Asian Hospital and Medical
Center, The Medical City, Cardinal
Santos Medical Center, Manila Doctors
Hospital, UST Hospital and the Medical
Center Manila: Kidney Transplant
costs upward of $200,000 in the
US, costs about PhP 1,000,000 or $23,
809.50 in the Philippines.
National Kidney and Transplant
Institute.
16

High-end private
hospitals may charge
an arm and a leg for
medical procedures
but the prices are still
affordable when you
compare them to the
rates charged by topnotch facilities in
first-world countries

17

HOSPITALS IN THE
PHILIPPINES

PRIVATE

GOVERNMENT

GENERAL
SPECIFIC

PRIMARY LEVEL
SECONDARY LEVEL
TERTIARY LEVEL
18

Private Hospitals

A private hospital is a
hospital owned by a forprofit company or a nonprofit organisation and
privately funded through
payment for medical
services by patients
themselves, by insurers, or
by foreign embassies.

19

PRIVATE HOSPITAL

20

PUBLIC HOSPITALS

A public hospital or
government hospital is a
hospital which is owned by a
government and receives
government funding. This type
of hospital provides medical
care free of charge, the cost of
which is covered by the funding
the hospital receives. Most
hospitals worldwide are public.
21

Types of Hospitals

General hospital

: deal with many

kinds of disease and injury, and normally
has an emergency department to deal with
immediate and urgent threats to health.
A general hospital typically is the major
health care facility in its region, with large
numbers of beds for intensive care and
long-term care; and specialized facilities for
surgery,
plastic
surgery,
childbirth,
bioassay laboratories, and so forth.
Larger cities may have several hospitals of
varying sizes and facilities. Some hospitals,
especially in the United States, have their
own ambulance service.

Specialized

deal

with

specific needs
Specialized
hospitals
include
trauma centers, rehabilitation
hospitals, children's hospitals,
seniors' (geriatric) hospitals, and
hospitals for dealing with specific
medical needs such as psychiatric
problems
(see
psychiatric
hospital),
certain
disease
categories, and so forth.

22

PHILIPPINE HOSPITAL CATEGORY

**ADMINISTRATIVE ORDER 147 S., 2004 (A.O. 70-A s., 2004 / A.O.68-A s.
1989)

PRIMARY CARE( FIRST LEVEL

REFERRAL HOSP./ SECONDARY)

Non-departmentalized hospital that provides clinical

care and management on the prevalent diseases in
the locality.

SECONDARY CARE (SECOND LEVEL

REFRL
HOSP./
TERTIARY)

Departmentalized hospital that provides

clinical care and management on the
prevalent diseases in the locality, as well as
particular forms of
treatment, surgical procedure and intensive
care.

TERTIARY CARE (THIRD LEVEL

REFRL HOSP./ TERTIARY) Teaching and
training hospitals that provides clinical care and
management on the prevalent diseases in the
locality, as well as specialized and
sub-specialized forms of treatment, surgical
procedure and intensive care.

INFIRMARY ( INFIRMARY /
PRIMARY ) provides emergency
treatment and care to the sick
and injured, as well as clinical
care and management to mothers
and newborn babies.
BIRTHING HOME provides
maternity service on pre-natal and
post-natal care, normal
spontaneous delivery, and care of
newborn babies.
ACUTE CHRONIC
PSYCHIATRIC CARE FACILITY
provides medical service, nursing
care, pharmacological treatment,
psychosocial intervention for
mentally ill patients.
CUSTODIAL PSYCHIATRIC
CARE FACILITY provides long
term care , including basic human
services such as food and shelter,
to chronic mentally ill patients.

