CHAPTER ONE

THE PROBLEM AND ITS SETTING

INTRODUCTION

Annually, both freshly graduates and Board repeaters who aim to be

officially professional prepare for the scheduled board examination in order to be

licensed. Focusing on medical and health care courses, the Professional Regulation

Commission (PRC) released the board examination results for the year 2015. Some of

the results are: 550 out of 868 Physical Therapist, 2061 out of 4446 Psychometricians,

1325 out of 3043 Radiologic and X-Ray Technologist, 9707 out of 17891 Nurses, and

2491 out of the 2921 Physicians Board takers who passed the licensure examinations.

Subsequent to passing the licensure examination, these board passers are

now ready to take responsibility by swearing an oath or pledge. There are different

kinds of pledges/oaths, the Florence Nightingale Pledge (for Nurses), the Physical

Therapist Oath, Radiologic and X-Ray Technologists Code of Ethics etc., but all of

these pledges and codes are anchored to the Hippocratic Oath.

According to the editor in Chief of Nova online, Peter Tyson, The

Hippocratic oath is one of the oldest binding documents in history, the Oath written

by Hippocrates is still apprehended by physicians sacredly: to treat the ill to the best

of one's ability, to preserve a patient's privacy, to teach the secrets of medicine to the

next generation, and to not be the cause to harm the patient’s life. It states the

obligation and proper conduct of all physicians, formerly taken by those beginning

medical practice. A part of the oath states that “I will remember that I do not treat a

fever chart, a cancerous growth, but a sick human being, whose illness may affect the

1
person's family and economic stability. My responsibility includes these related

problems, if I am to care adequately for the sick. I will prevent disease whenever I

can, for prevention is preferable to cure.” Despite of this statement, that they are

responsible to prevent its disease and treat a human being whenever they can, some

hospitals still reject patients in an emergency situation. The Emergency Medical

Treatment and Labor Act (EMTALA) is a law that establishes a “Treat first, Ask

question later” policy. It serves as dual purpose by protecting both private hospitals

and patients. It indicates that private hospitals have the right to turn down patients

except patients who needs emergency treatments. It also states that people who are

unlawfully denied by a hospital for the cause of not being able to pay or lack of

insurance has the right to contact a local malpractice attorney.

Life, dignity and morale are at stake. With so much at risk, such issues

should not be ignored.

STATEMENT OF THE PROBLEM

This study is all about the rejection of Private Hospitals to patients who is

incapable to pay in an emergency situation will be furthermore distinguished the

answer to the question below:

1. Do hospitals really reject patients in an emergency condition?

2. What is the disadvantage that may result to the hospital that’s been

alleged to reject patients in an emergency situation?

3. What can be the effect /s to the denied patients and their family?

2
ASSUMPTION/HYPOTHESIS

This study is assuming that hospitals turn down destitute patients because they

are prioritizing the patients who have the capability to pay. The rejection may highly

affect the patient’s family condition and patient’s life to the point of losing it. It may

also influence other people’s opinion to a certain hospital’s credibility for the reason

that these hospitals have rejected patients even in an emergency situation.

SIGNIFICANCE OF THE STUDY

This study will pave the way to clear the issue among hospital staffs from a

private hospital and to the patients who felt rejected. This research’s goal is to know if

they are rejecting patients who can’t afford the payment despite of the oath they have

committed. It also aims to find out the effects to the patients that are rejected.

SIGNIFICANCE FOR THE PATIENTS

To be fully aware that there is a possibility that unexpected incidents might

happen that is beyond the aid the hospital can offer. As an example, you had an

emergency or life and death situation and the only hospital near your location is a

private hospital. Through this, you will be able to prevent higher loss.

SIGNIFICANCE FOR THE HOSPITALS

This can be a way to eliminate the discrimination between the poor and rich

patients, also known as economic inequality in a hospital. This will help to bring back

the hospital’s dignity in the peoples view.

3
 SCOPE AND DELIMITATION

This study will be conducted with the participation of thirteen (13) respondents,

randomly picked and composed of ten (10) patients and three (3) hospital staff (like

doctors, nurses, and the like). The inclusion criteria for the patients are: they have

experience being rejected in a hospital. For the hospital staff: anyone experienced in

the emergency department. Gathering of data will start from September 2015 to

March 2016.

DEFINITION OF TERMS

 admission - a full stay. The formal acceptance by a hospital or other inpatient health

care facility of a patient who is to be provided with room, board, and continuous

nursing service in an area of the hospital or facility where patients generally reside at

least overnight.

Source: http://medical-dictionary.thefreedictionary.com/hospital+admission

 appraisal. An assessment or estimation of the worth, value, or quality of a person or

thing.

Source: http://www.thefreedictionary.com/appraisal

 down payment. a first payment that you make when you buy something with an

agreement to pay the rest later

Source: http://www.merriam-webster.com/dictionary/down%20payment

 economic inequality. Also known as income inequality, wealth inequality, gap

between rich and poor, gulf between rich and poor and contrast between rich and

poor, refers to how economic metrics are distributed among individuals in a group,

among groups in a population, or among countries.

Source: https://en.wikipedia.org/wiki/Economic_inequality

4
 EMTALA (Emergency Medical Treatment and Labor Act). The Emergency

Medical Treatment and Labor Act (EMTALA) is a federal law that requires anyone

coming to an emergency department to be stabilized and treated, regardless of their

insurance status or ability to pay, but since its enactment in 1986 has remained an

unfunded mandate.

Source: www.acep.org/News-Media-top-banner/EMTALA/

 fever chart. Is a graphical representation showing change of a variable over time.

Fever charts are used for data that changes continuously, like stock prices. They allow

for a clear visual representation of a change in one variable over a set amount of time.

Fever charts are sometimes called time-series charts.

Source: whatis.techtarget.com/definition/fever-charthippocrates

 Hippocrates.  ( born c. 460 BC, island of Cos, Greece—died c. 375 , Larissa,

Thessaly), ancient Greek physician who lived during Greece’s Classical period and is

Source: http://www.britannica.com/biography/Hippocrates traditionally regarded as

the father of medicine.

 Hippocratic Oath. (Ορκος) is perhaps the most widely known of Greek medical

texts. It requires a new physician to swear upon a number of healing gods that he will

uphold a number of professional ethical standards.

Source: https://www.nlm.nih.gov/hmd/greek/greek_oath.html

 oath. A solemn appeal to a deity, or to some revered person or thing, to witness one's

determination to speak the truth, to keep a promise, etc.:

Source: http://dictionary.reference.com/browse/oath

 pledge. A solemn promise or agreement to do or refrain from doing something

Source: http://dictionary.reference.com/browse/pledge?s=t

5
 primary care hospitals.  is the day-to-day healthcare given by a health care provider.

Typically this provider acts as the first contact and principal point of continuing care

for patientswithin a healthcare system, and coordinates other specialist care that the

patient may need.  Source: https://en.wikipedia.org/wiki/Primary_care

 Professional Regulation Commission. The Professional Regulation Commission is

the instrument of the Filipino people in securing for the nation a reliable, trustworthy

and progressive system of determining the competence of professionals by credible

and valid licensure examinations and standards of professional practice that are

globally recognized. 

Source:http://www.resultslet.com/p/professional-regulation-commission.html

 Psychometricians. A psychometrician is someone who practices the science of

educational and psychological measurement, or in other words, testing.

Source:http://www.altalang.com/beyond-words/2009/11/12/psychometricians-what-

they-are-and-what-they-do/

 referral. The process of directing or redirecting (as a medical case or a patient) to an

appropriate specialist or agency for definitive treatment.

Source: http://www.merriam-webster.com/dictionary/referral

  secondary care hospital. refers to a hospital which can support licensed physicians

in pediatrics, obstetrics, and gynecology, general surgery and etc.

Source: https://en.wikipedia.org/wiki/Secondary_hospital

 rejection. To turn down (an applicant, as for a job); refuse to accept.

Source: http://www.thefreedictionary.com/rejection

 tertiary care hospital.  (also called a tertiary hospital, tertiary referral center,

or tertiary care center, or tertiary center) is a hospital that provides tertiary care, which

6
is health care from specialists in a large hospital after referral from primary

care and secondary care.

Source: https://en.wikipedia.org/wiki/Tertiary_referral_hospital

CONCEPTUAL FRAMEWORK

The illustration shows and presents the process and reviews of the hospitals in

admitting patients that is incapable to pay. This study aims to know the standard

procedures and the legal processes on hospital admissions in accordance to the

Emergency Medical Treat and Labor Act (EMTALA), and Hippocratic Oath.

Figure 1.Hippocratic Oath: Rejection of Patients in a Hospital.

Emergency Situation

Hippocratic Oath
Hospital Denied Patients
&EMTALA

Emergency On-Call Procedure or/and Patient’s

Disadvantages for the private Effects of the

Changed perception of the people to

REVIEW OF RELATED LITERATURES

This chapter includes the ideas, generalization or conclusions, methodologies

and others. The review focuses on the rise of patients and responsibilities of the

professionals those that were included in this chapter helps in familiarizing

information that are relevant and similar to the present study.

According to Pellegrino (2008), Medicine as a profession, demands of

physician’s extraordinary moral sensitivity as they respond to patient’s vulnerability.

The importance of a unique medical morality cannot be understated. Customs, social

mores, and politics all too readily become moral norms without principled

justification. For that reason, medicine requires guidance from a central medical ethic

that is formalized in a professional oath that can at least offer some resistance to

fluctuating social opinion (2008). In the Encyclopedia of Ethics, Ruddick stated that

being a medical practitioner he/she must have a good character and passion in his

profession, which means he need to put all his heart, mind, body, time and soul to

save his patient and to extend the patient’s life (1998).

The Hippocratic Oath, written by Hippocrates, was revised by Louis Lasagna

(1964) into a modern version as it is stated:

I swear to fulfil, to the best of my ability and judgment, this covenant:

I will respect the hard-won scientific gains of those physicians in whose steps I walk,

and gladly share such knowledge as is mine with those who are to follow.

8
I will apply for the benefit of the sick, all measures which are required, avoiding

those twin traps of overtreatment and therapeutic nihilism.

I will remember that there is art to medicine as well as science, and that warmth,

sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug.

I will not be ashamed to say "I know not," nor will I fail to call in my colleagues when

the skills of another are needed for a patient's recovery.

I will respect the privacy of my patients, for their problems are not disclosed to me

that the world may know. Most especially must I treat with care in matters of life and

death. If it is given me to save a life, all thanks. But it may also be within my power to

take a life; this awesome responsibility must be faced with great humbleness and

awareness of my own frailty. Above all, I must not play at God.

I will remember that I do not treat a fever chart, a cancerous growth, but a sick

human being, whose illness may affect the person's family and economic stability. My

responsibility includes these related problems, if I am to care adequately for the sick.

I will prevent disease whenever I can, for prevention is preferable to cure.

I will remember that I remain a member of society, with special obligations to all my

fellow human beings, those sounds of mind and body as well as the infirm.

If I do not violate this oath, may I enjoy life and art, respected while I live and

remembered with affection thereafter. May I always act so as to preserve the finest

9
traditions of my calling and may I long experience the joy of healing those who seek

my help.

An oath is taken to mean the solemn pronouncement by which members of a

profession establish collective ethical standards and delineate acceptable professional

behaviour reflective of their unique roles and obligations in society. In the face of

such modern challenges as the quality-of-care crisis, the third-payer system, and the

burgeoning financial cost of health care, considerations of that professional oath and

discourse on medical morality are more critical than ever (Pellegrino, 2008).

The main purpose of the Hippocratic Oath is for the Physicians to give their

very best to cure and to not do any harm to the patient’s life. In relation to this, Dr.

