FEASIBILITY STUDY:

ESTABLISHMENT OF A GERIATRIC HEALTH CENTER IN QUEZON CITY

In partial fulfillment of the requirements for

PA 143: Program and Project Development and Management

Submitted by:
Angeles, Jamie Marie B.
Austria, Aries P.
Baliwag, Kiara Louise T.
Bautista, Kim Julienne A.
Bautista, Jonel Mico P.
Cortez, Ian Mico V.
Dimaano, Maria Michaela N.

Submitted to:
Prof. Dan A. Saguil

National College of Public Administration and Governance

University of the Philippines Diliman
2nd Semester, AY 2016-2017
 TABLE OF CONTENTS

EXECUTIVE SUMMARY 4
I. INTRODUCTION 5
A. Background of the Study 5
i. Profiling of Senior Citizens in Quezon City 6
ii. Office Responsible in Handling Senior Citizens in Quezon City 8
iii. Current Status of Senior Citizens in Quezon City 10
II. REVIEW OF RELATED LITERATURE 12
A. Geriatrics 12
B. Geriatric Healthcare Professionals 12
C. Geriatric Centers 14
III. PROJECT OVERVIEW 17
A. Overview of the Project 17
B. Goals and Objectives of the Study 17
C. Scope and Limitations 18
D. Methodology 18
IV. MARKET STUDY 20
A. Demand Analysis 20
i. Projected Demand Based on Past Demand 27
B. Supply (of Geriatric Facilities in Quezon City) 29
C. Marketing Program 30
V. TECHNICAL STUDY 32
A. Details of the Proposed Project 32
i. Prospect Location and Size 32
ii. Floor Plan of the Geriatric Health Center 33
B. Operation Strategy (PERT and Gantt Chart) 34
C. Construction Timeframe 38
i. Raw materials and equipment 40
ii. Furniture Cost Estimate 41
iii. Labor cost and requirements 41
VI. MANAGEMENT STUDY 42
 A. Organizational Structure 42
B. Manpower Requirements 42
Medical services 43
Hospital Operations Management 44
Patients’ Assistance and Cash Operations 44
Facilities Management 44
Security 44
C. Compensation 45
D. Legal Requirements 46
VII. FINANCIAL STUDY 48
A. Total Project Costs 48
B. Initial Capital 49
C. Sources of funding 49
D. Cost-Benefit Analysis 50
E. Net Present Value 51
VIII. SOCIO-ECONOMIC STUDY 54
A. Contribution of the project to the society/economy 54
B. Social Desirability 55
C. Social Acceptability (using PRINCE Analysis) 55
D. Social Rate of Return 57
IX. Findings and Recommendations 58
X. References 59
XI. Appendices 62
 EXECUTIVE SUMMARY

Provision for health services is one of the primary concerns of senior citizens given that

there is an increasing demand in their population. However, there is a limited number of certified

geriatricians and gerontologists in Quezon City, coupled with very limited geriatric health centers

(both outpatient and hospital-based). Based from the current condition of health services in

Quezon City that are intended for senior citizens, the researchers aim to find out the feasibility

and viability of establishing a 250 m2 geriatric health center to be located in Project 8, Quezon

City beside Quezon City General Hospital. This proposed center would cater not only the

medical needs of the patients but also their psychological and social needs through counselling

and cessation program (for those with vices). In addition, this would include programs for family

members of the senior patient to provide counselling and advising as to how they would better

take care of their senior relatives. Given the different setup of a geriatric health center, which is

basically an outpatient health center, the researchers will analyse the market (i.e., demand

projection), management (i.e., organizational staff), technical (i.e., materials and equipment),

financial (i.e., benefit-cost analysis), and social aspects (i.e., social desirability and stakeholder

analysis) of the project to determine whether the proposed project is feasible or not.
 I. INTRODUCTION

A. Background of the Study

The world’s population is experiencing an increase in the number of older persons

substantially in the recent years. According to the Department of Economic and Social Affairs of

the United Nations (2015), there were 901 million people aged 60 years and older worldwide in

2015. At an unprecedented pace, the Asia-Pacific Region currently shares 60 per cent of the

world’s population aged 60 years or older due to improvement of life expectancy and falling

fertility rates (United Nations ESCAP, 2017). It becomes one of the significant transformations of

the 21st century, and their number is expected to double from 547 million in the region to nearly

1.3 billion by 2050 (ibid).

The increasing number of older people due to improving life expectancy and falling

fertility rates is also true in the context of the Philippines. The senior citizens, regarded as those

aged 60 years old and over, constitute 6.8 percent or 6.7 million of the population in 2010 which

was higher than 6.0 percent in 2000 according to the Philippine Statistics Authority (2015a).

Additionally, these figures are projected to double in size reaching 14.33 million by 2030 (ibid.).

This population growth of senior citizens in the country is the result of the increase in life

expectancy 一 currently at 68 years old, with male expected life of 65 and female 72, giving the

country a world ranking of 121 一 as well as the reduction of fertility rates (Department of Health

[DOH], 2017; World Health Organization, 2015). Because of the increase in the ageing

population, the demand for health services to be availed for and by the elderly is increased as

well (DOH, n.d.). Recognizing its implications on health care delivery and services, the Republic

Act (RA) No. 9994, known as the “Expanded Seniors Citizen Act of 2010”, was created to

provide for additional benefits and privileges to senior citizens, further amending RA No. 7432,
otherwise known as “An Act to Maximize the Contribution of Senior Citizens to Nation Building,

Grant Benefits and Special Privileges and for other purposes”. (DOH, 2017).

Section 5C of RA 9994 states that “The DOH, in coordination with local government

units (LGUs), NGOs and POs for senior citizens, shall institute a national health program and

shall provide an integrated health service for senior citizens. It shall train community-based

health workers among senior citizens and health personnel to specialize in the geriatric care

and health problems of senior citizens...Throughout the country, there shall be established a

"senior citizens' ward" in every government hospital…” which “...shall be for the exclusive use of

senior citizens who are in need of hospital confinement by reason of their health conditions...”

Quezon City, consisting of a land area of 171.71 sq. km. and a population of 2.94 million

(Philippine Statistics Authority [PSA], 2015b), is the largest and most populous city in Metro

Manila or the National Capital Region, constituting 23.3% of its entire population. Making up an

estimate of over 16.5% or 485,414 (Office for Senior Citizens’ Affairs [OSCA], 2016) of the

capital city’s population are its senior citizens. In the local government’s continuous efforts to

improve the health and welfare of its elderly members, various ordinances granting them special

benefits and privileges, facilities, services, and programs are thus provided and made available

for their consumption. With the city’s increasing aging population, hence, comes the need to be

able to provide them with the proper geriatric and healthcare they need.

i. Profiling of Senior Citizens in Quezon City

The population of registered senior citizens in Quezon City has been rapidly increasing

in the last 16 years (see Figure 1). As of August 2016, there were 45,967 newly registered

senior citizens, a significant increase from the 7,400 citizens who registered in 2001 (OSCA,

2016). Results from the 2010 Census of Population and Housing undertaken by the National

Statistics Office (as cited in PSA, 2013) show that the population of senior citizens, aged 60 and
above, in Quezon City during 2010 was at 151,966 (see Table 1). Six years later, this figure

exceeded triple its size, reaching its current population of 485,414 according to the OSCA

(2016).

Figure 1: Total Registered Senior Citizens of Quezon City as of Year 2001 to August 2016
Source: Office of Senior Citizens’ Affairs Quezon City (2016)

Table 1: Household Population by Age Distribution in Quezon City, 2010

AGE GROUP POPULATION

Below 15 802,864

15 - 59 1,796,749

60 and above 151,966

TOTAL 2,751,579
----------------------------------------------------------------------------------------------------------------
Source: National Statistics Office, 2010 Census of Population and Housing

Moreover, comprising 41.8% of Quezon City’s registered senior population are the

males totaling at 202,843 as of December 2016 (OSCA, 2016). Meanwhile, the female senior
population comprises the remaining 58.2%, totaling at 282,571 (ibid.). Among the six legislative

districts of Quezon City, District II is the most populated having 160,128 registered senior

citizens whilst Districts V and VI are the least populated, having only 27,143 and 28,417

registered senior citizens respectively (see Figure 2). The substantial difference in the number

of registered senior citizens between District 2 and Districts V and VI is the result of the latter’s

recent creation in 2012 wherein the former, the biggest in Quezon City, was divided into three,

thus, increasing the city’s four districts into its current six.