PRIVATE HOSPITALS
Region 6

WESTERN VISAYAS REGION

AKLAN Kalibo
1. AKLAN COOPERATIVE
MISSION HOSPITAL
2. ST. JUDE'S HOSPITAL
3. ST. GABRIEL HOSPITAL
4 .AKLAN BAPTIST HOSPITAL
ANTIQUE Semirara, Caluya
1. SEMIRARA COAL
CORPORATION HOSPITAL
2. TUGON MEDICAL CLINIC
AND HOSPITAL
ILOILO
1. BAROTAC VIEJO MEDICAL
CENTER, INC.
2 .SEAMEN'S HOSPITAL ILOILO (NEW)

ILOILO CITY
1. SAINT PAUL'S HOSPITAL
2. ILOILO MISSION
HOSPITAL
3. ILOILO DOCTOR'S
HOSPITAL, INC. 300
4. ST. THERESE-MTC
COLLEGES HOSP.
CAPIZ-ROXAS CITY
1. CAPIZ DOCTOR'S
HOSPITAL
2. WELL FAMILY MIDWIFE
CLINIC (NEW)
3. CAPIZ EMMANUEL
HOSPITAL, INC.
4. ST. ANTHONY COLLEGE
HOSPITAL

24

PRIVATE HOSPITALS
Region 6

BACOLOD CITY
1. THE DOCTOR'S HOSPITAL, INC.
2. DR. PABLO O. TORRE SR.
MEMORIAL HOSPITAL
3. WELL FAMILY MIDWIFE CLINIC
(NEW)
4. WELL FAMILY MIDWIFE CLINIC
(NEW)
5. WELL FAMILY MIDWIFE CLINICFORTUNE TOWN (NEW)
6. WELL FAMILY MIDWIFE CLINIC
(NEW
7. BACOLOD OUR LADY OF MERCY
SPECIALTY HOSP.
8.BACOLOD ADVENTIST MEDICAL
CENTER (former BACOLOD
SANITARIUM AND HOSPITAL)

NEGROS OCCIDENTAL
1. HINIGARAN MEDICAL
CLINIC
NEGROS
OCCIDENTALKABANKALAN
CITY
1 SOUTHERN NEGROS
DOCTORS HOSPITAL
SAN CARLOS
1. SAN CARLOS DOCTORS
HOSPITAL, INC. (former SAN
CARLOS
PLANTERS & LABORER'S
HOSP)
SILAY CITY
1. WELL FAMILY MIDWIFE
CLINIC (NEW)
VICTORIAS CITY 1
IMMACULATE CONCEPTION
HEALTH CENTER

GOVERNMENT HOSPITAL
Region 6

WESTERN VISAYAS REGION

AKLAN
1.BURUANGA MEDICAL
COMMUNITY HOSPITAL
(former BURUANGA
MUNICIPAL HOSPITAL)
2 .IBAJAY DISTRICT
HOSPITAL
3. DR. RAFAEL S. TUMBOKON
MEMO. PROV. HOSP.
4 .LIBACAO MUNICIPAL
HOSPITAL 10
5 .DON LEOVIGILDO DIAPO
SR. MUNICIPAL HOSPITAL 10
6. BORACAY ISLAND
MUNICIPAL HOSPITAL 7
MALAY MUNICIPAL
HOSPITAL

ANTIQUE
1 PEDRO L. GINDAP MUNICIPAL
HOSPITAL
2 BUGASONG MEDICARE
COMMUNITY HOSPITAL
3 CULASI DISTRICT HOSPITAL
4 GOV. LEANDRO FULLON
DISTRICT HOSPITAL
5 ANGEL SALAZAR MEMORIAL
GENERAL HOSPITAL
6 SEBASTE COMMUNITY
HOSPITAL
7 RAMON MAZA SR. MEMORIAL
DISTRICT HOSPITAL
8 PRES. DIOSDADO MACAPAGAL
HOSPITAL
9 VALDERRAMA MUNICIPAL
HOSPITAL

GOVERNMENT HOSPITAL
Region 6

CAPIZ
1 SEN. GERARDO ROXAS
MEMORIAL DISTRICT HOSP.
2 CAMP PERALTA STATION
HOSPITAL
3 MAMBUSAO DISTRICT
HOSPITAL
4 BAILAN DISTRICT
HOSPITAL
5 TAPAZ DISTRICT HOSPITAL
ROXAS CITY
1 ROXAS MEMORIAL
PROVINCIAL HOSPITAL
GUIMARAS
1 GUIMARAS PROVINCIAL
HOSPITAL
2 NUEVA VALENCIA DISTRICT
HOSPITAL