Steve Pantillan (2008) clearly stated in “Beneficence vs. Nonmaleficence” that

medicine was created for the skilled Physicians who are knowledgeable enough to

help for the benefit of the patient’s health and to decrease the higher risks of ham at

any kind of treatment, medications, and procedure.

Patients’ rights vary in different countries and different jurisdiction, often

depending upon prevailing cultural and social norms. Different models of the patient-

physician relationship which can also represent the citizen-state relationship have

been developed, and this may have to inform the particular rights to which patients

are entitled. According to Clayton (1948), the Universal Declaration of Human Rights

recognizes “the inherent dignity” and the “equal and unalienable rights of all members

of the human family”. And it is on the basis of this concept of the person, in the

fundamental dignity and equality of all human beings, that the ideas of patient’s rights

were developed. In other words, what is owed to a patient as a human being, by

10
physicians and by the state, took shape in large part thanks to this understanding of

the basic rights of the person.

The Universal Declaration of Human Rights has been instrumental in

enshrining the notion of human dignity in international law, providing a legal and

moral grounding for improved standards of care on the basis of our basic

responsibilities towards each other as members of the “human family”, and giving

important guidance on critical social, legal and ethical issues. But there remains a

great deal of work to be done to clarify the relationship between human rights and

right to health, including patient’s rights.

Assuring that the rights of patients are protected, it requires more than

educating policy makers and health providers; it requires education citizens about

what they should expect from their governments and their health care providers- about

the of treatment and respect they are owed. Citizens, then, can have an important part

to play in elevating the standard of care when their own expectations of that care are

raised (Cooper 2003).

According to Annas (2003), common medical practice meant that physicians

made decisions for their patients. This paternalistic view has gradually been

supplanted by one promoting patient autonomy, whereby patients and doctors share

the decision-making responsibility. Consequently doctor-patients relationships are

very different now than they were just a few decades ago. However, conflicts still

abound as the medical community and those it serves struggle to define their

respective roles.

Wolf (2001) stated that approximately hundreds of hospitals violate the

Patient-dumping law that requires them to: offer an immediate emergency care to

11
anyone, not considering the fact that the person injured doesn’t have the ability to pay.

Wolf also included that leaving a patient unintended is a national disgrace.

In Japan, a case was reported when a 75-year-old man from Tokyo who has

problem with breathing died for the reason that while being driven around by an

ambulance for two hours, he was rejected 36 times by 25 hospitals. The local news

organization was informed by a paramedic that they had never experienced a patient

being rejected so many times (Daily Briefing, 2013). With same case, a dying child

was refused to be admitted in a private hospital in Butuan City, Philippines because of

deposit issue (Aquino &Reyes, 2014).

The Secretary of the Department of Health, Enrique Ona (2014), stated that

the essence of Kalusugang Pangkalahatan is that every Filipino should have equal

access to healthcare without considering their status in life.

Sustaining the statement, Republic Act No. 8334 of the Republic of the

Philippines (1997), Section 1 of Batas Pambansa Bilang 702 declares that in an

emergency situation an advance payment must not be the qualification for the

admission or for an injured to be treated urgently at any kind of hospital. On the other

hand, a hospital that has not enough facility has the right to transfer a patient into

another hospital that has the capability to treat the patient.

Congress passed the Emergency Medical Treatment and Active Labor Act

(EMTALA,1986), that aims to inhibit “patient dumping” or the disagreeable rejection

to “any emergency patient or to any woman in active labor”, they must be entertained

using proper treatment and care. Transferring of patients must not be permitted when

first aid was not given, for it may cause greater harm to the patient’s life.

12
 In an emergency situation, a patient has a right to treatment, regardless of

ability to pay. If a situation is likely to cause death, serious injury, or disability if not

attended to promptly, it is an emergency. Cardiac arrest, heavy bleeding, profound

shock, severe head injuries, and acute psychotic states are some examples of

emergencies. Less obvious situations can also be emergencies: broken bones, fever,

and cuts requiring stitches may also require immediate treatment. Both public and

private hospitals have a duty to administer medical care to a person experiencing and

emergency. If a hospital has emergency facilities, it is legally required to provide

appropriate treatment to a person experiencing and emergency. If the hospital is

unable to provide emergency services, it must provide a referral for appropriate

treatment. Hospital cannot refuse to treat prospective patients on the basis of race,

religion, or national origin, or refuse to treat someone with HIV or AIDS (Barnes,

2002).

The proposed right of patients include: the right to receive accurate, easily

understood information in order to make informed health care decisions; the right to a

choice of healthcare providers that is sufficient to ensure access to appropriate high-

quality health care; the right to access emergency healthcare services; the right and

responsibility to fully participate in all decisions related to their health care; the right

to considerate, respectful care from all members of healthcare system at all times and

under all circumstance ; The right to communicate with acceptance of the autonomy

of the patients makes that attitude unacceptable to physicians and the public alike.

Patients that are admitted for full recovery after being treated with immediate

care must not be apprehended to the cause of not being able to pay the hospital bills or

other expenses partially or in full. Hospitals don’t have the right to detain a patient.

13
Thus, the patient must have a promissory note carrying the obligation to pay the

unsettled bills (Republic Act No.9439, Section 1&2).

Private Hospitals offers services either an inpatient setting or an outpatient

setting, acute or rehabilitation comes with charges depending on the level of damage

(H. Wadee, 2007). There is no universal right to be admitted to a hospital in a

nonemergency situation. In nonemergency cases, admission rights depend largely on

the specific hospital, but basing admission on ability to pay is severely limited by

statutes, regulations, and judicial decisions. For example, most hospitals obtained

financial assistance from the federal government for construction; there hospitals are

required to provide a reasonable volume of services to persons unable to pay (Barnes,

2002).

According to Pellegrino (2008), the Hippocratic Oath, in reality, has yet to be

removed for three central reasons that defend its inertness. Firstly, some of the content

of the Hippocratic Oath is still relevant; therefore, physicians maintain the Oath in its

central position out of respect for its longevity. Further, the legalistic nature of the

Oath, irrespective of underlying ethical reasoning, offers some protection to

physicians in an era when medical litigation and frivolous lawsuits render medicine a

legally perilous endeavour. Finally, some physicians argue to maintain the

Hippocratic Oath out of sheer practicality that the vast majority of medical

professionals are not directly concerned about the Oath’s status and therefore it should

not be changed. One argument for why the Hippocratic Oath should be maintained as

the central guide for medical ethics rests on the canon’s historical longevity and the

fact that some of its content is still relevant, It was this document that formalized the

central medical responsibilities of non-malfeasance and competence as well as

asserted the appropriateness of yielding to specialists, guarding against financial

14
corruption, and ensuring confidentiality (Pellegrino, 2008). With such substantial

contributions to the medicine have survived millennia, the argument can be made that

the Hippocratic Oath needs only to be culturally modified to be kept.

Dr. Pellegrino’s 2nd part of medical ethic is a defensible and appropriate

replacement for the Hippocratic Oath. That ethic contains both a “universal set of

precepts about the nature of medicine” to which all physicians must subscribe as well

as “allowance for the personal philosophical and theological beliefs” of the physician

(Pellegrino, 2008). It is suitable for two reasons. Firstly, it maintains the act the

profession as a public declaration is needed to establish physician-patient contracts.

Secondly, it rests upon the philosophical foundation that asserts that healthcare

providers in confidence and to have the confidentiality of their individually

identifiable healthcare information protected; the right to a fair and efficient process

for resolving differences with their health plans, healthcare providers, and the

institutions that serve them; and the responsibility of consumers to do their part in

protecting their health.

Even though there’s an existence of rights for every patient, some

hospitals/professionals still discard some or most of them. There are several reasons

that the Hippocratic Oath should be removed as a central medical ethic. Firstly, the

classical version contains such a grave omission that is not salvageable, namely the

omission of a medical value now taken as essential: patient autonomy. The

Hippocratic Oath, in a failed attempt to address that omission, has language that is too

vague and does not meet the challenge of the complex modern healthcare landscape.

Finally, neither the classical nor the modern Hippocratic Oaths offer philosophical

explanation for their dictates, and in never addressing philosophically why medical

professionals are held to a special standard, they render themselves unjustified.

15
 Any argument for the removal of the Hippocratic Oath from modern medicine

must begin with unacceptable nature of many of its original precepts: “there are

serious problems in reliance on a set of texts that is 2500 years old” (Pellegrino,

2008). Firstly, the paternalist nature of the Oath, with is portrayal of an exclusive

fraternity of gentlemen-doctors as stewards of all medical knowledge and morality, is

sexist and elitist in the modern democratic context (Thomasma, 2008). The ancient

religious foundation of the Oath has become irrelevant, and current divergence of

opinion on specific issues such as abortion and euthanasia make the original Oath

intolerable (Pellegrino, 2006). Perhaps most egregious within the original Oath is the

subjugation of the patient as normatively subordinate: “If the physician is to help, his

relationship to the patient must be that of the person in command to one who obeys”

(2008). Modern medicine requires particular moral vigilance of the physician due to

the vulnerability of the patient in the physician-patient relationship. Thus, the precepts

provide a pragmatic, philosophically sound alternative to the Hippocratic Oath.

Medicine as a profession attracts a wide variety of individuals with divergent

personal values and beliefs and, in many ways (Marcum, 2008). A physician may

view ‘medicine’ as a means to help the sick, an institution, a lifetime of personal

relationships, a profitable business, an organic expression of human empathy, a

rigorous application of scientific innovation, or a disciplined body of knowledge. This

myriad of interpretations necessitates a unified philosophical grounding for medicine

and an agreement within the medical professional community on ethical constraints.

The Hippocratic Oath fails to meet those demands. Founded on the patient-physician

relationship as the central unique bedrock of medicine, Pellegrino’s precepts make an

appropriate and defensible replacement so long as precept 5 and precept 11 are

removed because they violate physician autonomy. Guided by an Oath with a strong

16
philosophical basis and clearly defined precepts. Physicians will be better equipped to

approach the challenges of practicing medicine in the modern United Sates in an

ethical and socially-just manner.

We have cited different literatures and articles that involves Human Rights,

Patient’s Right, Medical Ethics, Medical Philosophy, Hippocratic Oath including

Ethical, legal and social implications that will support our study which concentrates to

the refusal of private hospitals in the admission of a patient undergoing an emergency

situation discovering the possibilities that a hospital has Immunity in the said

situation. This study is also concerned to the possible effects of the denied treatment

to a patient and its family.

17
 CHAPTER THREE

METHODOLOGY

The fundamentals of this chapter deals with the researcher’s step by step

process in obtaining facts about the research. According to Polit and Hungler (2004),

methodology is a method to acquire, categorize, and analyze data gathered in which

rely on the kind of research question.

RESEARCH DESIGN

The study focused on qualitative research that deals with the data gathered

from interview stage. This research also deals with the opinion, behaviour and

perceptions of other people about the topic. Complimentarily, research design is based

on the conceptual framework, methods, and the assumption of the study by how it is

presented (Maxwell, 2009). That will briefly center to the effects of the hospitals

denying patients, and to the denied patients. This kind of research is conducted in

different ways like having an interview by person through electronic devices and

journal exercises. It is more descriptive ideas from other than predictive ideas. The

researchers design this qualitative research in order to gather information/ data to

support the topic.

RESEARCH LOCALE AND PARTICIPANTS

The study was conducted within these three hospitals namely: Divine Grace

Medical Center in Tejero General Trias, Cavite, De La Salle University Medical

Center in Dasmariñas, Cavite and General Trias Medical Center in Manggahan,

General Trias, Cavite.

18
 From these hospitals the researchers have interviewed twenty five

participants. The participants were composed of five hospital staffs and twenty

patients that are picked based on two categories: former patients and people who lived

around the area.

