AN ASSESSMENT ON THE HEALTHCARE SYSTEM OF

BESTCAP CAREER COLLEGE, INC.

AMIDST PANDEMIC: A BASIS
FOR IMPROVEMENT

INTRODUCTION

This chapter presents the background of the study, conceptual framework,

statement of the problem, objectives, significance, scope and limitation of the study, and

definition of terms.

Background of the Study

Health care is defined by the Merriam Webster dictionary as efforts made to

maintain or restore physical, mental, or emotional well-being especially by trained and

licensed professionals.

A healthcare system, sometimes spelled out as health care systems or just health

systems, is composed of the organization, the people that runs the system, and the actions

of the people with the goal to promote, restore, or maintain health (Pallipedia, n.d.). It

includes not only public facilities that deliver the services, but also a mother caring for a

sick child at home, health insurance companies, and private providers.

Ideal healthcare systems include universal access to comprehensive medical care

along with health promotion and disease prevention, according to a study conducted by

Tulchinsky and Varavikova (2014). Furthermore, they cited three reasons that requires

nations to modify and adapt organization and financing systems of health care, health

protection and promotion: (1) aging populations; (2) increasing costs; and, (3) advancing

and increasing technology.

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As Tulchinsky and Varavikova cited the World Health Organization (WHO) in

their study with the link to the website inaccessible, the six basic building blocks for

health systems are (1) service delivery, (2) health workforce, (3) information, (4) medical

products, vaccines, and technologies, (5) leadership and governance, and (6) financing.

With the definitions given above, clinics, can be identified as a healthcare system,

though some references might differ. Such is given with the definition from Agency for

Healthcare Research and Quality website, which says “The Darthmouth College Center

of Excellences defines a health system as an organization that consists of either at least

one hospital plus at least one group of physicians or more than one group of physicians.”

As defined by Seladi-Schulman (2020), a clinic is a healthcare facility where

people can receive outpatient care. In her article, she provided a list of 10 types of clinics,

with which each kind has different focus.

Even more, clinics can be classified as a primary healthcare. Primary healthcare is

defined by BetterHealth (n.d.) as the provision of a broad range of health services

provided by medical professionals in the community. It is the first contact a person has

with the health system when they have a health problem.

Brindis and Sanghvi (1997) concluded in their study that school-based clinics

(SBCs) and school-linked services serves as an alternative model of care that had

succeeded in the goals of a healthcare system, as stated in the second paragraph, towards

adolescents in the United States.

However, they stated that the continued success of such services in improving

adolescent health will depend on how well they can capitalize on their strategic position
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to reach adolescents, respond to their health needs, and reduce barriers to care, and how

effectively they can integrate themselves as the US health care delivery system evolves.

From this, the researchers decide to analyze how BESTCAP Career College,

Inc.’s (BCCI) school-based clinic have been in terms of their service delivery, health

workforce, medical products and technology, and facility.

The researchers think that this would be timely as the Coronavirus-19 (COVID-

19) is still a threat to students this 2022, especially since face-to-face classes are now

implemented by the school. The Department of Education (2020) had mentioned in a

notice that schools should ensure the refurbishment of their own clinics, since those who

have the symptoms of COVID-19 shall be brought inside the facility.

Knowing how the school-based clinic is doing will help the school to adjust what

needs to be improved. Gathered data will show the good parameters of the school-based

clinic, which will be recommended to be retained as needed. This research will serve as a

basis for improving the facility, that will lead to a better clinic experience for the students

of the school. Hence, this research proposal.

Statement of the Problem

The purpose of this study is to assess the status of BCCI’s school-based clinic

during the School Year 2022-2023, which will serve as a basis for improvement.
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Specifically, it will seek to answer the following questions:

1. How may the school’s clinic be described by the respondents in terms of:

a. service delivery

b. health workforce

c. medical products and technologies

d. facility

e. overall

2. What are the weak and strong parameters of the school-based clinic?

3. How may the clinic be improved in terms of:

a. service delivery

b. health workforce

c. medical products and technologies

d. facility

e. overall

Objectives of the Study

The objectives of this study are as follows:

1. To describe the school’s clinic in terms of:

a. service delivery

b. health workforce

c. medical products and technologies

d. facility

e. overall
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2. To identify the weak and strong parameters of the school’s clinic.