ILOILO
1 ALEOSAN DISTRICT HOSPITAL
2 JESUS COLMENARES DISTRICT
HOSPITAL
3 DON JOSE S. MONFORT MEDICAL
CENTER
4 RAMON TABIANA MEMORIAL
DISTRICT HOSPITAL
5 RICARDO S. PROVIDO SR.
MEMORIAL HOSPITAL
6 DUMANGAS DISTRICT HOSPITAL
7 REP. PEDRO TRONO MEMORIAL
DISTRICT HOSP.
8 FEDERICO ROMAN TIRADOR SR.
MEMORIAL DIST. HOSP.
9 DR. RICARDO Y. LADRIDO
MEMORIAL HOSPITAL
10 NEW LUCENA POLYTECHNIC
COLLEGE MEDICAL CLINIC
AND HOSP 10 Dr. Layla CatedralSolinap General Infirmary
11 ILOILO PROVINCIAL HOSPITAL
12 WESTERN VISAYAS SANITARIUM

GOVERNMENT HOSPITAL
Region 6

ILOILO CITY
1 WESTERN VISAYAS MEDICAL
CENTER
2 WEST VISAYAS STATE
UNIVERSITY MEDICAL CTR.
PASSI CITY
1 DON VALERIO PALMARES SR.
MEMO. DISTRICT HOSP.
NEGROS OCC.
1 CALATRAVA MUNICIPAL
HOSPITAL
2 CAUAYAN MUNICIPAL
HOSPITAL
3 VICENTE GUSTILO MEMORIAL
DISTRICT HOSPITAL
4 GOV. VALERIANO GATUSLAO
MEMO. DIST. HOSP
5 ISABELA DISTRICT
6 VALLADOLID DISTRICT

NEGROS OCC.1CORAZON LOCSIN

MONTELIBANO MEMORIAL
REGIONAL HOSP. 400 Dr.
BAGO CITY
1 BAGO CITY HOSPITAL 10
CADIZ CITY 1 CADIZ DISTRICT
HOSPITAL
KABANKALAN CITY
1 KABANKALAN DISTRICT
HOSPITAL
2 GUMERSINDO GARCIA SR.
MEMORIAL HOSPITAL
LA CARLOTA CITY
1 DON SALVADOR BENEDICTO
MEMORIAL DIST. HOSP.
SAGAY CITY
1 ALFREDO MARAON SR.
MEMORIAL DISTRICT HOSP.
SAN CARLOS CITY
1 SAN CARLOS CITY HOSPITAL
SILAY CITY
1 DR. JOSE C. LOCSIN MEMORIAL

HOSPITAL RESOURCE ISSUES

Resource Allocation

Includes the distribution of

resources to the hospitals
within the health sector, as
well as allocation among
hospitals, geographic region,
and population group served
(urban versus rural, vulnerable
vs non vulnerable, rich versus
poor).

Resource Management

The use of the resources of

hospitals comparing the output
to input, which are assessed
according to efficiency.

Resource Generation
Generating additional
resources for additional funds.
Insurance, user charges,
community financing hospital

RESOURCE ALLOCATION

Production Function

allocation of the department of inputs to achieve

the greatest output (< reduction in morbidity and
mortality)
ALLOCATIVE EFFICIENCY

30

31

Budget Allocation

The average budget allocation

for health since 2001 under
the Arroyo administration is
just 1.8% of the total budget- the lowest share for health
among the last three
administrations (Aquino at
3.1%, Ramos at 2.6%, and
Estrada at 2.4%).

Under the 2010 national

government budget
proposal, the health sector
is allocated P37.9 billion or
only 2.46% of the total
proposed budget. Based on
an estimated population of
94.01 million for 2010, this
means that real per capita
spending is just P403 per
Filipino for health services.

