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to_dave007

Types of Hospitals in Philippines and Prescription meds

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to_dave007

Most foreigners are used to the hospitals back home..  in Canada.. or US..  or Germany.. New Zealand..  or wherever.  But there are some big differences here that it may be worth understanding if you need medical care.

To begin.. there are public hospitals, and private hospitals, and very VERY big differences between what medical services you can access in the big cities, vs what you can access in the rural provincial areas.  And some "smallish cities may have very good hospitals..  just because of some historical reasons.  When you decide to settle here, it MAY be worthwhile to check out your local hospitals, to know what you CAN, and CAN'T access locally.. or quickly if you need it. 

To begin this thread, I offer the following description of hospital levels provide by PhilHealth:

Philhealth mentions Levels 1 to 4 in its Case Rates payment scheme?  What are these Levels?

For quick understanding, we can just say that a:

– Level 1  —  very small hospital

– Level 2  —  a small hospital

– Level 3  —  a big hospital

– Level 4  —  a very large hospital

The Department of Health (DOH) though has a more detailed description of these types of hospitals.  It’s even covered by administrative law, the DOH Administrative Order 205-0029.

Level 1 Hospital

– Emergency hospital

– initial treatment for cases that require immediate treatment and that provides primary care for prevalent diseases in the area

– general medicine, pediatrics, minor surgeries, and non-surgical gynecology

– primary clinical laboratory, pharmacy and first level radiology

– nursing care for patients needing minimal supervised care

Level 2 Hospital

– Non-departmentalized hospital

– general medicine, pediatrics, surgery, anesthesia, obstetrics and gynecology, first level radiology, secondary clinical laboratory, pharmacy

– nursing care for patients needing intermediate supervised care

Level 3 Hospital

– Departmentalized hospital

– all clinical services provided by Level 2 hospitals

– specialty clinical care

tertiary clinical laboratory, pharmacy, second level radiology

– nursing care for patients needing total and intensive care

Level 4 Hospital

– Teaching and training Hospital

– all clinical services provided by Level 3 hospitals

– specialized forms of treatments, intensive care and surgical procedures.

– tertiary clinical laboratory, third level radiology, pharmacy

-nursing care for patients needing continuous and specialized critical care

Hospitals can also be classified as:

1. General

2. Special

Other health facilities are:

– Birthing homes — maternity clinics that provide pre-natal and post-natal care, normal spontaneous delivery and newborn baby care

– Psychiatric care facilities — care of mentally ill patients

http://www.healthphilippines.net/2011/08/hospital-levels-philhealth/

Edited by Dafey
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to_dave007

In the November 26 (paper) copy of the Cebu Freeman I read that in the 2020 provincial budget they are including money to upgrade the provincial hospitals in Bogo, Danao and Carcar from Level 1 to Level 2 by addition of Intensive Care Unit, and the facilities and staff to support it.

The District Hospital here in Tuburan can deliver babies, but can not do a Caesarian and does not have an incubator.  Expectant mothers are screened to the appropriate risk level, and risky cases are routinely referred to the city. When I first arrived, the hospital did not have an X-Ray.  Now they have an x-ray, but they still must get the x-ray diagnosis from the city, so expect a 24 hour wait for the diagnosis.  Forget about MRI and CAT Scan.. those are years and years off in the future.  They can do dengue tests, but only during the day shift, so arrive early.  If you get smashed up in a road accident, they can set a bone, and stitch a wound..  but if you need a pin inserted, you'll be in an ambulance to the city.  If you need urgent care at 3am.. you MAY need to wait until the doctor is rousted from bed and gets there.  But if it's serious.. he'll come.

The hospital has doubled in size since I've been here, and capability continues to rise, thanks to strong efforts by Steve Lagary..  the head doctor and administrative manager there.  It's easy to complain about what capabilities are NOT here, but adding them is a step by step process..  and needs strong local advocacy..  and Steve has provided that.  But it's a Level 1 facility.

Back in 2012.. Tuburan was the scene of a typhoid outbreak.  In the beginning patients arrived one by one..  but within just a few days the hospital was totally overwhelmed by the number of patients who arrived.  The Army came..  with tents and beds..  and outdoor facilities were improvised overnight..  The most severe cases were sent by ambulance to the city..  and patients on cots filled the parking lot..  and the mayor shipped truckloads of bottled water to the mountain barangays..  and the municipality coped. 

If you come here thinking medical services will be just like back home..  well.. they aren't.

On the flip side of that..  when the British wife of my British friend was in the final stages of cancer, the hospital sent nurses to her home, so that she could receive pain medication in her own bed during her terminal period.  And my good Canadian friend N..  whom I've written about before.. finished his last days surrounded by people who cared how he felt..  and who cared about dignity.. with nurses visiting him in his own home twice a day.  At no time was he "just a number". 

Edited by to_dave007
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Bama
1 hour ago, to_dave007 said:

On the flip side of that..  when the British wife of my British friend was in the final stages of cancer, the hospital sent nurses to her home, so that she could receive pain medication in her own bed during her terminal period. 

I've read that RP hospitals often won't give any medication to a terminal patient regardless of how bad the pain gets.Some patients have sought respite from their ordeal via suicide. Seem to recall threads on LinC with complaints about some hospitals poor pain management programs.

