CHAPTER 1

THE PROBLEM AND BACKGROUND OF THE STUDY

Introduction

According to Clayton Browne (Master of Science in Linguistic Anthropology), Doctors

and nurses are the backbone of our health care system. They are the roots of our hope when our

health is in trouble. Of course, many other medical professionals, such as orderlies, radiology

technicians, and dietitians are employed in the health care industry, but the vast majority of

diagnosis and patient care are performed by doctors and nurses.

Health care is the prevention, treatment, management of illness, and the preservation of

mental and physical well-being through the services offered by the medical and allied health

professions (The American Heritage Medical Dictionary, 2004). It is the sole responsibility of

doctors and nurses to make sure a patient’s health is in good condition, for it is and should be the

number one concern of everyone to sustain life.

Hospitals are institutes that provide the health care everyone needs or may need when the

call arises to sustain life such as medical and surgical care and these hospitals can either be

public or private. Public hospitals or Government hospitals are owned by the government thus

provided with the sufficient government funding to do its function well, also in some countries in

specific cases when a public hospital provides health care, sometimes it is just free of charge as it

is covered by the reimbursement of the government while private hospitals, are the hospitals by a

for-profit company or a non-profit organization and is funded privately by the people who avail
health care from them which means there is nothing free of charge as it is not covered by the

government.

As a matter of fact, all doctors, nurses and other healtcare personnel, no matter where

hospital they work either public or private, they all have the same responsibilities concerning

their patients, since ensuring health care is their main task- efficient medical service is a must.

The effectiveness of their service is vital for everybody even for financially insufficient people to

sustain life but sustaining life does not mean to simply give operations or professional opinion-

according to Maslow’s hierarchy of needs, in order for a person to reach self actualization or self

fulfillment they must meet first the two levels which are the basic needs or in maslow’s term- in

the deficiency needs are the physiological needs which consists of food, water air, shelter,

warmth, sex and sleep and the safety needs which are security, protection, order, law, stability

and freedom from fear. These two needs are the basic needs of human beings in order to be able

to feel fulfilled or satisfied to be able to reach the highest level of fulfillment and actualization.

The NHS (National Health Services) in the United Kingdom, Britain, collected and

analyzed almost about 537 complaints and details of failing of NHS healthcare hospitals in the

year 2005-2010 and there were at least 11,982 complaints collected and 2,537 were negative. In

the data they collected the main issues were firstly, more on the rude attitude of the hospital staff

or being inresponsive to the patient’s requests, secondly, long waits and delays in between

appointments or transferring to another department and lastly, is that there was lack of care and

compassion such as ensuring if the patient was feeling comfortable or safe in their care. In these
cases they heard complaints more on about the problem with the environment such as poor food,

night time noises, cleanliness, health outcomes and even issues with dignity.

Either public nor private hospitals receive numerous complaints from their patients no

matter how expensive or cheap their healthcare is, both hospitals are similar in terms of offering

medical and surgical care differ from many factors such as price, facilities, etc. but both public

and private hospitals should be able to provide the physiological and safety needs of their patient

in order for them to be satisfied with their health care they receive; which is why the researchers

came up with this study to assess the hospitalization services between public and private

hospitals according to Maslow’s Hierarchy of needs, since the people who are confined in

hospitals are the people who stay in the hospital and experiences first hand on whether the

hospital just gives health care or also aims to satisfy their patients via the fulfilment of their basic

needs.

Statement of the Problem

This study was conducted to assess the level of satisfaction of hospital services based on

Maslow’s hierarchy of needs as perceived by selected patients. It specifically sought to answer

the question:

1. Does the decision of choosing between public or private hospital affect the level of

satisfaction of the patients in their hospitalization?

Scope and Delimitations

The study focuses on the on the level of satisfaction of hospital services in public and

private hospitals based on Maslow’s hierarchy of needs as perceived by selected patients.

The respondents will be patients who experienced confinement in either a public or

private hospitals in the duration of 3-7 days due to non-surgical cases. They can be in-patients,

people who had experienced being an in-patient for the past year only, or even the person who

stood as the legal guardian during the duration of the confinement.

Significance of the Study

The study on the fulfillment of basic needs of hospitalization services in public and

private hospitals as perceived by the selected patients would be beneficial to patients, hospital

staff, hospital administration board, arising hospital personnel and to the future researchers of the

study.

To the patients: They could use the data we have gathered to see to whether they really are

fulfilled with the health care they receive having receive their physiological and safety needs

either being in a public or private hospital. It is for them to be aware that the hospital should still

aim for these needs not just to give the medical or surgical care, it is for them to know that their

well being should be fulfilled.

To the hospital personnel: For they will be given awareness on how to act properly in

accordance to the patient’s current well being and make sure that the physiological and safety

needs are being met. This will also serve as their basis on how to communicate and interact

properly with the patients - be it from either a private or public hospital.

To the hospital administration board: Through the data presented by this research, they would

know how the system of the hospital truly works. It can also serve as their basis for the

adjustments and improvements of the hospital through knowing and understanding the

perception of their in-patients or guardians.

To arising hospital personnel: Through the data presented by this research, they would be able

to know on how to act, communicate and be sensitive towards their patients to ensure that they

are feeling fulfilled with the health care they receive. Also to inform them that they should

increase awareness on whether the physiological and safety of their patients are being met or not.

To the community: For with the data collected, if ever they may need to be hospitalized they will

know what services they should receive and what hospitals should aim to provide in the

healthcare they offer.

To the future researchers: For they will have a basis or a source for their research and that they

may be able to continue to further develop it for the awareness of other people concerned about

the level of satisfaction of the hospitalization services of both public and private hospitals on

whether they aim to satisfy the needs the physiological and safety needs of their patients.
Definition of terms:

The definition of terms contains the list of words used in the study for the clarification of

their usage.

1. Actualization- It is to realize one's full potential and to also express and activate all the

capacities of the organism or body.

2. Demographics- It is the statistical data of a population, especially those showing average

age, income, education, etc.

3. Hospitalization- It is the admittance to the hospital as a patient or

the period of confinement in a hospital.

4. Healthcare- It is the maintenance or improvement of health via diagnosis, treatment, and

prevention of disease, illness, injury, and other physical and mental impairments in

human beings.

5. Perception- A way of regarding, understanding, or interpreting something; a mental

impression.

6. Physiological- Consistent with an organisms’ or body’s normal functioning.

7. Safety- The condition of being protected from or unlikely to cause danger, risk, or injury.
 CHAPTER 2

REVIEW OF RELATED LITERATURE AND STUDIES

Foreign Literature

According to an article entitled “How the physical environment of a hospital affects

patient health” by Shira Anna, it is highly important to note that the physical environment of the

hospital can affect the health and the recuperation process of the patients. One factor are the

integrated design systems in hospitals to promote natural movement because it has been found

that patients’ stress levels can be lowered and maintained if they feel a strong sense of place in

the hospital and can easily navigate in it.

With the introduction of complex buildings and new systems, the levels of complexity

may spatially disorient a patient which causes their hospital visit to become an unfavourable one

while favourable visits to the hospital will reduce elevated heart rates which is always a good

thing for a recovering patient. Another factor is the reduction of noise levels in the hospital

because noise affects patients’ stress levels, it increases heart rates and blood pressure but

hospital background noise impedement ranges to a variety of ways such as technological

innovations, example is putting sound-absorbing ceiling tiles, also healthcare staff must also be

mindful that their voices will contribute to the noise level. Another Factor is the inclusion of

nature in the hospital because a simulated natural environment can also be used to divert patients

away from thinking about their pain or distress while increasing pleasant feelings of freedom and

serenity. This calms patients down, providing them with the right mindset to recover effectively

for many studies show evidence that even brief encounters with simulated nature settings can
bring about some recovery from stress within three to five minutes and the last factor is the easy

access to food. No research is required to say that a patient who is suffering from hunger can be

bit ill-tempered, dining halls or vending machines should be easily accessible in any healthcare

institution to ensure food is kept accessible to any patient or person who may be concered or

involved in hospitals.  

Creating a healing physical environment is crucial to a patient’s recovery. It is important

for the healthcare staff to work towards the improvement of the hospital's physical environment

as this will have a positive effect on a patient’s healing.

According to Herzliya Medical Center many of the medical tourists have uncertainties

whether to be admitted to a private hospital or a public hospital. Although, the services provided

by public and private hospitals have some similarities, some key differences set them apart.

Public hospitals are much larger than private hospitals, because of this, private hospitals can

offer more personalized care and treatment to patients. Public hospitals are funded by the

government and so are unable to turn away patients. Conversely, private hospitals can refuse

treatment; however, both by law should treat an emergency case and only then, the patient can be

sent to a public hospital.

