TY  - GEN
AU  - Mier, Jana Deborah B.
AU  - Cruzada, Evelyn C. (Panel Chairperson)
AU  - Mercado, Harold L. (Institutional Partner)
AU  - Roberto, Generoso (External Expert)
TI  - Development and application of a remote island medicine system in Quezon, Quezon
KW  - Health services administration
KW  - Remote island medicine system--Quezon, Quezon, Philippines
KW  - Rural health care
N1  - Graduate School of Public and Development Management
N2  - Bringing quality health care to remote islands remains a challenge in the Philippines. In Quezon, Quezon, a 5th class municipality in Alabat Island, there are problems encountered in the referral of patients requiring secondary or tertiary level of care or consultation with a medical specialist. Resulting delays in receiving appropriate level of medical care ultimately lead to poor patient outcomes - untimely deaths and disability, complications and prolonged course of illness.  This research-action project aimed to prevent poor patient outcomes in Quezon, Quezon brought about by issues that challenge the access to prompt and appropriate level of medical care, which are caused by geographical constraints and its consequences, being a remote island municipality. It explored the current local experience when a patient is in need of referral to a higher level of medical care, both from the demand and supply sides, and identified strategies and interventions that can be applied to improve patients' access to a higher level of medical care.  An audit of referral forms in the year 2015, key informant interviews with local government officials and focus group discussions with referred patients and their caregivers were conducted to come up  with a descriptive analysis of the current local experience when a patient is in need of referral to specialists or transfer to a hospital. The findings were then analyzed in comparison to the conceptual Remote Island Medical Framework.  Results from the different methods described the existing medical care and referral system in Quezon, Quezon and may be divided into the following themes: 1) referral patterns and patient experience including the causes of delays in referral,2) notable locally available or locally facilitated services and 3) gaps or remaining challenges. The gaps pointed out were regarding the inadequacy of locally available diagnostics, medicines and specialty services, the specific constraints delaying transfer to hospital or consultation with specialist - expected costs and lack of free emergency sea transport - and the inefficiencies in the referral process. These were then addressed by improving the capacity of the local health workforce, setting up eHealth solutions such as teleconsultation     services, strengthening the network with clinical specialists and referral centers, and establishing the patient transport system
ER  -