Figure 2: Total Registered Male and Female Senior Citizens in Quezon City (covered year 1993-2016)
Source: OSCA Quezon City (2016)

ii. Office Responsible in Handling Senior Citizens in Quezon City

According to the Department of Economic and Social Affairs of the United Nations

(2015), old age is associated with increased dependency and vulnerability. They have a growing

need for care and support as they become older because their health and income are declining.

Their source of support usually comes from social protection mechanisms such as insurance

and other health care benefits. The Department of Social Welfare and Services (DSWD), the

government’s social arm, mainly handles such public service delivery for people with special
needs in the Philippines that focus on care for the elderly and elderly volunteer programs. The

support programs that they provide include training, technical assistance, accreditation and

licensing of welfare agencies including public and private homes for the aged. These homes will

provide adequate care and relief from stress, family and community responsibilities and services

that will help achieve productive and satisfying life for the elderly.

In Quezon City, the office mainly responsible in handling its senior citizens’ concerns,

and come up with active programs and livelihood trainings for senior citizens for them to remain

productive and competitive members of society, is the Office for Senior Citizens’ Affairs (OSCA).

The office deals with several functions such as the issuing of a nationally uniform identification

(ID) for the seniors, providing Purchase Slip Booklets for medicine, organizing senior citizen

associations, disseminating information about senior citizen privileges, addressing their

complaints, and assisting the Social Service Development Department (SSDD) in their roles and

responsibilities (Local Government of Quezon City, n.d.).

The Social Service Development Department also covers social service and health care

for senior citizens. It oversees the implementation of volunteer work programs of the city for

senior citizens and retirees. Specifically, its role is to provide seniors with projects, activities and

programs that include recreation, livelihood and employment, medical and dental care, legal

assistance, and fitness and wellness. Home health care and assisted living are also covered. In

2015, 313 senior citizens participated in a volunteer program organized by the SSDD wherein

they were able to share their knowledge, experience, and expertise to others regarding other

programs of the city government such as in day care centers, public libraries, and in the

facilitation of activities among other senior citizens as well (Local Government of Quezon City,

2015).
 iii. Current Status of Senior Citizens in Quezon City

To achieve a productive, healthy and satisfying life for elders, an act recognizing Senior

Citizens’ right to have access to facilities was enacted into law, or the RA No. 7876, known as

“An Act Establishing a Senior Citizens Center in all Cities and Municipalities of the Philippines

and Appropriating Funds Therefor”. The facilities and centers are designed for recreational,

educational, health and social programs for the full enjoyment and benefit of the senior citizens

in the area, which will be jointly implemented by the DSWD, Federation of Senior Citizens

Association of the Philippines (FSCAP), and the Local Government Unit (Carlos, 1999).

The Quezon City government is one of the LGUs that considers adopting extended

programs for the elderly. The city currently has 485,414 registered senior citizens based on

OSCA records. Just in 2015, 40,026 of the city’s residents became senior citizens (Local

Government of Quezon City, 2015). The city government provides at least one per cent budget

allocation of its annual budget to the senior citizens which makes it the first local government in

the country to make such effort. Currently, the city provides an additional 18 per cent discount

on medical and dental services within two weeks of their birthday. Other benefits they receive

include the new tax break ordinance, Ordinance SP-2378, which exempts them from paying the

transfer tax once they sell their residential real property in Quezon City, movie privileges of up to

two movies every Mondays and Tuesdays, free parking in malls and establishments, and as per

Ordinance SP-1986, those reach their 100th birthday they will receive a plaque and Php 10,000

in cash (Local Government of Quezon City, 2015). A monthly allowance of Php 1,000, and a

cash gift of 1,000 together with their Christmas and birthday gift are also additional benefits

granted to the these centenarians through the issuance of Executive Order (EO) No. 10, series

of 2010. Furthermore, indigent senior citizens who are disabled, sick, or frail, receive a monthly

cash stipend amounting to Php 500 through the assistance of the Social Pension Program of

the national government (ibid.).

 The city government has also come up with an ordinance known as the Quezon City

Senior Citizens’ Shelter Home Ordinance of 2016, an initiative that will provide comprehensive

health care and rehabilitation program for senior citizens especially those who have been

abandoned and are homeless. The ordinance recognizes the right of senior citizens to have

their proper place in society. As such, the proposed home shelter serves as their transition

house and temporary shelter for not more than two weeks where they will receive immediate

care while the government aids them by contacting their relatives and other proper institutions

for their permanent custody and care (Philippine Information Agency, 2016). If remain unfetched

after the two-week lapse, they shall be referred to appropriate institutions (ibid.).

Proposed plans and activities for and from the senior citizens associations of barangays

registered under the Office of Senior Citizens Affairs (OSCA) can be funded once submitted and

duly approved by the corresponding officials (Local Government of Quezon City, n.d.). This is

enabled through the issuance of Ordinance no. 2355, series of 2015, which recognizes the need

to empower them.
 II. REVIEW OF RELATED LITERATURE

A. Geriatrics

In the early part of the twentieth century, Ignatz Nascher, a New York Physician, coined

the term geriatrics which deals with the health and care of old people (Aging Successfully,

2006). Recognized as the “Father of Geriatrics”, Nascher posits that the term be added to the

existing vocabulary to “emphasize the necessity of considering senility and its disease apart

from maturity and to assign it a separate place in medicine.” (ibid., p. 17). The term gerontology,

on the other hand, was created almost at the same time by Nobel Prize winner Elie Metchnikoff,

wherein he defines it as the study of aging. Simply put, whereas geriatrics concentrates on the

“medical conditions and disease of the aging, gerontology is a multidisciplinary study that

incorporates biology, psychology and sociology.” (Journal of Gerontology and Geriatric

Research, n.d.).

According to Section 3b of RA 9994, known as the “Expanded Senior Citizen’s Act of

2010”, geriatrics refer to the “branch of medical science devoted to the study of the biological

and physical changes and the diseases of old age.” Generally, it focuses on the maintenance of

function which, at the most fundamental level, is the ability to get in and out of bed, wash, dress,

feed, and toilet oneself (Aging Successfully, 2006). Moreover, according to Wieland (2012),

“Geriatrics addresses health complexities outside of biological processes, by weighing the

effects of social, psychological, and environmental factors on the manifestations in older

patients of multiple morbidity, system impairments, geriatric syndromes, and disabilities”

bringing full circle to the “social, economic, formal and informal sources of health and well-being

of older populations.”

B. Geriatric Healthcare Professionals

There are healthcare professionals or physicians who specialize on the care of the aging

population, known as the geriatricians. These physicians undergo special training to be able to
properly evaluate, treat, and manage the healthcare needs of older adults due to the latter’s

complicated medical care which entails special attention since they are prone to multiple health

problems (Aging Successfully, 2006). Likewise, they also have special medical skills that is

concerned with the clinical, preventive, remedial, and social aspects of the illnesses of older

persons (Srinivas. 2012). They seek to improve the aging population’s functions not just by

treating diseases as they occur but by also working closely with primary care to enhance these

people’s quality of life as they age (Aging Successfully, 2006). Other professionals in the

healthcare team who evaluate the older person’s medical, social, emotional, and other needs

include, but are not limited to, nurses, physician assistant, social worker, consultant pharmacist,

nutritionist, physical therapist, occupational therapist, speech and hearing specialist, and

geriatric psychiatrist (Aging & Health A to Z, 2012).

Furthermore, despite the fact that the population in need of specialized medical

knowledge in geriatrics is continuously increasing, the supply of geriatricians across the world is

declining (Mor & Katz, 2008). More alarming, however, is that because of this population

growth, developing nations, South Asia included, “have much less time to achieve the

transformations of social, economic and health systems necessary to maintain the health and

quality of life of older people.” (Wieland, 2012). V. Chua, a doctor specializing in internal and

geriatric medicine, claims there are only about 30 of them in Metro Manila and that most, if not

all, of them are working in private hospitals and institutions (personal communication, May 6,

2017).

In a research conducted by Meiboom, de Vries, Hertogh and Scheele (2015) which

aimed to determine the reason why medical students do not choose a career in geriatrics,

results show that this was due to (1) lack of exposure to older adults, (2) low status and low

financial reward, and (3) the nature of the work since geriatric patients often have complex and

multiple health problems. To remedy this non-commensurate number of geriatricians who can
address the needs the aging population, Bardach and Rowles (2012) suggest that we “move

from grudging, glacier like acceptance of the need for geriatric and gerontological education

toward enthusiastically embracing such education as a societal priority that must be met

regardless of cost and profitability.” (p. 617).