Despite the benefits of private health care, not all patients are able to afford private

insurance or fees for a particular treatment at a private hospital. While many public hospital

sectors face enormous pressure, due to an influx of patients, for example, this may only prolong

the time of treatment, which is of particular concern, particularly if a patient requires immediate

treatment and/ or have a suspected serious illness. Private hospitals offer an excellent doctor-to-

patient ratio. In addition, there is usually a larger number of attentive staff per patient within
private hospitals. A private hospital enables the patient to select their preferred surgeon. This is a

big advantage since no one wants to risk his or her life and take a risk in the slightest negligence

in treatment. In public hospitals, you are in the hands of a surgeon or an intern who is chosen

according to the hospital shift schedule. Choosing the right hospital and physician are important

factors to consider that significantly influence a patient’s treatment. The preferred choice for

many patients is choosing private care.

A study shows that Private hospitals have no long waiting lists. International patients

requiring surgery, be it a simple procedure or a complex medical treatment are admitted within a

couple of days. It is known that in public hospitals, one can wait a year for a knee replacement or

for a minimally invasive spinal surgery. Non-urgent patient cases may take longer to resolve and

could affect work performance. The majority of non-urgent cases, following medical advice, a

patient decides when to have their treatment, as well as choice of treating physician. Large public

hospitals often have emergencies or spontaneous occurrences that may result a delay of your

surgery until further notice this could take days to weeks. Conversely, at private, the operating

theater is ready for the sole purpose use of your surgery. Moreover, there are no strikes of

doctors and nurses due to low pay.

A study also shows that private hospitals are associated with higher fees for treatment, in

most cases, the cost of treatment is considerably cheaper than their home country. Anyone can

attend public hospitals for treatment and if you hold a Medicare card and choose to be treated as

a public patient your treatment is free. You may need to pay for additional services such as

dental, television hire, and prescription medication. If you are not eligible for a Medicare card,

you will be required to pay for treatment. For more information visit the Medicare eligibility
page. In some instances you can be treated as a private patient in a public hospital, meaning you

may get to choose the doctor who treats you. As a private patient you are responsible for the cost

of your treatment. Some of these costs may be claimed through Medicare and your private health

insurance.

There is a difference between private hospitals and public hospitals and that lies with the

governance of the hospital, in example, the services provided in a private and a public hospital

are more or less the same. But, in a customer’s point of view, or for that matter, in a patient’s

point of view, the main difference between private hospitals and public hospitals is the facilities

and the care given to a patient. Of course, it cannot be denied that the extra facilities and care

come at a cost. Let us search more about the differences between private hospitals and public

hospitals. The major difference between a private hospital and a public hospital is the ownership.

A private hospital is one which is owned and governed by a person or many people who are

managing the whole finances. A public hospital, on the other hand, is completely and entirely run

on the government’s funding and money. There is a big difference in Public and Private Hospital

in terms of the fees; the fees of a private hospital are higher than that of a public hospital. It

should be noted that most of the time public hospitals offer their services free of charge or for

reduced rates. In a public hospital, since the services are mostly free, waiting time is longer. For

some operations patients have to wait for years until they get their place. In a private hospital,

waiting time is less. If you have money, you can get you operation done very quickly. Private

hospitals have the most modern equipment and the equipment last longer too. Public hospitals

have good equipment, but due to the extreme use they can get damaged more often than those in

a private hospital. Number of patients per doctor is higher in public hospitals. It is not good as

the attention is too much divided. It is also exhausting for the doctor. Since private hospitals are
a kind of a business they earn a profit like any other business. However, that is not the case with

a public hospital. Governments operate public hospitals for the health of their people, and not to

earn a profit

As of 2015, there are a total of 26 hospitals and specialty centres in Singapore. The 16

public hospitals and specialty centres have bed complements between 185 to 2,010 beds. On the

other hand, the 10 private hospitals tend to be smaller, with capacity ranging from 20 to 345

beds. The Government's role as the dominant health care provider allows the Government to

influence the supply of hospital beds, the introduction of high-tech/high-cost medicine, and the

rate of cost increases in the public sector which sets the bench mark in terms of pricing for the

private sector. The 8 public hospitals comprise 6 acute general hospitals (SGH, NUH, CGH,

TTSH, KTPH & NTFGH), a women's and children's hospital (KKH) and a psychiatry hospital

(IMH). The general hospitals provide multi-disciplinary acute inpatient and specialist outpatient

services and a 24-hour emergency department. In addition, there are 8 national specialty centres

for cancer, cardiac, eye, skin, neuroscience, dental care and a medical centre for multiple

disciplines. Within the public hospitals, patients have a choice of the different types of ward

accommodation on their admission. 81% of the public hospitals' beds (class B2 and C) are

heavily subsidised with the remaining 19% with lower subsidy at 20% for class B1 and no

subsidy for A class wards. In 2012, the average length of stay in the public acute care hospitals is

about 5.8 days while the average occupancy rate is around 85%.

The Government has restructured all its acute hospitals and specialty centres to be run as

private companies wholly-owned by the government. This is to enable the public hospitals to

have the management autonomy and flexibility to respond more promptly to the needs of the

patients. In the process, commercial accounting systems have been introduced, providing a more
accurate picture of the operating costs and instilling greater financial discipline and

accountability. The public hospitals are different from the other private hospitals in that they

receive an annual government subvention or subsidy for the provision of subsidised medical

services to the patients. They are to be managed like not-for-profit organisations. The public

hospitals are subject to broad policy guidance by the Government through the Ministry of

Health. The Government has also introduced community hospitals for intermediate healthcare for

the convalescent sick and aged who do not require the care of the general hospitals.

The average efficiency of public and private hospitals is about 20 per cent below best

practice after adjusting for differences in what hospitals do and who they treat, according to the

‘Public and Private Hospitals’ Research Report released by the Productivity Commission. The

Commission also found that the private sector tends to be slightly more efficient among large

hospitals, while the public sector tends to be more efficient among small hospitals. The Report

responds to a request by the Australian Government to examine three aspects of the health care

system - the relative performance of public and private hospitals; rates of informed financial

consent for privately-insured patients; and the most appropriate indexation factor for the

Medicare Levy Surcharge income thresholds. Comparing the relative performance of hospitals

was challenging. There are major differences within and between public and private hospital

systems that make like-for-like comparisons difficult. There was also data limitations, which the

Commission sought to address. Future comparisons will be assisted by enhanced data collections

for public hospitals already foreshadowed by governments and would be further improved by

expanded reporting for private hospitals. Based on available data, the Commission also found

that: public and private hospitals have similar overall costs, but there are differences in the

composition of costs - medical and diagnostics, and prostheses are more costly in private
hospitals; while general hospital costs and capital costs are higher in public hospitals; Private

hospitals appear to have lower infection rates than public hospitals but private hospitals generally

treat patients who have a lower risk of infection; private hospitals have higher labour

productivity and shorter lengths of stay than public hospitals, partly due to differences between

the sectors in what they do and who they treat.

The study made by Ezra Sebakiga Bigira and Simon Peter Katongole entitled

“Management of Hospital Security in General Hospitals of Southwestern Uganda” focused on

determining the management of security in 6 different general hospitals in Southwestern Uganda

and only two out of six hospitals fairly met the security standards with identified gaps like lack

of security guidelines, security plans, security committees, and non-availability of training

opportunities for security personnel. According to the study, security concerns of the patients

were assaults, elopement, workplace violence, fighting and theft being the most pronounced

concern by both security personnel and key informants. Another concern was that there was non-

availability of modern security equipment including management aspect of security inputs as

security work plan and guidelines among others, none of the general hospitals had a security

committee and there was no evidence of security meetings taking place. The hospital managers,

such as medical superintendents and hospital administrators, and security personnel agreed to the

fact that security personnel use local tools such as sticks, spears, pangas and torches to execute

their duties. Another concern was in regards of the staffing of security personnel in general

hospitals and their associated work systems, although most of the hospitals had security

personnel at the time of this study the security staffing capacity in general hospitals ranged from

4 to 6 staff and majority (97%) of them highlighted hospital administrators as their immediate

supervisor. However, (87.9%) of security personnel revealed using personal mobile phones as
common means of communicating security issues to their supervisors. Some security personnel

in general hospitals (18.2%) reported being insecure at their environment of work which they

attributed to lack of security equipment like guns which they would use to defend themselves in

case of an enemy. This tallied with the fact that 60.6% of them had no specific security training

while 90.1% had undergone cadre course called “Chakamchaka” (a non informal training for

security vigilance and awareness).