3. To identify the improvements that the school clinic needs in terms of:

a. service delivery

b. health workforce

c. medical products and technologies

d. facility

e. overall

Significance of the Study

This study about healthcare systems is aimed to give additional information about

the current status of the school-based clinic and will benefit the following:

The students. Data gathered from the students who will be selected as

respondents will be able to input their assessment of the school clinic. The data will be

used as a reference for improvement, and will help for the betterment of their experience

in the facility.

The clinical manager (Capitalize Each). With the results of the research, he/she

can utilize the results of the study to overall improve the clinic.

The school-based clinic. The study will show what the school clinic should

continue to maintain and the basis for improvements. Clinic visits in turn would be more

desirable for students.

The school. The study will show how its school-based clinic is rated by the

students themselves. The study can be used by the school to further improve the

management of its facility.

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Lastly, this will serve as a reference to future researchers who will make a study

related to assessment of healthcare systems and the gathered basis for improvements in

school clinics. (Yun lang yung magbebenefit? How bout admin?)

Scope and Limitation of the Study

The researchers will limit five students randomly selected from each grade level

of the Junior High and Senior High School Departments of BCCI (Spell out) as the

respondents, regardless of the section.

The respondents will be limited to the students who have visited the clinic or have

asked for health services within the school. This study will be limited to the response to

be gathered from the selected students.

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Definition of Terms

The following terms with their respective definitions are used throughout this

study.

Clinic. A healthcare facility where people can receive outpatient care.

Clinical Managers. People tasked to oversee the administrative responsibilities of

running a medical clinic.

Distance Learning. Learning modality that is implemented since the start of the School

Year 2020-2021 where schools are not requiring students to physically attend physical

classrooms.

Face-to-Face Classes. Learning modality that is implemented by the school, wherein

students attend to physical establishments where they do almost every task that a student

needs to finish a school year.

Health Care. Efforts made to maintain or restore physical, mental, or emotional well-

being especially by trained and licensed professionals.

Health. The work of providing medical services.

Healthcare System. Composed of the organization, the people that runs the system, and

the actions of the people included in it.

Outpatient Care. Refers to any healthcare consultation, procedure, treatment, or other

service that is administered without an overnight stay in a hospital or medical facility.

Physician. A doctor, especially one who is a specialist in general medicine and not

surgery.

Primary Healthcare. Term used to describe the first contact of a person with the health

system when they have a health problem or issue that is not an emergency.
 8

School-Based Clinics. A place within the school campus wherein primary care is

rendered to a sick patient, and, first aid and initial nursing assessments are given during

emergent situations.

 
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REVIEW OF RELATED LITERATURE AND STUDIES

The chapter cites a list of Related Literature and Studies that served as the basis

and framework of the study.

Related Literature

The World Health Organization (n.d.) (WHO) defines primary health care as a

whole-of-society approach to effectively organize and strengthen national health systems

to bring services for health and wellbeing. It enables health systems to provide a person’s

health needs. This includes health promotion, disease prevention, treatment,

rehabilitation, palliative care and more.

The Department of Health (DOH) and WHO among others have pointed the need

to improve the primary health care of the Philippines. Dr. Gundo Weiler, WHO

Representative in the Philippines, said that the fairest and most affordable path to

universal health coverage is primary health care. Primary health care, for him, means

multiple sectors working together to bring care closer to home. (WHO, 2019)

The Department of Education (2019) (DepEd) once highlighted the importance

of stakeholders to help promote and give Filipino learners sustainable holistic school

health and nutrition programs toward healthier behavior and better learning outcomes.

They launched “Oplan Kalusugan (OK) sa DepEd” in 2019. This will focus on the major

school health programs like National Drug Education Program (NDEP), medical, dental,

and nursing services among others. DepEd Undersecretary for Administration Alain Del

Pascua told in Filipino that the program will not be launched without the help from DOH

and local government unit.

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The DepEd (2021) had planned to add 1800 additional dental and medical clinics

by the end of the second quarter the year the article was published. Said facilities was

also told to have health personnel, medical officer, dentist, nurse, and a reserved clinic

teacher that is trained in case of the medical staff being absent. The then Regional III

Supervising Dentist Dr. Leoncio Del Corro had stated that in every 4 out of 5 recipient

schools have already gotten the facilities already.