C. Geriatric Centers

Geriatric centers serve as a hub designed to address the increasing needs and interests

of the elderly while at the same time providing nutritional, social, physical, and educational

activities that foster independence and community engagement among its members (Jacobson,

O’Hanlon, Bennett, & McCloskey, 2004).

In the prefeasibility report of setting up a geriatric care center in Karnataka, India

conducted by ICRA Management Consulting Services Limited (2012), the proposed geriatric

center is a clinic that will provide day-to-day outpatient and inpatient services for geriatric

patients apart from also having special clinics for specific ailments. The center will be composed

of a healthcare team that includes doctors, nurses, hospital attendants, and cleaning staff. The

proposal to establish the center is a result of the absence of dedicated health centers for

geriatric medicine. As such, the geriatric center calls for “an integrated and holistic approach to

medical care as the mental psyche, physical ability, curing capability, responsiveness of the

body to medicines and financial capability of the patients is delicate as well” while still relying on

“the district hospital infrastructure for laboratory, diagnostic, ambulatory and referral service.”

(ibid., p. 11).

In India, Madras Medical College conducts community based outpatient and inpatient

services at the Government Peripheral Hospital (ICRA Management Consulting Services

Limited, 2012). In its outpatient services, people older than 60 years of age receive medical

treatment where about 350 patients get treated there every week. Meanwhile, their inpatient
ward has 34 beds wherein four of those are reserved for intensive care while ten are reserved

for long term care. Furthermore, their department treats acutely ill elderly patients who have

multiple health problems and transfers them to Government Peripheral Hospital if there is a

need to treat chronic diseases (ibid.).

Shrestha (2014) presented a study on the residential care home for elderly people in

Nepal which aims to provide comprehensive package services for elderly people such as

lodging, food, nursing care, recreation facilities, physiotherapy, and health care while

addressing their ailments as well. The residential care home model focuses on providing

nursing care for elderly people, providing recreational facilities for their social and mental peace,

and fostering a comfortable home environment able to respond to their daily needs. People

aged above 60 years old who need social and medical care could seek help at the home

environment with the aid of trained nurses under the supervision of a medical doctor (ibid.).

In the United States, research shows that the activities and services offered in senior

centers help foster the seniors’ mental and physical well-being, enhance their quality of life, and

facilitate their self-sufficiency (Jacobson et.al., 2004).

Launched in 2015, the NCH Brookdale Geriatric Center in the United States aims to

accommodate the medical needs of the aging population with a roster of geriatricians on the

medical staff at NCH specializing in aging adult care (NCH Healthcare System, 2015). Its

services and programs include community education offerings, such as classes for caregivers,

“community program information; palliative services; specialty wellness programs such as those

for stroke rehabilitation, back pain, osteoporosis, and water aerobics for multiple sclerosis and

Parkinson’s disease patients.” (ibid.).

In Japan, there is a Geriatric Health Services Facility called Roken that provides three

types of services, namely, (1) institutional services - to receive medical care, rehabilitation,
nursing, and other daily care services, (2) short stay services - to relieve the caregivers or

recondition the elderly, and (3) outpatient rehabilitation - to undergo rehabilitation therapies

(Japan Association of Geriatric Health Services Facilities, 2014). The idea behind Roken was

manifested in its original slogan, "to improve the user's function to enable them to go back

home.” Ultimately, its mission is “to enable a person under a Condition of Need for Long-Term

Care to live a long and meaningful life.” (ibid., p. 3).

The strong likelihood that older patients will develop multiple acute and chronic illnesses

and, therefore, will require constant care and treatment by medical professionals (Vedel,

Akhlaghpour, Vaghefi, Bergman, & Lapointe, 2013) emphasizes the need for a separate

geriatric health center. The common misperception of people is that the ailments the older

population get are due to old age and, thus, they simply accept these illnesses even though

they are curable hence resulting in the neglect of their health conditions (ICRA Management

Consulting Services Limited, 2012).

 III. PROJECT OVERVIEW

A. Overview of the Project

This study aims to assess the viability of establishing a geriatric health center in Project

8, Quezon City by conducting a comprehensive study on the project’s market, technical,

management, financial, and socio-economic aspects.

B. Goals and Objectives of the Study

According to Carlos (1999), health status bodies undergo changes as people age. This

development makes them less resistant to chronic, debilitating and disabling conditions which

may lead to developing disabilities and contracting diseases. Thus, there is a need for a strong

commitment that recognizes the need of senior citizens to take their proper place, as well as to

provide comprehensive health care and rehabilitation system for them to have a satisfying and

productive life. Considering these concerns, this paper aims to assess the feasibility of

developing and establishing a geriatric health center in Project 8, Quezon City. More

specifically, the study aims to:

1. Determine the scope of service availability and problems faced by geriatric patients in

the local government of Quezon City;

2. Create a criteria of site preference and selection for the development of geriatric health

center;

3. Analyze sites within the city that are appropriate for the development of geriatric health

center while considering the size, location, accessibility and general surroundings of the

area;

4. Identify physical infrastructures and resources needed for the provision of geriatric

health center; and

 5. Evaluate potential operating costs in the construction of the proposed geriatric health

center

C. Scope and Limitations

Scope. The purpose of this paper is to assess the feasibility of establishing a geriatric

health center to be located in Project 8, Quezon City by utilizing quantitative and qualitative

analysis.

Limitations. This study is limited to the assessment of establishing a geriatric health

center which will cater to the needs and wellness of outpatient senior citizens. Although some

points regarding in-patient senior citizens will be discussed in the succeeding chapters, the

overall study is focusing on the viability and sustainability of establishing an outpatient geriatric

health center in Quezon City.

D. Methodology

The researchers employed quantitative and qualitative mechanisms in the preparation of

this feasibility study. The data gathering procedure commenced by conducting an initial profiling

of Quezon City and its residents ㅡ particularly the senior citizens ㅡ by obtaining data and

relevant statistics from the website of the local government of Quezon City, the Office of Senior

Citizen Citizens Affairs (OSCA), as well as from other online sources. Furthermore, relevant

documents pertaining to health statistics of the residents in Quezon City were acquired from the

Quezon City Health Department. A consultation with the City Planning Office was also held to

determine the most feasible site of construction of the geriatric health center which was also

based on their office’s initial projects. Given that geriatric care services encompass a variety of

health services intended for senior citizens, the researchers conducted an online interview with

Dr. Lydia Manahan from the College of Nursing, University of the Philippines (UP) Manila and a
personal interview with Dr. Vic Fileto Chua, an Internist and Geriatrician from Far Eastern

University Nicanor Reyes Medical Foundation (FEU-NRMF).

Based from the data gathered, the researchers employed various quantitative methods

in order to analyze the overall viability of establishing a geriatric health center in Project 8,

Quezon City. The following are the quantitative methods used: Statistical Parabolic Method,

Gantt and Program Evaluation Review Technique (PERT) Chart, Cost-Benefit Ratio, Cost-

Benefit Analysis, and Net Present Value.

 IV. MARKET STUDY

A. Demand Analysis

The Philippine Statistics Authority (PSA) is the lead agency mandated to make an

inventory of the population in the country. As of the latest population consensus published by

the office, the country has a population of approximately 100.98 million people. This means that

the current population density of the country increased from 308 to 337 persons per square

kilometer. Based on the 2012 consensus, 5,905,000 people in the country are part of the senior

population which comprises 6.1% of the total population.

The National Capital Region (NCR), also known as the most densely populated region,

has a population density of 20,785 persons per square kilometer. Quezon City, occupying

171.71 kilometers (27.8%) of the total land area of Metro Manila, is known as the largest city in

the region with an annual population growth rate of 1.17% based on the 2010-2015 population

consensuses. It is also known as the most populated city in the region with a total of 2,936,116

persons as of 2015, making its population density to be approximately 17,100 persons per

square kilometer.

Geriatric care is one of the emerging issues in the country since the Philippines’ senior

citizen population is continuously growing. As of 2016, the population of senior citizens (those

who are 60 years old and above) living in Quezon City is 180,811 or 5.52% of the total

population which is 3,273,907. Since Quezon City is the biggest city in the metro, aging and

public health services are mostly in demand but also insufficient due to the great volume of

senior citizens in the country.

