MSN 202 COURSEWORK

In Partial Fulfillment of the Requirements for the course

ADVANCED HEALTHCARE ECONOMICS WITH NURSING
ENTREPRENEURSHIP
for the degree Master of Science in Nursing – Adult Health

Submitted to:

Maria Girlie Jordan, MSN

SPUP Graduate School Faculty

Submitted by:

Edward P. De Mesa
Hershey Vonn Primero

SPUP MSN 2019 Student

2nd Trimester 2019

 Table of Contents

Partner Activity
Module A………………………………………………2
Module B………………………………………………3

Individual (Part 2)
Module C.………………………………………………4
Edward P. De Mesa………………………………5
Hershey Vonn
Primero………………………………6

Individual (Part 3)
Edward P. De Mesa……………………………..7
Hershey Vonn Primero………………………..8

References……………………………………………9
 Module A

Definition of Terms
Health Economics - is a branch of economics concerned with issues related to efficiency,
effectiveness, value and behavior in the production and consumption of health and healthcare. In
broad terms, health economists study the functioning of healthcare systems and health-affecting
behaviors such as smoking.
Cost - is the value of money that has been used up to produce something or deliver a service, and
hence is not available for use anymore.
Created Wants - equilibrium in the product market does not represent optimal consumer utility
in the form of consumer surplus
Public Wants - A group of people may also share the same want, such as highways, drinking
water, and education. For the most part local, state, and federal governments satisfy public
wants
Capitation - the payment of a fee or grant to a doctor, school, or other person or body
providing services to a number of people, such that the amount paid is determined by the
number of patients, students, or customers.
Preferred Payment Organization - A type of health plan that contracts with medical providers,
such as hospitals and doctors, to create a network of participating providers. You pay less if you
use providers that belong to the plan's network.
Macro Health Economics - is a branch of the economics field that studies how the aggregate
economy behaves. In macroeconomics, a variety of economy-wide phenomena is thoroughly
examined such as, inflation, price levels, rate of growth, national income, gross domestic
product and changes in unemployment. It focuses on trends in the economy and how the
economy moves as a whole. Therefore, macroeconomics is the study of an entire nation’s
economic status.
Cost Benefit Analysis - is a process by which organizations can analyze decisions, systems or
projects, or determine a value for intangibles.
Microeconomics - studies how the behaviors of individual market participants such as buyers,
sellers, and business owners—affect the allocation of resources
Third Party Transaction - s a business deal that involves a person or entity other than the main
participants. Typically, it would involve a buyer, a seller and another party, the third party. The
involvement of the third party can vary, based on the type of business transaction.
Health Management Organization - A health maintenance organization (HMO) is an
organization that provides health coverage with providers under contract. A Health
Maintenance Organization (HMO) differs from traditional health insurance by the contracts it
has with its providers. These contracts allow for premiums to be lower, because the health
providers has the advantage of having patients directed to them; but these contracts also add
additional restrictions to the HMO's members.

Republic Act 7875 – an act instituting a national health program for all Filipinos and
establishing the Philippines health insurance corporation for the purpose. An act instituting a
national health insurance program for all Filipinos and establishing the Philippine Health
Insurance Corporation for the purpose. It is known as the "National Health Insurance Act of
1995", approved by President Fidel V. Ramos last February 14, 1995. It institutes a National
Health Insurance Program for all Filipinos and creates the Philippine Health Insurance
Corporation and the National Health Insurance Fund. It also provides for a system of grievance
and appeal wherein members, dependents or health care providers may seek redress if they think
that they have been aggrieved by any decision of the implementers of the Program, and provides
penalties for violations of its provisions.