The conclusion of the study was that general hospitals in south western Uganda lack the

capacity to manage health care security especially in terms of security infrastructure, security

personnel and security equipment. There was an evidence of security threats occurring in these

general hospitals the preparedness to handle them was poor. The compliance for meeting

established security standards was not fully meeting the standards because of their inadequacies

that originated from poor staffing, lack of required security equipment, poor financing and

poorly designed security infrastructure, even the fact that some general hospitals are located near

the borders with insecure countries is a major security challenge.

It is a very common observation that the planet we live in these days is never free of

diseases. In many instances, many of us have time and again sought the service of a medical

practitioner or in simple terms a doctor who in many cases will be found in a Hospital although

clinics and health institutes will still offer the same service. The continued nature of a fast and

indeed genuine growth of capitalism has transformed health sector practices and has

consequently led to the development of two types of hospitals; private hospitals and public

hospitals. As it will obviously seem on face value, both private and public hospitals are health
centers that offer health services that are the same. The truth about the matter however, is that

they are distinct and unique differences that are characterized by the two.

One of the most basic difference is based mainly on the open reality that a private

hospital is a health center that is independently run by a person or groups of persons who by

many respects control all the financial processes pertaining to that hospital. In a private hospital,

the whole administration and staff including the doctors and nurses are answerable to the person

who in other words can be said to own the hospital. Private hospitals are generally popular

among patients probably on the largely held assumptions that private hospitals are health

establishments that are relatively well equipped and service offered is of high quality. In many

cases this is actually the truth. The truth of the matter about private hospital and their heath care

is that while it is true that the quality of service offered to individual patients is very high, the

cost associated with it is also very enormous however in societies where people have the means

to access the quality service of health, private hospitals will always be top of their lists.

Public hospitals as opposed to private ones are entirely funded by the tax payer on areas

such as construction, drugs, equipment and medicine purchases and payments for doctors and

staff members. According to many people, public hospitals are assumed to be the inevitable

choice of the financially less well -off in societies who are not able to afford the high prices of

private hospitals. The surprising aspect of government owned hospital is the apparent inability of

concerned governments to provide high quality service in public hospitals considering the vast

ability of the government in terms of resources compared to private hospital owners.

 In general the fundamental distinction between private and public hospitals is based on

the fact that public hospitals are entirely funded by the state or its partners while a private one is

financed by the owner. The two also are different when it comes to service quality where private

hospitals carry the day. The cost is also a key difference noted obviously by the high cost of

hospital fees in private hospitals as compared to public ones.

Local Literature

As studied by Dela Rosa, J.F., Flavier, J.D., Quimbo, S.L., (2011) Traditionally, Public

hospitals are larger and and have more beds than in private hospitals, in the Philippines. From

1997 to 2007, the average number of beds has decreased. Totaled to 43 846 for public, and 41

206 for private hospitals. The average bed-to-population ratio for the 10 year period was 107 per

100 000 population. Still the ratio meets the standard given by the department of health (DOH)

of 1 bed per 1000 population, ratios across regions, provinces and municipalities. Also that there

is an increase gap between the population size and supply.

In terms of the patients’ level of care, whether acute or chronic, hospital beds are not

classified to that but according to the capability of the hospital’s service. There are more level 2

and level 4 hospital beds, in public sectors, in terms of the mix of beds. Level 1 or the primary

level, the beds, both for public and private hospitals are equal in numbers. About 40% of beds

are found in all hospitals happen to be in teaching/training hospitals. By 2007 the number of

public beds and private beds are almost equal, so it is worth perceiving that DOH categorized

public acute-chronic and custodial psychiatric care beds and facilities as Level 4 facilities,

leaving only the private psychiatric care beds and facilities in these categories

.
 Public hospitals are assigned to operate with not less than 90% of the bed capacity as

‘charity’ of for free, as based on Republic Act 1939 (1957), as for private hospitals are required

to make not less than 10% of the beds as ‘charity beds’ this is through the AO 41 (2007). It was

given as a requirement for hospital licensure.

According to The Department of Health (2011), The Health care system of the

Philippines has evolved through many changes. In 1991, Health service was pass on Local

Government Units (LGUs), but still it hasn’t conquered the fragmentation issues. There is a huge

involvement of the private sector include 50% of the health but system regulatory functions of

the government have yet to be fully expand. Which caused the Health human resource struggles

with the problems of underemployment, insufficiency and skewed distribution.

Health facilities in the Philippines, such as public hospitals, private hospitals, and

primary health care facilities. Hospitals are based on the ownership as public or private hospitals,

around 40% of hospitals are public. That out of the 721 hospitals, only 70 are managed by the

DOH, while the other remaining hospitals are managed by LGUs and other national government

agencies (Department of Health, 2009). As for private and public hospitals both can be classified

by their services capabilities, At present, Level-1 hospitals detailed to almost 56 percent of the

total number of hospitals (Department of Health, 2009; Lavado, 2010) which have very limited

capacity, comparable only to infirmaries.

In The National Demographic Health Survey (2008) there have been 50% of patients who

sought medical care and treatment from public hospitals, 42% for private hospitals, and 7%
wanted the alternative or the traditional care. The most visited health facilities were Rural

Health Units (RHUs) and Barangay Health Centers with 33% in all most all the region except for

NCR and CAR, where most of the patients went to private hospital/clinic for medical treatment

or advice. The most common reasons for people seek for health care were illness or injury with

68%, 28% for medical checkup, dental care 2%, and medical requirement 1% (NSO, 2008).

The Health Human resources, are one of the main drivers of the Health care system and

are all essential for the efficient management and operation of the public health system. They are

the providers of health service and the health educator. Despite that they are important they are

unevenly distributed, as for most are on the urban area such as Metro Manila and other cities.

The number of hospital beds is also a good basis of health service availability, the World

Health Organization suggests that there should be 20 hospital beds per 10,000 population. The

distribution of private and public hospital beds by region. Almost have deficient beds

corresponding to the population except for the National Capital Region (NCR), Northern

Mindanao, Southern Mindanao and CAR. Amidst the seventeen regions, Autonomous Region in

Muslim Mindanao (ARMM) has the lowest bed to population ratio of 0.17 beds per 1000

population, far lower than the national average.

Private Hospitals in the Philippines continue to be as one of the important institution that

contribute health care services to the majority of the Filipino population. In 2009, the hospitals

which are privately-owned are 60% (DOH, 2009) with terms of utilization, 48% of the

population sought inpatient care are confined in private hospitals (NSO; Macro International,
2009). These institutions are also concerned by the political, socio and economic dynamics of the

country, even with their large contribution, it may rattle viability, sustainability and investment.

In a study it shows that, the Philippines, has the majority of hospitals, even in all levels of

hospitals, are privately owned. Besides, most of these hospitals are operating as profit

institutions. And that the majority of private hospitals are located in Luzon, particularly in

Central Luzon and NCR. It is also notable that private hospitals is high in areas with low

incidence of poverty. The Majority of Level 3 and 4 hospitals are located in urbanized areas,

while for Level 1 and Level 2 that seem to be well distributed. Most private hospitals are

PhilHealth accredited. The accreditation rate increases accordingly to the hospital’s level.

Regional variation was observed with regards to utilization, High private utilization was

observed in areas with high number of private hospitals (e.g. NCR, CALABARZON and

Davao). Such that private hospitals are more likely to be utilized with high number of

socioeconomic status and social in insurance. As almost half of the population sought for

inpatient care was confined in private hospitals. At the national level, the average expenditure of

patients confined in private hospitals is twice bigger than the average for patients confined in

public hospitals. But, forsome regions like Davao, the average expenditure of patients confined

in private hospitals are almost the same with their counterparts confined in public hospitals.

(Lavado,R.F.2011)

A Study of Resource Management in Government-Retained Hospitals conducted by the

Philippine Institute for Development Studies (PIDS) shows that the share of hospital allocation

in the total DOH budget has been declining. From 60-66% recorded from 2003 up to 2006, it
down to 59% in 2007. Whilst in ostensible terms the assignment for hospitals in 2008 was at an

indistinguishable level from earlier years, its share in the overall DOH spending saw a marked

decrease in 2008 bookkeeping just to 35 percent. This change mirrors a shift in the priority of

DOH from individual personal health care to public health programs.

This study also shows that payments to hospital personnel comprise the largest share of

hospital budgets. In 2008, individual services represents three-fifths of the financial plan. There

has been an enduring decrease in the share of Maintenance and Other Operating Expenditures

(MOOE) in the hospital budget, from the 44 percent in 2000, the share of MOOE went down to

only 32 percent in 2008. From 2000 to 2008, MOOE declined by as much as 52 percent in

genuine terms. Capital Outlay had been zero from 2001 to 2006, partially because of the fiscal

trouble and the sternness measures imposed during this time. Capital expense was only allotted

to all hospitals in 2007 yet such was downsized in 2008 with only 13 hospitals accepting CO

apportionments.

