Hospital reclassification to burden poor?

The Department of Health hospital reclassification program is bound to make it more difficult for poor people to access healthcare and even prevent health workers from going abroad

RECLASSIFICATION. At the Fabella Memorial Hospital. Photo by Rick Rocamora

MANILA, Philippines – The Department of Health (DOH) hospital reclassification program is bound to make it more difficult for poor people to access healthcare and even prevent health workers from going abroad.

Private Hospitals Association of the Philippines (PHAP) President Dr Rustico Jimenez told Rappler that the reclassification of hospitals may render PhilHealth cards useless and cause a doubling, on the average, of the already expensive cost of healthcare in the Philippines.

Jimenez said the reclassification of hospitals will downgrade almost all of the 1,800 hospitals in the country. This includes more than 500 primary hospitals that will now be classified as mere “infirmaries” which are not credited by PhilHealth.

“The problem with this is that these hospitals, a third of the total, are mostly private facilities located in small towns and municipalities which are often 4 to 5 hours away from the nearest government hospital. These are the facilities put up by doctors on their own because of the lack of healthcare facilties in a particular town or province,” Jimenez explained.

Jimenez said the reclassification will affect some 8,000 patients of the more than 500 primary hospitals. He said this is because these facilities have 5 to 15 beds each.

In terms of personnel, this will also douse the dreams of healthworkers — nurses, doctors, medical technicians, pharmacists, and others — who are eyeing positions abroad. Jimenez explained that employers abroad require potential employees to have worked in tertiary facilities before they can be hired.

But under the reclassification, with most hospital classifications getting downgraded, these potential dollar earners or Overseas Filipino Workers (OFWs) will not be accredited by international employers.

“Even the OFWs who will be leaving will be affected because they will not be accredited by their employers. Even some public hospitals will experience downgrades in their classifications,” Jimenez said.  

“To comply, these ‘infirmaries’ for example, need millions because they need a blood bank, an operating room, etc. This is why we need 5 to 6 more years to comply with the reclassification requirements,” he added.

Position paper

The Philippine Hospital Association (PHA) and PHAP also warned that the reclassification of hospitals may force existing facilities to close and render PhilHealth cards useless.

In a joint position paper, PHA president Dr Bu Castro and Jimenez said that once reclassified, Level 1 hospitals will become mere infirmaries. This will cause confusion among clients who will think these facilties will not accept patients for confinement.

Under the reclassification, “infirmaries” will no longer be automatically accredited by the Philhealth unless they comply with the new requirements of Level 1 hospitals under the new classification.

“This confusion on the part of the client is translated to financial losses on the part of the affected hospitals, more particularly the private hospitals and loss of services on the part of the government hospitals. This is still not considering the impact on the reimbursement claims with PhilHealth which would likewise be certainly affected despite assurances by Philhealth officers,” the groups said.

New classifications

Under the new DOH reclassification order, Level-1 hospitals should have the following facilities:

  • surgery room
  • isolation
  • surgical and maternity facilities
  • dental clinics
  • secondary clinical laboratory
  • blood station
  • first level X-ray
  • a pharmacy

Level-2 hospitals require additional departmentalized clinical services including:

  • a respiratory unit
  • high pregnancy risk unit
  • second level X-ray with mobile unit

Level-3 hospitals should have:

  • DOH-accredited teaching and training on 4 major clinical services, ambulatory surgical and dialysis clinics
  • a blood bank

“It is the position of both PHA and PHAP that the existing classification be maintained and that the New Classification of Hospitals as contained in DOH AO No. 2012 be applied prospectively to new hospitals to be constructed yet,” the paper stated.

“It is rather unhealthy to re-classify hospitals whenever a new Secretary of Health is installed into Office,” it added. “One could not imagine if the next Secretary of Health after Dr Enrique Ona would again reclassify hospitals in the next administration.”

Hospitals and healthcare facilities are presently classified according to their “service capacities” and compliance with standards for manpower, equipment, construction and physical activities.

But based on a “Survey of the Services and Equipment Available in Hospitals Nationwide” conducted by the DOH in 2011, the agency found the need to do the reclassification.

“Partial results of the survey had indicated variation in the service characteristics of hospitals not only among the different categories but also within the same category based on the facilities and services they provide,” the AO said. –

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