4 PRECONDITIONS FOR THE ESTABLISHMENT OF

MODERN MEDICAL CARE
Effective Medical Technology
 Technological developments in healthcare have saved countless patients and are
continuously improving our quality of life. Not only that, but technology in the
medical fields has a massive impact on nearly all processes and practices of
healthcare professionals. The Impact of Technology on Healthcare – AIMS
EDUCATION. Technology today affects every single aspect of modern society. In fact,
there isn’t an industry out there that hasn’t been affected by the hi-tech revolution.
Whether we are talking about transportation, communication, security, banking or
healthcare, they all rely on technology in one way or another. But nowhere is this
immense impact more apparent than in the field of medicine and healthcare.
 Technological breakthroughs are revolutionizing the way healthcare is being
delivered. Modern technology has changed the structure and organization of the
entire medical field. From widespread adoption of electronic medical records, to
advances in bio-medical engineering and technology, modern healthcare and its
delivery methods are changing at an ever increasing rate.
Low Risk of Death such that improving health is worthwhile
 Lifestyle behaviors lie at the root of many chronic diseases. Smoking, unhealthy
diets, and sedentary behaviors predispose numerous people to diseases that rank
among the leading causes of death such as heart disease, cancer, stroke, and
diabetes. The costs associated with these behaviors are enormous. Few studies
relating multiple low-risk lifestyle factors to all-cause mortality have been conducted
in the United States or have included substantial samples of racial/ethnic minorities.
Therefore, we examined the relationship between 4 lifestyle behaviors—never
smoked, healthy diet, adequate physical activity, and moderate alcohol
consumption—and all-cause mortality in a national sample of people in the United
States.
Adequate Wealth to Pay for Advanced Medical Treatment
 I think, to an extent, these two concepts are closely interlinked.
The assumption could be that 'better' healthcare is that which is technologically
advanced and which employs the use of both the most experienced practitioners but
also the most up to date research; drugs and equipment.
Healthcare development is a costly business and the newest drugs, for example, are
expensive.
Financial Organization/Insurance to pool funds from many people
 Direct, out-of-pocket health payments, including payments for medicines, fees for
consultations and procedures and, sometimes, informal payments, are barriers for
access to health services and cause financial hardship to those who have to resort to
paying them in order to get the services they need. Even if people have some degree
of financial protection from prepaid funds, they may need to cost-share (e.g. co-
payments, health insurance). Reducing the reliance on direct, out-of-pocket
payments will lower the financial barriers to access and reduce the impoverishing
impact of health payments. Increasing the level and share of revenues channeled
through prepaid and pooled mechanisms, reducing fragmentation to increase the
distributional capacity of the pooled funds, and using the pooled funds to cover the
health care costs for those in need, are key elements of the broad strategy that
countries need to rely on in order to move towards universal coverage.
It is economic development that creates the foundation for modern medicine
 economic development on population health. That such a causal effect exists is
plausible: firstly, growth may affect the consumption of health-relevant
commodities. Importantly, growth may improve nutrition through an increase in the
consumption of nutritious foods. Well-nourished individuals are in turn in a better
position to resist bacterial diseases and have better prospects to recover from
illnesses. Increasing incomes can lead to an increase in consumption of calories and
 micronutrients, which is particularly beneficial for better health outcomes in
developing countries. People may invest in curative as well as preventative health
goods as well as other health-relevant goods as a result of higher incomes. Secondly,
economic growth may affect the supply side of health if it allows governments to
increase spending on effective public health services and complements in the
production of health.

4 Periods of Growth of Humanity

1. Stone Age
 Population - Genetic evidence is revealing that human populations began to expand
in size in Africa during the Late Stone Age approximately 40,000 years ago. Scientists
have found that sub-Saharan populations increased in size well before the
development of agriculture.
 Technology - humans created increasingly more sophisticated stone tools. These
included hand axes, spear points for hunting large game, scrapers which could be
used to prepare animal hides and awls for shredding plant fibers and making
clothing. Not all Stone Age tools were made of stone. first to discover and use fire.
Fire was not just used for warmth and cooking, which were necessary as the Ice Age
occurred in the middle of the Stone Age, but also for protection from wild animals,
most tools and weapons were made from stone or other basic materials, like wood
and bone. Rather than just using big rocks or clubs, though, the Stone.
 Knowledge Transmission – knowledge and skills were also critical for the adaptation
of hunter-gatherer bands and led to social resilience – an evolutionary process that
enabled individuals to save time and effort by exploiting the already existing
knowledge and skill. Individuals with the ability to create a more efficient network of
knowledge might have thereby increased their own resilience. Anthropological
studies have a revealed that patterns of sharing interaction also play an important,
embedded role among contemporary hunter gatherer societies as possible risk
management mechanism.
 Economic/Political Organization - Anthropologists were able to draw these
conclusions about Paleolithic people by extrapolating from the experiences of
modern hunter-gatherer communities, such as the Khoisan of the African Kalahari
Desert. Based on the experiences of modern hunter-gatherer societies, who typically
have around 500 members, and based on theoretical mathematical models of group
process, Paleolithic bands of people were likely around twenty-five members each,
and typically about twenty bands constituted a tribe.
  Income Distribution - Paleolithic humans had little control of the environment, so
they focused on staking out territory and negotiating relationships with nearby
communities. Eventually, groups created small, temporary settlements, often near
bodies of water. These settlements allowed for division of labor, and labor was often
divided along gender lines, with women doing much of the gathering, cooking, and
child-rearing and men doing much of the hunting, though this was certainly not the
case across all Paleolithic societies.

2. Agricultural Age

 Population - In roughly 10,000 to 15,000 years, advances in agriculture have allowed

the human population to become roughly 1000 times larger. Agriculture also has
had environmental impacts.