There appears to be no coherent allocation criteria for hospital budget. Before, financial

plans are dependent on the amount of hospital beds, but as hospitals progressed with more

complex composition of cases – this procedure is not applicable anymore. Hospitals that

accommodate to more complex cases such as Medical Centers and Regional Hospitals receive

lower per bed allocations than Extension and District Hospitals.

This study also shows that there is no overall sector plan for hospitals sector. Planning is a

vital stage towards deciding a plan, which will reflect the current needs of the hospitals. In a

considerable length of time, it shows up that there might have been no clear arrangement of
DOH-retained hospitals, which translated under a plan in light of authentic data, rather than

serious needs of the facilities. At those hospital level, planning and budgeting appear to be ad

hoc and missing in overall strategy. There are no oversight arrangements in terms of arranging

the financial plans, and no reasonable rules exist over budget preparation particularly created for

hospitals.

Unfunded practices of natural law distort coverage of uses of funds. Mandating hospitals to

provide Magna Carta welfare without giving them the appropriate budget and the restrictive rule

on the uses of funds button the hospitals to resort to composition manipulation. Interviews with

DBM-Exchange Berth as well as DOH-Central Office Budget Segmentation reveal that the

reason for the high budget utilization rate is due to the use of preservation as earnings meant for

Magna Carta welfare. Under RA 7305, or the Magna Carta of Public Health Workers, public

health workers are entitled to, among others, subsistence valuation reserve, washing allowance,

longevity wage, chance pay, and higher earnings tier upon retirement, among others. Since it’s

handing over in 1992, government has not been able to fully provide for in the budget the

payment of such welfare as prescribed in the law. Only the subsistence and laundry leeway are

provided but these are not given in full, i.e. for subsistence allowance, of the Php1, 500 under the

IRR of the magna carta for health workers, only Php900/calendar month is funded from the GAA

while Php600/month from nest egg; for laundry allowance (Php150/month based on the IRR,

only Php125/month is funded from the GAA while Php25/month is sourced from savings.

Hazard allowances are budgeted but these are only for x-ray technicians. The rest of the benefits

prescribed in the Magna Carta are not funded at all.

 In another article entitled “The Anatomy of Philippine Health Care: recurring problems,

challenges, and solutions” by Nickky Faustine P. de Guzman, a reporter of Business World

online Philippines; The World Health Organization recommends that there should be 20 beds in

a hospital per 10,000 people and during the year 2015 the Philippines’ population was over 100

million. Beds, among our many needs, are usually insufficient. According to the 2008 DoH

report entitled “The Philippine Health System at a Glance” available on its website, almost all

regions have insufficient beds relative to population. The sufficiency of beds is one indicator of a

good (or a failing) health care system. The Autonomous Region of Muslim Mindanao (ARMM)

has the smallest bed-population ratio according to the data they collected.

In the article, it gave a background on the other problems that also the DoH faces to

improve the Philippine Health Care namely- First, the reforming Formulary on drugs to be able

to make list drugs based on their cost-effectiveness and safety for some are not cost-effective that

need to be replaced. Second, the increased spending of the Doh due to the PhilHealth

shouldering and covering about 80% of the population including the retirees as its latest

members.Third, the Private help and clinical trials of the filipinos, there a handful of people that

apply for work in the medical field but majority leave the country and work for international

companies. DoH was working on better incentives for skilled workers to address the problem of

brain drain and lastly, the Philippines not being medical tourist destination, in particular Metro

Manila, but the country has all the right ingredients to be one but before that to happen the DoH

must face the first significant issue in the Philippines healthcare as their first step. (Guzman,

2015)
 CHAPTER 3

RESEARCH METHODOLOGY

Research Design

This study employed the Phenomenology method that assessed the perception of the

respondents on thel level of satisfaction of hospitalization services in selected public hospital and

private hospital. The Phenomenology method provides an understanding on the lived experiences

or perceptions of the respondents, for it is more concerned with the question of how individuals

make sense of the world around them.

Locale of the Study

The locale of the study will be the various residences of the respondents located in Siena

College of Taytay will also be another location to conduct the interviews and it is located in E.

Rodriguez Ave. Taytay, Rizal.

Population and Sampling

The respondents of the study were the male and female in-patients, former in-patients or

their guardians who experienced the hospitalization services of both public and private hospitals.

The researchers used non-probabilty sampling specifically, purposive sampling in selecting the

respondents for the study, Purposive sampling is used to gather enough data on the selected

respondents in answering the interview questions.

 The study had a total of 10 respondents, 5 respondents who experienced the

hospitalization services of a public hospital and 5 respondents who experienced the

hospitalization services of a private hospital who answered the interview questions to the best of

their knowledge and belief.

Research Instrumentation

The instrument used in gathering information was through the use of structured

interview questions that was validated by the research advisers and asked to the respondents. The

interview questions were a series of questions related to Maslow’s Hierarchy of needs theory that

focused more on the first two levels which were the basic/deficiency needs which are the

physiological and safety needs that will be distributed to the respondents and analyzed

thoroughly for the results. The following questions were asked:

1) How often do you receive your food provisions? (Gaano kadalas mo natatanggap ang

iyong pagkain?)

2) How often do the nurses update your medical record? (Gaano kadalas ka pinupuntahan

ng mga nars?)

3) How often does your room get cleaned? (Gaano kadalas nililinis ang iyong kwarto?)

4) How do the nurses maintain a conjusive environment? (Paano pinananatili ng mga

nars ang isang kaaya ayang paligid?)

5) How do you feel safe in your room? (Paano mo nararamdamang ligtas ka sa loob ng

iyong kwarto?)
 6) How did the hospital ensure your safety? (Paano sinisigurado ng Ospital na ligtas ka?)

7) How can you ensure your own safety in the hospital? (Paano mo masisigurado ang

iyong kaligtasan sa loob ng ospital)

8) What are the problems in the rules and regulations of the hospital?(Ano-abo ba ang

mga problema sa patakaran ng ospital?)

9) Describe your stay in the hospital? (Ilarawan ang iyong karanasan sa loob ng

ospital?)

10) What advice will you give to other patients like you? (Anong payo ang maibibigay mo

sa ibang pasyenteng katulad mo?)

11) Would you recommend the hospital you have stayed in? why or why not?

( Irerekomenda mo ba ang ospital na iyong napuntahan? Bakit?)

Data Gathering Procedure

There were different ways to make the study possible and effective. The researchers

applied a step-by-step procedure to fully provide the details or information that was relevant to

the research and to produce accurate results.

First, the researchers brainstormed and inquired about the possible interview questions to

avoid biased or quantitative type questions. Second, the researchers collected the names of the

respondents who fit the demographics for the study and made a final list. Third, the researchers

conducted individual and group interviews to collected the data

they needed, and the information acquired was written and recorded. Fifth, the information was

gathered and organized for the treatment of data. Lastly, analysis, interpretation, and conclusion

were garnered from the collected data.

Data Rigor and Trustworthiness

The data for the study will be obtained through the use of interview and observation.

Being a Qualitative research design, it is more on social constructivism. The research aims to

obtain data about the possible views of the in-patients, former in-patients and their guardians on

the capacity of the hospitalization services of both public and private hospitals to satisfy their

patients via the fulfilment of the safety needs and physiological needs of their patients according

Maslow’s hieararchy of needs, in the data to be gathered for the study will vary with each

respondent and will be seen as subjective. For this reason, the researchers do not have criteria for

the credibilty of the respondents’ answers; however, the versatility of the data to be collected and

gained may serve as a basis for further analyses due to its limited prospects and exploration of

concepts in both a medical and social points of views.

 CHAPTER 4

PRESENTATION, ANALYSIS AND INTERPRETATION OF DATA

Table 1: Frequency Distribution showing the answers of the respondents from Public Hospitals

on the question: “How often do you receive your food provisions? (Gaano kadalas mo

natatanggap ang iyong pagkain?)”

Item Frequency Percentage (%) Rank

“3 times a day” 3 60 % 1
“On time” 2 40 % 2
Total 5 100%

Table 1, shows that the answer “3 times a day” ranked first as to how often the

respondents’ received their food provisions with a frequency of 3 and a percentage of 60% then

followed by the answer “On time” which ranked as second or last as to how often they received

their food provisions with a frequency of 2 and a percentage of 40%.

