Measuring the primary care performance of the Manila health Cluster: Manila philippines 2010

ABSTRACT

Background: Efforts to determine and quantify primary care all over the world are increasing as evidence suggests that it contributes to improving health outcomes. Example of such assessments is disability adjusted life expectancy which showed good results among countries with better primary care. In this pilot study, primary care assessment tool- Facility Survey (PCAT FS) prepared by Barbara Starfield, was used to assess these services by the Manila Health Cluster. The Manila Health Cluster, consisting of hospitals, health centers, satellite and lying ins, is the agency responsible for providing the general health services to the whole City of Manila based on programs recommended by the Department of Health. General Objectives: This study was conducted to assess if the principles of primary care are practiced in the Manila Health cluster using the PCAT facility short version questionnaire. Results: A total of 35 out of 52 public health centers were randomly selected in the different primary care facilities run by the Manila Health Cluster. The lead person of the different health care facility responded to the questionnaire. A significant percentage of patients were being seen in their clinic anywhere from 1-10 years time. The practice focus of the facilities is general practice. Majority of the physicians receive their compensation by salary from the local government. The practice focus of all health centers is family practice/general practice. Majority claim that about 20% of the patients seen have long term behavioral problems. Majority also state that the patients stay with them for more than 5 years and they have geographically defined population to serve. Of all the 9 domain, the programs had very good scores in coordination of care, family-centeredness, ongoing care and information system. However, improvement is needed for cultural orientation, services that are available, services being provided, and access. In terms of the overall primary care score for the core indicators, the Manila Health Cluster primary care orientation evaluation did not reach the target mean score of 3.5. When the other domains were added, the overall mean primary care orientation of the Manila Health cluster did not meet the desired level of score targeted to conclude that the facilities are primary care oriented.