 Figure 3: Population of newly registered Senior Citizens in OSCA from 2012 to 2016
Source: Office of Senior Citizens’ Affairs, Quezon City Hall

According to the 2015 report of Department of Health (DOH), as shown below, a total of

298 (7.76%) of Quezon City residents from ages 60 and above suffer from acute lower

respiratory tract infection and pneumonia. This is one of the top 10 leading causes of morbidity

in the country. Aside from health concerns, there is an alarming number of elderly who are

reported as neglected, abandoned and maltreated. In 2015, a total of 55 elderly were reported

under the same case while a total of 20 elderly were reported in May 2016.

Table 2: Acute Lower Respiratory Tract Infection and Pneumonia

Source: Department of Health, 2015
 Figure 4: Morbidity Rate of Senior Citizens in Quezon City in 2014
Source: Quezon City Health Department, 2014

In the figure above, it shows that according to Quezon City Health Department, in 2014

the leading cause of morbidity among senior citizens in Quezon City is hypertension, while

pulmonary tuberculosis ranked second, and upper respiratory tract diseases ranked third. This

result is not that different from the table present previously in which respiratory tract infection

and pneumonia was identified as the leading causes of morbidity among elderly people.

Senior citizens in the country receive substantive amount of benefits from the

government in order to sustain their daily needs. As stated in Republic Act No. 9994 or the

Expanded Senior Citizens Act, senior citizens enjoy the following benefits: 1) entitled to a 20%

discount and exemption, if applicable, on different sales of goods and services; 2) a minimum

5% discount on monthly utility bills; 3) free medical and dental services, diagnostic and

laboratory fees; 4) free vaccination; 5) provision of express lanes for senior citizens in all

commercial and government establishments; and 6) death benefit assistance of a minimum of

Two thousand pesos (Php2,000.00). Additional benefits can be further experienced depending

on which area the senior citizen is currently living.

In Quezon City, additional benefits like free parking, free movie tickets and 8% discount

on medical and dental services within two weeks of their birthday. Centenarians receive benefits

which include Php 10,000 on their hundredth birthday, Php 1,000 cash gift on every succeeding

birthday, Php 1,000 monthly allowance, and another Php 1,000 every Christmas. Aside from

these benefits, Quezon City government is considering to carry out projects and programs

implemented in other countries like Japan, Hawaii and Europe in order to cater their increasing

needs (Philippine Information Agency, n.d.).

Even if the older people are continuously and consistently receiving additional and

special benefits from both the national and local governments, one of the problems encountered

by the ageing population is the lack of or insufficient health care facilities that are specifically

designed for them. In Quezon City, only one social welfare facility, the Senior Citizens Day

Center, is available. As people age, the condition of their health starts to deteriorate.

Physiological and psychological changes in the body makes a person less resistant to chronic,

debilitating and disabling conditions while also making the person more at risk of developing

disabilities and contracting diseases. Some of the leading causes of mortality and morbidity

among elderly people is shown in Figures 5 and 6.

Figure 5: 10 leading causes of mortality for senior citizens for the year 2014.
Source: Quezon City Health Department, 2014
 Figure 6: 10 leading causes of mortality for senior citizens for the year 2015.
Source: Quezon City Health Department, 2015

Mortality is known to be the condition of being subjected to death. In the data provided

by the Quezon City Health Office, the leading cause of death for the older people in the year

2014 and 2015 are Myocardial infarction and Pneumonia, respectively. Myocardial infarction, or

better known as heart attack, is the death of the heart muscle due to sudden loss of circulating

blood while pneumonia is the inflammation of the air sacs of one or both lungs.

According to a clinical review done by Dr. Art Resnick, as people get older, they tend to

be more susceptible to heart disease since their blood vessels are also getting older. Aside from

the fact that these vessels become less flexible, the probability of fatty deposits along the artery

walls are much higher as you age. This is why older people are recommended to have regular

checkups and watch their heart disease risk factors. Pneumonia, on the other hand, tends to

affect seniors because of three main reasons: 1) older people are frailer and therefore, they

cannot clear secretions from their lungs; 2) older people tend to have weaker immune systems;

and 3) seniors are more likely to have other ailments (Sollitto).

 Based from the data and information provided by the Quezon City Health Department for

the years 2015 and 2016, the top three health programs that senior citizens avail were oral

health programs, cardiovascular prevention and control programs, and health, education and

information/lifestyle and behavior modification, respectively (See Figures 7 and 8).

Oral health programs provided by the local government of Quezon City to the seniors

include oral examinations, oral prophylaxis, tooth extraction, gum treatment, permanent filling

and temporary filling. Data from both years showed that oral examinations were the most sought

after programs while temporary filling garnered the least number of people.

Figure 8: Types of health care programs availed by the senior citizens in Quezon, 2015.
Source: Quezon City Health Department, 2015

Figure 8: Types of health care programs availed by the senior citizens

Source: Quezon City Health Department, 2016
 Cardiovascular programs, on the other hand, include screenings, diagnosis of home

parenteral nutrition (HPN) patients, treatments and screening of older people for specific

conditions such as blood sugar level, cholesterol level and Electrocardiogram (ECG).

Screenings for the possibility of acquiring heart diseases were the most availed service while

screenings for specific body conditions were the least. The last program anchors on the fact that

human behavior plays a vital role in the maintenance of health and prevention of disease.

A parallel feasibility study about senior care facility conducted in Arizona,USA by Copper

Queen Community Hospital in cooperation with the City of Bisbee presented the different types

of senior care facilities with a brief and general description of the services offered by the varying

types:

Type of Senior Short Description

Care Facility

Active Adult Generally 55+, unaffiliated with health-care services

(though generally close by), for older adults who are able
to care for themselves fully

Independent Living Generally for 55+, affiliated with some type of health-care
service, for older adults who can generally care for
themselves fully but may have higher health or lifestyle
risks

Assisted Living A residential care solution with fully integrated health

services including supervisory, personal, or directed care
on a continuing basis for older adults needing the
additional support

Nursing/ This specialty care is almost exclusively residential (or

Memory Care 24hr home integration) as these more specific, high-risk
(Alzheimer/Dementia) aging related medical conditions require significant
 supervisory, personal, and medical care on a constant
basis

Hospice Care These highly specialized facilities are used during the
“end of life” stage, for the extremely terminally ill and near
death patients requiring constant care, but with no
possibility of recovery or extended life expectancy.
Generally a hospice facility is used by the client/patient for
less than 14 days

Continuing Care A facility that incorporates some or all of the above types
Community in one facility/campus

Based from the analysis of the provided data, information and parallel studies, this

feasibility study would like to propose the establishment of a geriatric health center which will

provide geriatric services for the senior population in Quezon City. In this study, the researchers

would like to propose a senior care facility which will cater to the basic health care needs of the

seniors and provide basic medical assistance and services that are specifically intended for

them. Aside from these, the researcher would also like to address the psychosocial needs of the

senior citizens by integrating a counseling and cessation program through the aid of a

community psychologist.

i. Projected Demand Based on Past Demand

In order to validate the trend of demand of senior citizens in Quezon City, a quantitative

approach was employed by the researchers. Using Statistical Parabolic Method in analyzing the

four-year demand projection, the table below shows the computed projection of population

demand of senior citizens in Quezon City who will be availing various health care services.

Among the different projection methods, the researchers used Statistical Parabolic Method

since it has the least standard deviation (See Table 3).

 Table 3: Population Demand Projection of Senior Citizens in Quezon City registering in OSCA

Formula:

Yc = a + bX + cX2 b = 1.231185

a = 20.83099 c = 0.031204

Based from the computed values of demand projection from 2001 to 2020, the

researchers were able to plot its values using a line table to have a visual presentation of the

trend of senior citizens who will register in Quezon City to avail various services. Looking at

Figure 9, we can see that, based from our projection using Statistical Parabolic Method, there

will be a constantly increasing number of senior citizens who will be registering to the Office of

Senior Citizens’ Affairs to avail services from 2017 to 2020.