Table 1.1: Frequency Distribution showing the answers of the respondents from Private

Hospitals on the question: “How often do you receive your food provisions? (Gaano kadalas

mo natatanggap ang iyong pagkain?)”

Item Frequency Percentage (%) Rank

“3 times a day” 3 60 % 1
“On time” 1 20 % 2
“More than 3 times a 1 20% 2
day”
Total 5 100%

Table 1.1; shows that the answer “3 times a day” is ranked first as to how often the

respondents’ receive their food provisions having the frequency of 3 and a percentage of 60%

then the aswers “On time” and “More than 3 times a day” are both ranked second or last having

the frequency of 1 and the percentage of 20%.

 According to Lenus; The Irish Health Repository All patients have a right to safe,

nutritious food, they expect that their nutritional needs will be fulfilled during hospitalisation.

The benefits of providing nutritional support have been documented in several clinical situations.

While some patients may benefit from special techniques of nutritional support (by the enteral or

parenteral routes), most depend on ordinary hospital food to improve or maintain their nutritional

status in order to optimise their recovery from illness.

Table 2: Frequency Distribution showing the answers of the respondents from Public Hospitals

on the question: “How often do the nurses update your medical record? (Gaano kadalas ka

pinupuntahan ng mga nars?)”

Item Frequency Percentage (%) Rank

“4 times a day” 2 40% 1
“3 times a day” 1 20% 2
“2 times a day” 1 20% 2
“As required by the 1 20% 2
doctor”
Total 5 100%

Table 2; shows that the answer “4 times a day” ranked first as to how often the nurses

update their medical record with a frequency of 2 and a percentage of 40% then the answers “3

times a day”, ”2 times a day” and “as required by the doctor” is ranked second or last as to how

often the nurses update the respondents’ medical record with all of them having a frequency of 1

and a percentage of 20%.

Table 2.1: Frequency Distribution showing the answers of the respondents from Private

Hospitals on the question: “How often do the nurses update your medical record? (Gaano

kadalas ka pinupuntahan ng mga nars?)”

 Item Frequency Percentage (%) Rank
“Always” 2 40% 1
“3 times a day” 2 40% 1
“4 times a day” 1 20% 2
Total 5 100%

Table 2.1; shows that the answers “Always” and “3 times a day” both ranked first as to

how often the nurses update the respondents’ medical record having the frequency of 2 and a

percentage of 40% while the answer “4 times a day” is ranked second or last having a frequency

of 1 and a percentage of 20%.

Accoding to the Georgia Department of Public Health, If the nurse decides to refer the

client, the referral must be documented in the client's chart. The documentation should include

where/to whom the client was referred, what medical information was sent with the client or

authorized to be released and any assistance and/or instructions provided to the client. Results of

the referral and any changes in the client's plan of care should subsequently be documented.

The Code of Professional Conduct (NMC, 2002a) advises that good note-taking is a vital

tool of communication between nurses. It states that nurses ‘must ensure that the health care

record for the patient or client is an accurate account of treatment, care planning and delivery. It

should be written with the involvement of the patient or client wherever practicable and

completed as soon as possible after an event has occurred. It should provide clear evidence of the

care planned, the decisions made, the care delivered and the information shared’.

Table 3: Frequency Distribution showing the answers of the respondents from Public Hospitals

on the question: “How often does your room get cleaned? (Gaano kadalas nililinis ang iyong

kwarto?)”
 Item Frequency Percentage (%) Rank
“The staff just comes 2 40% 1
in and out of the room
suddenly”
“Every morning” 1 20% 2
“When requested” 1 20% 2
“I do not see or feel 1 20% 2
the cleanliness”
Total 5 100%

Table 3; shows that the answer “The staff just comes in and out of the room suddenly”

ranked first as to how often the room of the respondents’ get cleaned with having a frequency of

2 and a percentage of 40% then the answers “Every morning”, “When requested” and “I do not

see or feel the cleanlines” is ranked second or last with all of the having a frequency of 1 and a

percentage of 20%.[

Item Frequency Percentage (%) Rank

“Every Morning” 2 40% 1
“Always” 1 20% 2
“Twice a day” 1 20% 2
“Sef clean in the 1 20% 2
room”
Total 5 100%
Table 3.1: Frequency Distribution showing the answers of the respondents from Private

Hospitals on the question: “How often does your room get cleaned? (Gaano kadalas nililinis

ang iyong kwarto?)”

Table 3.1; shows that the answer “Every morning” ranked first as to how often the room of the

respondents’ get cleaned with having a frequency of 2 and a percentage of 40% while the
answers “Always”, “Twice a day” and “Self clean in the room” are all ranked second or last

having a frequency of 1 and a percentage of 20%.

According to an article of (ICT) Infection Control Today, Thorough environmental

cleaning and disinfection of rooms where patients with multidrug-resistant organisms (MDROs)

were hospitalized and treated is essential. The purpose of this cleaning and disinfection process

is to remove bacterial contamination from environmental surfaces and equipment surfaces where

patients receive care in order to prevent the transmission of the microorganism from patient to

patient, from patients to healthcare workers, and from patients to visitors.

Item Frequency Percentage (%) Rank

“Friendly and 1 20% 1
professional”
“Attentive to the 1 20% 1
needs of the patient”
“Silent” 1 20% 1
“Neutral” 1 20% 1
“Organized” 1 20% 1
Total 5 100%
Table 4: Frequency Distribution showing the answers of the respondents from Public Hospitals

on the question: “How do the nurses maintain a conjusive environment? (Paano pinananatili

ng mga nars ang isang kaaya ayang paligid?)”

Table 4; shows that the answers “Friendly and professional, “Attentive to the needs of

the patient”, “Silent, “Neutral”and “Organized”all ranked first as to how the nurses maintained

a conjusive environment with all having a frequency of 1 and a percentage of 20%.

Table 4.1: Frequency Distribution showing the answers of the respondents from Private

Hospitals on the question: “How do the nurses maintain a conjusive environment? (Paano

pinananatili ng mga nars ang isang kaaya ayang paligid?)”

Item Frequency Percentage (%) Rank

“Friendly and 2 40% 1
approachable”
“They have 2 40% 1
professionalism”
“Organized and 1 20% 2
clean”
Total 5 100%

Table 4.1; shows that the answers “Friendly and approachable” and “They have

professionalism” ranked first as to how the nurses maintain a conducive environment both

having a frequency of 2 and a percentage of 40% while the answer “Organized and clean” is

ranked second or last having a frequency of 1 and a percentage of 20%.

According to Nurse Bob's MICU/CCU Survival Guide: Critical Care Concepts (General

Nursing Requirements of the Intensive Care Patient) number 28, “The environment will be

maintained in a mechanically safe condition through:  dry floors, good repair of furniture,

proper placement of machines and equipment, cleanliness, freedom from clutter, and good

repair of equipment. Rationale: To reduce risks to patients, visitors, or staff.”

According to an article entitled “How the physical environment of a hospital affects

patient health” by Shira Anna, it is highly important to note that the physical environment of the

hospital can affect the health and the recuperation process of the patients and it is important for
the healthcare staff to work towards the improvement of the hospital's physical environment as

this will have a positive effect on a patient’s healing.

Item Frequency Percentage (%) Rank

“I did not feel safe” 2 40% 1
“Securing our 2 40% 1
things”
“Just safe” 1 20% 2
Total 5 100%
Table 5: Frequency Distribution showing the answers of the respondents from Public Hospitals

on the question: “How do you feel safe in your room? (Paano mo nararamdamang ligtas ka sa

loob ng iyong kwarto?)

Table 5; shows that the asnwers “I did not feel safe” and “Securing our things” ranked

first as to the how the respondents felt safe in their room having the frequency of 2 and a

percentage of 40% then the answer “Just safe” ranked second or last having the frequency of 1

and a percentage of 20%.

Table 5.1: Frequency Distribution showing the answers of the respondents from Private

Hospitals on the question: “How do you feel safe in your room? (Paano mo nararamdamang

ligtas ka sa loob ng iyong kwarto?)

Item Frequency Percentage (%) Rank

“I did not feel safe” 2 40% 1
“Securing our 2 40% 1
things”
“Just safe” 1 20% 2
Total 5 100%
Item Frequency Percentage (%) Rank
“Felt safe” 2 40% 1
“Nurses ensures 1 20% 2
safety”
“The nurses 1 20% 2
 familiarize themselves
to us”
“They have an 1 20% 2
emergency button”
Total 5 100%
Table 5.1; shows that the answer “Felt safe” ranked first as to how the respondents’ felt safe in

their room having a frequency of 2 and a percentage of 40% then the answers “Nurses ensure

safety”, “The nurses Familiarize themselves to us” and “They have an emergency button” all

ranked second or last having a frequency 1 and a percentage of 20%.