 Technology - All that changed in the 18th century with the agricultural revolution, a
period of agricultural development that saw a massive and rapid increase in
agricultural productivity and vast improvements in farm technology like Plow and
moldboard (is a farm tool with one or more heavy blades that breaks the soil and cut
a furrow or small ditch for sowing seeds), Seeds Drills, Reapers Binder (cuts the
grain and binds it in sheaves), and etc.

 Knowledge Transmission – Indigenous agricultural knowledge acts as a distinct and

highly relevant piece of the much larger agriculture system puzzle on which this
relationship acts and Its importance is vast but it is neither an end goal of
sustainable agriculture nor the only method through which it can be reached. They
brought to the various indigenous techniques as well as knowledge behind those
techniques.
 Economic/Political Organization - agrarian society, or agricultural society, is any
community whose economy is based on producing and maintaining crops and
farmland or seeing how much of a nation's total production is in agriculture. In this
society the land is the primary source of wealth.

 Income Distribution - The productivity of a patch of land is directly proportional to

the amount of energy you put into it. This principle that hard work is a virtue, and its
corollary that individual wealth is a reflection of merit, is perhaps the most obvious
of the agricultural revolution’s many social, economic and cultural legacies.

3. Industrial Age

 Population - At the dawn of the Industrial Revolution in the mid-1700s, the world's
human population grew by about 57 percent to 700 million. It would reach one
billion in 1800.

 Technology - In the early part of the Industrial Revolution natural power sources
such as water and wind were used as power. Later, new power technologies such as
 a steam power and electricity played a major role in allowing the Industrial
Revolution to grow.

 Knowledge Transmission - information became available cheaply and plentifully.

One result of this change in the conceptualization of knowledge occurred as the
technologies of mass production and mass transportation commoditized knowledge.

 Economic/Political Organization – British Isles and colonies overseas represented

huge markets that created a large demand for British goods. Britain also had one of
the largest spheres of influence (SOI - spatial region or concept division over which a
state or organization has a level of cultural, economic, military, or political
exclusivity) due to its massive navy and merchant marine.

 Income Distribution – between 1700 and 1860 the industrial revolution, as the
transformation came to be known, caused a sustained rise in real income per person
in England and, as its effects spread, in the rest of the Western world

4. Information Age

 Population - began around the 1970s and is still going on today. It is also known as
the Computer Age, Digital Age, or New Media Age. This era brought about a time
period in which people could access information and knowledge easily.

 Technology - associated with the development of transistor technology, particularly

the MOSFET (metal-oxide-semiconductor field-effect transistor), which
revolutionized modern technology and became the fundamental building block of
digital electronics in the information age.

 Knowledge Transmission – Renaissance influenced the Information Age by creating

the idea inventions, During the Renaissance, people began to write realistic books
and not just religious stories. People's mindset about themselves changed. It was no
longer about what humans could do for God, but what humans could do for
themselves. This way of thinking is called humanism.

 Economic/Political Organization – characteristics and study their effects on financial

success in the computer and electronics industry, which is highly dynamic. Using
survey data collected from a large-scale world-wide sample of business units in the
computer and electronics industry, we quantify these characteristics and relate
them to market success

 Income Distribution - has affected the workforce in several ways. It has created a
situation in which workers who perform easily automated tasks are forced to find
work that is not easily automated. Workers are also being forced to compete in a
global job market.
 Mortality and Morbidity Rate in the
Philippines
The economy as a whole is measured by the Gross National Product. From 2008 to 2018
Gross national product (GNP) is an estimate of total value of all the final products and services
turned out in a given period by the means of production owned by a country's residents.

YEAR GROSS NATIONAL GROSS NATIONAL BUDGET PERCENTAGE

INCOME per PRODUCT FOR HEALTH FOR HEALTH
capita at current price
2008 2445 221 18,912,010,000 3.1
2009 2435.3 223.8 23,666,655,000 3.2

2010 2578.7 241 24,649,765,000 3.2

2011 2822 268.3 31,828,616,000 3.4
2012 3093.5 299.1 42,155,963,000 3.6
2013 3316.3 326.3 50,442,299,000 4.0
2014 6650 387.9 83,720,921,000 4.7
2015 6930 411.3 86,968,697,000 5.2
2016 7702.0 325.35 122,630,000,00 6.4
0
2017 2989.086 234 26,724,822,000 3.5
2018 3104.263 109.471 44,168,864,000 3.8

SOURCE: http://www.doh.gov.ph/doh-budget
http://ieconomics.com/philippines-gross-national-income-per-capita-forecast
http://ieconomics.com/philippines-gross-national-product-forecast