 Figure 9: Projected Population Demand of Senior Citizens in Quezon City from 2001 to 2020 using
Statistical Parabolic

B. Supply (of Geriatric Facilities in Quezon City)

Given that there are still no existing geriatric health centers in Quezon City, the

researchers will then present the number of hospital-based geriatric facilities in Metro Manila

according to Philippine College of Geriatric Medicine, Inc. Based from their official list, as of

2017, there are only four (4) hospital-based geriatric services in Metro Manila which is

presented in the table below:

29
 Table 4: List of Geriatric Medicine Hospital Services in Metro Manila
Source: Philippine College of Geriatric Medicine, Inc. Retrieved from:
http://www.geriatricsphilippines.org/GeriatricsHospitalsandHomecare.html

Geriatric Medicine Hospital Services Location

Center for Healthy Aging Geriatric Wellness Pasig City

Geriatric Multidisciplinary Clinic Manila City

Philippine General Hospital Manila City

St. Luke’s Medical Center Quezon City

University of Sto. Tomas Manila City

Table 5: List of Hospital-Based geriatric facility in Quezon City

Hospital-based geriatric Number of available Number of bed spaces

facility in Quezon City Geriatricians specific for geriatric
patients

St. Luke’s Medical Center 4 Undefineda

Quezon City General 1b 10

Hospital

a There are no specific wards and suite rooms that are intended for geriatric patients due to its

overlapping use for all in-patients.

b Visiting consultant

C. Marketing Program
Saint Luke’s Medical Center is the only hospital which has a geriatric center dedicated to

offer health care services which address the special health care demands and needs of the

senior population. They also offer home care programs for patients who cannot travel and are

bedbound or have difficulty into following up all ambulatory out-patient clinics.

30
 This feasibility study aims to present a project which can address the increasing

demands of the senior population for health care services given that its population is

continuously growing.

Since the researchers are planning to establish a new geriatric health center which will

be undertaken by the local government of Quezon City, the marketing strategy that the

researchers would like to implement is through either partnership with non-government

organizations or private institutions (if possible), presenting the findings of the feasibility study to

the Office of Senior Citizens’ Affairs, City Planning Office, and Health Department of Quezon

City to provide an avenue for the lobbying of the project proposal to the Sangguniang

Panlungsod and ensure that it will be supported by these offices.

31
 V. TECHNICAL STUDY

A. Details of the Proposed Project

In this section of the paper where the prospect location, size, and floor plan of the

proposed geriatric health center will be presented. Also, details on the construction timeframe

and specific resources including construction costs and equipment costs will be shown below.

i. Prospect Location and Size

Among the different possible locations within Quezon City, the researchers chose to

establish a 250m2 geriatric health center in Project 8, Quezon City, specifically beside the

Quezon City General Hospital to make it more accessible to the public. Given that the

abovementioned hospital is one of the few hospitals in Quezon City that offers a 10-bed IP

geriatric ward, it would be more accessible for the patients to visit QC General Hospital

whenever referral from the geriatrician is applied or in some circumstances, whenever patients

are advised by the geriatrician for confinement.

Figure 10: Aerial view of Quezon City General Hospital, Project 8, Quezon City
Source: Google Earth Pro

32
ii. Floor Plan of the Geriatric Health Center
To have a visual presentation of the proposed 250m2 geriatric health center, the

researchers used the software SmartDraw 2017 to demonstrate its main components. Based

from our consultation with experts in building constructions, it was found that, although 250m2

was allotted for the establishment of the health center, only 160m2 will be utilized for its

construction. The figure below shows the proposed floor plan of the geriatric health center,

together with its dimensions and components.

Figure 11: Proposed Floor Plan of 160 m2 Geriatric Health Center in Project 8, Quezon City

33
Components of the Geriatric Health Center:

1 - Reception Area and Waiting Area (6 x 7m2)

2 - Doctor’s Room (Geriatrician) (6 x 5m2)
3 - Counselling and Cessation Program Room (5 x 6m2)
4 - Fire Exit
5 - Janitorial Room (1.5 x 3m2)
6 - Pantry (4 x 4m2)
7 - Multipurpose Room (5 x 4m2)
8 - Nurse Cabin (3 x 2.6m2)
9 - Comfort Rooms (2.2 x 2.4m2 each) *2 units

B. Operation Strategy (PERT and Gantt Chart)

The Program Evaluation Review Technique (PERT) is a tool used in project

management to coordinate, organize and schedule the different tasks within the project. It

involves the proper timing and scheduling of sequential tasks and activities which would help

the project managers to estimate the original schedule of activities and also to determine the

shortest (crash) amount of time needed in order to complete the project.

Below is the PERT Chart for the proposed Geriatric Facility of the research team:

Figure 12: Original Schedule of Construction using PERT Chart

34
The sequential activities involved in the construction of the Geriatric Facility are as follows:

Table 6: Sequential Activities per path, PERT Chart

PATHS

A Obtaining of financing

B Machinery supplier selection

C Materials supplier selection

D Plant site acquisition

E Order and receipt of machinery

F Order and receipt of materials

G Building construction

H Machinery installation

The table below shows the path for each activity sequence together with their

corresponding normal duration and the crash (shortest) duration. The new schedule (crash

duration) for the construction of the geriatric facility is also indicated in the PERT Chart below.

The researchers, however, were not able to compute for the normal cost and crash cost due to

lack of experts to assist in performing shadow-pricing.

35
 Table 7: PERT-Time and Duration of Construction (both normal and crash)

PERT-Time Duration

Activity Beginning End Normal Crash

A 1 2 6 5

B 1 4 2 1

C 1 6 1 1

D 2 3 3 2

E 4 5 8 7

F 6 7 2 1

G 3 5 6 5

H 5 7 2 1

Figure 13: New Schedule of Construction using PERT Chart

36
 The content of the Gantt chart, on the other hand, is similar to PERT Chart, however, it

is only in bar chart form. This chart is often used by researchers to illustrate the schedule of

their proposed projects including the start date and end date. Gantt charts may also illustrate

those activities that may be performed on the same month, meaning, it has the ability to present

which activities may be done simultaneously but not necessarily overlapping each other.

Presented below are the Gantt chart which illustrates both the original schedule and new

schedule based from the computed values in PERT Chart.

Table 8: Original Project Construction Schedule (Gantt Chart)

Activity Number of months from the date of start

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
Obtaining of
financing
Machinery
supplier
selection
Materials
supplier
selection
Plant site
acquisition
Order and
receipt of
machinery
Order and
receipt of
materials
Building
construction
Machinery
installation

37
 Table 9: New Project Construction Schedule (Gantt Chart)

Activity Number of months from the date of start

1 2 3 4 5 6 7 8 9 10 11 12 13 14
Obtaining of
financing
Machinery
supplier
selection
Materials
supplier
selection
Plant site
acquisition
Order and
receipt of
machinery
Order and
receipt of
materials
Building
construction
Machinery
installation

C. Construction Timeframe

For the cost of building the facility, the researchers used the area method in order to

estimate the amount of money needed to set up the health center in Project 8, Quezon City. In

order to get the estimated cost for this project, the researchers computed for the total floor area

of the facility and also the cost factor which were determined by experienced engineers.

Estimated building cost were determined by multiplying the floor area to the cost factor.

Land Acquisition @ Php 50,000 per m2

Total Land Cost (250 m2): Php 12,500,000.00

38
 Item Remarks Product
S.No.

1 Reception Area/Waiting Room 6.5 x 5 m2 32.5

2 Doctor's Room 5 x 6 m2 30

Counselling and Cessation

3 24
Program Room 4 x 6 m2

4 Janitorial Room 1.5 x 3 m2 4.5

5 Pantry 4 x 4 m2 12

6 Multipurpose Room 3 x 3.5m2 10.5

7 Nurse Cabin 3 x 5 m2 15

8 Comfort Rooms 2 x 2.5 m2 [*2] 10

9 Open Space (Aisle) 22.06

Total Area 160.56 m2

Cost of Development @ Php 2500/m2 Php 25,000 4,014,000

Total Building Cost Php 4,014,000

Construction period: 6 months

Ave. manpower: 15-20 laborers

Total structure area: 160.56 m2

Permits and Licenses Cost: 5-10% of actual cost

Design and Management Cost: 5-10% of actual cost

Note: Cost may vary, depending on the kinds and types of materials to be used. Considered for

this cost estimate are just simple plastered paint cement finish, simple tiles, etc.