According to the study of Karen Ballard MA, RN entitled “Patient Safety: A Shared

Responsibility”, Patient safety is an essential and vital component of quality nursing care.

However, the nation’s health care system is prone to errors, and can be detrimental to safe patient

care, as a result of basic systems flaws. A variety of stakeholders (society in general; patients;

individual nurses; nursing educators, administrators, and researchers; physicians; governments

and legislative bodies; professional associations; and accrediting agencies) are responsible for

ensuring that patient care is safely delivered and that no harm occurs to patients. The

responsibility of these stakeholders in addressing patient safety in the context of a nursing

shortage is discussed, along with specific actions they have taken, and can continue to take, to

promote safe care.

Table 6: Frequency Distribution showing the answers of the respondents from Public Hospitals

on the question: “How did the hospital ensure your safety? (Paano sinisigurado ng Ospital na

ligtas ka)”

Item Frequency Percentage (%) Rank

“Lobby security and 2 40% 1
nurse stations”
“Protocols in the 2 40% 1
 visiting hours”
“Complete staff” 1 20% 2
Total 5 100%

Table 6; shows that the asnwers “Lobby security and nurse stations” and “Protocols in the

vising hours” ranked first as to the how the respondents felt safe in their room having the

frequency of 2 and a percentage of 40% then the answer “Complete staff” ranked second or last

having the frequency of 1 and a percentage of 20%.

Table 6.1: Frequency Distribution showing the answers of the respondents from Private

Hospitals on the question: “How did the hospital ensure your safety? (Paano sinisigurado ng

Ospital na ligtas ka)”

Item Frequency Percentage (%) Rank

“Security and 2 40% 1
assigned personnel”
“Protocols in the 1 20% 2
visiting hours”
“CCTVs” 1 20% 2
“Rules and 1 20% 2
regulations”
Total 5 100%

Table 6.1; shows that the answer “Security and assigned personnel” ranked first as to how the

hospital ensured the safety of the respondent having a frequency of 2 and a percentage of 40%

while the answers “Protocols in the visiting hours”, “CCTVs” and “Rules and regulations” all

ranked second or last having a frequency of 1 and a percentage of 20%.

According to an article of BetterHealth Channel of the Victoria State Government on the

safety and security in hospitals, to keep staff, patients and visitors safe, hospitals use a range of
security measures, including the use of CCTV cameras, duress alarms for staff members and

electronic access control systems for doorways. Some hospitals also employ security staff. In

Hospital visitors and safety, As a hospital visitor, it is important that you respect visiting hours

and rest periods for patients during the day. If you want to bring a gift or something for a loved

one, check with the hospital to make sure it is okay. Some wards do not allow pot plants, flowers

or food and another part of keeping patients safe in hospital is making sure they get the right

treatment, do not pick up infections, have falls, take the wrong medication or develop pressure

sores. 

Item Frequency Percentage (%) Rank

“Not fully relying on 3 60% 1
the hospital”
“Following the rules 1 20% 2
of the hospital”
“Giving 1 20% 2
Consideration to the
staff”
Total 5 100%
Table 7: Frequency Distribution showing the answers of the respondents from Public Hospitals

on the question: “How can you ensure your own safety in the hospital? (Paano mo

masisigurado ang iyong kaligtasan sa loob ng ospital)”

Table 7; shows that the answer “Not fully relying on the hospital” is ranked first as to

how one can ensure one’s safety in a hospital having a frequency of 3 and a percentage of 60%

then the answers “Following the rules of the hospital” and “Giving consideration to the staff”

ranked second or last having the percentage of only 1 and a percentage of 20%.
 Item Frequency Percentage (%) Rank
“I already felt safe” 2 40% 1
“Not fully relying on 1 20% 2
the hospital”
“Check the reputation 1 20% 2
of the hospital”
“Organize things” 1 20% 2
Total 5 100%
Table 7.1: Frequency Distribution showing the answers of the respondents from Private

Hospitals on the question: “How can you ensure your own safety in the hospital? (Paano mo

masisigurado ang iyong kaligtasan sa loob ng ospital)”

Table 7.1; shows that the aswer “I already felt safe” ranked first as to how the

respondents ensured their own safety with having a frequency of 2 and a percentage of 40%

while the answers “Not fully relying on the hospital”, Check the reputation of the hospital” and

“Organize things” all ranked second or last having a frequency of 1 and a percentage of 20%.

According to the Leapfrog Hospital Safety Grade, In preparing for your hospital stay-

You can reduce the chance for safety errors while you’re in the hospital by knowing Medication

safety for improvement is a top priority for hospitals To prepare for your hospital stay, be sure

to: Bring all the medicines you are currently taking so that your health care team can review

them. Make sure your care team knows about any allergies to medications. Bring a family

member or friend to the hospital with you. This way, even when you are not feeling well, this

person can be alert, ask questions, provide important information, and step in if there are any

problems. Know what the medicines given to you in the hospital look and taste like. If anything
is different when your nurse brings them to you, ask why. Know what conditions your medicines

treat. It is helpful to know both the clinical and common name for your condition(s).

Table 8: Frequency Distribution showing the answers of the respondents from Public Hospitals

on the question: “What are the problems in the rules and regulations of the hospital? (Ano-abo

ba ang mga problema sa patakaran ng ospital?”

Item Frequency Percentage (%) Rank

“The hospital was 2 40% 1
strict with their rules”
“Followed by the 2 40% 1
hospittal staff but not
by everyone”
“Unorganized and 1 20% 2
unconsistent rules”
Total 5 100%

Table 8; shows that the answers “The hospital was strict their rules” and “Followd by the

hospital staff but not by everyone” both ranked first as to what were the problems in the rules

and regulations of the hospital with having the frequency of 2 and a percentage of 40% while the

answer “Unorganized and unconsistent rules” is ranked second having a frequency of 1 and a

percentage of 20%.

Table 8.1: Frequency Distribution showing the answers of the respondents from Private

Hospitals on the question: “What are the problems in the rules and regulations of the hospital?

(Ano-abo ba ang mga problema sa patakaran ng ospital?”

Item Frequency Percentage (%) Rank

“None” 2 40% 1
“The hospital was 1 20% 2
strict”
“Maybe there were 1 20% 2
 some problems”
“Rules were not 1 20% 2
followed by everyone”
Total 5 100%
Table 8.1; shows that the aswer “None” ranked as to what were the problems in the rules and

regulations of the hospital as to having a frequency of 2 and a percentage of 40% while the

answers “The hospital was strict”, “Maybe there were some problems” and “Rules were not

followed by everyone” are all ranked second or last with all of them having the frequency of 1

and a percentage of 20%.

According to PSQH (Patient Safety and Quality Healthcare), The Purpose of Policies and

Procedures is to Facilitate adherence with recognized professional practices, promote compliance

with regulations, statutes, and accreditation requirements, reduce practice variation, standardize

practices across multiple entities within a single a health system, serve as a resource for staff,

particularly new personnel and reduce reliance on memory, which, when overtaxed, has been

shown to be a major source of human errors or oversights. These functions demonstrate how

central policies and procedures are to the healthcare system’s patient safety program.

According to Becker’s Hospital Review, In the wake of consolidation, many executives

are beginning to realize their health systems are merely jumbled collections of healthcare

facilities with different strategies, distinct cultures, duplicate fundraising campaigns and varying

reimbursement rates. Many have yet to achieve true "systemness." Health systems that haven't

achieved true integration yet are presented with the opportunity to reevaluate and develop a clear

integration strategy — with the benefit that stalled integration likely preserved their mutually

reinforcing capabilities.
Table 9: Frequency Distribution showing the answers of the respondents from Public Hospitals

on the question: “Describe your stay in the hospital? (Ilarawan ang iyong karanasan sa loob ng

ospital?)”

Item Frequency Percentage (%) Rank

“Uncomfortable” 3 60% 1
“Will be alright if 1 20% 2
they improve their
medicie/pharmacy”
“Okay compared to 1 20% 2
other hosptals”
Total 5 100%

Table 9; shows that the answer “Uncomfortable” ranked first as to how the respondents’

describe their stay in the hospital having a frequency of 3 and a percentage of 60% while the

answers “Will be alright if they improve their medicie/pharmacy” and “Okay compared to other

hosptals” both ranked second or last having a frequency of 1 and a percentage of 20%.

Table 9.1: Frequency Distribution showing the answers of the respondents from Private

Hospitals on the question: “Describe your stay in the hospital? (Ilarawan ang iyong karanasan

sa loob ng ospital?)”