RESEARCH INSTRUMENTS

The researchers provided instruments and equipment to gather data

seamlessly. These equipment are specifically a voice and video recorder for the

interview, cell phone and telephone for on-call procedure, laptop for research and

editing purposes and a questionnaire.

DATA GATHERING PROCEDURES

The researchers conducted an unstructured interview or may also be

referred as discovery interview to emergency personnel and patients subject to the

rejection at the selected hospitals in order to clarify or to find out the reason behind

the rejection of patients that is incapable to pay. The use of flexible questions made it

easier for the participants to express their answers in more than one word. It also

helped the researchers gain valid statements without taking the participants aback

with the given open-ended questions. The researchers also used on-call procedures,

which are recorded, that provide data without the knowledge of the hospital involved.

19
 CHAPTER FOUR

RESULTS AND DISCUSSIONS

This chapter contains facts and information gathered by the researchers

through careful interviews and analysis that will probably allow the people to clearly

view both sides of the variables involved: “rejected” patients and staffs of private

hospitals from the emergency department. This chapter also comprises the discussion

about the determined results of the study.

Results

Hospital staff participants

Interviewer: Ano pong pangalan niyo?

Interviewee: Doctor Ian Gutierrez sa internal medicine dito sa UMC.

Interviewer: Ano po yung current position niyo po?

Interviewee: 2nd year Internal Medicine resident ako.

Interviewer: Gaano na po kayo katagal nagtatrabaho dito?

Interviewee: Sa hospital 2 years na ako resident tapos pero andito na ako since 2013

nag start as intern tapos ngayon co- resident na.

Interviewer: So medyo matagal na rin po.

Interviewee: So bali mga 3 years na rin ako nasa hospital

20
Interviewer: So siyempre po diba iba’t ibang mga pasyente ang pumupunta dito.

Paano niyo po nahahandle yung dami ng pasyente?

Interviewee: One at a time lang tapos prioritization lang kung sino ang kailangan

unahin kailangan puntahan muna. Halimbawa nahirapang huminga syempre yun yung

priority muna or nagche-chest pain nagpaprioritized.

Interviewer: Sa isang araw po ano po ang estimated dami po ng pasyente dito po sa

ospital?

Interviewee: Dito sa Emergency room siguro per day mga 150 patients a day 150

patients dito ang nakikita. Pero dito sa IM siguro mga internal medicine mga 100

patients.

Interviewer: Pwede po ba kayong mag enumerate ng mga cases po from minor to

major po?

Interviewee: Cases from minor to major mahirap yun ah. Pero ang common cases na

nakikita namin dito ay Pneumnia, Diarrhea tapos ay UTI mga ganun tapos mga Heart

Attack tapos Cardiac Percussion tapos mga Stroke patients, Pero ang pinaka number 1

ay yung hypertension.

Interviewer: Paan po pag walang pera yung pasyente?

Interviewee: Meron kaming charity beds, Charity wards tapos yung talaga for

consultation meron kaming Out Patient Department Service. Doon sila pinapa punta

kasi dito sa emergency room may payment agad, 600 pesos pag may consultation.

Interviewer: Ano po yung referral?

21
Interviewee: Yung referral kapag halimbawa, kapag one department to another

department for example may surgery may dumating na patient na may abdominal pain

dumating dito sa emergency room initially mapupunta muna siya sa surgical

department tapos saka siya irerefer dito sa internal medicine para matignan namin,

yun ang ibig sabihin ng referral.

Interviewer: Sir, bakit po dun sa sinabi nyo po na may payment po agad. Paano po

kung hindi po talaga sila makakabayad?

Interviewee: Pag hindi makapagayad usually may promissory note naman kaya okay

lang naman atleast kung hindi sila makakabayad for a mean time.Parang may utang

sila sa hospital na pwede nila bayaran in future para makalabas agad sila or makapag

transfer sila ng hospital para mafacilitate ang admission nila.

Interviewer: Pag emergency po meron po ba?

Interviewee: Wala, walang bayad pag emergency talaga yung kailangan talagang

operahan kahit walang bayad iyon na ia-up naman.

Interviewer: Saan po ba ibibigay yung promissory note?

Interviewee: Hindi naman kailangan ng promissory note pag emergency.

Interviewer: Thank you po sir.

Hospital staff participants

Interviewee: Head Nurse ako pero sa operating room pero nagkaroon ako ng prior to

that siguro mga 5 years, kasi 13 years na ako siguro mga 7 or 8 years ago nagduduty

doon pero malapit lang kasi ang operating room at emergency room so typically

masasagot ko rin naman. Pero yung position ko kasi is Head nurse.

22
Interviewer: Saang Hospital po kayo nagtatrabaho?

Interviewee: General Trias Maternity and Pediatric Hospital sa Tejero.

Interviewer: Mahirap po ba sa emergency room?

Interviewee: Depende kasi yan kasi sa nursing, kapag halimbawang nakagraduate ka,

halimbawa pumasa ka sa board exams tapos mag aapply ka, yung areas mo kasi is

may training so kung ikaw ay nakapagtraining naman ng maayos magagawa mo

naman pero ang kailangan kasi dyan meron for me may characteristics ang nurses pag

dating sa bawat area for example sa E.R. kasi dapat hindi mahina yung loob mo for

one, to patients and to relatives kasi yung mga pasyente iba-ibang kaso ang makukuha

mo araw-araw may mga minor lang ibig sabihin yung mga typical lang na sakit,

meron din naman na mabibigat yung sakit and secondly yung mga relatives or yung

mga kasama nung pasyente kailangan icoconsider mo rin yun, kasi may mga relatives

na madaling kausap meron din naming mahirap kausap, so nasa training yun e, lahat

ng areas, lahat naman ng trabaho is mahirap sa una pero as you go on with the training

magiging madali din kasi kahit ako tanungin niyo ako sa operating room kung

mahirap ba syempre initially sabihin ko is oo kung hindi kapa nakakapagtraining kasi

may mga fears yan e halimbawa may sakit ka sa ganito, ganyan, nerbyoso ka, sa una

mahihirapan ka pero as you go on hindi na ganun kahirap.

Interviewer: Pano po pag wala pong pangbayad yung mga pasyente sa emergency?

Interviewee: Ganito yan, sa government hospital kasi the policy is you accept every

patient na pupunta sa inyo walang kailangang deposit, walang kailangan hihingiin na

pambayad different from the private hospitals, private hospitals kasi is a from the

name itself private sector ang nagpapalakad niyan or kaya yung mga cooperation or

23
family or kaya naman a single person or a group na hindi hawak ng gobyerno, yung

rule ng private hospitals pag dating sa ganyang admission is medyo may kaibahan lalo

ng yung pagtanggap ng deposits, kasi may policy rin na sarili ang private hospital

pero on the existing law sa atin, sa medical field kahit na ang mga private hospital is

hindi pwedeng tumanggi ng pasiyente, may mga certain fees lang na kailangan sila

iconsider bago sila i-admit pero yung mga check-up lahat tinatanggap yun.

Interviewer: Bago po i-admit, pano po kung parang critical condition?

Interviewee: Sa Critical patients kasi yun yung sinabi ko kasi may mga hospital kasi

iba iba yan may primary, secondary, tertiary kung ang kaso ng pasiyente is hindi

kayang ihandle sa primary hospital yung pang secondary, pag tertiary kasi pag

sinabing secondary and tertiary may mga machines diyan, may mga gamit na hindi

mo makikita, hindi mo matatagpuan sa primary hospital kasi primary level nga lang,

lahat ng primary level ang tatanggapin lang niyan is yung mga sakit na pang primary

lang talaga, yung mga pang secondary pang secondary, yung pang tertiary pang

tertiary so kapag yung mga sinasabi mo na critical yung sakit ia-assess yan kung

halimbawang hindi kakayanin sa primary naturally itatransfer siya, hindi siya yung

rejection pero transfer. Pwede din namang mag decide yung pasyente or yung relative

ng pasyente kung mag stick parin sila dun kahit na sinabi na sa kanila na hindi kaya

dito or magpipirma sila na ita-transfer sa ibang hospital, kasi depende yun e

halimbawang hindi kakayanin sa primary hindi ipipilit yun kasi magkakaroon naman

ng compromised situation sa pasyente kasi halimbawa hindi naman kaya sa hospital

na ito, pero pinilit parin natin wala namang gamit, maco-compromise yung sakit nung

pasyente baka mas lalo pa siyang lumala or more so na maging mortality so depende

iyon, tsaka isa pa, kung tatanungin mo yung pambayad kasi may mga appraisal na

tinatawag sabi ko nga pag check-up tinatanggap lahat ‘yan kapag halimbawa namang

24
for admission ang gagawin sa kanila, is pupunta muna sila sa admitting office para

iappraise sila “what do you mean with appraisal?” for example ma’am ganito po, per

day po dito ay ganitong amount and medicines po, ang doctors po ay ganito ang

appraisal po sa inyo more or less for the 24 hours ay ganitong presyo, so nasa

pasyente yun or nasa relative ng pasyente if they want to go on with the admission or

not. Kasi kahit naman tayo diba, kung halimbawang narinig natin yung appraisal na

ganun nasa sa atin kung kaya ba natin to or hindi, so ang mangyayari is same thing

with the condition with the pasiyente, kung halimbawa ay hindi ko po kaya, pipirma

sila, ita-transfer sila pero kapag halimbawa na talagang yung mga kailangan muna ng

emergency medications, kailangan muna ng first aid bibigyan muna yan ng first aid,

bibigyan muna ng emergency drugs, emergency care, bago sila i-transfer. Hindi

pwede yung pagdating mo dun tapos halimbawa critical yung pasiyente, for example

is manganganak pag nandiyan na yung baby hindi muna pwedeng itransfer yun

talagang paanakin muna doon.

Interviewer: Paano po yung first aid may bayad rin po yun?

Interviewee: Depende. Kung ano ang ibibigay na first aid for an oxygen and i-

stabilize lang yung pasyente halimbawa is mga medicine, may bayad yun pero kung

halimbawang oxygen lang yung tiningnan lang, kung ano ang situation mo or

halimbawa nilagyan lang ng splint, halimbawa naaksidente or nakita mo na nafracture

yung kamay nilagyan lang ng temporary splint wala na yun, ewan ko lang sa ibang

hospital pero alam ko sa ibang hospital is may emergency room fee pero sa hospital

na pinagtatrabahuhan ko, they don’t collect emergency room fee walang bayad yung

pagstay mo sa emergency room pero ang alam ko sa malalaking hospital just like sa

Divine, may bayad ang pag stay sa emergency room, may bayad ang emergency care

mo kahit na doon ka pa iaadmit, may emergency room fee parin more so pag

25
itatransfer ka, basta yung mga bibigay na gamot and supplies na ibibigay sa pasyente

is babayaran niyo.

Interviewer: So as Nurse po, ano po yung stand niyo sa parang iniisip ng mga tao dun

sa rejection ng patients dahil wala pong pangbayad?

Interviewee: Marami kaming instances na tatanggapin sa hospital without considering

the monetary situation, tatanggapin niyan ang problema is bibigyan muna ang lahat

ooperahan mo tapos hindi makakabayad, so ang mangyayari sa hospital na

pinagtatrabahuhan ko is they would really have to stay to the hospital minsan

pumipirma nalang ng waiver or kaya naman nag aapply sa Philippine Charity, ang

stand ko kasi doon is hindi lang as a nurse pero as yung percent as individual, “I don’t

think I can manage the monitary situation ng isang hospital, why would I go there?”