39
i. Raw materials and equipment

Item Quantity Cost Per Unit Cost

1 Nebulizer 2 3,900 7,800a

2 Glucometer 1 1,900 1,900a

3 Ultrasound Therapy 1 114,400 114,400b

4 Biomedical collection setup (4 bin system) 2 2000 4,000

5 Trans Electric Nerve Simulator (TENS) 1 2,200b

Machine Digital 2200

6 Wheel chair 2 4,500 9,000a

7 Stretcher Trolley 1 10,500 10,500a

8 Adjustable walker 2 1,200 2,400a

9 Bed 3 8,500 25,500a

10 Infrared Non-Contact Thermometer 1 1,800 1,800

11 Blood Pressure Aneroid and Stethoscope Set 1 1,500 1,500

12 Stethoscope 2 250 500

Total Equipment Cost Php 181,500

a Bambang Medical

b Philippine Medical Supplies

40
ii. Furniture Cost Estimate
Listed in the table below are the furniture and other materials needed in putting up the

proposed geriatric health center.

S.No Item Quantity Cost Per Unit Product

1 Reception table 1 15,000 15,000

2 Television 1
12,000 12,000
3 Chairs 25 3,000 75,000
4 Cabinet 5 10,000 50,000
5 Sofa 3 25,000 75,000

6 Table 8
5,000 40,000

Total Furniture Cost:

Php 267,000

iii. Labor cost and requirements

In order to get the total labor cost for this project, the researchers will use the data

retrieved from the Philippine Statistics Authority which determined that the labor cost in the

construction industry registered the lowest share at 18.1 percent of the total cost for building the

facility.

Number of laborers Total Budget for Total Labor Cost

needed Building Construction (18.1% of construction
cost)
20 Php 17,316,800 Php 3,134,340.8

41
 VI. MANAGEMENT STUDY

A. Organizational Structure

The geriatric center’s organizational structure is patterned to Department of Health’s

prescription of organizational structure for the lowest classification of health facilities as stated in

the Revised Organizational Structure and Staffing Standards for Government Hospitals (2013).

Figure 14: Organizational Structure in a Health Center

B. Manpower Requirements

The required manpower for the geriatric center was based on the feasibility study, Pre-

feasibility Report for setting up a District Geriatric Care Center and Department of Health’s

Revised Organizational Structure and Staffing Standards for Government Hospitals. The

following staffs is needed for the geriatric center:

42
Medical services

1. Geriatrician
The geriatricians shall attend to the health care needs of older out-patients who visit

the geriatric health center. They are especially trained to cater the needs of the

older people whom have different conditions compared to other ages. Because of

the scarcity of geriatrician and the health center’s limited services, the researchers

plan to hire a geriatrician that will be in charged in the health consultations of older

patients.

2. Community Psychologist
The community psychologist is in charge of the counselling of the olders’ families.

This counselling is to impart information to the families on how to take care of the

elder members of the family.

Nursing services

1. Nurse
Nurses shall be responsible for giving constant care and assistance to geriatric

patients. The researchers are considering for only one nurse. Unlike other health

facilities who implement shifting of health personnel such as nurses, the geriatric

health center will only implement a single shift per day as the facility will only be

open from 8 in the morning to 5 in the afternoon.

2. Caregivers
The caregivers will assist in providing care for the older patients of the geriatric

health center. The proposed number for this specific staff will be two as each will

be responsible for giving care to an average of 30 patients a day.

43
Hospital Operations Management

Patients’ Assistance and Cash Operations

1. Administrative Officer (Front-Desk Personnel or Cash Clerk)

The administrative officer is responsible for guiding the patients in their

inquiries during their visit in the geriatric health center; he or she is mainly in-

charge of collecting all the payments from the geriatric health center’s clients.

Facilities Management

1. Administrative Aides (Utility workers or Janitors and Laundry Worker)

The health center’s administrative aides is composed of utility workers and

laundry workers. The utility workers is responsible for maintaining the

cleanliness in the health center whilst the laundry worker is in-charged of

washing the linens, pillowcase, and curtains to promote hygiene.

Security

1. Security guards
He or she secures the premises, personnel and properties by patrolling

around the health center and inspecting every person who enters the facility.

44
C. Compensation
The table below shows the list of prospect personnel needed in operating the geriatric

health center, together with their corresponding salary grade based from the Department of

Budget and Management:

Table 10: Personnel needed in a geriatric health center and their corresponding compensation

Staff Number Salary Monthly Total Annual Salary

of Staff Grade Salary Monthly
per Staff Salary

Geriatrician 1 16 33,584 33,584 403,008

Community 1 15 33,279 33,279 399348

Psychologist

Nurse II 1 14 27,755 27,755 333060

Caregivers 2 1

11,068 22136 265632

Administrative 1 6 14,847 14,847 178164

Officer (Front Desk
Personnel or Cash
Clerk II)

Administrative Aide 1 1 11,068 11,068 132,816

I (Utility Worker
I/Janitor)

Security Guards 2 9 16,986 33,972 407,664

(contracted
out)

Total 17 148,587 176,641 Php 2,119,692

45
D. Legal Requirements

The geriatric center shall be governed by all existing biomedical, statutory and legal

laws governing hospitals or health centers.

The geriatric center shall get itself certified for and obtain certificates as follows:

A. Building permit
This will be acquired by the proposed geriatric health center if it adheres to the

building standards as prescribed in the Presidential Decree No. 1096 or the

National Building Code of the Philippines.

B. Fire Inspection Clearance

This clearance shall be issued by the Bureau of Fire Protection upon compliance to

Rule 10 or Fire Safety Measures of the implementing rules and regulations of the

Fire Code of the Philippines.

C. Sanitary Permit
The geriatric health center shall apply for and annually renew a sanitary permit

which shall be issued by the local health officer upon complying to the Presidential

Decree No. 856 or Code on Sanitation of the Philippines.

It shall also observe compliance to the following manuals and guidelines:

A. Manual and Technical Guidelines for Hospitals and Health Facilities Planning and

Design

This manual was published by the Department of Health which sets guidelines for

schematic planning and technical requirements of a 10-bed, 25-bed or 100-bed

hospital and health facilities.

46
B. Health Care Waste Management

This manual seeks to manage the health care waste; it is intended for health

facilities and local government units who are involved in handling, storage,

treatment and disposal of healthcare waste.

C. Signage Systems Manual for Hospitals and Offices

D. Health Facilities Maintenance Manual

E. Guidelines for Construction and Equipment

47
 VII. FINANCIAL STUDY

A. Total Project Costs

The tables below show the total project costs of putting up a geriatric health center which

includes capital outlay, personnel services, and maintaining and other operating expenses:

Table 11: Total Construction Cost of the Project

Items Cost

Land Acquisition Php 12,500,000

Building and Labor Cost Php 4,014,000

Permits and Licenses Cost 5-10% of actual cost (Php 200,700 - 401,400)

Design and Management Cost 5-10% of actual cost (Php 200,700 - 401,
400)

Labor Costs (Construction) Php 3,134,340.8

Equipment Cost Php 181,500

Furniture Cost Php 267,000

Total Cost of the Project (Construction) Php 20,899,641

(permits and licenses, and design and
management costs at maximum range limit)

48
 Table 12: Total Project Cost of Geriatric Health Center (includes PS, CO, and MOOE)

COST

Capital Outlay: Php 20,899,641

Operating Costs: Php 2,301,933

Manpower Services: Php 2,119,692

TOTAL COSTS: PHP 25,321,266

B. Initial Capital

Based on the development plans and estimates prepared by the Special Design Group

(SDG) of the City Engineering Department, the local government of Quezon City is planning to

purchase a total land area of 1 hectare (10,000m2) amounting to Php 350,000,000 that is

intended for putting up projects for senior citizens and children in-conflict with the law (CICL).

With this, the geriatric center having a land area of 250m2 will be appropriated with the amount

of Php 12,500,000. In addition, initial capital will be tapped from different offices that address

social welfare of senior citizens such as Health Department, Office of Senior Citizens Affairs,

and Social Services and Development Department.

C. Sources of funding

In accordance with Section 287 of RA No. 7160, every LGU shall appropriate in its

annual budget no less than twenty percent (20%) of its annual Internal Revenue Allotment for

development projects. The 20% of shall be utilized to finance the LGU's priority development

projects, as embodied in its duly approved local development plans and shall contribute to the

attainment of desirable socio-economic development and environmental management

49
outcomes of the LGU, and shall partake the nature of investment or capital expenditures. In this

regard, funds for the construction and operation of the Geriatric Center will come mainly from

the Quezon City government. Furthermore, national government agencies such as the

Department of Health can support for the funding of the facility. World Bank through its Urban

Health and Nutrition Program (UHNP) may provide infrastructure, manpower and logistic

support especially in urban poor areas since the current Quezon City Health Department

building was constructed using funds from this program. Moreover, the source of funding will be

included in the 2018 General Appropriations Ordinance of Quezon City.

