8 February 2016
New PhilHealth Circulars Burden on Doctors and Patients
New requirements force healthcare providers to keep patients longer than needed
For Health Alliance for Democracy (HEAD), the latest circulars from the Philippine Health Insurance Corporation (PhilHealth) will put additional difficulties on patients and the already strained government-run healthcare system.
PhilHealth Circulars 2016-001 and 002 are Policy Statements on the Diagnosis and Management of Acute Gastroenteritis (AGE) and Urinary Tract Infection (UTI), respectively.According to Dr. Joseph Carabeo, HEAD secretary-general, “These circulars will force the doctor’s hand in the management of patients with such diseases.”
Because these circulars prescribe a minimum hospital stay of 3 days for AGE and 4 days for uncomplicated UTI in order for claims to be reimbursed, patients with these diseases must be hospitalized even if they are well enough to go home or even if there is no reason to keep them hospitalized. Otherwise, their claims will be denied.”
The “double burden” will be largely felt at the primary and secondary levels, particularly in district and provincial hospitals that are already battling limited resources.
“By forcing longer hospitalization, patients who may be income-earners are prevented from going back to work. At the same time, resources are unnecessarily used up and the patients themselves are placed at higher risk of hospital-acquired infection.”
“On the other hand, if doctors exercise proper clinical decision-making and send their patients home before the prescribed period, the patients themselves will have to shell out their ownmoney.”
In short, the latest circulars are unfair to both healthcare providers and patients.
“One again, it seems that PhilHealth is implementing something without considering its implications. Such anti-people policies are characteristic of the Aquino government. This must stop.” ###