Diba, kung halimbawa, kung ang kaya lang ng finances ko is pang public, I would

raise my time and effort to go to a public hospital rather than go to a tertiary na

magSt. Lukes ako na hindi ko naman kaya, so ang pangit lang kasi is ang tingin ng iba

tao is hospitals reject patients because of pambayad, no, ang ano kasi dun is

cinoconsider din naming just like yung sinabi ko kanina yung sitwasyon nung hospital

we don’t want to risk the health and the condition of the patient kung hindi naming

kakayanin, and regarding din dun sa stand parang masyadong malalim na word yung

rejection we rather call it as a transfer of the patients choice, kaya nga may tinatawag

kaming transfer to hospital of choice, kasi from the name itself yung relative parin at

yung pasiyente parin meron parin silang stand sa pag lipat nila, hindi lang yung

hospital may stand parin sila kasi lahat ng advantages and disadvantages lahat ng mga

points mga percept, ineexplain naman ng mga doctor yan tsaka ng nurse hindi basta

basta palilipatin, paaalisin nalang yung pasiyente, I’m speaking for my work place

kasi hindi ko naman alam yung sa ibang ospital kasi may mga naririnig-rinig tayong

26
mga news na basta nalang papalipat ng ganito, kasi from the hospital that I’m working

from, ganun kami pagkailangan ng first aid, first aid muna kung kailangan itransfer

first aid muna bago itransfer yung mga critical na pasiyente intubate muna bago

itransfer kasi hindi rin naman tatanggapin sa ibang hospital yun e. kapag halimbawa

ng pinatransfer mo tapos wala kang ginawa kasi the first thing that they would ask

from doon sa pasiyente and relative is may pinanggalingan naba kayong hospital?

Kapag nalaman nila na nanggaling kami ditto sa hospital na ganito at walang ginawa

most probably hindi nila tatanggapin so kailangan muna stabilize muna yung pasyente

bago itransfer the word rejection is very deep, sa pinagtatrabahuhan ko is we don’t

reject patients from the simple situations. We transfer them with the points.

Continuation of Interview:

Interviewer: Kami po yung nag-interview nungnakaraan.

Interviewee: Oo.

Interviewer: Ipa-follow up lang po namin, meron po kaming konting katanungan po

ulit.

Interviewee: Ah, okay.

Interviewer: Meron po bang posibilidad po na, kasi nga po diba maraming pasyente sa

emergency room, meron po bang posibilidad na hindi po ma-explain dun sa pasyente

kung bakit nare-reject. Kung bat’ hindi po tinatanggap, I mean.

Interviewee: Ah, anong ibig mong sabihing posibilidad, na hindi nila maintindihan?

Interviewer: Na-hindi po maiexplain nung staff.

27
Interviewee: There’s no way kasi na may possibility na hindi maexplain, kasi hindi

pwede na paalisin or hindi pwede na i-transfer yung pasyente na hindi naeexplain ng

maayos, so kailangan talaga na maexplain yon ng maayos bago mailipat yung

pasyente. So for me ha, sa trabahong pinagtatrabahuhan ko, walang posisbilidad na

hindi dapat maipaliwanag ng maayos kasi hindi nila maiintidihan lalo at lalong di sila

makakalipat ng maayos kung hindi natin ipapaliwanag ‘di ba.

Interviewer: Kahit po sobrang critical napo nung case nung pasyente?

Interviewee: Panong sobrang critical, kase di ba, kapag halimbawa ang pasyente is

kailangan muna bigyan ng emergency treatment or first aid treatment bago mailipat

yon sa ibang hospital, hindi naman pagkadating sa Hospital ay tatanggihan agad iyon

or papalipatin agad, kung halimbawang critical yung patient bibigyan muna yon ng

first aid yon tsaka emergency treatment bago mailipat or maitransfer sa ibang

institution.

Interviewer: Pano po pag buntis?

Interviewee: Pag buntis, case to case basis, siyempre kung halimbawang nan dyan na

manganganak na papaanakin na yon, hindi muna maililipat yon, hindi na naming

masasabi sa pasyente or sa relatives ng pasyente naililipat, pero ia-assist yon ng

doctor, pagna-assist na kung kakayanin pa na lumipat, katulad nang sinabi ko dati

kung may circumstances na talagang hindi nila kakayain or kailangan nila ng mga

special na facility para dun sa pasyente ita-transfer sila sa ibang lugar pero kung

halimbawa naman nandyan na talaga manganganak na e walang choice kundi

paanakin na yon.

28
Interviewer: Pano po pag kunyare po nag mamadali po yung pasyente, diba po di na

nila kayang antayin yung pag e-explain ng staff sa kanila, pwede na po ba silang

umalis agad ng wala pong explanation galling sa staff?

Interviewee: Nasa sa kanila yon kasi it would go down to the point na sila din naman

ang maaapektuhan, di ba sila ang pumunta sa hospital they have the right and they

have the purpose na mag pagamot diba, ngayon kung sila ang aalis, they would rid

kung anuman ang magiging result nung bigla nilang pagalis diba, tsaka kapag ang

mga pasyente ay pinapatransfer sa ibang institution meron silang pinipirmahan

katunyan nasila ay pumayag at nakinig dun sa medical doctor at medical staff

naipinaliwanag sakanila kung bat’ sila kailangang lumipat, so may pipirmahan sila,

hindi sila pwede basta basta nalang umalis, nasa sa kanila yon kung gusto talaga nila

na hindi na sila makapagantay, nasa sa kanila yon kung ano magiging resultang

aggressiveness nila at yung illusion na yon.

Interviewer: Meron po kaming nainterview na pasyente buntis po siya tapos inadmit

po siya, kaso wala po silang enough na pera, ang ginawa po dinettained po yung baby

pero pinalabas po yong nanay, pwede po ba yon?

Interviewee: Pina-stay yung baby?

Interviewee: Opo, para pong dinettain yung baby, di nya po kayang kuhanin yung

baby.

Interviewee: May mga ano kasing cases, may mga baby kasi na kaya nila iniistay

muna kasi may kinukumpleto pang gamut doon sa hospital, pero nasa law natin na

hindi pupwede yung ganon na nag de-detain or nag papa-stay ng patient sa isang

hospital because ngayon binibigayan na sila ng advices na kapag walang pambayad

29
nag sisign sila ng waiver or kaya naman ay note that they would pay o kaya naman ay

pwede silang lumpit sa PCSO ginagawa yon sa government at saka sa private

hospitals, pero I don’t know hndi ko kasi ma-justify yung ganong kaso, kase depende

nga baka naman kailangan pang mag stay nung baby kase may problema pa or kaya

naman may mga kailangan pang medications at test nakailangan yung baby, kasi nga

ang mother kapag nakapanganak kung halimbawang normal delivery 24 hours to 48

hours pwede na talaga siyang lumabas, pero may mga medical conditions na pwede

ng naapektuhan yung baby halimabawa prolong labor or mga ibat-ibang medical

conditions na kailangan pa mag stay nung baby sa hospital kase nga may mga

ginagawa pa dun sa mga binibigay na medications, hindi ko ma-justify yung sa

ininterview nyo, kasi hindi ko din alam yung totoong reason kung bat’ na-stay yung

baby , pero according to law hindi pwede madettain yung mga pasyente saka yun

yung mga infants.

Interviewee: Sige po, thank you po, marami pong salamat. Sorry po sa istorbo.

30
 Hospital staff participants

Interviewer: Good afternoon po, kami po ay 4th year students po of Bethel Academy.

Ano pong pangalan niyo?

Interviewee: Rosalinda Madlangbayan Herrera.

Interviewer: Ano po yung current position niyo ngayon sa ospital?

Interviewee: Supervisor ako sa Saudi, sa emergency room.

Interviewer: May experience po ba kayo na magtrabaho sa emergency department

dito sa Philippines?

Interviewee: Oo, sa Divine Grace Hospital.

Interviewer: Paki kwento po yung experience niyo bilang nurse.

Interviewee: Sa Divine Grace ang posiyon ko don, inirorotate kami sa emergency

department, sa ICU at sa ward. Tapos supervisor din ako dun, kaya nadudutyhan ko

lahat.

Interviewer: Meron po bang pasyente na pumupunta na hindi po kayang magbayad sa

emergency situation?

Interviewee: Meron din, pero private hospital kaya kalimitan kapag dinadala nila yung

pasyente mayroon na silang budget for the hospital. Kasi kung dadalhin mo yung

pasyente, for example magdadala ka ng pasyente tapos mahirap lang yung pasyente,

depende sa case, kung ang patient hindi nila agad hinihingian ng bayad. Bibigyan

muna ng first aid tapos kung kailangan i-admit or outpatient, kung ano lang yung

nagamit sa emergency room, yun lang ang babayaran nila. Pero kung ang patient ay

kailangan iadmit kailangan talaga magdown, para sa mga room at para sa doctor.

31
Interviewer: Pero meron po bang mga pasyente na nirerefer or tinatransfer sa ibang

ospital dahil walang pambayad?

Interviewee: Ang nirerefer lang namin noon, yung mga nirerefer sa malalaking ospital

o kaya sa mga katulad ng mga kailangan dalhin sa San Lazaro, na kailangan i-isolate

ang pasyente na mahirap din. Kasi tulad ng mga nakagat ng aso tapos may rabies na

sila so kailangan silang dalhin sa San lazaro. Yung San Lazaro kasi government

hospital.

Interviewer: Ano po yung stand niyo po as nurse dun po sa mga issue po sa mga

patients na walang kakayanang magbayad. Totoo po ba yun?

Interviewee: Kasi para sakin di mo talaga kailangan magreject ng pasiyente kung

talagang kailangan nila ng first aid diba halimbawa ang kailangan ng pasiyente eh

tahini ang sugat or halimbawa namaga or nahulog kailangan bigyan mo muna siya

agad ng first aid bago mo sila singilin kung magkano ang nagamit nila sa ospital.

Interviewer: Sa tingin niyo po bat po naiisip ng mga pasiyente na narereject sila ng

ospital?

Interviewee: Siguro kasi sa ngayon ang mga hospital yun at yun ang tinatanong nila

yung pambayad hindi yung kalagayan ng pasiyente.

Interviewer: Sige po, thank you po sa time niyo po.

Patient participants

Interviewer: Magandang gabi po kami po ay estudyante ng Bethel Academy. Andito

po kami para mag interview para sa aming thesis. Ano pong pangalan niyo?

Interviewee: Ang pangalan ko ay Cristine Dela Cruz

32
Interviewer: Meron po ba kayong na experience na mareject po sa ospital?

Interviewee: Meron. Noong 11 months palang ang baby ko, minata kami akala nila na

wala kaming pambayad sakanila.

Interviewer: Pwede nyo po bang ikwento sa amin?

Interviewee: Sige. Hatinggabi na noon tapos nilalagnat yung baby ko na 11 months

palang syempre nagmadali kaming pumunta ng GT hindi na kame nagpalit pa ng

damit pumunta kami dun ng naka pantulog kahit na may butas-butas ‘di na kami

nagbihis kase syempre alangan namang unahin pa namin yung sarili namin.Pag dating

namin sa hospital tiningnan kami ng mga tao dun sa emergency room, Ininterview

tinanong saakin kung may Phil.Health sabi ko naman Wala, Tapos chineck up naman

yung baby sinaksakan na nila ng pampababa ng lagnat yung baby, Tapos tinanong ako

ng nag iinterview sa hospital kung kaya ba namin na doon iconfine yung baby ko

kung kaya ko yung gastusin, So ang sabi ko sige po ano po ba ang kailangan? Sabi sa

akin ng nag i-interview ay pumunta daw ako sa cashier at makipag usap tungkol doon

sa payments, Tapos nagpunta kami ng cashier kasama ko tatay ko nagtanong kami

kung paano iadmit yung bata kasi nga kailangan namin para okay na yung bata diba

nakakaawa kasi, so ang sabi ng cashier na yung ward daw ay 500 a day tapos 500 din

yung bayad sa doctor kung ilang araw pa daw ito ma-oospital tapos yung sa gamit pa

daw na gagamitin, Tapos sabi ko magkano po ba ang kailagan na ideposit tapos sabi

ng cashier 3000 daw so dumukot si tatay sa wallet niya ng 3000 tapos nung nakita nila

na may pang deposit kami sabi ng cashier na kung ilalabas na daw ang bata tsaka na

daw magbayad ng bill. So yon minata-mata kami dahil sa itsura.

