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 The Philippines is an archipelago composed of about 7,640 islands,[17][182] covering a total area, including inland bodies of water, of around 300,000 square kilometers (115,831 sq mi),[183][184] with cadastral survey data suggesting it may be larger.[185] Its 36,289 kilometers (22,549 mi) coastline gives it the world's fifth-longest coastline.[186] The EEZ of the Philippines covers 2,263,816 km2 (874,064 sq mi).[187] It is located between 116° 40', and 126° 34' E longitude and 4° 40' and 21° 10' N latitude and is bordered by the Philippine Sea to the east,[188][189] the South China Sea to the west,[190] and the Celebes Sea to the south.[191] The island of Borneo is located a few hundred kilometers southwest,[192] and Taiwan is located directly to the north. Sulawesi is located to the southwest and Palau is located to the east of the islands.[193][194]

The highest mountain is Mount Apo. It measures up to 2,954 meters (9,692 ft) above sea level and is located on the island of Mindanao.[195] The 10,540-metre (34,580 ft) Galathea Depth of the Philippine Trench in the Philippine Sea is the deepest point in the country and the third deepest in the world.[196][197][failed verification] The longest river is the Cagayan River in northern Luzon, measuring about 520 kilometers (320 mi).[198] Manila Bay,[199] upon the shore of which the capital city of Manila lies, is connected to Laguna de Bay,[200] the largest lake in the Philippines, by the Pasig River.[201] The Puerto Princesa Subterranean River, which runs 8.2 kilometers (5.1 mi) underground through a karst landscape before reaching the ocean, is a UNESCO World Heritage Site.[202]

Mayon is an active stratovolcano, located in the south of the island of Luzon

Situated on the western fringes of the Pacific Ring of Fire, the Philippines experiences frequent seismic and volcanic activity.[203] The Benham Plateau to the east in the Philippine Sea is an undersea region active in tectonic subduction.[204] Around 20 earthquakes are registered daily, though most are too weak to be felt. The last major earthquake was the 1990 Luzon earthquake.[205] There are many active volcanoes such as the Mayon Volcano, Mount Pinatubo, and Taal Volcano.[206] The eruption of Mount Pinatubo in June 1991 produced the second largest terrestrial eruption of the 20th century.[207] The Philippines is the world's second-biggest geothermal energy producer behind the United States, with 18% of the country's electricity needs being met by geothermal power.[208]

The country has valuable,[209] mineral deposits as a result of the its complex geologic structure and high level of seismic activity.[210][211] The Philippine are thought to have the second-largest gold deposits after South Africa, along with a large amount of copper deposits,[212] and the world's largest deposits of palladium.[213] Other minerals include chromite, nickel, and zinc. Despite this, a lack of law enforcement, poor management, opposition due to the presence of indigenous communities, and past instances of environmental damage and disaster, have resulted in these mineral resources remaining largely untapped.

The delivery of modern health care depends on groups of trained professionals and paraprofessionals coming together as interdisciplinary teams.[6] This includes professionals in medicinepsychologyphysiotherapynursingdentistrymidwifery and allied health, along with many others such as public health practitionerscommunity health workers and assistive personnel, who systematically provide personal and population-based preventive, curative and rehabilitative care services.

While the definitions of the various types of health care vary depending on the different cultural, political, organizational and disciplinary perspectives, there appears to be some consensus that primary care constitutes the first element of a continuing health care process and may also include the provision of secondary and tertiary levels of care.[7] Health care can be defined as either public or private.

The emergency room is often a frontline venue for the delivery of primary medical care.

Primary care

Hospital train "Therapist Matvei Mudrov" in Khabarovsk, Russia[8]

Primary care refers to the work of health professionals who act as a first point of consultation for all patients within the health care system.[7][9] Such a professional would usually be a primary care physician, such as a general practitioner or family physician. Another professional would be a licensed independent practitioner such as a physiotherapist, or a non-physician primary care provider such as a physician assistant or nurse practitioner. Depending on the locality, health system organization the patient may see another health care professional first, such as a pharmacist or nurse. Depending on the nature of the health condition, patients may be referred for secondary or tertiary care.

Primary care is often used as the term for the health care services that play a role in the local community. It can be provided in different settings, such as Urgent care centers that provide same-day appointments or services on a walk-in basis.

Primary care involves the widest scope of health care, including all ages of patients, patients of all socioeconomic and geographic origins, patients seeking to maintain optimal health, and patients with all types of acute and chronic physical, mental and social health issues, including multiple chronic diseases. Consequently, a primary care practitioner must possess a wide breadth of knowledge in many areas. Continuity is a key characteristic of primary care, as patients usually prefer to consult the same practitioner for routine check-ups and preventive carehealth education, and every time they require an initial consultation about a new health problem. The International Classification of Primary Care (ICPC) is a standardized tool for understanding and analyzing information on interventions in primary care based on the reason for the patient's visit.[10]

Common chronic illnesses usually treated in primary care may include, for example: hypertensiondiabetesasthmaCOPDdepression and anxietyback painarthritis or thyroid dysfunction. Primary care also includes many basic maternal and child health care services, such as family planning services and vaccinations. In the United States, the 2013 National Health Interview Survey found that skin disorders (42.7%), osteoarthritis and joint disorders (33.6%), back problems (23.9%), disorders of lipid metabolism (22.4%), and upper respiratory tract disease (22.1%, excluding asthma) were the most common reasons for accessing a physician.[11]

In the United States, primary care physicians have begun to deliver primary care outside of the managed care (insurance-billing) system through direct primary care which is a subset of the more familiar concierge medicine. Physicians in this model bill patients directly for services, either on a pre-paid monthly, quarterly, or annual basis, or bill for each service in the office. Examples of direct primary care practices include Foundation Health in Colorado and Qliance in Washington.

In context of global population aging, with increasing numbers of older adults at greater risk of chronic non-communicable diseases, rapidly increasing demand for primary care services is expected in both developed and developing countries.[12][13] The World Health Organization attributes the provision of essential primary care as an integral component of an inclusive primary health care strategy.[7]

Secondary care

Secondary care includes acute care: necessary treatment for a short period of time for a brief but serious illness, injury, or other health condition. This care is often found in a hospital emergency department. Secondary care also includes skilled attendance during childbirthintensive care, and medical imaging services.[14]

The term "secondary care" is sometimes used synonymously with "hospital care". However, many secondary care providers, such as psychiatristsclinical psychologistsoccupational therapists, most dental specialties or physiotherapists, do not necessarily work in hospitals. Some primary care services are delivered within hospitals. Depending on the organization and policies of the national health system, patients may be required to see a primary care provider for a referral before they can access secondary care.[15][16]

In countries that operate under a mixed market health care system, some physicians limit their practice to secondary care by requiring patients to see a primary care provider first. This restriction may be imposed under the terms of the payment agreements in private or group health insurance plans. In other cases, medical specialists may see patients without a referral, and patients may decide whether self-referral is preferred.

In other countries patient self-referral to a medical specialist for secondary care is rare as prior referral from another physician (either a primary care physician or another specialist) is considered necessary, regardless of whether the funding is from private insurance schemes or national health insurance.

Allied health professionals, such as physical therapistsrespiratory therapistsoccupational therapistsspeech therapists, and dietitians, also generally work in secondary care, accessed through either patient self-referral or through physician referral.

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