Date as of: August 2018

The data shows that the national health expenditures rise with income per capita per
year. Health outcomes improve in the same way because the government allotted more budget
compared from the past years. According to the report of Department of Health as one of their
achievements in 2015, was improving financial risk protection. The National Health Insurance
Program of the Philippine Health Insurance Corporation (PhilHealth) covered 92 percent or
93.45 million principal members and dependents of the country’s 2015 projected population of
101.45 million. Of this total coverage, 45.41 million principal members and dependents were
enrolled as national government sponsored members as of December 31, 2015. In 2015, the
Department continued to deploy physicians, nurses, midwives, and other health professionals
to communities that needed those most. For the first time, dentists and medical technologists
were included in the deployment. The Department of Health also intensified its efforts to
improve health outcomes among priority vulnerable populations nationwide through the
Universal Health Care High Impact Five (Hi-5) strategy. The regional operations strategy has as
its theme, “Sa Tuwid na Daan, Kalusugang Tuloy-tuloy para sa Pamilyang Pinoy,” and focuses on
the five critical areas of maternal care, infant care, child care, HIV/AIDS, and service delivery
network.

QUESTION: In terms of health care expenditure, how much had government and the private
sector
spent for health care. From the public sector,

60% was spent for preventive research, teaching and training

40% for curative research, teaching and training

Factors that cause high cost of health care:

• Increased use of health agencies
• Inflation
• Population increase
• Demography
• Focus on illness care
• Cost reimbursement
• Fee for service reimbursement
• Technology
• Indigent care
• Malpractice (House Bill 4955)
• Health pattern changes (Impact on HIV-AIDS, SARS, DENGUE, MERS-COV, ZIKA, etc.)

QUESTION:

Explain /discuss why these 11 factors identified have contributed to the high cost of health
care.
The Department of Health (DOH) is the principal health agency in the Philippines. It is
responsible for ensuring access to basic public health services to all Filipinos through the
provision of quality health care and regulation of providers of health goods and services.
However, DOH can’t serve well all the Filipinos, which are why there’s proliferation of health
agencies mainly built by private sector. These agencies can provide quality healthcare services
with a very high cost, because of the vast amount invested by the private and also limited
access to its service and products.
Much new technology comes on the market after being tested only for safety or
whether the new treatment is comparable to existing ones or even placebos. Prices for newer
treatments are often higher than for the products they replace. Since health care is costly and
the vast majority of uninsured have limited financial means, many uninsured often cannot pay
their medical bills. Recognizing the need for and importance of health care providers that care
for those without insurance, the government has long provided support—financial and
otherwise—to help defray providers’ the costs of caring for uninsured individuals. Malpractice
premiums and jury awards are part of what drives spending. However, it is also doctors
prescribing unnecessary tests or treatment out of fear of facing a lawsuit.
Health pattern changes (Impact on HIV-AIDS, SARS, DENGUE, Zika, etc) and chronic
conditions, such as asthma, heart disease or diabetes drive up costs. And there’s additional
discover and additional medical spending. Accordingly, the rising proportion of older people is
placing upward pressure on overall health care spending in the developed world, although
other factors such as income growth and advances in the technological capabilities of medicine
generally play a much larger role.

Module B
Part 2 (Edward P. De Mesa)