Interviewer: Isang tanong lang ate nung ininterview kayo nabigyan na po ba ng first

aid yung baby?

33
Interviewee: Yung simpleng pang pababa lang nang lagnat yung sinaksakan siya ng

paracetamol para bumaba yung lagnat medyo okay na kasi nahimasmasan na tapos

yun doon na kami inano kung doon ba daw namin ico-confine or ililipat namin ng

ibang hospital nag-offer sila ng hospital na public, willing naman silang pahiramin sa

amin yung ambulansya nila kung sakaling gusto naming ilipat yung baby ng hospital.

Interviewer: Yun lang po, thank you po sa kooperasyon niyo ginang Cristine.

Patient participants

Interviewer: Magandang hapon po kami po ay taga Bethel Academy nandito po kami

para mag interview para sa aming thesis. Ano pong pangalan niyo?

Interviewee: Ang pangalan ko ay Elizabeth Sayson.

Interviewer: Naka encounter na po ba kayo na reject na po ba kayo sa isang hospital

dahil po wala kayong pang downpayment ganun po.

Interviewee: Oo nung 2000, 2000 ako nanganak di ako tinanggap dahil wala kaming

pang downpayment yung promissory note ayaw naman nilang tanggapin tapos yung

baby ko ayaw nilang ibigay saakin. Pinamedia ko ngayon nagbayad ako ng 250,000

para sa anak ko tapos sa akin naman ay 38,000 ako nakalabas pero naiwan yung baby

ko, Ngayon 3 months na ang nakuha ko ang baby ko nakakausap na lumapit ako

ngayon sa media kay Tulfo tsaka naman ako lumapit sa Trece binigay sa akin ni Bong

Revilla tsaka pinuntahan ng media kay Tulfo kaya lang saakin naibigay yung bata at

binayaran namin yung kakulangan namin na 1000 kaya kami nakalabas.

Interviewer: Pero nung pumunta po kayo ng ospital tinanggap po kayo?

34
Interviewee: Hindi basta basta kaya lang ako tinanggap dahil nangingitim na ako

nalalason na ako ng dugo ko gawa ng bata dahil 2 araw at 2 gabi na ako nilelabor

dahil hindi lumalabas ang bata

Interviewer: Inexplain po ba nila?

Interviewee: Walang explain ayaw nilang humarap sa media hindi nag explain saakin

kesyo private daw kesyo wala kaming pera, mahirap lang kami, kaya lang nila

ibinigay ang bata gawa ng lumapit na kami sa media.

Interviewer: Saan pong ospital?

Interviewee: Bautista Hospital. Tapos hindi rin tinanggap yung anak ko sa cavite city

yata yon government. Dahil dinudugo siya noon at wala kaming pang down payment

kaya pina uwi saamin kaya ibang ospital wala kasi kaming pera noon sabi ko

asikasuhin niyo na at ako ang kukuha ng pera shempre emergency wala kang dalang

pera shempre uunahin mo muna yung pasyente mo e hindi nila inasikaso yung bata

dinugo na ng dinugo kaya itinakbo namin sa ibang hospital.

Interviewer: Hindi po kayo pinagamit ng ambulansya?

Interviewee: Wala, walang ambulansya wala kahit ano.

Interviewer: Hindi po ba kayo ipina refer sa ibang ospital?

Interviewee: Wala kami lang talaga ang nag hanap kasi emergency na yun eh kasi

yung mama nito ay dinugo na ng dinugo. Ang nararamdaman ko sama ng loob sana

masara yung ospital, lahat ng sama ng loob mo syempre anak mo sarili mo wala ka

lang pera hindi ka tatanggapin edi siyempre ang sama sama ng loob mo.

Interviewer: Meron po bang epekto ang pagreject nila sa inyo?

35
Interviewee: Meron. Siyempre wag na sana silang pumunta s ospital na yan dahil

mamamatay lang kayo.

Interviewer: Salamat po

Patient respondent

Interviewer: Tatanungin po muna namin pangalan ninyo tapos ipapakwento po

naming yung nangyare sa inyo.

Interviewee: Kaninong pangalan? Saakin?

Interviewer: Sainyo po.

Interviewee: Carmensita Nosellado

Interviewer: Sige po, pwede po ba naming marinig yung kwento ? Nung pagreject po

dun sa--

Interviewee: Yung asawa ko na-ano siya. Yung inaatake siya noong Lunes.

Nangangatal, nanginginig yung kamay niya. Ngayon yung bunganga niya nagaano din

pati naninigas yung mga kamay. Ngayon dinala namin siya sa Trece. Ngayon hindi

siya naadmit at puno daw at walang bakanteng kama. Ngayon sabi samin i-refer daw

namin sa ibang ospital kasi kailangang kailangan siyang maconfine gawa ang mga

gamot niya sa injection idadaan tsaka imomonitor daw yung mga sugar. Kase naano

siya e yung bumagsak yung ulo niya, nabagok. Ngayon C-ni-TScan siya yung utak

daw nya yung ugat barado. Sabi ng doctor doon sa CTscan niya e kailangang

kailangang ngang maconfine e ayaw naman tanggapin dahil puno daw ang mga ward,

pwede siyang ma-confine sa private e wala naman kaming ipaprivate na ano.

Interviewer: Hindi po kayo nagbaka sakali sa mga private hospital.

36
Interviewee: Ay! Nagbakasakali, nanghingi ng down eh wala naman kaming

idodown.

Interviewer: Hindi po kayo nirefer sa ibang mga ospital ng mga private hospitals?

Interviewee: Hindi na rin at wala namang pera eh Basta private nagdodown talaga.

Interviewer: Inexplain po ba sa inyo ng mga private hospitals po tungkol dun sa ano

sa down payment po?

Interviewee: Naano naman e kailangan kasi yan tinanong muna sa GT noong 17 ng

January naistoke ulit siya dalawang beses na siya nai-stroke eh. February, January

tsaka February dinala namin siya sa GT eh hinihingian kami ng down eh wala wala

kaming maibigay ngayon ang bayad nga naming dun e 8000 e ilang oras lang e gawa

ng sobra ang taas ng sugar niya.

Interviewer: Binigyan po ba kayo ng First Aid?

Interviewee: Meron.

Interviewer: Meron po.

Interviewee: Meron binigyan nga siya kaya nga nagbayad kami ng 8000.

Interviewer: Dahil po dun sa first aid?

Interviewee: Oo. First aid niya ngayon nirefer kami di pinalipat ulit kami sa sa PGH

eh hindi naman din tinanggap at nga ang dami nga puno nga ang ano ang ano ang mga

ward ngayon edi umuwi na ulit kami at dito na lang namin dinala inano dalawang

beses na kaming nagpunta ng PGH.

Interviewer: Tinanong po kung may Philhealth po kayo?

37
Interviewee: Eh wala na na-lapse na ang phil health niya yung anak ko.

Interviewer: Pero tinanong po kayo sa private?

Interviewee: Tinanong.

Interviewer: Tinanong.

Interviewee: Ngayon yung anak ko nage-EPZA e meron na daw siyang card eh di ko

natanong kung pwedeng gamitin yung card sa EPZA diba meron.

Interviewer: Ano po yung naramdaman niyo po nung nareject po yung asawa niyo sa

ospital?

Interviewee: Syempre ninenerbiyos na ano, ninenerbiyos para gusto niyang gumaling

e bago ayaw tanggapin wala kaming magawa kung hindi umuwi na lang e ayaw nga

tanggapin eh nirerefer kami kung saan saan sa ano ditto sa ospital ng maynila e ganon

din naman doon kasi nararanas na naming magdala doon ‘di rin naman tinanggap siya

pabalik-balik na talaga sa ospital umpisa pa noong 2009 hanggang ngayon.

Interviewer: Paano po naapektuhan nung pagrereject po dun ng mga ospital sa asawa

niyo po nakaapekto dun sa sa buhay niyo po?

Interviewee: Ay, wala hindi naman.

Interviewer: Ahh, Hindi naman po?

Interviewee: Oo. Kasi nga ang asawa ko nga ano na siya yung maintenance na ang

sakit niya ngayon inaanuhan lang ng yung para bang ang pagdala sa ospital eh parang

first aid lang na malapatan ng gamot.

Interviewer: Sige po. Salamat po.

38
Interviewee: Oo, sige.

Patient participants

Interviewer: Magandang hapon kami po ang taga Bethel Academy, 4th year students

iinterviewhin lang po sana namin kayo para po sa thesis namin, ano po ang pangalan

niyo?

Interviewee: Maria Teresa Bilyas.

Interviewer: Meron na po ba kayong na encounter or mga kakilala na nareject ng

ospital dahil po hinihingan ng pangdown o mga ganun po?

Interviewee: Ang akin ang na encounter ko hindi sa pera ang kuwan nila kasi nung

dinala nila yung pamangkin ko nung sabi kong ico-confine namin yun nga,

ipapaospital namin gawa ng kuwan nung pinacheck up namin merong ngang

appendicitis ngayon nung dinala namin sa isang ospital hindi siya natanggap gawa ng

hiningian kami tinanung kung may Philhealth sabi ko wala po sabi niya “Ay hindi rin

po matatanggap dito kasi may medical mission.” Edi yun, dinala nanamin sa ibang

ospital.

Interviewer: Pero bago po yung ospital na yun may napuntahan na po kayo?

Interviewee: Yun, yung unang pinagdalhan namin sa public kasi ang katwiran ko yun

ang public yun ang unang choice namin kasi mura nga kung baga kaya namin kahit

papaano na mai-hospitalize siya.

Interviewer: Saan niyu po dinala nung sumunod ?

Interviewee: Sa Dasma, UMC ba yun.

Interviewer: Dun po tinanggap po?

39
Interviewee: Oo.

Interviewer: Pwede dun po sa public ospital

Interviewee: Hiningian nga, tinanung agad niya yung Philhealth e hindi pa naman

nagtatrabaho tsaka hindi pa nakakakuha ng Philhealth.

Interviewer: Hindi po inexamine yung pasyente?

Interviewee: Tiningnan din yung referral niya tapos nung tiningnan sabi, appendicitis

nga ito.

Interviewer: Inexplain po ba ng ospital na…

Interviewee: Meron nga raw na medical mission. Yung ang paliwanag

Interviewer: Galing saan po yung referral?

Interviewee: Kay Dra. Lou

Interviewer: Sa clinic lang po?

Interviewee: Oo sa clinic lang diyan kay Dra. Lou.

Interviewer: Ano po yung narmadaman niyo?

Interviewee: Syempre ako unang una takot. Syempre takot para sa pamangkin ko kasi

delikado iyon, alam mo kase yung appendicitis delikadong sakit pagpumutok iyon,

malalason ang katawan .

Interviewer: Sa UMC po tinanong din po phil health niyo?

Interviewee: Tinanong, inasikaso siya doon tapos tinanong agad kami kung ano bang

nangyare sa pasyente ganon ganon e sa marami naman silang pasyente syempre hindi

40
naman agad-agad, naghintay din kami ng ilang oras para maiadmit, hindi agad-agad

pero hindi kami nireject. Doon narin inoperahan.