Perhaps things are getting better in this regard.I Hope so.

 Will try to dig up links to support what I have just posted.

https://www.livingincebuforums.com/topic/92991-keeping-my-disability/page/3/?tab=comments#comment-1213454

Read ozboy comments from 2016 about his wife's pain experience.

A link picked from a thread in 2015.

http://www.philstar.com/headlines/2015/02/27/1428140/strict-drug-policies-deprive-filipinos-pain-relief

 

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to_dave007
11 hours ago, Bama said:

I've read that RP hospitals often won't give any medication to a terminal patient regardless of how bad the pain gets.Some patients have sought respite from their ordeal via suicide. Seem to recall threads on LinC with complaints about some hospitals poor pain management programs.

It's a good point you make.  I suspect that there ARE real differences from 10 years ago..  when my friends wife needed pain meds in her final days.  It was just a few years back when no prescription was needed for antibiotics..  one reason my Amoxicillin is pretty much useless here now.  WAY overused.  But I think they tightened up the rules about what needs a prescription and what doesn't, and even when some drugs can be prescribed at all.  Would EXPECT that this would include any of the pain killers that get "abused".

The key is.  how to get it when you really need it.

Edited by to_dave007
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Bama
47 minutes ago, to_dave007 said:

But I think they tightened up the rules about what needs a prescription and what doesn't, and even when some drugs can be prescribed at all. 

Yes, they did tighten up the rules about prescribing drugs in 2002 as mentioned in one of the links provided. As mentioned below why would any doctor go through the hassles of getting the correct licensing to prescribe pain killers and then risk scrutiny anytime they use it.

Actually, I have read of another much more basic reason why pain meds aren't used when they should be---won't upset some peoples sensibility on LinC by posting it.

 

Quote

 

Restrictive policies

According to Lu, Republic Act 9165 or the Comprehensive Dangerous Drugs Act of 2002 restricts doctors from using opioids in pain management.

The law imposes jail term and fines for unlawful and unnecessary prescriptions of dangerous drugs, but the definition of these two categories is not clear.

“What is unlawful and unnecessary? If you’re a doctor who earns a lot of money from surgery or dermatology, would you want an extra license so you can prescribe opioids for patients? Those are some of the barriers,” he said.

Doctors are required to secure yellow prescription pads before they can prescribe painkillers such as opioids or morphine.

Lu lamented the string of requirements that doctors must comply with before they could acquire the yellow prescription pads, aside from the fact that they have to purchase them.

“We need a balanced regulation. We’ve never been a primary source of abuse in this country. It’s easier for an addict to get illicit drugs from the street than going to a doctor to get a yellow prescription,” he said.

 

 

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liquido

I know we all have a rule of thumb of which hospital we would go to in case of a medical condition..For me I would choose https://www.bumrungrad.com/en .

Of course the conditions have to be right and that is if you are able to travel and hopefully get an honest opinion from a doctor here that you are able to travel...Bumrungrad in Thailand is well known for there superior services...Yes I know small stuff here can develop into life threatening..I do not think you would need a watcher there...lol

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Headshot
5 hours ago, liquido said:

I know we all have a rule of thumb of which hospital we would go to in case of a medical condition..For me I would choose https://www.bumrungrad.com/en .

Of course the conditions have to be right and that is if you are able to travel and hopefully get an honest opinion from a doctor here that you are able to travel...Bumrungrad in Thailand is well known for there superior services...Yes I know small stuff here can develop into life threatening..I do not think you would need a watcher there...lol

Personally, if I was well enough to fly to Thailand for care, I would just board a plane for the US.

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jtmwatchbiz
7 minutes ago, Headshot said:

Personally, if I was well enough to fly to Thailand for care, I would just board a plane for the US.

I think Thailand would make for a quicker, easier and less expensive trip if the sole purpose was for medical treatment. 

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Headshot
6 minutes ago, jtmwatchbiz said:

I think Thailand would make for a quicker, easier and less expensive trip if the sole purpose was for medical treatment. 

That depends on the type of medical treatment the person needs and on the insurance coverage a person has in the US vs. overseas. Plus, I really wouldn't trust the care I would receive in any SEA country if the medical condition was serious enough to not trust the doctors in the Philippines.

But you are free to make whatever decision you like. I was just offering my personal view on what I would do. Others ... including you ... are free to see things differently.

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jtmwatchbiz
2 minutes ago, Headshot said:

But you are free to make whatever decision you like. I was just offering my personal view on what I would do. Others ... including you ... are free to see things differently.

I don't know what to say except thanks!

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Kabisay-an gid

Asia's best kept secret in medical tourism destinations - better medical care than Thailand & quite affordable - not to mention a thousand kilometers closer to the Philippines than Thailand, making travel there also affordable:

https://medisetter.com/blog/en/medical-tourism-in-taiwan-best-kept-secret/

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liquido
1 hour ago, Kabisay-an gid said:

Asia's best kept secret in medical tourism destinations - better medical care than Thailand & quite affordable - not to mention a thousand kilometers closer to the Philippines than Thailand, making travel there also affordable:

https://medisetter.com/blog/en/medical-tourism-in-taiwan-best-kept-secret/

Worth looking into to....

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