Item Frequency Percentage (%) Rank

“Comfortable and 3 60% 1
Good service”
“Hard but fast 1 20% 2
recovery”
“Very satisfying” 1 20% 2
Total 5 100%
 Table 9.1; shows that the aswer “Comfortable and Good service” ranked first as to how

the respondents described their stay in the hospital having a frequency of 3 and a percentage of

60% while the answers “Hard but fast recovery” and “Very satisfying” both ranked second or

last having the frequency of only 1 and a percentage of 20%.

According to the article of Amy Corderoy. Most hospital patients in NSW have a positive

experience in the public system but a Bureau of Health Information survey of 17,000 patients

found thinly stretched hospital resources are contributing to some negative experiences. One in

five patients who were worried about their treatment was never able to discuss their concerns

with their doctor, and more than one in 10 experienced problems such as not being able to find

staff to talk to, not being able to be involved in medication choices, and not being given enough

information. An overall large proportion reported being treated with dignity and respect, and

receiving good quality and well-organised care. Australian Medication Association NSW head

Brian Owler said the survey was extremely encouraging .''The vast majority of the people who go

through our public hospital system do have a positive experience. However, there are

improvements that can be made, it's a system that is stretched in terms of its resources.'' The

survey found that 16 % of people waited more than eight weeks for an appointment with a

specialist, while 7% waited more than a year for surgery and 59 % of people said they were not

always able to get a staff member to help them when they needed within a ''reasonable time

frame''. Professor Owler said while the problems with waiting times to see specialists were

considerable in some areas, people should be cautious with their expectations once they were in

hospital, waiting times for hospital appointments, treatment and/or surgery have become a major

political and health service problem.

 Data collection in South America, occurred in 2012–13 and the Participants differentiated

between experiences of ‘waiting for’ and ‘waiting public and private hospitals. Whilst ‘waiting

for’ public hospitals was longer than private hospitals, this was often justified and accepted by

public patients, therefore it did not lead to distrust of public hospitals. Private patients had

shorter ‘waiting for’ hospital services, increasing their trust in private hospitals and distrust of

public hospitals, they also recounted many experiences of longer ‘waiting in’ public hospitals,

leading to frustration and anxiety, although they rarely blamed or distrusted the doctors or

nurses, instead blaming an underfunded system and over-worked staff. Although public patients

experienced longer ‘waiting for’ and ‘waiting in’ public hospitals, it did not lead to widespread

distrust in public hospitals or healthcare professionals. Private patients recounted largely positive

stories of reduced ‘waiting for’ and ‘waiting in’ private hospitals, and generally distrusted public

hospitals. The continuing trust by public patients in the face of negative experiences may be

understood as a form of exchange trust norm, in which institutional trust is based on base-level

expectations of consistency and minimum standards of care and safety. The institutional trust by

private patients may be understood as a form of communal trust norm, whereby trust is based on

the additional and higher-level expectations of flexibility, reduced waiting and more time with

healthcare professionals.

Table 10: Frequency Distribution showing the answers of the respondents from Public

Hospitals on the question: “What advice will you give to other patients like you? (Anong payo

ang maibibigay mo sa ibang pasyenteng katulad mo?)”

Item Frequency Percentage (%) Rank

“Go to a Private 2 40% 1
hospital if you can”
“Go to the hospital I 1 20% 2
stayed in”
 “Conduct your own 1 20% 2
safety measures”
“Be Patient” 1 20% 2
Total 5 100%
Table 10; shows that the answer “Go to a Private hospital if you can” ranked first as to

what advice the respondents they will give to patients like them having a frequency of 2 and a

percentage of 40% while the answers “Go to the hospital I stayed in”, “Conduct your own safety

measures” and “Be Patient” all ranked as last or second having thefrequency of 1 and a

percentage of 20%.

Table 10.1: Frequency Distribution showing the answers of the respondents from Private

Hospitals on the question: “What advice will you give to other patients like you? (Anong payo

ang maibibigay mo sa ibang pasyenteng katulad mo?)”

Item Frequency Percentage (%) Rank

“Annual Checkup”
“Safe in a private
hospital”
“Respect others”
“Observe things and
don’t fully rely on the
hospital”
“Make sure you are
the no.1 priority”
Total
1 20 % 1
1 20% 1
1 20% 1
1 20% 1
1 20% 1
5 100%

Table 10.1; shows that all the answers “Annual Checkup”, “Safe in a private hospital”,

“Observe things” and “don’t fully rely on the hospital” and “Make sure you are the no.

priority” are all ranked first having a frequency of 1 and a percentage of 20%.

According to one of the articles of Medpagetoday’s KevinMD, they enlisted 10 tips on

survivng your stay in a hospital and they are the following: Bring your own pillow, Bring a
laptop computer or request one from the hospital, bring an accurate and updated medication list

with you. Nothing leaves you more vulnerable to hospital errors than to have your doctor give

you medication you haven’t taken in months, Write down all your questions early and be patient.

You’re going to be told things that contradict each other multiple times a day, just accept it. All

your doctors and nurses carry their own perspective and experience. Always remember being

sick is highly unpredictable, so be cautious. Your doctors and nurses are not dumb or uncaring

because they don’t do things exactly as you wish or respond to your every need or request with

immediacy. That’s why the closest we can come is to provide you with our AIDET process (its a

communication framework for healthcare professionals to communicate with patients and each

other in a way that decreases patient anxiety, increases patient compliance, and improves clinical

outcomes. It stands for Acknowledge, Introduce, Duration, Explanation, and Thank you) Be nice.

If you are mean to your doctors or nurses, they will consciously (or subconsciously) avoid

interaction with you and your family and lastly request a hospitalist. We’ll get you out quicker

and less sicker.

Table 11: Frequency Distribution showing the answers of the respondents from Public Hospitals

on the question: “Would you recommend the hospital you have stayed in? why or why not?

( Irerekomenda mo ba ang ospital na iyong napuntahan? Bakit?)”

Item Frequency Percentage (%) Rank

“Would Recommend 4 80% 1
because the hospital
is alright”
“Would not 1 20% 2
recommmend because
the hospital is unsafe”
Total 5 100%
 Table 11; shows that the answer “Would Recommend because the hospital is alright”

ranked first as to whether the respondents will or will not recommend the hospital they have

stayed in having a frequency of 4 and a percentage of 80% while the answer “Would not

recommmend because the hospital is unsafe” ranked second or last having a frequency of only 1

and a percentage of 20%.

Table 11.1: Frequency Distribution showing the answers of the respondents from Private

Hospitals on the question: “Would you recommend the hospital you have stayed in? why or

why not?( Irerekomenda mo ba ang ospital na iyong napuntahan? Bakit?)”

Item Frequency Percentage (%) Rank

“Would Recommend 5 100% 1
because the hospital
is alright”
Total 5 100%

Table 11.1; shows that the answer “Would Recommend because the hospital is alright”

ranked first as as to whether the respondents will or will not recommend the hospital they have

stayed in having a frequency of 5 and a percentage of 100%

According to an article of Consumer rights entitled “How to choose a hospital”, There

are different hospital ratings to find a good hospital in your area, these ratings can help you

identify and be prepared for any potential problems at the hospital you do go to. First is Patient

experience: Based on a government survey of millions of patients, these ratings tell you whether

patients would recommend the hospital, their overall assessment of it, and their experience with

topics such as communication with doctors and nurses, pain control, and whether their rooms
were kept clean and quiet. Second is Patient Outcomes: These ratings, based on data submitted

by hospitals to the federal government, or states, provide information on how well hospitals

prevent bloodstream and surgical-site infections, and the chance that patients have to be

readmitted to a hospital within 30 days of their initial discharge. The need for such readmission

can indicate problems in care while the patient was first hospitalized, including a hospital-

acquired infection . Third is Hospital practices: Two measures are included under this heading,

the use of electronic health records, and the appropriate use of CT scanning. The ratings for

electronic health records are based on a survey of hospitals conducted by the American Hospital

Association on the extent to which a hospital uses a computerized system for documenting

physicans' and nurses' notes, viewing lab reports, and other purposes. The ratings for CT

scanning comes from billing data submitted to CMS that calculates the percent of scans of the

abdomen and chest that are performed twice, once with and once without a dye. Such scans

usually aren't necessary and can expose you to unnecessary radiation and lastly Safety

score: This is a summary of several key categories related to hospital safety: avoiding infections,

avoiding readmissions, communicating about new medications and discharge, appropriate use of

chest and abdominal CT scanning, avoiding serious complications, and avoiding mortality. The

score is expressed on 100-point scale. A hospital would score 100 if it earned the highest

possible score in all measures and would score 1 if it earned the lowest scores in all measures.