The average cost of an emergency room visit in the Philippines back in 2017 was

Php2,500, while the average cost of a doctor’s visit was Php500. There are over 20,000

pharmacies where you can buy medicine. And the public healthcare system is delivered

in primary healthcare centers linked to barangay health centers. Forty percent of the

hospitals are public, but there are opinions that public hospitals aren’t as good as private

ones. (Wise, 2017)

Meanwhile, based from the website of Asia Healthcare Market Research (n.d.),

around 1,800 hospitals in the Philippines are private. This roughly amounts to about 3 in

5 hospitals around the country. However, only 3 in every 10 Filipinos use them, and they

are financially capable to pay the bills of such services. The rest use public services.

Leading medical institutions in the Philippines are top-notch when compared to

other international hospitals. However, facilities in the provincial level still experience

problems in providing the most basic needs at primary care level. Health centers are

tasked to provide primary care in their place. But roughly 60% of barangays in the

country don’t have health centers.

An article from Future Learn (2022) have mentioned the lack of medical

practitioners in the country. Concerning healthcare in the Philippines, there is one

 11

physician in every 33,000 Filipinos. Many doctors find work in other countries. This

trend also applies to other medicine-related jobs. The number of dentists and midwives

are lacking. Medical staffs tend to emigrate to Western countries.

The Coronavirus Disease-19 (COVID-19) has affected the health of students. At

first, when schools were closed and little information was available about the SARS-

CoV-2, the protein involved with COVID-19, little cases in children were reported. This

led to the idea that children were spared from the virus.

But after some progress on research, children have been identified as susceptible

to virus. Following the series of events, distance learning became the new normal for

students to maintain education. (Cuffari, 2021)

Two years since distance learning became the mode of learning of Filipinos,

students are now eligible to attend face-to-face classes as of 2022. This was based on an

article written by Magsambol (2022). During August of that year, not all schools are

allowing full in-person classes.

It is essential to contain and dampen the spread and infection rate of the virus.

Improving health systems also helps in it. Questions posed regarding the COVID-19

pandemic are about production, delivery and equitable access to vaccines. The pandemic

revealed that vulnerabilities in health systems may impact health among the other

mentioned factors. (OECD, n.d.)

Related Studies
 12

Primary care inequities are present in the Philippines, as of 2020. A review from

58 text records had shown that health programs, facilities, human health resources,

finances, and training are the sectors of healthcare that has bias. The study yielded results

that stakeholders are combatting the said problems. While political commitments might

help in improving primary care in the Philippines, social accountability of Filipinos is

mentioned as the remedy for the so-called social and behavioral barriers in accessing

primary care. Regular training of workers on healthcare services and delivery is also

needed. (Borlongan et al., 2020)

Government policies on school health have strengthened the role of private

schools in providing health care to students, according to a study conducted by Racelis

(2013). This role of the said institutions has put them in a strategic position to maintain

and promote the health of around 4.5 million Filipinos in 2012. The study estimated that

three-tenths of the private schools have employed a complete team of health personnel.

She defined a complete team as comprised of at least one doctor, nurse, and dentist. This

trend is seen in schools with large enrollments. One-tenths of schools have a doctor and a

nurse, while around two-tenths only have a nurse.

Primary health care facilities, from a study conducted by Aytona et al. (2022),

were deemed to be inefficient since there are differences between the amount of staffs

found in different facilities. Three out of 40 rural health units (RHU) and city health

offices had the required number of physicians. Shortage of physicians are seen in 22

facilities, who are working under high workload pressure. Nurses at RHUs also have high

workload pressure. Meanwhile, low workload pressure is seen at midwives working at

barangay health stations.

 13

Shackleton et al. (2016) have found in their systematic review of reviews that

multicomponent school-based interventions, such as school policy changes and work

with local communities, are effective for promoting sexual health and preventing bullying

and smoking. Though there is less evidence that intervention programs can reduce

alcohol and drug use, school clinics may promote smoking cessation.