32

DEPARTMENT OF HEALTH
CY 1991-2009 BUDGET APPROPRIATION

YEAR

PS

MOOE

CO

TOTAL

1991

2,970,670,000

3,882,689,000

319,392,000

7,172,751,000

1992

5,089,652,000

4,710,415,000

427,677,000

10,227,744,000

1993

2,227,344,000

3,862,613,000

824,775,000

6,914,732,000

1994

2,274,670,000

3,679,651,000

1,377,870,000

7,332,191,000

1995

2,872,405,000

3,595,884,000

2,065,787,000

8,534,076,000

1996

3,370,752,000

4,089,307,000

1,777,494,000

9,237,553,000

1997

3,965,000,000

4,537,828,000

2,435,029,000

10,937,857,000

1998

4,967,983,000

5,435,953,000

2,539,281,000

12,943,217,000

1999

5,042,874,000

5,300,903,000

922,061,000

11,265,838,000

2000

5,028,963,000

5,313,600,000

396,342,000

10,738,905,000

2001

5,020,223,000

4,392,428,000

43,612,000

9,456,263,000

2002

5,404,739,000

5,115,498,000

899,000,000

11,419,237,000

2003

5,368,302,000

3,807,988,000

730,000,000

9,906,290,000

2004

5,368,302,000

3,789,927,000

405,575,000

9,563,804,000

2005

5,397,944,000

3,942,388,000

384,986,000

9,725,318,000

2006

5,397,944,000

3,760,310,000

299,031,000

9,457,285,000

2007

5,789,064,000

4,639,809,000

969,898,000

11,398,771,000

2008

5,832,513,000

10,643,479,000

2,436,018,000

18,912,010,000

2009

6,727,340,000

10,584,705,000

6,354,610,000

23,666,655,000

SOURCE: General Appropriations Act 1991-2009

33

34

35

EVALUATION OF RESOURCE
ALLOCATION

36

St. Luke's has taken and applied the best

practices in the field of hospitality in its
premises, providing services and amenities
such as a selective menu, private butler
service, and cable television. St. Luke's
believes that comfort and a positive
experience are vital in the quest for health
and
recovery.
St. Luke's has a total of 650 beds, which
include 342 private suites, one presidential
suite, one ambassador suite and a newlyinaugurated
Birthing
Room.
A range of accommodations to suit
different needs and budgets is available at
St. Luke's. More affordably-priced semiprivate rooms and wards are also wise
choices. To St. Luke's, what is essential is
an uncompromising standard of excellent
service at any level.

Patient Rooms

Ambassador Suite
Birthing Room
Presidential Suite
Private Room
Semi-Private Room
Suites
Ward
37

RESOURCE ALLOCATION

Cost Function

The relationship between hospital cost and output

levels; Minimization of operating unit costs,

ECONOMIES OF SCALE : constant, increasing,

decreasing

38

39

Health Expenditure Per Capita

40

OUT OF THE POCKET HEALTH EXPENDITURE

41

RESOURCE MANAGEMENT
MANAGEMENT
FUNCTION
1. Technical Efficiency:
inputs : personnel,
equipment, supplies
2. Economic Efficiency :
least combination at
the desired level of
output
3. Scale Efficiency
4. Efficiency
Interrelationships

Poor management
results to wastage of
resources, including
money, staff, building
and equipment

42

43

Hospital Beds

44

Nurses and Midwives in the Philippines

45

Health Professionals

Professionals for Healthcare Consumers

St. Lukes Medical Center has over 1,500 medical consultants, 230 medical
residents and 123 fellows on its roster, apart from interns from its College
of Medicine. There are 644 nurses and 2,000 other paramedical,
administrative and support staff.

Over 4,000 professionals in medicine and its allied fields, as well as business
management and hospital support staff, are the crown jewels of St. Lukes.
Their collective expertise and dynamic synergy provide a roster of local and
international patients with health care skills and optimum technology.

46

RESOURCE GENERATION

47

48

Equity in health
fair,

just, and equal access to

health care by all Filipinos.

Constitutional

guarantee: Article
II Section 15 The State shall
protect and promote the right to
health of the people and instil
health consciousness among
them.

END
50