Advanced Practice Nursing APNs Access Cost and Quality

Access, Cost, and Quality for Advanced Practice Nursing (APNs)

Introduction

Provision of quality healthcare requires reasonable and appropriate treatment plans, access, an adequately qualified workforce, and responsible patient follow-through. People of all ages, particularly the elderly, usually require critical and emergency care services (Woo et al., 2017). This is due to rising cases of chronic illnesses, thus, the need for a more qualified workforce to provide such services. With an increasing demand for healthcare services, the effective utilization of advanced practice nurses is paramount to guarantee cost-effective and high-quality health services accessible to everyone. In some countries, healthcare wages total around 50 percent of healthcare expenditure (Joel, 2017). Therefore, regulatory cost strategies must be adopted to receive quality healthcare services. Various states are implementing measures to enhance access by increasing APN capacity.

According to research findings, the global annual growth of advanced practice nurses is approximately three to nine times more than physicians. Health policymakers should, as a result, ensure the proper utilization of advanced practice nurses (Joel, 2017). The roles of advanced practice nurses were first introduced to offer a solution to meet the primary care needs of the underserved and rural population due to the absence of enough primary care physicians (Abraham et al., 2019). Basic care has initial contact with patients and then, through coordination of care in line with patients' requirements, provides continuity of health services within healthcare systems. Evaluation of primary care quality provided by the advanced practice nurses has been established to be similar to that of physicians in terms of safety and effectiveness.

In addition, since the establishment of advanced nursing in primary care, its services have expanded to cover other healthcare contexts like acute care (Woo et al., 2017). Patients with critical illness, complex acute, and unstable chronic conditions are given short-term restorative stabilization through acute care. Acute care covers critical care and emergencies. Advanced practice nurses have similarities with primary and emergency care nursing practice because they both serve first-contact access to healthcare (Joel, 2017). Moreover, advanced practice nurses are trained to hand patients with limb-threatening or acute life conditions. Within the past decades, advanced practice nurses had autonomy in critical and emergency care (Free, 2004). However, due to the expansion of APN roles, they undertook some tasks initially performed by physicians only. As a result, service efficiency and healthcare access are enhanced and, at the same time, mitigate the cost of healthcare services.

Access, Cost, and Quality of Quality Environments, as well as Recent Quality Initiatives

Cost, quality, and access are the critical aspects of the provision of healthcare services. Cost is usually the payment made to the healthcare provider by the client seeking healthcare services. Access, however, refers to having a personal health service within an appropriate time that meets the best health outcomes (Woo et al., 2017). Quality of healthcare refers to the degree to which healthcare services provided to the patients enhance and increase the chances of desired health outcomes and meet the current professional expectation (Joel, 2017). To guarantee holistic care provision, quality care has to encompass access, cost, and quality of the quality environment.

Primary causes of disability and death globally include chronic diseases. By 2030, the impact of chronic diseases on the global economy is anticipated to hit $47 trillion. In 2015, the United States spent over $3.2 trillion on healthcare alone, with chronic diseases consuming close to 86 percent of that budget (Woo et al., 2017). Therefore, due to the high cost of healthcare services, policymakers, researchers, and clinicians developed an innovative, cost-effective care delivery mechanism to minimize spending. As a result, even though physicians handled chronic disease care in the past, the current primary care services demand is beyond the available number of physicians (Joel, 2017). For instance, below 10 percent of the entire physician workforce are found in rural areas where more than 21 percent of the total United States population resides. This limits rural residents' access to care. Due to this inadequacy, the services of advanced practice nurses (APNs) were of great need to ensure care delivery for chronic diseases.

Moreover, With the introduction of the affordable care act, several American citizens obtained health insurance that included enrolment for medication, particularly amongst the baby boomers. Consequently, there was rising demand for APNs due to the growing population with health insurance coverage (Woo et al. 2017). Accordingly, the involvement of APNs is critical in attaining effective healthcare delivery. Nonetheless, the practice of advanced practice nurses is relatively restricted while serving in the public hospital, private offices, clinics, outpatient facilities, or among the patient resides. In so doing, advanced practice nurses must seek approval from the authorities who are physicians before delivering any care to patients (Joel, 2017). This also has limited access of advanced practice nurses to the public.

Besides, due to the continuous increase in the number of advanced practice nurses taking care of chronic diseases, multiple studies have indicated that advanced practice nursing is cost-effective; however, some studies have also argued that advanced practice nursing is more expensive than physicians (Joel, 2017). Moreover, many citizens' lack of health insurance is a crucial factor in accessing APN services, resulting in increased mortality and morbidity, the rising cost of healthcare, and a lack of continuous care.

On the other hand, APN's work environment is critical and affects healthcare quality. An environment with excellent and supportive practice motivates and empowers APNs to be more productive, record increased job satisfaction, improve service quality, experience reduced burnout, practice professionally, and experience a low turnover rate (Woo et al. 2017). Furthermore, the quality of healthcare service delivery is likely to improve due to low turnover due to APNs' conducive work environment (Free, 2004). This is because whenever there is a high turnover rate, there is a proportionate loss of competent and experienced APNs, which seriously impacts the quality of healthcare delivery. Additionally, quality care is guaranteed in a favorable working environment (Joel, 2017). A safe and quality environment indicates the organization's compassion and vigilance over patients' welfare. As a result, the quality of the environment of work for APNs substantially impacts the healthcare quality provided as well as the safety of patients.

Consequently, healthcare quality enhancement includes a systematic and organized approach by healthcare institutions in assessing, monitoring, and enhancing the quality of healthcare standards. Programs that enhance healthcare quality require continuous improvement to ensure improvement and higher performance levels are achieved (Woo et al. 2017). Progressive improvement and scaling of healthcare programs can transform healthcare institutions from old and ineffective perspectives to using technologies and tools that deliver effective performance to produce quality results. Quality enhancement is directly correlated to healthcare efficacy, patient satisfaction, the efficiency of the outcome, and care delivery.