D. Cost-Benefit Analysis

In computing for the cost-benefit analysis, the researchers used a formula in order to get

the estimated monetary benefits of a geriatric health center comparing both private and public

health services. Based from this, the researchers came up with an estimated value of monetary

benefits in establishing a geriatric health center in Quezon City, as presented below.

Formula in computing for Monetary Benefits:

Average Number of Outpatient/ Check-Up per Year x (Average Private Health Center

Services Cost - Average Public Health Center Services Cost) = Benefit

13,000a * (4,400b –1,200c) = Php 41,600,000

a
Estimated 10% of the total demand for a geriatrician
a
[700 (consultation fee) + 400 (laboratory fees)] * 4 (number of checkups annually)
b
[ 0 (free consultation fee) + 300 (laboratory fees) * 4 (number of checkups annually)

50
Net Benefit

In computing for the net benefits, the researchers basically subtracted the total

estimated costs of putting up a geriatric health center from the total estimated monetary

benefits. Based from this, the computed net benefits is Php 16,278,734.

Net Benefit = Benefit – Cost

= 41,600,000 - 25,321,266 = Php 16,278,734

Benefit-Cost Ratio

The Benefit-Cost Ratio, on the other hand, measures the profitability of the proposed

project based from values of total estimated cost and total estimated benefits. If the result gets a

positive value or greater than 1, it means the proposed project is profitable. If the project,

however, gets a computed value less than 0, then the project is not profitable or not worth it. As

presented below, the benefit-cost ratio of establishing a geriatric health center garnered 1.64

points, therefore, the proposed project is profitable.

𝟒𝟏,𝟔𝟎𝟎,𝟎𝟎𝟎
Benefit-Cost Ratio = 𝟐𝟓,𝟑𝟐𝟏,𝟐𝟔𝟔 = 1.64

E. Net Present Value

The Net Present Value (NPV) is a computation method of determining the difference

between the present value of cash inflows and the present value of cash outflows using a

discount rate (for the Philippines, we used 15%). It is also a good method of computing for the

profitability of the proposed project. In this method, if the computed value is positive, it means

the project is profitable but, if the computed value is negative, then the project is not profitable.

Based from the computation below, it shows that the proposed project is profitable given that

the project has a net present value of Php 40,654.13.

51
 𝑛
𝐵𝑖 − 𝐶𝑖
𝑁𝑃𝑉 = ∑
(1 + 𝑟)𝑖
𝑖=0

Given:

Initial Investment = Php 25,321,266

R = 15%

Table 13: Net Present Value Computation

Year Benefit Cost df Bd Cd

2018 0 25,321,266.00 1 0 25,321,266

2019 20,800,000 15,218,081 0.8696 18,087,680 13,233,643.12

2020 22,880,000 13,949,485 0.7561 17,299,568 10,547,205.94

2021 24,128,000 13,443,060 0.6575 15,864,160 8,838,812.029

2022 24,960,000 13,189,847 0.5718 14,272,128 7,541,954.777

65,523,536 65,482,881.87

Total NPV (Bd – Cd):

Php 40,654.13

52
Benefit-Cost Ratio (Discounted)

The discounted benefit-cost ratio is just the same with the previous computation,

however, the difference here is that the values used in computing for the ratio was got from the

discounted benefits and costs. Based from the formula below, the final benefit-cost ratio of the

researchers’ proposed project is 1.0006 which means the project is feasible.

𝐵𝑖
∑𝑛𝑖=0
(1 + 1)𝑖 𝟔𝟓, 𝟓𝟐𝟑, 𝟓𝟑𝟔
𝐵𝐶𝑅 = = = 1.0006
𝐶𝑖
∑𝑛𝑖=0 𝟔𝟓, 𝟒𝟖𝟐, 𝟖𝟖𝟏. 𝟖𝟕
(1 + 1)𝑖

53
 VIII. SOCIO-ECONOMIC STUDY

A. Contribution of the project to the society/economy

The geriatric health center would offer a better support to the social fabric of Quezon

City by providing effective medical care to its senior citizens. It would reinforce the commitment

and mandate of the government towards the welfare of its constituents. There are a number of

social and economic contributions of a geriatric center to Quezon City.

With the establishment of a geriatric center, an economic stimulus will positively affect

the location where it is in will be created. New job opportunities will be available and a market

brought about by those who come and go in and out of the center will be generated. The values

of properties around the center will also increase due to the increased activity that the center will

provide in its general area. This can lead to significantly greater tax revenues that the local

government receives from said properties.

The geriatric center offers a less expensive option in treating the ailments of our older

population. This makes for a broader reach of geriatric health care that can translate to a

decrease in the percentage of senior citizens in Quezon City with illnesses that they are unable

to get taken care of. This also implies that there will be less financial burdens that cause tension

within families that carry the responsibility to look after their elderly. Aside from these, the

geriatric health center that will be established will not only cater the medical needs of senior

patients, but also the psychosocial needs of both senior patients and their family members.

Given that in the Philippines, it is not part of the culture of FIlipinos to send their senior

relatives to a ‘home-for-the-aged centers,’ establishing a geriatric health center would provide

counselling and cessation programs for patients who do not really need medical assistance but

psychological counselling to boost their esteem and morale. At the same time, family members

of the senior patient will be able to avail services from the geriatric health center which will help

54
them improve their knowledge and capacities on how to better take care of their senior relatives

without sending them to an independent or assisted senior care.

B. Social Desirability

As the population of senior citizens in Quezon City rapidly increases, the need for a

geriatric center that will provide them better accessibility to services that their disposition

requires also increases.

The OSCA and the Senior Citizen Council of Quezon City attests to the need for such

facility that will cater to the growing needs of Quezon City’s senior population. The Senior

Citizens and their families are also supportive to the proposed center for it will provide them a

means of availing relatively affordable medical care and psychosocial services.

C. Social Acceptability (using PRINCE Analysis)

In measuring for the social acceptability of various stakeholders, PRINCE Analysis or

Probe, Interact, Calculate, and Execute was used by the researchers as a tool in evaluating the

overall percentage of stakeholders’ support on the proposed project based on three criteria

namely, issue position, power, and priority. In this case, the researchers were able to rate each

stakeholder depending on their issue position, power, and priority. After the stakeholders have

been rated, all the points were then combined and the percentage were computed. The higher

the percentage a proposed project gets, the higher the chance that its lobbying and

implementation will be supported by the identified stakeholders. The table below shows the set

of stakeholders concerned with geriatric health center together with their ratings per criterion

(i.e., issue position, power, and priority).

55
 Table 14: PRINCE Analysis

Stakeholders Position Power Priority Total

Chief Executive of Quezon City 3 5 2 30

Quezon City Office of 5 3 4 60

Senior Citizens Affairs

Senior Citizen Council of Quezon City 5 1 5 25

Quezon City Health Department 2 3 2 12

Quezon City Office of 2 3 2 12

City Planning and Development

Senior Citizens of Quezon City (0) 5 5 (25)

Total: 151.5

Percentage: 92.38%

Computation:

Total Support Score = 30 + 60 + 25 + 12 + 12 + 12.5 = 151.5

Total Stakeholder Score = 30 + 60 + 25 + 12 + 12 + 25 = 164

Probability * 100 = 92.37805%

A consensus has been made to decide on the level of the involvement and roles of the

different stakeholders in the establishment of a geriatric center in Quezon City. Three criteria

were measured for this PRINCE Analysis - position, power, and priority. Position refers to

whether one is in favor or opposed to the project. Power, on the other hand, is the ability of an

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individual or an institution to make the project happen. Finally, priority is the importance one

gives for the fulfillment of the project.

After evaluating the criteria using PRINCE analysis, it has been found that the

acceptability of the stakeholders for the establishment of a geriatric center in Quezon City is at

92.38%. This means that there is little to no disagreements in the construction of a geriatric

center and that those involved poses no conflicts with this.

D. Social Rate of Return

Productivity in the area is expected to rise after the establishment of the geriatric facility.

Along with this is the shift in the activity in different sectors of the society. This includes better

health, increase in local security, and more socially aware citizens. These benefits to the society

can promote social cohesion among the residents of Quezon City.