Standards of Medical Care in Diabetes—2019 Abridged for Primary Care Providers

As for American Diabetes Association’s (ADA’s) Standards of Medical Care in Diabetes is
updated and published annually in a supplement to the January issue of Diabetes Care. The
ADA’s Professional Practice Committee, which includes physicians, diabetes educators,
registered dietitians (RDs), and public health experts, develops the Standards. The Standards
include the most current evidence-based recommendations for diagnosing and treating adults
and children with all forms of diabetes. To improved care and promoting the health in the
patient with diabetes we must ensure treatment decisions are timely, rely on evidence-based
guidelines, and are made collaboratively with patients based on individual preferences,
prognoses, and comorbidities, Align approaches to diabetes management with the Chronic Care
Model, emphasizing productive interactions between a prepared proactive care team and an
informed activated patient care systems should facilitate team-based care, patient registries,
decision support tools, and community involvement to meet patient needs.
We must teach our patient and educate them how to control or prevent a person with
diabetes by means of At least annual monitoring for the development of type 2 diabetes in
those with prediabetes is suggested. “Prediabetes” is the term used for individuals whose
glucose levels do not meet the criteria for diabetes but are too high to be considered normal.
Prediabetes should not be viewed as a clinical entity in its own right but rather as an increased
risk for diabetes and cardiovascular disease (CVD). Screening for prediabetes and type 2
diabetes risk through an informal assessment of risk factors or with an assessment tool such as
the ADA risk test is recommended to guide providers on whether to perform a diagnostic test
for prediabetes and previously undiagnosed type 2 diabetes. Lifestyle Interventions, refer
patients with prediabetes to an intensive behavioral lifestyle intervention program modeled on
the Diabetes Prevention Program to achieve and maintain 7% loss of initial body weight and
increase moderate-intensity physical activity (such as brisk walking) to at least 150 min/week.
Several major randomized controlled trials, including the Diabetes Prevention Program (DPP),
have demonstrated that an intensive lifestyle intervention can reduce the incidence of type 2
diabetes. In the DPP, diabetes incidence was reduced by 58% over 3 years. Follow-up in the
Diabetes Prevention Program Outcomes Study has shown sustained reduction in the rate of
conversion to type 2 diabetes of 34% at 10 years and 27% at 15 years. The DPP’s 7% weight loss
goal was selected because it was feasible to achieve and maintain and likely to lessen the risk of
developing diabetes. Nutrition, structured behavioral weight loss therapy, including a reduced
calorie meal plan and physical activity, is of paramount importance for those at high risk for
developing type 2 diabetes who have overweight or obesity. Based on intervention trials, the
eating patterns that may be helpful for those with prediabetes include a Mediterranean eating
plan and a low-calorie, low-fat eating plan. Additional research is needed regarding whether a
low-carbohydrate eating plan is beneficial for persons with prediabetes. In addition, evidence
suggests that the overall quality of food consumed (as measured by the Alternative Healthy
Eating Index), with an emphasis on whole grains, legumes, nuts, fruits, and vegetables and
minimal refined and processed foods, is also important. Whereas overall healthy low-calorie
eating patterns should be encouraged, there is also some evidence that particular dietary
components impact diabetes risk in observational studies. Higher intakes of nuts, berries,
yogurt, coffee, and tea are associated with reduced diabetes risk. Conversely, red meats and
sugar-sweetened beverages are associated with an increased risk of type 2 diabetes.
Diet, physical activity, and behavioral therapy designed to achieve and maintain >5%
weight loss should be prescribed for patients with type 2 diabetes who are overweight or obese
and ready to achieve weight loss. Such interventions should be high intensity (≥16 sessions in 6
months) and focus on diet, physical activity, and behavioral strategies to achieve a 500–750
kcal/day energy deficit. Diets should be individualized, as those that provide the same caloric
restriction but differ in protein, carbohydrate, and fat content are equally effective in achieving
weight loss. For patients who achieve short-term weight-loss goals, long-term (≥1 year)
comprehensive weight maintenance programs should be prescribed. Such programs should
provide at least monthly contact and encourage ongoing monitoring of body weight (weekly or
more frequently) and/or other self-monitoring strategies, such as tracking intake, steps, etc.;
continued consumption of a reduced-calorie diet; and participation in high levels of physical
activity (200–300 min/week). To achieve weight loss of >5%, short-term (3-month)
interventions that use very low-calorie diets (≤800 kcal/day) and total meal replacements may
be prescribed for carefully selected patients by trained practitioners in medical care settings
with close medical monitoring. To maintain weight loss, such programs must incorporate long-
term comprehensive weight-maintenance counseling.
MSN STUDENT NAME: Edward P. De Mesa
TAKE HOME EXAMINATION
PART 3A: INSIGHTS
1 How can you further enhance the development of the nursing profession so that nurses
can also contribute to the country’s economic success? Discuss.
As a nurse we can enhance and develop nursing profession by mean of activities to
assure the adequacy and performance of hospital nurses, improving quality care, and
achieve effective control of hospital costs need to be harmonized. As Nurses do far
more, and the work entails both substantial intellectual and organizational competence.
Among the critical tasks carried out by nurses are ongoing monitoring and assessment
of their patients and, as necessary, initiating interventions to address complications or
reduce risk, coordinating care delivered by other providers and educating patients and
family members for discharge, which can reduce the risk of post hospital complications
and re-admission. We can contribute to our economy as a nurse by means of provide
not only physical care in terms of administering medication and providing treatment,
but they provide emotional support, counsel and educate families, and collaborate with
other medical professionals. Nurses perform a plethora of duties that if they were to be
hired out separately would create an enormous economic burden on families and
insurance companies. Just as mothers and fathers perform duties such as cooking, doing
laundry, chauffeuring children, and coordinating schedules, nurses provide a variety of
services and skills when caring for their patients. In general, is becoming more highly
educated, and nurses are receiving increased training in specialty areas. This is enabling
nurses to take on tasks that 10 or 20 years ago only doctors would have been able to
perform. With the increase of nurse practitioners many people are now visiting nurses
who are able to make diagnoses and prescribe medication. Since nurses normally don't
charge as much as doctors, the savings to families as well as insurance companies can be
substantial. Nurses who can treat patients with everything from flu to bronchitis, as well
as complete basic procedures such as sports physicals, will continue to have a positive
impact on the economic and social well-being of individuals and families.
2 If you are one of the senators in the Philippines, what specific bill for nurses will you
propose? Discuss its contents and benefits to the nurses and economic status.
As one of the senator of the Philippines I will propose a bill for a nurse is ‘Nurses have
the right to fair compensation for their work, consistent with their knowledge,
experience and professional responsibilities’ with these bill we as nurse we give
competent quality health care services to the satisfaction of our patient. It will help to
our economy when we give the nurses the right pay for their expert in the field of their
profession they will never think of traveling abroad to earn enough money for their
family and continue their career, they will prefer to stay here in the Philippines and here
work as a nurse because they earn enough income to support their families. Nurses
working in hospitals with excessive patient workloads and poor work environments are
 more likely to be burned out and dissatisfied with their job. These conditions the level of
nurse staffing and the quality of nurses’ work environment can be changed through
good management and organizational practices that value professional nursing. To
nurses, the organizational climate may be as or even more important than wages as a
reason for staying in their job, Wage increases may need to be combined with non-
pecuniary factors, especially modifiable hospital factors such as work environment and
workload, to recruit adequate numbers of nurses and prevent them from leaving the
hospital setting to work in other jobs. One might expect that better staffed hospitals
with the best work environments also pay higher wages to their nurses. If true, work
environment and staffing might be acting as a proxy when better wages is actually the
determining factor for mitigating poor nurse outcomes like burnout and job
dissatisfaction. Another possibility is that hospitals with less favorable work
environments or staffing levels pay higher wages to compensate for poor work
conditions.
3 The Philippines is part of the countries in the ASEAN integration, as a professional nurse,
what is the impact of this in your current job and in the Philippine economy in relation
to ASEAN BluePrint 2025 particularly in the Healthcare? Discuss.
We found that, in general, ASEAN countries have made good progress toward Universal
Health Care, partly due to relatively sustained political commitments to endorse UHC in
these countries. However, all the countries in ASEAN are facing several common barriers
to achieving UHC, namely 1) financial constraints, including low levels of overall and
government spending on health; 2) supply side constraints, including inadequate
numbers and densities of health workers; and 3) the ongoing epidemiological transition
at different stages characterized by increasing burdens of non-communicable diseases,
persisting infectious diseases, and reemergence of potentially pandemic infectious
diseases. The ASEAN Economic Community's goal of regional economic integration and a
single market by 2015 presents both opportunities and challenges for UHC. Healthcare
services have become more available but health and healthcare inequities will likely
worsen as better-off citizens of member states might receive more benefits from the
liberalization of trade policy in health, either via regional outmigration of health workers
or intra-country health worker movement toward private hospitals, which tend to be
located in urban areas. UHC should be explicitly considered to mitigate deleterious
effects of economic integration. Political commitments to safeguard health budgets and
increase health spending will be necessary given liberalization's risks to health equity as
well as migration and population aging which will increase demand on health systems.
There is potential to organize select health services regionally to improve further
efficiency. We hope that all citizens can enjoy higher health and safety standards,
comprehensive social protection, and improved health status. We believe economic and
other integration efforts can further these aspirations.
4 If you were to submit a proposal to address the problem of brain drain among Filipino
nurses and to improve the economic situation of Filipinos nurses, what proposal will you
include and why? Discuss.
We can solve our problem with the brain drain of nurses here in the Philippines by
giving other opportunities to grow and learned other areas of nurse specialties and
adequate salaries and benefits due to their expertise, give incentives, health assistance
for them and their loved ones, it not just in the public but in private hospitals also that
they work for. That way we can avoid leaving our nurses abroad and they will choose
to stay here to continue their career and show off their high quality of health service to
their countrymen.
5 With the proliferation of the recent vaccine issues, the main question for consumers is
how to ensure the quality, safety and efficacy of vaccines. Discuss today’s immunization
issues and the economic benefits of vaccines. Provide your contribution as a nurse.
Provide facts and evidences.
Vaccines are vigorously tested and proven safe before being licensed and introduced
into national immunization programmes. Normal side effects are minor; however in rare
cases individuals can have a mild or serious reaction to a vaccine. Most events thought
to be related to the administration of a vaccine are actually not due to the vaccine itself.
Many are simply coincidental events, while others (particularly in developing countries)
are due to human or programme error. However, as incidence of vaccine-preventable
diseases continues to decline, some people have become increasingly concerned about
the risks associated with the vaccines, and less fearful of the diseases they are designed
to prevent. Failure to deal rapidly and effectively with allegations of vaccine-related
adverse events can undermine confidence in a vaccine and ultimately reduce
immunization coverage and increase diseases incidence. As a nurse improvements in
public health led to a more productive population that was healthier. In turn, that more
productive population was able to afford even more improvements in public health, all
in a self-feeding loop; Health is a key factor for the promotion of economic growth at
the national, regional, and global levels. The vaccine industry and vaccination programs
targeted at populations of different ages can contribute substantially to economic
growth by keeping people healthy throughout their lives, with continuous investment in
research & development to protect populations against an increasing number of existing
or new vaccine-preventable diseases. There is a clear need for a commitment to
vaccination not only from health authorities but also from governments. In particular,
the finance ministries and treasuries of different governments need to assess how best
vaccines and vaccination can make an efficient contribution to their national economic
growth, Greater impetus and investment in their use is needed to provide evidence to
determine the full economic value of vaccination.
PART 3B
1. Discuss today’s role of Nurse Entrepreneurs in the 21st Century Nursing. Expand.

