The SPMC Journal of Health Care Services is the official journal of Southern Philippines Medical Center (SPMC). It is a multi-disciplinary, peer reviewed, Open Access journal that showcases the written works of SPMC employees and other submitting authors. The journal is published twice a year. The goal of the publication is to contribute to local and international efforts to broaden the knowledge base of health care services.

SPMC Journal of Health Care Services is owned and published by Southern Philippines Medical Center (SPMC). The owner grants editorial freedom to the editors of this publication.

Information contained in the SPMC Journal of Health Care Services is intended for professionals and students of health care disciplines. Contents made available in this publication are contributions of individuals or organizations. SPMC is not responsible for the accuracy of any data used in coming up with the contents reported in the articles.

The views and opinions expressed by the authors of individual articles in the SPMC Journal of Health Care Services are their own and do not reflect the official position of SPMC. Contents in this publication shall not be used to disregard or replace the advise of a qualified medical professional. SPMC shall not be held liable for any damages resulting from the use or inability to use the contents of the SPMC Journal of Health Care Services.


Editor in Chief
Alvin Concha

Associate editors
Christine May Perandos-Astudillo
Rodel Roño

Managing editor
Clarence Xlasi Ladrero

Layout editor
Clarence Xlasi Ladrero


Fitzgerald Cabahug Arancel

Chief of Medical Professional Staff, Southern Philippines Medical Center

Maria Elinore Alba-Concha

Chief Training Officer, Southern Philippines Medical Center

Vicente Belizario Jr

College of Public Health, University of the Philippines Manila
SEAMEO TROPMED Regional Centre for Public Health, Hospital Administration, Environmental and Occupational Health

Noel Espallardo

Board of Trustee, Philippine Academy of Familly Physicians
Editor-in-chief, The Filipino Family Physician
Chair, Research Committee, PAFP
Chair, Publication Committee, PAFP

Noel Juban

University of the Philippines Manila

Jose Florencio Lapeña

University of the Philippines Manila
College of Medicine - Philippine General Hospital
Professor of Otorhinolaryngology, UP College of Medicine
University Scientist III, University of the Philippines System
Editor, Philipp J Otolaryngol Head Neck Surg
Charter President, Philippine Association of Medical Journal Editors (PAMJE)
Secretary, World Association of Medical Editors (WAME)

Lynette Lu Lasala

Southern Philippines Medical Center

Zorayda Leopando

University of the Philippines – Philippine General Hospital

Anthony Sales

Regional Director, Department of Science and Technology XI

Leopoldo Vega

Former Medical Center Chief, Southern Philippines Medical Center


The overall quality of this journal greatly relies on the comments and recommendations of peer reviewers. We would like to acknowledge the following peer reviewers for their invaluable contribution in the article selection process of the SPMC Journal of Health Care Services.

Mary Jane Ayco
Maria Elinore Alba-Concha
Robert Bandolon
Vergel Bautista
Mary Jo Kristine Bunagan
Claire Angela Canda
Antonietta Rolida Cañedo
Bernard Chiew
Wenelito Clapano
Katrina Cecilia Cruz
Rae Dapitanon-Solis
Henry Derla
Madelle Anne Dumlao
Je-Ann Faith Fabian-Tan
Laricelle Feliciano-Paguican
Reece Feliciano-Paguican
Rodel Migue Flores
Ernesto Guadalupe
Ruby Jane Sahid Guerrero
Bryan Edgar Ko Guevara
Victoria Guillano
Michelle Harun
Ann Marie Tabucan Isaga
Maria Lourdes Lacanilao
Crystal Lademora
Evelyn Lao
Annabelle Lao-Reyes
Peter Paul Lim
Ria Fortugaliza Luengas
Lynnette Lu-Lasala
Donnah Lumanlan
Leandro Manalaysay
Julaidah Mastura-Glang
Armand Merton
Bryan Norico
Loida Michelle Ong
Mark Anthony Paderanga
Agnes Padilla
Elizabeth Pague
Noel Peñaranda
Ella Joy Nogas Perez
Jay Karlou Piedad Sanchez-Regondola
June Pearl Trofeo Sanson
Paolo Alan Tabar
Peter Ian Tabar
Ronald Tangente
Mark Anthony Tom
May Uyking-Naranjo
Delfin Valdez Jr
Gabriel Anthony Villa

and the peer reviewers who wish to remain anonymous. Many thanks for your participation!

- SPMC JHCS Editorial Staff

SPMC Journal of Health Care Services


Copyright © 2024 Southern Philippines Medical Center.
ISSN (Online): 2467-5962. ISSN (Print): 2012-3183.
All rights reserved.