The document discusses South Africa's policy for classifying and managing public hospitals. There are 5 levels of hospitals regulated by the National Health Act. The policy aims to address issues of equity, affordability, efficiency and effectiveness through hospital reclassification. Primary health care services are available free at state clinics and community health centers. Hospitals are classified into district, regional, tertiary and specialized hospitals based on size and services provided. Fees for patients are determined based on categories of full paying, subsidized or free services depending on factors like income level.
The document discusses South Africa's policy for classifying and managing public hospitals. There are 5 levels of hospitals regulated by the National Health Act. The policy aims to address issues of equity, affordability, efficiency and effectiveness through hospital reclassification. Primary health care services are available free at state clinics and community health centers. Hospitals are classified into district, regional, tertiary and specialized hospitals based on size and services provided. Fees for patients are determined based on categories of full paying, subsidized or free services depending on factors like income level.
The document discusses South Africa's policy for classifying and managing public hospitals. There are 5 levels of hospitals regulated by the National Health Act. The policy aims to address issues of equity, affordability, efficiency and effectiveness through hospital reclassification. Primary health care services are available free at state clinics and community health centers. Hospitals are classified into district, regional, tertiary and specialized hospitals based on size and services provided. Fees for patients are determined based on categories of full paying, subsidized or free services depending on factors like income level.
The document discusses South Africa's policy for classifying and managing public hospitals. There are 5 levels of hospitals regulated by the National Health Act. The policy aims to address issues of equity, affordability, efficiency and effectiveness through hospital reclassification. Primary health care services are available free at state clinics and community health centers. Hospitals are classified into district, regional, tertiary and specialized hospitals based on size and services provided. Fees for patients are determined based on categories of full paying, subsidized or free services depending on factors like income level.
and PHC 2014 There is five levels of hospitals and this is regulated by NATIONAL HEALTH ACT, 2003 (Act No.61 of 2003) POLICY ON THE MANAGEMENT OF PUBLIC HOSPITALS http://www.doh.gov.za/docs/policy/2012/ho spmanpolicy.pdf
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and PHC 2014 One of the crucial aspects of this policy is to ensure reclassification of hospitals to address issues of: Equity Affordability Efficiency Effectiveness
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Medicine and PHC 2014 Primary health care services are available free of charge at State health care facilities: ◦ clinics; ◦ community health centres; ◦ mobile clinics; ◦ satellite clinics; ◦ health care facilities that are funded or subsidised fully or partly by the State
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and PHC 2014 These will be classified into 3 categories: 1. Small district hospitals with no less than 50 beds and no more than 150 beds; 2. Medium size district hospitals with more than 150 beds and no more than 300 beds; 3. Large district hospitals with no less than 300 beds and no more than 600 beds.
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and PHC 2014 Management: A medically trained person to act as both CEO and clinical manager. Services: It includes trauma and emergency care, in-patient care, out-patient visits and paediatric and obstetric care. The services are provided by family physicians, general practitioners, and clinical nurse practitioners (PHC). **These hospitals may only employ specialists in the form of family physicians, paediatricians, obstetrician/gynaecologists, and general surgery.
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and PHC 2014 Services: At general specialist level, receive referrals from district hospitals and provide general specialist services to a number of district hospitals. They also serve as a platform for training of health workers and research. Most of the care provided will be at level 2 and will require the expertise of teams led by experienced specialists e.g. General Surgery, Orthopaedics, Internal Medicine, Paediatrics, Obstetrics & Gynaecology, Family Medicine, Radiology and Anaesthetics
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and PHC 2014 Services: Specialist and sub--specialist care to a number of regional hospitals and also serve as a platform for training of health workers and research. Most care provided will be at level 3 and will require the expertise of teams led by specialists e.g. cardiology, cardiothoracic surgery, craniofacial surgery, diagnostic radiology, ENT, endocrinology, geriatrics, haematology, human genetics, infectious diseases, general surgery, orthopaedics, general medicine, paediatrics, obstetrics & gynaecology, radiology and anaesthetics.
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and PHC 2014 These hospitals render a very high specialized tertiary and quaternary service on a national basis and a platform for the training of health workers and research. They also function as highly specialized referral units for the other hospitals and provide a high cost and low volume service. These hospitals employ high technology and highly trained staff.
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and PHC 2014 Psychiatric Hospitals: Specialist psychiatric hospital services to people with mental illness and intellectually disability and provide a platform for the training of health workers and research.
Tuberculosis Hospitals: Hospitalization of acutely ill
and complex TB patients (including XDR & MDR~TB). Rehabilitation Centres: Specialized rehabilitation services for persons with physical disabilities, including the provision of orthotic and prosthetic services.
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and PHC 2014 Fee structure classification
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and PHC 2014 http://www.doh.gov.za/docs/programmes/201 2/appendixH.pdf
To determine the service fee, patients are
divided into groups: a. Full paying patients b. Subsidised patients c. Free services.
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and PHC 2014 This category of patients includes but is not limited to: ◦ externally funded patients ◦ patients being treated by their private practitioner ◦ certain categories of non-South African citizens. They are liable for the full Uniform Patient Fee Schedule (UPFS).
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and PHC 2014 Externally funded patients ◦ Compensation for Occupational Injuries and Diseases Act, 1993 (Act No 130 of 1993), ◦ Road Accident Fund created in terms of the Road Accident Fund Act, 1996 (Act No 56 of 1996), ◦ medical scheme registered in terms of the Medical Schemes ◦ Act, 1998 (Act No 131 of 1998). ◦ Patients treated on the account of: another state department, local authority, foreign government, any other employer. Patients treated by a private practitioner Non South African citizens – Excluding the following: ◦ immigrants permanently resident in the RSA but who have not ◦ attained citizenship ◦ non South African citizens with temporary residence or work ◦ permits ◦ persons from SADC states who enter the RSA illegally.
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and PHC 2014 H0 – patients qualifying for full subsidy: ◦ Social pensioners ◦ formally unemployed (registered at UIF) ◦ Re-classified by hospital admin ◦ Pregnant women and children under the age of 6 ◦ Primary Health care services ◦ Termination of pregnancy and complications thereof
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and PHC 2014 Other subsidized services: Criminal procedure act (Assault, Rape, Post mortem, Corporal Punishment) Child Care act Mental care Act Infectious, formidable and/or notifiable diseases Malnutrition and pellagra Donors
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and PHC 2014 H1, H2 and H3 – partially subsidized (Means test is used as baseline)
See web site for the requirements and
services that are subsidized
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and PHC 2014 The H1 inpatient fee is expressed as a percentage of 7 days of the UPFS General Ward Inpatient fee to approximate the average length of stay of inpatients in this category. Although the fee calculation is based on 7 days, for H1 patients this fee will be applicable for each 30 days of inpatient stay or part thereof.