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A Critical Analysis of Purchasing of Health Services in the Philippines: A Case Study of PhilHealth

Author

Listed:
  • Pantig, Ida Marie T.
  • Ulep, Valerie Gilbert T.
  • Picazo, Oscar F.
  • Ho, Beverly Lorraine C.

Abstract

This study is a critical analysis of health services purchasing undertaken by the PhilHealth, which implements the National Health Insurance Program of the Philippines. Purchasing is about how an institution should determine, negotiate for, and obtain health services on behalf of a group of people that has contributed resources, either through taxes, premiums, or point-of-service payments, in exchange for anticipated health services.The study employs a principal/agent framework for analyzing three critical relationships: that between the purchaser and health-care providers, between the purchaser and citizens (or members of Philhealth), and between the purchaser and the government, both as regulator and as funder of services, at the national government and local government levels. The study is an analysis of the key alignments and variances of purchasing practices vis-a-vis the "design" and the theoretical ideal in each of the three relationships. To do this, the study employs an extensive document review as well as key informant interviews of decisionmakers and other stakeholders, including PhilHealth management and staff, the Department of Health, provider representatives, and consumer representatives. It is part of a multicountry analysis of purchasing of health services in selected African and Asian health-financing organizations. It also provides key findings and policy implications.

Suggested Citation

  • Pantig, Ida Marie T. & Ulep, Valerie Gilbert T. & Picazo, Oscar F. & Ho, Beverly Lorraine C., 2015. "A Critical Analysis of Purchasing of Health Services in the Philippines: A Case Study of PhilHealth," Discussion Papers DP 2015-54, Philippine Institute for Development Studies.
    • Handle: RePEc:phd:dpaper:dp_2015-54
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    File URL: https://www.pids.gov.ph/publication/discussion-papers/a-critical-analysis-of-purchasing-of-health-services-in-the-philippines-a-case-study-of-philhealth
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    References listed on IDEAS

    as
    1. Lavado, Rouselle F. & Sanglay-Dunleavy, Abigail Barbara & Matsuda, Yasuhiko & Jimenez, Jeanette F., 2010. "How Are Government Hospitals Performing? A Study of Resource Management in DOH-retained Hospitals," Discussion Papers DP 2010-02, Philippine Institute for Development Studies.
    2. Lavado, Rouselle F. & Pantig, Ida Marie T. & Ulep, Valerie Gilbert T. & Datu, Maria Blesila G. & Ortiz, Danica Aisa P. & Jimenez, Jeanette F. & Banzon, Eduardo P., 2011. "Profile of Private Hospitals in the Philippines," Discussion Papers DP 2011-05, Philippine Institute for Development Studies.
    3. Avestruz, Fred, 1995. "A Study of Philippine Hospital Management Administrative Systems," Discussion Papers DP 1995-16, Philippine Institute for Development Studies.
    4. Wong, John Q. & Baclay, J. Richelcyn M. & Duque, Richelle G. & Roque, Patricia Margarita S. & Serrano, Grace Kathleen T. & Tumlos, Jenina Olivia A. & Ronsing, Aisha-Aziza A., 2014. "The Prevalence of Philippine Prescribing, Dispensing, and Use Behavior in Relation to Generic Drugs and their Risk Factors," Discussion Papers DP 2014-17, Philippine Institute for Development Studies.
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    Cited by:

    1. de Claro, Vergil, 2018. "Rapid Assessment of Strategic Purchasing in the Philippines: A Country Case Study," EconStor Research Reports 238680, ZBW - Leibniz Information Centre for Economics.
    2. Alejandro Herrin, 2017. "Preventing chilhood stunting: Why and how?," Working Papers id:12069, eSocialSciences.

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    1. Picazo, Oscar F. & Ho, Beverly Lorraine C. & Ulep, Valerie Gilbert T. & Pantig, Ida Marie T., 2015. "A Critical Analysis of Purchasing of Health Services in the Philippines: A Case Study of PhilHealth," Research Paper Series DP 2015-54, Philippine Institute for Development Studies.
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