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 IX. Findings and Recommendations

Based from the overall analysis of the researchers which employed both quantitative and

qualitative methods, it was found that geriatric health services for elderly population in Quezon

City is highly needed given that there is an increasing demand for such services. This study also

found that the needs of senior citizens is not only confined to medical assistance but also to

psychological, mental, and social assistance. Given the limited supply of geriatric health centers

in Quezon City, together with the unique culture of FIlipinos in treating senior citizens, the

researchers came up with a feasibility study on establishing a geriatric health center to be

located in Project 8, Quezon City beside Quezon City General Hospital. This center will be

intended for outpatient seniors who need general consultation, comprehensive geriatric

assessment, and counselling and cessation program (for those with vices). The geriatric health

center was made for outpatient seniors because the researchers took into consideration those

senior citizens who need medical checkups, counselling, and rehabilitation programs but do not

require longer stay in any senior care facilities which means after the program, the seniors

would eventually go back to their homes.

Based from the results of various analysis conducted in the previous sections, the

researchers conclude that establishing a geriatric health center in Quezon City would be

beneficial in addressing the medical and psychosocial needs of senior citizens. In addition,

referring to the result of the computation in financial analysis, it can be concluded that a geriatric

health center would be feasible and viable given that the proposed project garnered a benefit-

cost ratio (discounted) of 1.0006. However, due to the complexity of various needs of senior

citizens, the researchers recognize the need to take a comprehensive study on the best

possible health services that should be offered to them that would capture both physical,

mental, social, and psychological aspects. Also, there should be a consideration to the limited

number of geriatricians and gerontologists in the city.

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 X. References

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aging-and-health-a-to-z/topic:geriatrics/.

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letters/spring_06.pdf.

Bardach, S., and Rowles, G. (2012). Geriatric education in the health professions: Are we
making progress? The Gerontologist, 52(5), 607–618. Retrieved from http://doi.org/
10.1093/geront/gns006

Department of Health. (2017, January). Policy guidelines on the standards of care for older
persons in all healthcare settings. Administrative Order No. 2017 - 0001. Retrieved from
http://www.doh.gov.ph/health-and-wellbeing-of-older-persons

Department of Health. (n.d.). Health and well-being of older persons. Retrieved from
http://www.doh.gov.ph/health-and-wellbeing-of-older-persons

ICRA Management Consulting Services Limited. (2012). Prefeasibility report for setting up a
district geriatric care centre. Karnataka Infrastructure Development Department and ,
Bangalore. Retrieved from http://www.idd.kar.nic.in/docs/64.gcc.pdf.

Jacobson, E., O’Hanlon, J., & McCloskey, S. (2002). Healthcare policy. Retrieved from Institute
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Journal of Gerontology & Geriatric Research. (n.d.). Gerontology. Retrieved from

https://www.omicsonline.org/scholarly/gerontology-journals-articles-ppts-list.php

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not choose a career in geriatrics: a systematic review. BioMed Central Medical Education.
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Mor, V. and Katz, P. (2008). A modest proposition to align geriatrics and long term care
medicine. BioMed Central Geriatrics. doi: 10.1186/1471-2318-8-29

NCH Healthcare System. (2015, November). Health Matters. Retrieved from

https://d17lvj5xn8sco6.cloudfront.net/B9/FB/91/CB/00/94/2E/AA/48/18/6F/54/3A/CA/D7/A
2/0000B246/common/downloads/publication.pdf.

Office of Senior Citizen Affairs. (2016). Total Registered Senior Citizens of Quezon City

Philippine Information Agency. (2016). Quezon City eyeing to roll out more programs for senior.
Retrieved from http://news.pia.gov.ph/article/view/231470021460/quezon-city-eyeing -to-
roll-out-more-programs-for-senior.

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Philippine Statistics Authority. (2016). Highlights of the Philippine Population 2015 Census of
Population. Retrieved from https://psa.gov.ph/content/highlights-philippine-population-
2015-census-population

Philippine Statistics Authority. (2015a). The Philippines in figures 2015. Retrieved from
https://www.psa.gov.ph/sites/default/files/2015%20PIF%20Final_%20as%20of%2002291
6.pdf

Philippine Statistics Authority. (2015b). Population, land area, population density, and percent
change in population density of the Philippines by region, province/highly urbanized city,
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attachments/hsd/pressrelease/2015%20Population%20Density.web.xlsx

Philippine Statistics Authority. (2013). Quezon City population peaked at 2.8 million (results from
the 2010 Census of Population and Housing). Retrieved from
https://psa.gov.ph/content/quezon-city-population-peaked-28-million-results-2010-census-
population-and-housing

Philippine Statistics Authority. (2016). Structure of Labor Cost in the Philippines. Retrieved from
https://psa.gov.ph/sites/default/files/attachments/ird/pressrelease/vol20_11.pdf

Philippine Statistics Authority. (2015). Total population by city, municipality, and barangay: As of
August 1, 2015. Retrieved from http://psa.gov/sites/default/files/attachments
/hsd/pressrelease/NCR.xlsx

Republic Act 7432. An Act to Maximize the Contribution of Senior Citizens to Nation Building,
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The Local Government of Quezon City. (n.d.). Office for Senior Citizens Affairs (OSCA).
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 XI. Appendices

Total Registered Senior Citizens of Quezon City

District 2001 2002 2003 2004 2005 2006 2007 2008

I 1,390 2,087 3,259 3,026 3,882 3,909 3,781 4,397

II 3,700 4,400 5,000 4,237 4,922 6,748 8,195 8,042

III 1,170 1.653 2,099 1,622 3,622 2,348 2,462 2,856

IV 1,140 2,520 2,440 2,463 3,766 2,602 2,781 3,041

TOTAL 7,400 10,660 12,798 11,348 16,192 15,607 17,219 18,336

District 2009 2010 2011 2012 2013 2014 2015 2016

I 4,365 6,711 5,504 7,392 5,106 8,257 8,053 8,653

II 9,547 11,926 12,462 12,494 5,075 6,912 7,272 7,824

III 2,583 4,920 3,172 4,915 3,664 5,991 5,934 6,243

IV 4,015 4,249 4,315 6,632 4,853 7,181 6,939 7,454

V - - - - 5,668 4,954 7,981 8,540

VI - - - - 7,201 7,325 6,638 7,253

TOTAL 20,510 27,806 25,453 31,433 31,567 40,620 42,817 45,967

Source: Office of Senior Citizens’ Affairs Quezon City (2016)

Total Registered Senior Citizens by District

1993 - 2015 as of December 2016

DISTRICT I 108,128

DISTRICT II 160,153

DISTRICT III 72.383

DISTRICT IV 89,190

DISTRICT V 27,143

DISTRICT VI 28,417

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 TOTAL 485,414

Source: Office of Senior Citizens’ Affairs Quezon City (2016)

Total Registered Male and Female Senior Citizens

Covered Period (Year 1993 - December 2016)

DISTRICT MALE FEMALE TOTAL

I 45,096 63,032 108,128

II 65,530 94,623 160,153

III 30,420 41,963 72,383

IV 38,605 50,585 89,190

V 11,238 15,905 27,143

VI 11,954 16,463 28,417

TOTAL 202,843 282,571 485,414

Source: Office of Senior Citizens’ Affairs Quezon City (2016)

Total Figure of Registered Senior Citizens

2016 1993 - 2015 TOTAL

DISTRICT I 8,653 99,475 108,128

DISTRICT II 7,824 152,329 160,153

DISTRICT III 6,243 66,140 72,383

DISTRICT IV 7,454 81,736 89,190

DISTRICT V 8,540 18,603 27,143

DISTRICT VI 7,253 21,164 28,417

TOTAL 45,967 439,447 485,414

Source: Office of Senior Citizens’ Affairs Quezon City (2016)

Total Quezon City Living Centenarian

from 2009 up to the 4th Quarter of Monthly Pension 2016

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 DISTRICT MALE FEMALE TOTAL

I 2 17 19

II 2 5 7

III 5 21 26

IV 9 30 39

V 2 12 14

VI 4 17 21

TOTAL 24 102 126

Source: Office of Senior Citizens’ Affairs Quezon City (2016)

Total Recognized QC Centenarian as of 2009 to 2016

Female Centenarian - 176 (deceased - 74)
Male Centenarian - 32 (deceased - 8)
Total - 208

Total Figure of Social Pensioner for Indigent Senior Citizens of QC

DISTRICT MALE FEMALE TOTAL

I 36 146 182

II 33 150 183

III 22 78 100

IV 29 122 151

V 30 110 140

VI 10 54 64

TOTAL 160 660 820

Source: Office of Senior Citizens’ Affairs Quezon City (2016)

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