Motivated by the national government’s efforts toward Universal Healthcare “Kalusugan Pangkalahatan”, PHC embarked on an ambitious program to provide greater access to specialized cardiovascular care by enabling existing regional medical centers to serve as regional heart centers. Regional medical centers are supported with manpower expertise, heart surgery equipment and supplies, vital endorsements to the Department of Health for infrastructure funding, and endorsement to PhilHealth Z-benefit for accreditation.
Background and Problem
Driven by their shared desire to improve the health status of the Filipino people, the PHC provides comprehensive cardiovascular care enhanced by education and research that is accessible to all. In the past years, cardiovascular treatments, especially surgery for heart disease, was concentrated in big hospitals in the Greater Manila Area due to lack of confidence of local medical practitioners for specialized procedures. There is, however, a long waiting list for surgery usually lasting for 3-5 years.
Solution and Impact
PHC conceptualized a strategic initiative to decentralize cardiovascular care to the regions. To increase access to cardiovascular care in the country, bringing the “brand” of PHC (i.e. patient-focused and compassionate care) to the regions were necessary. Performing pilot procedures as proof of concept was not the real goal of PHC. Enabling these regional heart centers to perform procedures independently with the shortest possible incubation period is the structured and definitive program for PHC. The maturity scale designed by PHC for the certification of PhilHealth Health Care Institutions (HCI) both private and government will be used to evaluate the capabilities to serve as regional heart centers. The impact for stakeholders was numerous, especially for patients. No balance bill for cardiac surgery among PhilHealth members assured government subsidy to the marginalized; and reduced costs by 50 percent at 100 to 200 thousand pesos for those who can afford. “Kalusugan Pangkalahatan” for all Filipinos was felt by the Filipinos for heart surgery. Training of physicians to practice in the regions was also encouraged. The leadership commitment for regional hospitals has gained ten (10) surgical missions in the last three years since 2013, with 148 patients operated and 60 personnel trained (for both nurses and doctors).
Milestones
The initial five regional heart centers were:
- Southern Philippines Medical Center (Davao, Southern Mindanao, Region XI)
- Northern Mindanao Medical Center (Cagayan de Oro, Region X)
- Vicente Sotto Memorial Medical Center (Cebu, Central Visayas, Region VII)
- Bicol Regional Training and Teaching Hospital (Legazpi, Region V)
- Mariano Marcos Memorial Hospital and Medical Center (Batac, Ilocos Norte, Northern Luzon, Region I).
A five year development plan through a Memorandum of Agreement was signed with the regional hospitals. Ten outreach open heart surgeries have been performed in all five regional heart centers and interventional catheter-based device closures in Bicol, Cebu, and Davao. For each mission, at least 20 personnel were sent.
The training of cardiovascular specialists for all these five centers have been prioritized so that candidates for highly competitive training slots in cardiovascular surgery, adult and pediatric cardiology, perfusion, and critical care nursing will be accepted in their requested programs provided that they commit to return to their regional centers. Full support for pilot procedures was extended to all regional centers with the dispatch of multiple heart teams capable of simultaneous cases including complete heart equipment and supplies for the recent Region I open heart surgery mission.
To ensure sustainability, these regional heart centers have been endorsed for certification for the PhilHealth Z-Benefit program which provides financial subsidy for cardiac surgery. PHC also strengthened linkages through institutional partnerships with private organizations that are supportive of PHC vision. A Multi-Sectoral Governance Coalition (MSGC- Heartlink) was established with institutional partners like Mending Kids International, Children’s Heart Foundation, and Philippine Airlines.