2
Noun Project." https://thenounproject.com/.
Background - Fragmentation of Healthcare
Lack of service coordination between different levels and settings of care.
Vertical disease-oriented programmes - HIV/AIDS, malaria, tuberculosis and other infectious diseases,
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Integrated care
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Models of Integrated Care
Polikum
Patients should be able to obtain all types of
outpatient care under one roof.
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Models of Integrated Care
Singapore
The Agency for Integrated Care (AIC) is set up by
the Ministry of Health to oversee, coordinate and
facilitate all efforts in care integration.
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Objective and Methodology
● To create a health system assessment framework for Integrated care
Literature Review
Identification of principles
Consulting health experts at Asian Development Bank and Access Health International.
1 “Good Practice Guidelines for Indicator Development - OECD.org."
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https://www.oecd.org/site/progresskorea/43586563.pdf..
Core Principles of Integrated Care
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Indicator 1.1: Existence of a national health policy that incorporate integrated care in its goals/objectives/principle/strategy
Indicator definition The indicator will measure whether a country’s national health policy incorporates the principles of integrated care
Purpose It reflects the government’s awareness and commitment to move towards an integrated model of care.
Definition of key terms Integrated Care: WHO defines Person centered Integrated Care as “Health services that are managed and delivered in a way that ensures
people receive a continuum of health promotion, disease prevention, diagnosis, treatment, disease management, rehabilitation, and
palliative care services, at the different levels and sites of care within the health system, and according to their needs throughout their life
course.”
Data Source This will include national health policies, administrative records, legal and regulatory documents, national health strategies, budget
documents, and regulations and guidelines that relate to the management, organization and financing of the health sector. These
documents can be obtained from government publications, legal and administrative department web sites.
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References
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Indicator Definition
Comprehensive – Does the health policy incorporate care that is comprehensive and tailored to the evolving
health needs (communicable and non-communicable diseases)? Does the policy commit to universal health
coverage?
Coordinated – Does the health policy incorporate coordination across different providers (private, public,
NGO) and settings (level of care)?
Continuous – Does the policy include any instrument that enables continuum of care - providing care and
services across the life course?
Holistic – Does the policy focus on physical, socioeconomic, mental and emotional well-being?
Co-produced – Does the policy promote active partnerships of people and communities at an individual,
organizational and policy-level.
Systems thinking – Does the health policy promote interaction with other government bodies to improve
health status of the country? 13
Results
Indicator 1.1: Existence of inter-ministerial partnerships to improve health -
INDIA PHILIPPINES
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Results
Indicator 1.3: Existence of a health financing strategy that supports and funds integrated care
INDIA PHILIPPINES
● Health is a state subject, however, the centre promotes ● Decentralized governance. The National Health Insurance
health programs - NHPS and NHM. Program under PhilHealth was instituted as a strategy
● Existence of multiple risk pools - ESIS, CGHS, RSBY, towards a shift to a single payer system, ultimately
State sponsored schemes achieving universal health coverage
● PhilHealth covers the entire population.
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Results
Indicator 1.5: Existence of a referral system that is both vertically and horizontally integrated
Indicator 1.7: Existence of patient satisfaction surveys for government owned/empaneled medical facilities
INDIA PHILIPPINES
● Patients from PHCs. SCs and CHCs can be referred to ● The referral system encompasses a bi-directional referral
sub-district or district level and then to tertiary health system. The DOH handles tertiary level care while local
facilities. government units (LGUs) handle both secondary and
● My Health Record primary care
● My Hospital - Public and Private (987) ● The Philippines does not have an electronic health record.
● There are select government health facilities that deploy
satisfaction surveys, however, no standard are set by DOH 16
Results
Indicator 1.8: Existence of Standard Treatment Guideline for the treatment of comorbid conditions
Indicator 1.9: Existence of coordinated health programs in contrast to vertical health programs
INDIA PHILIPPINES
● Standards and Protocols - National Health Portal ● Clinical practice guidelines are developed and regulated by
● National Health Mission the different associations of medical specialization.
Department of Health, Professional Regulation
Commission, Philippine Medical Association, Private
medical specialty organizations
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Results
Indicator 1.10: Existence of continuum of care in service delivery
Indicator 1.11: Existence of home based and community care in service delivery
Indicator 1.12: Existence of integrate promotive, preventive, long-term, and rehabilitative care at the primary level of care
INDIA PHILIPPINES
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Thank you. Questions?
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