Interviewer: Eh dun po sa isang ospital sa trece po. Dun po kayo nireject di po ba?

Interviewee: Dun nga. Rejection na rin siguro iyon kase nga Philhealth ang unang

tinanong nila eh

Interviewer: Ano po yung naging apekto sa pamilya ninyo? At sa kamaganak niyo

po?

Interviewee: Yun nga sa unang una sa financial yun ang epekto kase alam namin pag

public siyempre hindi masyadong mabigat sa bulsa yun lang naman ang epekto sa

financial wala na.

Interviewer: Sige po, salamat po.

Patient participants

Interviewer: Good Afternoon po kami po ay nag aaral sa Bethel Academy. We are

4th year student po at mag iinterview po kami para sa aming thesis. Ano pong

pangalan niyo?

Interviewee: Kersty Fortunado

Interviewer: Naka encounter na po ba kayo na rejection galing sa hospital dahil po

walang pang bayad?

Interviewee: Oo, dalawamng beses na

Interviewer: Pwede niyo po bang ikwento saamin?

41
Interviewee: Yung unang encounter ko ay yung sa pangatlong anak ko kasi

nagpreterm labor na ako ng 7 months kailangan yung hospital na pupuntahan ko ay

may incubator. Public hospital lang naman ang may incubator yung Fabella at Trece,

pumunta kami ng Trece pero di ako inadmit kasi daw puno na ang incubator nila

walang available kung sakaling dun nga daw ako manganganak hindi nila ma

iincubator dahil nga puno na. Kaya nirefer ulit nila ako sa Fabella pag punta naman

namin sa Fabella meron daw silang memo na bawal tumanggap ng mga bagong

pasyente dahil lilinisin daw nila yung ospital kaya parang wala muna silang

tatanggapin, So naghanap na kami ng iba kasi no choice na kasi puro public, walang

ano. Pumunta kami ng private kaso kailangan may down ka hanggang sa makarating

kami sa malaking hospital na hinihingian kami ng 300,000 para sa panganganak kasi

hanggat naka confine ako tapos hindi pa ako nanganganak yung incubator na para sa

lalagyan ng baby ay binabayaran din araw-araw habang nakaconfine ka.

Interviewer: Saan pong hospital yun?

Interviewee: Dun sa manggahan yung Gentri Doctors. 300,000 tapos hinihingian pa

ng pang down payment na 15,000 kaya ayun, Hanggang sa makarating kami sa UMC

ganun rin hindi din kami tinanggap sa UMC kesyo mas priority nila yung mga

pasyente nilang nakaconfine doon na nagpreterm labor din tsaka puno na daw yung

mga incubator nila. Tapos kung kaya ba daw namin yung halagang ganun, Hanggang

sa bumagsak kami diyan sa Pinagtipunan diyan sa Medic Care diyan ako nakaconfine

ng 4 days binigyan nila ako ng pang pakapit tapos ito namang bunso ko ganun din

preterm din siya nanganak ako ng 7 months pero nanganak na ako sa Medic Care kaso

1.7 lang siya maliit premature kailangan daw naming ilipat sa ospital na may

incubator kasi nga maliit siya para malaman kung may hindi pa nade-develop

kailangan ng incubator daw, Ganun rin ang nangyari ikot kami ng ikot hindi rin kami

42
tinanggap sa Trece at Fabellan dumating kami diyan sa GT tatanggapin na sana kami

kaso wala silang incubator wala silang facility na kaya doon. Kumbaga saakin lang

kaya ko siya para maadmit kung ano man ang mangyari atleast nasa ospital kaso

marami din silang kulang na gamit kaya sabi nila saamin na dalhin namin sa mga

malalalaking ospital, Katulad nga doon sa una naming naencounter sabi ko nalang sa

asawa ko na umuwi nalang kami kasi ganon nalang din naman ang mangyayari tulad

nung una tatanggihan lang tayo hihingian ng down.

Interviewer: Pero sa mga ospital na pinuntahan niyo pinagamit po ba kayo ng

ambulansya nila?

Interviewee: Oo naman pinagamit nila saamin yung ambulansya nila libre naman

walang bayad.

Interviewer: Naexplain po ba nila ng maayos kung bakit kayo hindi nila kayang

tanggapin?

Interviewee: Hindi naman. Kasi syempre hindi naman nila sasabihini na wala kayong

pang down kaya hindi namin kayo tatanggapin pero parang ganun narin naman ang

punto nila kung wala kang pera hindi ka nila tatanggapin, Kasi kung tatanggapin ka

nila hindi ka na nila iinterviewhin kung ano ang mga babayaran niyo per day kung

kaya po ng budget niyo. Pinapaliwanag lang nila na misis ganito po mangyayari sa

atin kapag tinanggap po namin kayo .

Interviewer: Ano po naramdaman niyo nung hindi kayo tinatanggap ng mga hospital?

Interviewee: Syempre nahabag sa sarili na mayaman lang ba ang may karapatang ma-

ospital? Paano nalang kung namatay ako dun pati na yung baby sino sisisihin ng

asawa ko, Pero kung sana yung mga ospital ay may mga kompletong gamit or Charity

43
Ward man sila para sa mga buntis at emergency cases na walang pang down siguro

naman kahit papaano gagawa ng paraan ang mga tao para lang makabayad. Yung sa

pagkakataon sana na emergency na ganon wag na muna pera ang hanapin nila kasi

buhay naman ng tao ang pinag-uusapan nila. Kaya nga ngayon maraming lumalabas

na maraming namamatay dahil sa wala ngang pera .

Interviewer: Tinanong po ba nila kung may Phil.Health kayo ganon?

Interviewee: Oo tinatanong naman nila tulad nun ang Phil.Health ko ay na-lapse hindi

ko magagamit edi wala rin hidni rin nila tinanggap.

Interviewer: Nirefer po ba kayo yung hindi po diba kayo tinanggap sa ibang ospital.

Nirefer po ba kayo sa ibang ospital?

Interviewee: Hindi, Hindi naman kasi sila nagbibigay ng referral.

Interviewer: Pero pinagamit po kayo ng ambulansya?

Interviewee: Government na ambulansya hindi yung ambulansya ng ospital nila yung

sa mga munisipyo.

Interviewer: Ano po ang naging epekto nito sa inyo dahil sa pagrereject sa inyo ano

po anng epekto nito sa pamilya niyo?

Interviewee: Syempre parang discrimination na sa amin yun kasi kahit na may mga

trabaho kami hindi naman kami kikita ng ganong kalaking halaga.

Patient participants

Interviewer: Magandang hapon po. We our students from Bethel Academy po. I-

interviewhin lang po naming kayo para po sa thesis namin, ano po ang pangalan niyo?

44
Interviewee: Angelina Dela Cruz

Interviewer: May na-encounter na po ba kayo or kakilala na hindi po tinanggap sa

ospital kasi hinihingian ng pangdown?

Interviewee: Oo nanay ko.

Interviewer: Pwede niyu po bang ikwento sa amin?

Interviewee: Dinala namin doon, nagkasakit, dinala, pinasok, tinignan, tapos ayun.

Hinihingian nga ng 10,000 down payment. E wala kaming pangdown.

Interviewer: Saang ospital po?

Interviewee: Sa GT tapos nilipat namin sa Trece, yung ospital sa Trece, basta Trece

pag dating doon inobserbahan, obserba, pinalalabas kasi puno daw, puno. Ipinasok

namin sa isa, yung katabi, Korean! Puno din, tapos sabi kung may 10,000 nga daw

may room, eh wala kaming 10,000 nilipat namin sa Dasma. Yun doon tiningnan kaso

mo mahal naman hindi namin kaya, inilipat ulit sa manila pagdating sa manila, tuloy,

dedo, patay.

Interviewer: Ano po ba yung sakit po nung pasyente?

Interviewee: Sabi Pneumonia... Pneumonia. Komplikasyon kase matanda na nga.

Interviewer: Dun po ba sa GT inexamine po muna yung pasyente?

Interviewee: Oo. Oo tiningnan naman, kaya nga lang hindi talaga namin kaya yung

bayad. Pero talagang icoconfine kung meron kaming (pera)

Interviewer: Inexplain naman po sainyo nung mga staff?

Interviewee: Oo.

45
Interviewer: Tinanong naman sainyo kung may Philhealth po or any?

Interviewee: Oo. Oo kaya nga lang wala siya noong Philhealth, eh ngayon okay na

yon, dahil ngayon automatic lahat ng ano diba may Philhealth, eh hindi siya umabot

don. Hindi daw siya umabot.

Interviewer: Hindi lang po kayo pinayagan magpaadmit?

Interviewee: Hindi, payag sila kaso kailangnan namin ng pangdown. Atska sa GT

naman okay, kaya lang hindi naman kaya. Malaki (ang pambayad).

Interviewer: Bale for admittance lang po yung 10k?

Interviewee: Oo.

Interviewer: Ano po yung naramdaman niyo nung palipat-lipat po ng ospital.

Interviewee: Edi syempre masakit, para bang, syempre para kinukurot ang mga puso

naming, syempre nakikita mo yung pasyente mo na naghihirap tapos hindi mo

maipasok, masakit.

Interviewer: Ano po yung naging epekto nun sa pamilya ninyo.

Interviewee: Edi syempre, sumama loob namin sa mga ano, ospital dito sa atin, kahit

saan naman eh. Sabagay, sa maynila, kino-confine din naman siya don dahil manila

madali lang, kaya lang inaabot ng kamatayan. Sa ka-kapalipat lipat. Nagsimula kami

sa GT, nilipat sa Trece, nilipat dyan sa Dasma, dito pa sa may Kawit, sa may St.

Martin. 10,000 din hinihingi don. Nilipat namin sa Trece ulit, tapos hindi na naman

inano, dinala namin sa dasma na nga, doon okay naman sana kaso sobarng mahal, di

namin kaya.

Interviewer: Sige po, salamat po sa pagkuwento niyo po.

46
Patient participants

Interviewer: Good afternoon po nay kami po ay 4 th year students from Bethel

Academy, gusto po naming kayong interviewhin po for our thesis po, ano po ang

pangalan niyo?

Interviewee: Yolanda Rosal Colorado

Interviewer: Meron po ba kayong naecounter na mga pasyente na hindi po tinanggap

sa hospital dahil wala pong pangbayad?

Interviewer: Ako lang naman ang alam ko eh pero ewan ko lang kung yung iba nga e

ganun ang nangyari kasi naranasan ko na nga sa manugang ko bago ako e mamatay sa

sama ng loob gawa nga noon, noong hindi kami tinanggap nag mamakaawa ako hindi

kami tinanggap kaya umalis nalang kami nung pumunta naman kami sa ibang hospital

hindi rin tinanggap kasi wala daw check up e kaya ayaw tanggapin.

Interviewer: Sa unang hospital po, saang hospital po yun?

Interviewee: Una naming dinala sa Trece hindi naman tinanggap hanggang sa cavite

sa salamangka hanggang sa manila hanggang PGH hanggang sa Jose Fabella.

Interviewer: Inexplain po ba sa inyu kung bakit hindi tinanggap?

Interviewee: Hindi nga raw siya nagpapacheck up walang record ng check up kaya

hindi tinanggap.

Interviewer: Hindi po kayo hinanapan ng pangdown?

Interviewee: Noon nga dito hinahanapan nga kami dyan sa GT hindi nga kami

tinanggap kasi nga kulang ang pera namin e kasi nga noon ang nanghari sa akin ay

galit, ang nangyari naman naadmit dun sa Cavite sa Barangay 39 yung manugang ko

47
ang lakas lakas bakit namatay, ang sabi ng mga tao doon sinaksakan daw kaya

pinalabas ang bata kaya yung patay pinalabas na nila wala daw silang sagutin

barangay 39 yun kaya ang laki ng galit ko doon.