In order to ensure that nurses are ready to assume new leadership roles, nursing
professional development programs need to embed traditional and nontraditional
leadership-related competencies throughout. All nurses must take responsibility for
their personal and professional growth by developing new leadership competencies and
exercising these competencies across all care settings. As human rights become
increasingly under threat it will challenge nurses’ caring and their resolve to respect
human dignity regardless of circumstances; our target populations are those who are
the most vulnerable and who need our protection and advocacy at all times. The
populations we serve are not general workers or university students who can rise up
and demand what they think they are entitled to – ours are vulnerable, compromised
peoples who rely on us as nurses to safeguard their rights. We have the power not only
to safeguard ALL their rights but to rise up and advocate for their right to access and
obtain quality health and nursing care. In the process, nurses must develop deep
intolerance towards the lack of essential equipment and supplies, to the shortage of
beds and other essentials so that a laboring woman does not suffer the indignity of
delivering her baby on a floor and then, suffer the trauma of losing her baby. With the
advent of populist leaders we as nurses should develop and repetitive tasks. Artificial
intelligence integrated into robots with “a sophisticated, human-like design” enables the
simulation of human behavior to a much higher level of refinement. Humanoids, as they
are called, are more social and personal in their interactions with people and can
demonstrate near human intelligence required in thinking and decision-making activities
areas of functioning that nursing has consistently claimed as making it different from
a task-based, vocation.