A pilot study with responses gathered from 200 patients surveyed in 2016 to 2017

had shown that patient satisfaction has greatly increased after primary care services in a

facility were strengthened. Highest satisfaction scores are recorded in three categories:

(1) overall wait times, (2) coordination of care, and (3) health advice. Findings from the

study recommends digitalizing health records, financing laboratory and pharmaceutical

services, and retraining staff to improve patient satisfaction. (De Mesa, 2019)

In terms of mental health, Filipinos across the world are reluctant to formal help-

seeking even with high rates of psychological distress. A study made by Martinez et al.

(2020) included the reasons of local Filipinos as financial constraints and unavailability

of services. Social stigma attributed to mental problems also affected Filipinos, even the

ones in another country. Low utilization of mental health services among Filipinos are

confirmed by the researchers.

An individual’s evaluation of his or her health-care experience is called patient

satisfaction. It also includes his emotional reaction. The concept of patient satisfaction is

getting more important as health-care facilities are using this data for self-assessment.

According to Shirley and Sanders (2013), high patient satisfaction is associated with

increased market share and financial gains. Factors that can change the patient
 14

satisfaction include physician-patient communication, less waiting times, and continuity

of care.

Shirley and Sanders’ claim was backed up by Doyle et al. (2013) in their study.

Positive associations between patient experience and patient safety and clinical

effectiveness are more common. Parameters included in the study are mortality, physical

symptoms, length of stay and adherence to treatment. They concluded that patient

experience should be included in the pillars of quality in healthcare.

A succeeding study from Shirley and Sanders (2016) have mentioned that

certain factors have led satisfaction to be implied as a global indicator of health-care

quality. However, high satisfaction scores are not always related with safety indicators.

They determined that satisfaction surveys are not a good way to measure overall quality

of care. Quality assessment of health-care facilities needs multidimensional approach

with different measures for each discipline.

One hundred fifty five physicians were asked to respond to a study conducted by

Rabago et al. (2014) to gather information about the impact of patient satisfaction ratings

on them and the clinical care. Of the respondents, 130 have reported that patient

satisfaction surveys have had an effect on their job satisfaction. Thiry percent have

considered to leave the medical field. Almost half believed that these surveys may lead to

inappropriate care in order to get higher scores. Among the listed misconduct are

unnecessary antibiotic prescriptions, admissions, and tests.

Conceptual Framework

This shows the Input, Process, and Output of the Study, the steps the researcher

will take to be able to come up with a result.

 15

Figure 1. Conceptual Framework of the Study

Permission Letter
Questionnaire
Input

Ask permission from the school head to start the research

Conduct the survey
Proce Gather the data from the survey
Analyze the data collected
ss

An Assessment on the Healthcare System of BESTCAP Career

Outpu College, Inc. amidst Pandemic: A Basis for Improvement

t
 16

METHODS AND PROCEDURES

This chapter presents the Research Design, Locale of the Study, Respondents of

the Study, Data Gathering Procedure, Data Gathering Instruments and Data Analysis.

Research Design

This study will use qualitative research design to assess the healthcare system of

BESTCAP Career College, Inc. during the school year 2022-2023.

A questionnaire will be given to the respondents that will then be used to rate the

school-based clinic. A separate space in the questionnaire will be allotted for the

respondents’ recommendations on improvements for the school-based clinic.

Locale of the Study

This study will be conducted at BESTCAP Career College, Inc., Malacampa,

Camiling, Tarlac.

Respondents of the Study

The respondents of the study will be 60, having five from Grade 7 to Grade 12

regardless of the section. Simple random sampling will be used to select the respondents

from each grade level.

Data Gathering Instrument

The researchers will create a questionnaire to gather the data about how the

school-based clinic can be described in terms of service delivery, health workforce,

medical products and technologies, and its facility, and the possible recommendations for

its improvement.

Data Gathering Procedure

 17

The researchers will create a letter to conduct the study and will present it to their

research adviser, principal, and school head. The researchers will request a list of the

students from the advisers of each section, and will randomly select the respondents.

They will then personally join the respondents to go inside the school clinic that

will be assessed. In there, the respondents will each receive a copy of the questionnaire

and can ask questions to the researchers while answering the questionnaire.

Data Analysis

In order to statistically analyze and interpret the gathered data, the following
statistical tools will be used:

For Objective number 1: Likert scale will be used

For Objective number 2: Results from Objective number will be used

For Objective number 3: Listing will be used.

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APPENDIX
 23

FIGURES