Interviewer: Pero dun po sa mga hospital na pinuntahan niyu po hindi po kayo ni refer

sa ibang hospital or kung ginamit po yung ambulansya ?

Interviewee: Hindi kasi umalis na nga lang kami kaya pag naaalala ko yung

manugang ko naiiyak ako.

Patient participants

Interviewee: Imelda Garcia.

Interviewer: Ahm, meron po kayong naexperiance na nireject po sa ospital?

Interviewee: Meron yung anak ko si Imelda Moraya.

Interviewer: Ano po yung dahilan kung bakit po nireject?

Interviewee: Dahilan kasi wala kaming pambayad para sa cesarean.

Interviewer: Saan pong ospital kayo nireject?

Interviewee: Diyan sa J.R, PGH tsaka dun sa isa.

Interviewer: Trece po?

Interviewee: Hindi, J.R. nga yung sa Trece eh kasi parang sa Jose Reyes nireject

kaming lahat doon kasi nga kailangan down para maoperahan yung cesarean tapos

nung sabi baka makasakali dun sa Fabella tapos nung pagkapunta namin sa Fabella

tinanong siya kung ano-ano e wala po kasi kaming pang ano e, sige gagawaan natin

ng paraan yan na ikaw ay mapa-anak kahit hindi cesarean kaya lang mag hihintay

48
kapa, sabing ganon tsaka hindi po ganyan kung bakit ganon sabi e ano na ito e parang

sobra na to sabing ganon tapos nung tinawag na yung pangalan niya may number kasi

don tapos nun nung tinawag yung pangalan niya kasama ako sabing ganon neng

kailan ba ang due date mo ganon kasya eh bakit hindi ka napaano dun sa may inyo

wala daw po kasing pambayad sa cesarean eh kaya dito po dinala ng nanay ko o sige

eexamine ka naming ganon pero hindi kami nakakatiyak kung cesarean nga kasi kung

cesarian malaki laki ang mauubos sabing ganon eh dito talaga hindi kami nag aano ng

cesarean kung hindi rin daw manganganak doon tapos yung ano na examine na siya

sabi neng mapapanganak daw ng ganon kaya nga lang may problema nga dahil yung

bata nga parang hindi masyadong gumagalaw pero buhay edi nag intay kami siguro

mga maghapon ata kinabukasan sabi mganganganak na raw manganganak na luma

nung ano sabi eh hindi namin natitiyak kasi parang may problema ho ang nanay tsaka

yung bata pipirma po kayo sa waiver sabing ganon sige ho pumirma ako na sa

katunayan pumapayag ako dun manganak kahit ano man ang mangyayari hindi nila

sagutin ang tanong, kung ano gusto ko yung bata or yung nanay kung pwepwedo ho

parehas kaso kung ano po ang dapat niyo mailigtas yun nalang po tapos nung ano nga

maghapon nayon nanganak tapos nung tumagal sabi e nay may problema ho kami e

baka ho baka ho nasa ICU silang dalawa e ano ho ano ho ba talaga gusto niyo sabi sa

akin e kayo na po ang bahala e willing naman kasi ako yung tatay naman nung bata e

wala ako ako nga ang umaanong nanay eh awa ng diyos nakaraos parin kaya nga lang

tumatagal ginagamot yun bata ginagamot si Imelda.

Interviewer: Dun po sa ospital na nireject kayo nirerefer po ba kayo sa ibang ospital?

Interviewee: Hindi, humanap nalang daw kami eh ayaw nalang magparefer sa iba.

Interviewer: Kayo na po naghanap?

49
Interviewee: Oo, kami na mismo. Kasi pag nirefer ka bibigyan ka ng papel sulat na

para mairefer doon ayaw nila hindi nag parefer.

Interviewer: Inexplain po ba sa inyo kung bakit po kayo hindi tinanggap sa ospital?

Interviewee: Yun nga inano nila na malaki yung bayad sa ospital.

Interviewer: E pinagamit po ba kayo ng ambulansya?

Interviewee: Hindi na, kami na mismo gumastos na kami ng ano kasi nung una sa JR

inano kami ng ambulansya iniwan nalang kami doon pag kaano nagbiyahe-biyahe

nalang kami.

Interviewer: May bayad po ba yung ambulansya?

Interviewee: 500.

Interviewer: Binayaran niyo po?

Interviewee: Binayaran namin kasi yun ang ano dito pag kayun sa maynila daw 1000

na ganon 500 lang.

Interviewer: Ano po naging epekto nung pag rereject nila sa pamilya niyo po?

Interviewee: Kaya nga nireject nga kasi nga walang pambayad sa cesarean at tsaka

para daw baka ang bata e due date na ganon baka magkakaroon daw ng malaking

problema lalong lalaki daw ang gastos.

Interviewer: Ano yung naramdaman niyo lagi nung hindi po siya tinanggap nung una

punta ?

Interviewee: Naramdaman ko wala na e wala kundi iuwi ko sa bahay maghintay

nalang kung ano ang sasapitin eh meron nga pang 3 ospital na yun.

50
Interviewer: Hindi po tinanggap ?

Interviewee: Bahala na ganon nalang ang ano ko e wala e diba kung parehas sila

walang magagawa e kung may mabubuhay okay awa naman ng Diyos parehas

nabuhay.

Patient participants

Interviewee: Pero ano naman inano nila pero inerefer kami sa iba di nila man lamang

binigyan ng first aid ganoon.

Interviewer: Yun lang po?

Interviewee: Tapos kung hindi pa ako nagwala, yung naman sa nanay ko, ganito

dinala ko natutulog pa raw yung doctor kung hindi kapa magagalit hindi yun ganon.

Interviewer: Saan pong ospital ?

Interviewee: Yan sa community hospital dyan pero pag may bayad syempre

tatanggapin ka pero yung mga ganyan yung mga public pang karaniwan maraming

ganon. Yung community hospital diyan sa Pinagtipunan ganon malimit sabihin sayo

ang doctor tulog pa e alanganing oras tulog pa.

Interviewer: Ano po ba yung case kung bakit hindi po tinanggap nung una?

Interviewee: Puno na raw yung ospital.

Interviewer: Ano po yung sakit?

Interviewee: Yung una sa anak ko nagka-LBM pero galing na kami sa Contreras non

tapos noon nung bandang hapon nag out kami doon ng 1 oclock halimbawa 1 or 2

tapos nung 7 oclock nag LBM ulit siya.

51
Interviewer: Tinanggap po kayo sa Contreras?

Interviewee: Siyempre may bayad doon. Basta pag yung private madali kahit saan ka

private. Sa public palibhasa ang babayaran mo lang doon minsan yung gamot yang

ganyan tapos noon ang doctor free yun e hindi katulad sa private na ano pag alam na

may ibabayad ka talagang tatanggapin ka.

Interviewer: Sinabi po sa inyu kung bakit parang hindi po kayo nirefer po kayo?

Interviewee: Yun nga yung sa LBM kasi ano wala na raw place puno na raw. Oo,

dapat sabi ko dapat puno dapat fifirst aidan niyu muna kung ano ang dapat inumin

ganon tapos magrerefer ka sa trece.

Interviewer: Eh ano po sabi ng ano kung bakit daw po hindi binigyan ng first aid?

Interviewee: Basta puno na raw yun ang sabi nila sa akin eh nagwala pa nga ako doon

eh.

Interviewer: Ano po yung naramdaman niyo po?

Interviewee: Siyempre nagalit ako. Natural naman yon.

Interviewer: Opo, ano po ang pangalan niyo?

Interviewee: Angelina Loren.

Patient participants

Interviewer: Magandang hapon po sa inyo, kami ay estudyante from Bethel Academy.

Nandito po kami para mag-interview sa inyo para sa thesis namin. Ano pong pangalan

ninyo?

Interviewee: Ako si Mylene Encarnacion.

52
Interviewer: Gusto po sana naming malaman kung may naranasan na po ba kayong

parang rejection sa mga ospital?

Interviewee: Oo, ganito yon. Si bunso ko nilagnat two days, akala namin lagnat lang

talaga yun pala appendicitis na, dinala namin siya sa Manggang Bukol sabi sa amin sa

Manggang Bukol ‘di daw nila kaya yon, appendicitis daw kasi yon, dalhin daw namin

sa trece, pagdala namin sa trece wala daw naman silang pediatrician kasi maliit pa

siya, mga 5 years old or 4 years ganoon. ‘Di kami tinanggap doon pinapunta ulit kami

sa PGH, umuwi kami dito. Paguwi namin dito dinala ulit namin siya ng PGH inayos

namin yung mga damit niya, pagdating naman namin ng PGH hindi raw basta

maooperahan kasi daw baka may emergency darating mas milma o ano, yun daw

yung mauuna, kinabukasan pa raw. Naawa na ako sa anak ko at talagang payat na

payat na, putlang putla na. Dinala namin sa ibang ospital wala din kaming

mapuntahan panay puno. Ang ginawa namin, umuwi na kami. Sabi, paguwi namin

sabi nga ng tata ‘wala tayong pera’. E! Dinala pala muna namin siya ng Family Clinic

ang nangyari naman sa Family Clinic sa Tanza hinihingian kami ng down payment na

twenty thousand, wala kaming hawak na twenty thousand, inuwi namin siya paguwi

namin sabi ng tata, ‘yaan mo pano gagawin natin kung mamatay edi mamamatay,

wala tayong pangdown payment . Inuwi namin tiyempo naman siguro mga alas’ dose

imedia na rin ng gabi o alas dose na, alas quatro palang naglalakad-lakad na kami sa

mga ospital, wala ngang tumanggap sa amin, pagdating ng alas dose ng gabi kung

saan na nga kami nakarating paguwi namin, dumating ang kanyang ninang, inaantay

nga nung ninang niya sabi ‘ano na ba nangyari sa inyo?’ idinala kako namin si bunso

sa kung saan saang ospital na, sa Family Clinic kako ooperahan sana, hiningian

naman kami ng twenty thousand, wala naman kako kaming pang down, pagkasabing

ganon ‘sige magbhis kayo at dalhin natin si bunso doon sa Family Clinic’, pagdating

53
namin doon dinalihan naman kami na wala daw silang pediatrician, inuubo yung bata,

sabing ganyan. Dinala naman namin sila sa Devine Grace pagdating naman doon

ayaw din naman kami basta tanggapin kung di kami may malaking down payment

tapos ang daming hiningi sa aming requirements mga kung anu-ano, binirahan na

namin ng alis, dinala na namin ng Manila Doctors sa Manila yun doon pagdating

naman doon ang nurse medyo antok na antok kasi medyo ala una pasado na ,

alanganin ang oras ang dating namin doon, ipainom ng… tinignan niya nilalagnat,

pinainom ng gamot e yun pala kapag ooperahan bawal painumin ng gamot, bawal ang

tubig, bawal ang gamut, kahit ano wala dapat ilalagay sa loob ng tyan, ngayon

magaantay pa siya dapat ng 24 hours yata, bago ka maoperahan. Naririning ko yung

mga nurse, sabi kapag yan namaty kasi acute na ang kanyang appendix, yun edi

inexray siya, dinala siya pagdating ng umaga sabi samin wala daw doctor. Edi

dumating na yung umaga chineck up tapos yon sinalang na siya sa operating room.

Sabi ng doktora ng sakin ang lakas ng loob ng batang yan, kapayat payat na,

napakapayat, sabi nung doctor pag opera ko ba diyan meron pang bituka na nalagot,

inayos ko kaya sabi napakalakas ng loob ng batang yan siguro nakailang linggo kami

don bago kami nakaalis, dun na kami tinanggap.

