Top referring hospitals to VSMMC blame limited beds, expertise

·5 min read

SOME hospitals in Cebu that made it to the top 10 list of hospitals referring patients to the Vicente Sotto Memorial Medical Center (VSMMC) have defended their referrals, citing the volume of patients they cater to and their limited capabilities.

Dr. Pythagoras M. Zerna, medical center chief of Eversley Childs Sanitarium and General Hospital in Barangay Jagobiao, Mandaue City, said Eversley was classified as a Level 1 hospital that could cater only to patients that need a minimum level of care.

He told SunStar Cebu Friday, Aug. 26, 2022, that they refer only those who need a higher level of hospital care to VSMMC, since VSMMC is a Level 3 hospital having enough facilities to deal with such cases.

During a meeting Gov. Gwendolyn Garcia held with the mayors, representatives of the Department of Health (DOH), municipal and city health officers, and representatives of the district and provincial hospitals at the Capitol Social Hall Wednesday, VSMMC Chief Gerardo Aquino Jr. had identified the top 10 referring hospitals in Cebu Province as having referred a total of 6,419 patients to the VSMMC from January to June 30, 2022.

Eversley ranked third on that list with 732 referrals.

The hospitals in the list under Cebu Province earned the ire of Garcia for allegedly referring patients to the VSMMC even if they were capable of treating such patients themselves.

These are the provincial hospitals in Danao City, which ranked fourth on the list, with 649 referrals; Carcar City, seventh, 336 referrals; Bogo City, eighth, 320 referrals, and Balamban, tenth, 239 referrals.


Zerna said Eversley caters to patients not only in Mandaue City but also neighboring areas such as Consolacion and Liloan, stressing that the three have huge populations.

Zerna said the hospital is overloaded with an authorized bed capacity of only 110, and yet it serves an average of 200 patients daily.

“We usually do not have empty rooms because every time we discharge patients, there are about 20 waiting in our emergency room to fill the vacant rooms,” Zerna said.

He denied that they refer patients with manageable diseases.

Zerna said patients who need expert advice, technical examinations that are available only in higher-level hospitals, major surgeries and severe monitoring, such as those needed to be in an intensive care unit (ICU), are the ones being transferred.

He added that Eversley Hospital is now working toward upgrading its classification from Level 1 to Level 2 to reduce its referrals.

Zerna said for the upgrade, they will need to expand their facilities, such as by increasing their number of beds, equipment and staff.

Currently, the hospital has about 400 staff, both medical and non-medical, with about 30 doctors.


The Cebu City Medical Center (CCMC), which ranked ninth on Aquino’s list with 253 referrals, also said its referral of patients to the VSMMC was valid.

In a statement sent to SunStar Cebu Thursday, Aug. 25, Dr. Mary Jean Loreche, the city’s consultant for health, said that from January to August 2022, CCMC had referred a total of 343 patients to the VSMMC but only 252 had been accepted.

Loreche explained that during this period, the CCMC was allowed to operate as a Level 1 Category Healthcare Facility.

“There were cases and procedures that needed a referral to a higher institution such as VSMMC, a government apex hospital,” said Loreche.

A Level 1 category hospital is allowed to offer only consulting specialists in, but not limited to medicine, pediatrics, ob-gyne, surgery, emergency and outpatient services, isolation facilities, and surgical or maternity facilities.

On the other hand, a Level 2 hospital can do all the functions of the preceding level and offer departmentalized clinical services, respiratory unit, general ICU, high-risk pregnancy unit, newborn ICU, and dental clinic services as well.

Loreche said the referred cases required further management with the capabilities and expertise of VSMMC, such as neuro-surgical and orthopedic procedures, ENT cases requiring special procedures, and emergency cesarean deliveries.

“It’s not because physicians of CCMC do not want to care for these patients. Cases were referred for proper management and treatment considering the unavailability of medical specialists and the inherent limitations of a Level 1 health care facility,” Loreche said.

According to Loreche, CCMC was already accredited by the DOH last Aug. 24 to operate as a Level 2 facility so it can now be expected to have the capacity to better address the health needs of Cebuanos.


The Cebu Provincial Hospital-Balamban, which ranked tenth on the list with 239 referrals over the six-month period, is investigating the referral of patients from the hospital to VSMMC, Dr. Olive Dandan, chief of hospital, told SunStar Cebu Friday.

Dandan said the doctors were already informed about it.

“Investigation [is still ongoing] on the referral if indeed the referrals were for tertiary care,” she said.

Governor Garcia had fired a warning last Aug. 24 to medical personnel, particularly doctors in provincial hospitals who referred patients to VSMMC, despite their capacity to treat certain diseases, saying the provincial government had invested a lot of money for their salaries yet they seemed to operate like clinics.

Garcia said their “shameful and greedy habit at the expense of our people” should not continue.

VSMMC’s Aquino identified the top 10 referred cases from hospitals in Cebu as fracture; pneumonia; chronic kidney disease; anemia; CVD; appendicitis; sepsis/septic shock; kidney diseases (nephrotic syndrome, UTI, lithiasis); preterm/prematurity; and tuberculosis (pulmonary/extrapulmonary).

Based on VSMMC’s data, Balamban had about 131 referred patients among the top 10 cases identified by Aquino.

When asked whether such cases really need tertiary care, Dandan said there is indeed a need for referrals should patients have complications and if there was no medical specialist on duty.

The others in the top list of referring hospitals were DOH 711 hotline, first on the list, 2,294 referrals; Lapu-Lapu City Hospital, second, 815 referrals; Cebu South Medical Center (the former Talisay District Hospital), fifth, 417 referrals; and Mandaue City Hospital, sixth, 364 referrals. (HIC, IRT, MKG)