department of health bureau of health facilities and services atty. nicolas b. lutero iii, ceso iii...
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DEPARTMENT OF HEALTH BUREAU OF HEALTH FACILITIES AND SERVICES
Atty. Nicolas B. Lutero III, CESO III
March 2, 2012, Duque Hall, DOH
PUBLIC CONSULTATION
“Proposed Classification of Hospitals and Other Health Facilities”
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%
36%
60%
DOH-Retained
Government
Private
Source: DOH – BHFS 2010
Figure 2. Percentage of DOH Licensed Hospitals with PhilHealth Accreditation
n = 1,812
88%
12%
PhilHealthAccredited
Non-PhilHealthAccredited
Source: DOH – BHFS and PHIC, 2010
Figure 3. Percent Distribution of DOH Licensed Hospitals According to
Scope of Services, n = 1, 812
95%
5%
General
Special
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%
38%
42%Level 4 Level 3
Level 2 Level 1
Source: DOH – BHFS 2010
Figure 6. Percent Distribution of Authorized Beds of DOH Licensed Hospitals, n = 98,154
37%
22%
28%
13%
Level 4 Level 3
Level 2 Level 1
Source: DOH – BHFS 2010
Legal Basis for Defining a Hospital Per R.A. 4226
Section 2 Section 8 Section 16
Beds or cribs or
bassinets for 24
hour use or longer
Bed spaceLaboratory
ORX-ray
PharmacyOPDDR
IsolationMorgue
Classify hospitalsas 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 Section 8
Section 16
Beds or cribs or bassinets for 24 hour
use or longer
Bed spaceLaboratory
ORX-ray
PharmacyOPDDR
IsolationMorgue
Classify hospitalsas 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 Section 8 Section 16
Beds or cribs or bassinets for 24 hour
use or longer
Bed spaceLaboratory
ORX-ray
PharmacyOPDDR
IsolationMorgue
Classify hospitalsas 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 Section 8 Section 16
Beds or cribs or bassinets for 24 hour
use or longer
Bed spaceLaboratory
ORX-ray
PharmacyOPDDR
IsolationMorgue
Classify hospitalsas 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 LEVEL 2 LEVEL 3 LEVEL 4
Primary care Level 1 plus: Level 2 plus: Level 3 plus:
General Medicine Surgery Specialty Clinical Care with departmentalized clinical services
Teaching and/or training with at least 1 accredited residency training program for physicians
General Pediatrics
AnesthesiaEmergency and Out-patient Services
General DentistryDepartment of Emergency Medicine
General Obstetrics
Pharmacy Provision for ICUSpecialized and sub-specialized forms of treatment, surgical procedure and intensive care
Non-surgical Gynecology
Secondary Clinical Laboratory
Tertiary Clinical Laboratory
Rehabilitation Service
Minor Surgery1st Level Radiology
2nd Level Radiology
3rd Level Radiology
INCONSISTENCY OF CURRENT CLASSIFICATION VS. LAW
CATEGORY
Bed space
OR DR OPD Lab X-ray P I MConsistent with Law
Level 1 ✓ X ✓ X X X X X X NO
Level 2 ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ YES
Level 3✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓
YES
Level 4✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓
YES
Legend:
OR – Operating Room P – Pharmacy
DR – Delivery Room
OPD – Out-patient Department
I – Isolation Facilities
Lab – Clinical Laboratory
M – Morgue Level 2 – cadaver holding area Levels 3 and 4 – mortuary
INCONSISTENCY OF CURRENT CLASSIFICATION VS. LAW
CATEGORY
Bed space
OR DR OPD Lab X-ray P I MConsistent with Law
Level 1 ✓ X ✓ X X X X X X NO
Level 2 ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ YES
Level 3✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓
YES
Level 4✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓
YES
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 HospitalsTeaching/training sites for physicians and other health professionals. It
may be linked with medical school(s) or universities for medical research.
CURRENT PROPOSED
LEVEL IRE-CLASSIFY TO PRIMARY CARE
FACILITY
LEVEL 2 LEVEL 1
LEVEL 3 LEVEL 2
LEVEL 4 LEVEL 3
Classification of General Hospitals
PROPOSED LEVEL 1 LEVEL 2 LEVEL 3
Clinical Services for in-patients
MedicinePediatricsOB-GYNESurgeryAnesthesia
Level 1 plus: Level 2 plus:
Departmentalized Clinical Services
Teaching with accredited residency training program in the 4 major clinical services
Emergency and Out-patient Services
Respiratory UnitDepartment of Emergency Medicine
Maternity Facilities ICU Rehabilitation unit
Isolation Facilities Dental UnitAmbulatory Surgical Clinic
Dialysis Clinic
Ancillary Services
Secondary Clinical Laboratory
Tertiary Clinical Laboratory
Tertiary lab with histopathology
Blood Bank
1st Level X-ray2nd Level X-ray with mobile unit
3rd Level X-ray
Pharmacy
PROPOSED CLASSIFICATION OF OTHER HEALTH FACILITIES
A B C D
Primary Care Facility
Custodial Care Facility
Diagnostic FacilitySpecialized Out-patient Facility
With in-patient Beds:Infirmary/ DispensaryBirthing Home
Psychiatric Care Facility
Laboratories:Clinical Lab/ HIVBlood Service FacilitiesDrug Test LabNB Screening LabWater Lab
Dialysis Clinic (DC)
Without Beds:Medical Out-patient ClinicsOFW ClinicsDental Clinics
Drug Abuse Treatment and Rehabilitation Center (DATRC)
Radiologic Facility with X-ray, CT scan, mammography, etc.
Ambulatory Surgical Clinic (ASC)
LeprosariumBiophysical Tests, Ultrasound, 2-D Echo, Stress Test, ECG, MRI
In-Vitro Fertilization (IVF) Centers
Nursing Home Nuclear MedicinePhilippine Oncology Center
HOSPITALSOTHER HEALTH
FACILITIESGeneral
Level 1 Level 2 Level 3
A. Primary Care Facility
Specialty B. Custodial Care Facility
Teaching/ Research
C. Diagnostic Facility
D. Specialized Out-patient Facility
PROPOSED CLASSIFICATION
DOH Website
www.doh.gov.ph
Doing Business
Licensing
BHFS Requirements
Hospitals and Other Health Facilities
BUREAU OF HEALTH FACILITIES AND SERVICES
Division ChiefContact Number/
Email Address
Standards Development
Division
Dr. Cynthia R. Rosuman
6517800 local 25257119572 (direct)
Licensing and Accreditation
Division
Atty. Rodel C. Flores (OIC)
6517800 local 2502-25047116982 (direct)
Quality Assurance and
Monitoring Division
Dr. Beauty A. Palongpalong
6517800 local 2528bapalongpalong@yahoo.
com
Administrative Unit
Ms. Teresa Salgado
6517800 local 2500
Thank you.
SPECIALTY HOSPITALSParticular Disease
Particular Organ(s)
Particular Group of Patients
National Orthopedic
HospitalLung Center
Philippine Children’s Medical Center
National Center for Mental Health
Philippine Heart Center
Dr. Jose Fabella Memorial Hospital
San Lazaro Hospital
National Kidney and Transplant
Institute
Philippine Geriatric Center