Interviewer: Ano pong naramdaman niyo na palipat lipat po kayo ng ospital?

Interviewee: Awang awa ako kay bunso iyak ako ng iyak ang hirap pala ng walang

pera.

Interviewer: Ano pong nagging epekto po nito sa pamilya niyo?

Interviewee: Natatakot ako sa anak ko kasi pwede niyang ikamatay yon, acute na kasi

eh buti na lang lagi siyang nakakadumi ng nakakadumi kung baga naiilabas niya yung

lason sa katawan, sabi ko kung di mo pa talaga oras, hindi ka pa talaga mamamatay

54
kasi yung iba pagpumutok na yung appendix namamatay na din agad. Kasi siya

nalalabas niya naman, naidumi niya yung mga itim na dumi yung malalambot.

Interviewer: Sa bawat ospital na nireject kayo meron po ba silang inadvice na ospital

na pupuntahan niyo?

Interviewee: Walang sinabi sakin umalis na lang ako kasi wala akong pera.

Interviewer: Hindi po kayo nirerefer sa ospital?

Interviewee: Iyon dung sa Trece nirefer kami sa Manila Doctors.

Interviewer: Iyon lang po ba yung ospital na nagrefer sa inyo?

Interviewee: Oo.

Interviewer: Inexplain po ba sainyo kung bakit kayo hindi inadmit?

Interviewee: Kailangan daw ng down payment.

Interviewer: Iyon lang po, thank you po sa time niyo.

Discussion

Based on the information gathered through interviews, the patients stated that they

were rejected because they weren’t admitted in the private hospitals. Without

acknowledging that private hospitals have their own rules or policy that keeps the

medical center in order. The patients should also consider that there are three levels of

health care systems, the primary, secondary and tertiary. Depending on the extent of

health or treatment they can provide. There are different factors that drive the patients

to feel rejected. Some patients felt that they were misjudged by the hospital staffs just

by the way they look. Others knew that they can’t be admitted due to financial

55
deficiency. They were helpless.They felt the social discrimination upon them and

their feelings were hurt. Basing on the patients testimony, some of them

recommended to not go at a private hospital for they will surely die. Another patient

even cursed the hospital because of what happened to them. As what the patient

aforesaid in our interview, she said that if an emergency happen in your life, do not go

in a hospital who cannot handle your situation because you might lose your life. But

there are still patients who recommend to go to a private hospitals instead, the reason

is in private hospital they can cure your situation because and they will prioritize wht

you need brcouse you have money. These effects likely gave birth to a disadvantage

for the hospital. The patients’ opinion can influence and cause a high damage to the

peoples view for a certain hospital's credibility.

56
 CHAPTER FIVE

SUMMARY, CONCLUSION AND RECOMMENDATION

This chapter includes all the data the researchers have gathered. It also

includes the summary and conclusion of the study. Lastly, it contains the

recommendations of the researchers for the patients who cannot afford to pay and felt

rejected.

SUMMARY

The primary purpose of this study is to know the truth and clear the two points

of the party about the negative speculation of patients to the Private Hospitals that

they reject patients who’s incapable to pay; it also aims to give knowledge and to

educate patients about their rights of being a patient. Through the interview, house to

house process and on-call procedure, this study obtained thirteen (13) participants,

trimmed into two groups:

a) The Hospital participants; consisting of one doctor from U.M.C and two nurses from

Divine Grace and G.T Hospital.

b) and the patients participants; consisting of 10 patients which respectively from the

corner of NIA road in Barangay San Juan 1 to San Juan 2,  Tondo in Sta. Clara

G.T.C., Barangay Vibora Squatters Area and Barangay San Gabriel Chico Ville.

Based on the data gathered, with the use of the research instruments, the result

of this study shows the misconception of patient to private hospital unable to provide

patients a proper medical demand without acknowledging that private hospitals have

57
their own rules or policy that keeps the medical center in order and considering the

availability of the hospital to their condition.

Thus the following questions subsequent to the state of the problem was

answered using the results gathered during the interview and through collecting

review related literatures:

1. Do hospitals really reject patients in an emergency condition?

 As the reseracher's examined all data gathered the data showed a negative

response, which resulting to definite “No” answer. And according to Mrs.

Nerissa Barbuco, a registereded nurse in Gen. Trias Maternity and

Pediatric Hospital, rejection is a deep word, transfer of patient's choice is

the proper term that can be used.

2. What is the disadvantage that may result to the hospital that’s been alleged to

reject patients in an emergency situation?

 The false speculation of patient to hospitals may lead to  minimization of

hospital credibility. The hospital may accumulate a bad name or reputaion

by the negative reponse and opinions of people surrounding the issue.

3. What can be the effect/s to the denied patients and their family?

 The patients feel discriminated, for they think that hospitals are prioritizing

wealthy patient instead of equal treatment. Nonetheless, the effects of it to

their family leads to make a hateful remarks on them, by the thought of

wanting hospital to be closed for it may cause a life of a member of their

family.

58
 CONCLUSION

The researchers conclude that this issue is just a misconception between the

patients’ family and the hospital. The patients’ family tend to think more likely for

themselves without considering the hospitals regulations.

There are reasons why the patient’s family think like this. First, they are

baffled seeing their family member in an emergency condition so they’re rushing in

any hospital without pondering their financial capability. Second, they see the fact

that they don’t have enough money to pay so they anticipate that this is the reason

why the hospital can’t accept them. Third and last, they don’t know the hospitals rules

and regulations in their management. They dont even know the difference among

referral, transfer and rejection of patients. Not only the patient’s family have the

downside in this issue. Hospitals then were careless for thinking that the patient’s

family’s point of view for their quality of service will not affect their credibility as a

hospital. There are times that they do not explain clearly to the patients what is the

real reason for the transfer. Quality of sevice may also affect the patient’s perspective

about the transfer; this could be slow response for the patients or obscure explanation.

RECOMMENDATION

As a result of the given conclusion, the following recommendations are given:

1. Patients should consider and respect the rules, regulations and policy of private

hospitals.

2. Patients should have long patience towards the hospitals. They should also be aware

of their rights and the hospitals process in accomodating the patients.

3. Hospital staffs should make the patients understand and give them the proper

knowledge of the hospital’s management.

59
4. Patients should choose hospital to the degree of their affordability.

5. Patients should be aware of their financial capability and be prepared for emergency

purpose. Be engage in health insurance like Philhealth. Most importantly, save

money.

60
 REFERENCES

1. Annas, George J. (2003). “The Rights of Patients.”

URL: www.ajol.info/index.php/jema/article/download/52115/40743

2. Aquino & Reyes, (2014)

URL: http://www.interaksyon.com/article/93302/ona-hospitals-should-not-turn-away-

patients-because-of-deposit-issue

3. “Barnes, James A. (2002). “Action Versus Inaction.”

URL: http://legal-dictionary.thefreedictionary.com/Patients'+Rights

4. Clayton (1948). “The Universal Declaration of Human Rights”

URL:https://humanrights.nd.edu/assets/129657/sle_indirect_expropriation_in_internat

ional_law_chapter_3_.pdf

5. Cooper (2003).

URL: http://scholarcommons.usf.edu/cgi/viewcontent.cgi?article=5693&context=etd

6. Daily Briefing, (2013)

URL: https://www.advisory.com/daily-briefing/2013/03/07/japanese-man-dies-after-

hospitals-reject-him

7. Dr. Steve Pantillan (2008)

URL:http://missinglink.ucsf.edu/lm/ethics/Content

%20Pages/fast_fact_bene_nonmal.htm

8. Emergency Medical Treatment and Active Labor Act (EMTALA,1986)

URL: http://www.acep.org/News-Media-top-banner/EMTALA/

9. Hippocratic Oath revised by Louis Lasagna (1964)

URL: http://www.pbs.org/wgbh/nova/body/hippocratic-oath-today.html

61
10. Marcum, J. (2008). “An Introductory Philosophy of Medicine: Humanizing Modern

Medicine.”

URL: https://campus.georgetown.edu/bbcswebdav/pid-2181925-dt-content

11. Oberman, Michelle. (1996). “Minor Rights and Wrongs.” Journal of Law, Medicine,

and Ethics 24

URL:http://digitalcommons.law.scu.edu/cgi/viewcontent.cgi?

article=1508&context=facpubs

12. Pellegrino, E. (1988), (2008). “For the Patient’s Good: The Restoration of

Beneficence in Health Care.”, “Toward an Expanded Medical Ethics: the Hippocratic

Ethic Revisited”, “Medical Ethics: Entering the Post-Hipoocratic era.”

URL: https://blogs.commons.georgetown.edu/journal-of-health-sciences/issues-2/vol-

6-no-2-july-2012/the-fall-of-the-hippocratic-oath-why-the-hippocratic-oath-should-

be-discarded-in-favor-of-a-modified-version-of-pellegrino%E2%80%99s-precepts/

URL: https://repository.library.georgetown.edu/handle/10822/712033

URL: https://repository.library.georgetown.edu/handle/10822/733595

13. Republic Act No. 8334 of the Republic of the Philippines (1997)

URL: http://www.lawphil.net/statutes/repacts/ra1997/ra_8344_1997.html

14. Republic Act No.9439, Section 1&2.

URL: http://www.lawphil.net/statutes/repacts/ra2007/ra_9439_2007.html

15. The Secretary of the Department of Health, Enrique Ona (2014)

URL: http://www.lawphil.net/judjuris/juri2014/apr2014/gr_204819_2014.html

16. Thomasma, (2008)

URL: https://blogs.commons.georgetown.edu/journal-of-health-sciences/issues-2/vol-

6-no-2-july-2012/the-fall-of-the-hippocratic-oath-why-the-hippocratic-oath-should-

be-discarded-in-favor-of-a-modified-version-of-pellegrino%E2%80%99s-precepts/

62
17. Universal Declaration of Human Rights” (1948-1998)

URL: http://unesdoc.unesco.org/images/0011/001144/114488E.pdf

18. Universal Declaration on the Human Genome and Human Rights, UNESCO (1997)

URL:http://www.unesco.org/new/en/social-and-human-

sciences/themes/bioethics/human-genome-and-human-rights/

19. H. Wadee, (2007)

URL: http://ro.uow.edu.au/cgi/viewcontent.cgi?article=4518&context=theses

20. William Ruddick (1998)

URL: http://www.nyu.edu/gsas/dept/philo/faculty/ruddick/papers/medethics.html

21. Wolf (2001)

URL:http://digitalcommons.wcl.american.edu/cgi/viewcontent.cgi?

article=1731&context=aulr

63
 APPENDIX

CERTIFICATION FROM THE VALIDATORS

64
65
66
 INTERVIEW PROTOCOL

Hospital Staff Participant

Interview Questions 1.0

How is he/she related to the

Name of the Hospital involved:_________________________________________

1. How long have you been working at this hospital?

__________________________________________________________________

2. What is your current position in the said Hospital?

__________________________________________________________________

3. Do you find your job hard to handle?

__________________________________________________________________

4. How do you handle the volume of patients that are being brought in the Emergency
Room?

__________________________________________________________________

5. What is your stand about the widespread issue that private hospitals reject patients?

__________________________________________________________________

67
 INTERVIEW PROTOCOL

PATIENT PARTICIPANT

Interview Questions 2.0

How is he/she related to the

__________________________________________________________________

1. Have you experience rejection in a hospital?

__________________________________________________________________

2. Please tell us your story.

__________________________________________________________________

3. Do you have any insights about ‘patient rejection’ during an emergency?

__________________________________________________________________

4. What is your stand about the said subject?

__________________________________________________________________

5. What is the effect of this issue to your family?

__________________________________________________________________

68