2. There are wide range of different theories and models in setting up a business, what do
you think is the best for Nurse Entrepreneurs? Discuss.
As a nurse entrepreneur i would start a business as A Hospice Nurse and A Legal
Consultant Nurse. As we know some of the best nurses love their professions. They
know that they’re making a difference in the world, and that gives them a sense of
fulfillment. Some nurses want to start a small business, but they don’t want to give up
their passion and get stuck behind a desk all day. If this is you, consider starting a
Hospice Nurse business. These nurses help patients in their own homes, providing
important care and assistance while still making an amazing living. Hospice Nurses don’t
just care for the elderly and terminally ill – they also care for those recovering from
serious athletic injuries, back injuries, and much more. The great thing about this
business is that it’s extremely scalable. You can start it off as just an independent
contractor with a single employee (yourself) with relatively low startup costs. As your
business grows, you can then hire more staff and expand your client list until you’re
 making some seriously good money. Once again, this type of business is always in
demand, and so you’re almost guaranteed success.
As a Legal Consultant Nurse might just be the best course of action. There are numerous
court cases every year which call for real, qualified professionals in the medical field to
assist in legal proceedings. Courts need people like Registered Nurses to share their
expert opinions, and determine things that others just can’t understand. Veteran nurses
know when certain procedures are taken incorrectly, and who is to blame for certain
mishaps. This kind of information is very useful to the courts. This type of business is a
great option for those who have spent many years working as a nurse. Those who think
they’ve seen and done everything in a medical setting are perfect for this role. One huge
benefit of this type of business is that there are virtually zero startup costs. You’re
essentially just selling your knowledge and expertise, so very little is needed to get
started. That being said, you may need a basic knowledge of how the court system
works, and strong networking skills could prove to be essential.
3. Provide one example of an existing international nurse-led (organization or individual)
venture that can serve as an inspiration to be implemented in the Philippines that will
positively affect the industry. Discuss.
Unleashing Nurse-Led Innovation
To do this, we surveyed clinical and business leader stakeholders themselves—including
at hospitals, post-acute providers, payers, biotech and med device companies on where
they’ll find the most value from nursing by 2025. What we found is that organizations
across the system are already looking to nurses for individual-level innovation and
clinical acumen skills. But they’re missing out on the opportunity including improved
patient outcomes that comes from bringing nurses into innovation at the leadership
level. If true care transformation is to take shape, health systems and businesses must
recognize that nursing can and must extend well beyond the bedside and the
community and into the boardroom. Nurses are already leading sweeping innovations at
larger, systemic levels within clinical and business organizations. They just have to
navigate around certain roadblocks to do it. To create a consumer-centric health system
capable of addressing perplexing health issues like the opioid crisis, caring for the aging
population and chronic care management, roadblocks need to be removed and systems
must embrace nurses as leaders in innovation. Unleashed nurses innovators is a care
imperative and a business imperative. Too often, stakeholders in the health system
leave nurses completely out of the process much to their own detriment. No matter
how promising a new health technology, regulatory update or organizational process
might seem, if the nurses within a health organization or business do not find it practical
or valuable in the day-to-day patient setting, it will die on the vine. Even worse, it could
subsequently hinder patient care. Giving nurses room to claim a seat at the table
throughout the entire development process is key to greater and better patient
outcomes. We must prepare present and future nursing leaders with the knowledge and
skills they need to effectively lead in this fast-changing environment. This means
developing skills in areas like quality improvement and safety processes, broader
organizational dynamics, design thinking and business acumen.
4. Along with a good business plan, there are also blockroads in executing a new business
especially in the Philippine regulation. Pick at least five (5) among the 18 Barriers to
Business Entrepreneurship in Nursing (Colichi et al, 2018) that could interfere for its
implementation. Discuss and suggest/provide an action plan.
Barriers to Business Entrepreneur in Nursing
 Hospital Care Model - in this standard, access to therapeutic tools for primary,
secondary and tertiary prevention is centralized in the hospital activity, with the
private area remaining the focus in primary care and in the prevention of
diseases. Understand which patient populations are at greatest risk of
readmissions. It is critical hospitals identify which patient populations are at
increased risk of hospital readmissions to target specific patients. Join a
readmission prevention-focused collaborative. Although they do not involve
financial incentives, collaborate can provide a way for health systems and
hospitals to team together and share best practices and strategies for preventing
hospital readmissions. Ensure patients schedule a seven-day follow-up. Medical
studies have suggested that patients who followed up with their physician within
seven days of discharge were less likely to be readmitted to the hospital. Clearly
communicate post-discharge instructions. Patient communication and education
is a critical component of readmission prevention. Effectively staff nurses during
patient care. Another study showed effective and proper nurse staffing while the
patients are still in the hospital can decrease preventable readmissions. Ensure
smooth transitional care, Transitional care could feature a transitional care team
or professional who facilitates the coordination and continuity of care for
patients as they change providers post-discharge.
 Collaborative arrangements with physicians - the collaborative arrangement is
understood as the partnership between a nurse and a physician working in a
private practice, being a model required in some countries as a reimbursement
criterion. In this model, besides the difficulty of finding a physician with whom to
collaborate, the latter may charge a fee for the establishment of the
collaborative arrangement. In addition, these relationships reinforce the medico-
center model. As health care professionals assuming complementary roles and
cooperatively working together, sharing responsibility for problem-solving and
making decisions to formulate and carry out plans for patient care. Collaboration
between physicians, nurses, and other health care professionals increases team
members’ awareness of each other type of knowledge and skills, leading to
continued improvement in decision making.
 Lack of technical support – since nurses are accustomed to the hospital
environment and teamwork. We avoid this by means of identify and evaluate the
problem level to pinpoint the problem immediately and quickly evaluate
whether it’s something that can potentially be solved with a simple fix or
directing customers to helpful resources like video tutorials, step by step
instructions, and user forums that provide immediate answers to common tech
problems can be a great way to speed things along.
  Personal and ethical conflicts - personal values prevent the opening of
businesses related to caring for people, since profit generates ethical conflict and
make money would be incompatible with the mentality of nursing services, more
related to volunteering than to profit. Understand what constitutes a multiple
relationship, protect confidentiality, Respect people's autonomy, know your
supervisory responsibilities, Identify your client and role, Document, Practice
only where you have expertise, Know the difference between abandonment and
termination, Stick to the evidence.
 Lack of corporatism among nurses - This tendency is not observed to privilege
the interests of the professional group itself, reflecting more individualistic and
less supportive attitudes.