All of the categories are worth 20 points except for avoiding complications and avoiding

mortality, each of which are worth 10 points. 

 CHAPTER V

SUMMARY OF FINDINGS, CONCLUSIONS, AND RECOMMENDATIONS

Summary of Findings

The outcome of this study gave answers to the mentioned problem statement. The use

of interviews made it possible for the researcher to attain the answers needed.

The 10 respondents consists of, 5 persons who experienced being an in-patient,

former in-patient or the legal guardian at that time confinement in a Public hospital and

another 5 persons who experienced being an in-patient, former in-patient or the legal

guardian at that time confinement in a Private hospital. These people were able to point out

their views, experiences and opinions on the level of satisfaction of the hospitalization

services of both Public and Private Hospitals.

According to the conducted study by the researchers:

For the first question from the respondents from Public hospitals, 3 answered that they

receive their daily meals 3 times a day (60%) and 2 answered they receive their daily meals on

time (40%). While, For the first question from the respondents from Private hospitals, 3

answered that they receive their daily meals 3 times a day (60%), 1 respondent answered they

receive their daily meals one time (20%) and the last 1 respondent answered they receive their

daily meals more than 3 times a day (20%).

For the second question from the respondents from Public hospitals, 2 answered that the

nurses update their medical record 4 times a day (40%), 1 answered the nurses update their
medical record 3 times a day (20%), 1 answered that the nurses update their medical record 2

times a day (20%) and lastly 1 answered that the nurses update their medical record as required

by the doctor (20%). While for the second question from the respondents from Private hospitals,

2 answered that the nurses always update their medical record (40%), also another 2 answered

that the nurses update their medical record 3 times a day (40%) and only 1 answered that the

nurses update their medical record 4 times a day (20%).

For the third question from the respondents from Public hospitals, 2 answered that, the

staff suddenly comes in and out to clean their room (40%), and 1 answered that their room gets

cleaned every morning (20%), 1 answered that their room only gets cleaned when requested

(20%), and another1 answered that they did not see nor feel their room got cleaned (20%).

While for the third question from the respondents from Private hospitals, 2 answered that their

room are gets cleaned every morning (40%), 1 answered that their room got cleaned always

(20%), 1 answered that their room got cleaned twice a day (20%), and the last 1 answered that

they were the one who cleaned the room (20%).

For the fourth question from the respondents from Public hospitals, 1 answered that

nurses are Friendly and professional (20%), 1 also answered that nurses are attentive to their

needs (20%), 1 answered that nurses are silent (20%), another 1 answered that nurses are just

neutral (20%), and lastly 1 answered that nurses are organized (20%). While for the fourth

question from the respondents from Private hospitals, 2 answered that nurses are Friendly and

approachable (40%), and another 2 answered that nurses have professionalism (40%), and lastly

1 answered answered that nurses are organized and clean (20%).

For the fifth question from the respondents from Public hospitals, 2 answered that they

did not feel safe in their room (40%), and another 2 answered that to feel safe they fave to secure
their things (40%), and 1 answered that they are just safe in their room (20%). While for the

fifth question from the respondents from Private hospitals, 2 answered that they felt safe in their

room (40%), 1 answered that the nurses ensures their safety (20%), 1 answered that the nurses

familiarize themselves to the patients (20%), and another 1 answered that the room have an

emergency button (20%).

For the sixth question from the respondents from Public hospitals, 2 answered that the

hospital ensure the safety by having lobby securities and nurse stations (40%), another 2

answered that the hospital ensures the safety by having protocols in the visiting hours (40%),

and 1 answered that the hospital ensures the safety by having complete staff (20%). While for

the sixth question from the respondents from Private hospitals, 2 answered that the hospital

ensures their safety by having security and assigned personnel (40%), 1 answered that the

hospital ensures their safety by having protocols in the visiting hours (20%), 1 answered that the

hospital ensures their safety by having CCTVs (20%) and another 1 answered that the hospital

ensures their safety by their rules and regulations (20%).

For the seventh question from the respondents from Public hospitals, 3 answered that

they ensure their safety inside the hospital by not fully relying on the hospital (60%), 1 answered

that they ensure their safety inside the hospital by following its rules and regulations (20%), 1

answered that they ensure their safety inside the hospital by giving consideration to the staff

(20%). While for the seventh question from the respondents from Private hospitals, 2 answered

that they already felt safe inside the hospital (40%), 1 answered that they ensure their safety

inside the hospital by not fully relying on the hospital (20%), and another 1 answered that they

ensure their safety inside the hospital by checking the hospital’s reputation (20%), and lastly 1

answered that they ensure their safety inside the hospital by organizing their things (20%).
 For the eighth question from the respondents from Public hospitals, 2 answered that the

problems on the rules and regulations of the hospital is that it was strict (40%), and another 2

answered that the rules and regulations are only followed by the hospital staff but not everyone

(40%), 1 answered that the problems on the rules and regulations of the hospital is its

inconsistency and being unorganized (20%). While for the eighth question from the respondents

from Private hospitals, 2 answered that there is no problem s in the hospital’s rules and

regulations (40%), 1 that the problems on the rules and regulations of the hospital was it being

strict (20%), 1 answered that maybe there were some problems (20%) and 1 that the problems

on the rules and regulations is it was not being followed by everyone (20%).

For the ninth question from the respondents from Public hospitals, 3 answered that their

stay was uncomfortable (60%), 1 answered that their stay will be alright if the hospital improve

their medicine/pharmacy (20%) and another 1 answered that it’s okay compared to other

hospitals (20%). While for the ninth question from the respondents from Private hospitals, 3

answered that their stay was comfortable and is at good service (60%), 1 answered that their stay

was hard but their recovery is fast (20%) and another 1 answered that their stay was very

satisfying (20%).

For the tenth question from the respondents from Public hospitals, 2 answered that they

would advice to other patients to go to a private hospital instead, if they can (40%), 1 answered

that they would advice other patients to go to the hospital they stayed in (20%), 1 answered that

other patients should conduct their own safety measures (20%), and another 1 answered that

patients should be patient (20%). While for the ninth question from the respondents from Private

hospitals, 1 answered that patients should have annual checkups (20%), 1 answered that they

would advice other patients that its safe in a private hospital (20%), 1 answered that patients
should respect others (20%), and another 1 answered that patients should observe things and to

don’t fully rely on the hospital (20%), and lastly 1 answered that they would advice to other

patients to make sure that they are the hospital’s number 1 priority (20%).

For the eleventh question from the respondents from Public hospitals, 4 answered that

they would recommend the hospital because the hospital is alright (80%), and 1 would not

recommend the hospital because it is unsafe (20%). While for the eleventh question from the

respondents from Private hospitals, 5 answered that they would recommend the hospital because

the hospital is alright (100%).

Conclusions

After a long process, the researchers have concluded that there is an effect in the decision

of choosing between public or private hospital in the level of satisfaction of the patients in their

hospitalization.

Some of the problems encountered by the people in Public Hospitals are relating to the

Food, the cleanliness of rooms, having a conjusive environment, the safety of the patients in their

rooms, the hospitals’ rules and regulations, and most importantly, the patients being

uncomfortable throughout their stay in the hospital. Some of the problems encountered by the

people in Private Hospitals are relating to the patients safety inside their room and in the

hospital, the hospitals’ rules and regulations.

The researchers conclude that there is really an effect in the decision of choosing between

public or private hospitals. Since the majority of the respondents would recommend private

hospitals because of their good or positive experience all in all, whereas when it comes to public

there are hindrances in the recommendation of the respondent because of different negative or

bad they have had being confined.

Recommendations

Based on the data in this study and the conclusions drawn, the researchers recommend the

following:

a) To the patients; choose a hospital that will greatly fit your specific need for a better

hospitalization, regardless of the hospital type.

b) For the hospital administration; Evaluate and study the system of your hospital for a

better set-up to know what and where to develop that would be of help in the

effectiveness of your hospitalization services.

c) To the hospital personnel; Be aware on how to properly and professionally act in

accordance to the patient’s current well being and make sure that the basic needs, the

Physiological and safety needs, are being met.

d) For the arising hospital personnel; Be wary of your actions and be sensitive towards the

patients to ensure the best of their stay in the hospital and take note of what the

professionals before you are doing.

e) For the community; Inform the citizens on what services they should get once being

hospitalized iregardless of the hospital’s type and what hospitals would be the best for

their condition or affordability.

f) For the future researchers; Choose respondents that are coming from the same

Public/Private hospital for a more accurate comparison.