5. By creating successful businesses within the healthcare system, nurse entrepreneur’s

help push the technological advancements. Provide at least one example of technology
that may be developed by nurse entrepreneurs and how will it benefit in general.
Discuss.
Centralized Command Center – its improved patient experiences and better ways for
RNs and doctors to manage supplies, clinical technology, and capacity. This is done
through software applications such as dashboards that provide real-time updates for an
organization. With shorter or non-existent delays between transitions of care, nurses
and doctors can actively be aware of room availability, OR schedules, and what
individual patients still need in order to be discharged. This allows everyone to do their
job more efficiently, and help patients more effectively. Specifically designed for
capacity management, command centers being piloted around the country are
performing well. Many hospitals report operating at higher capacity, and overall
improved patient experiences. Improved patient experiences and better ways for RNs
and doctors to manage supplies, clinical technology, and capacity. This is done through
software applications such as dashboards that provide real-time updates for an
organization. With shorter or non-existent delays between transitions of care, nurses
and doctors can actively be aware of room availability, OR schedules, and what
individual patients still need in order to be discharged. This allows everyone to do their
job more efficiently, and help patients more effectively. Specifically designed for
capacity management, command centers being piloted around the country are
performing well. Many hospitals report operating at higher capacity, and overall
improved patient experiences.