Discussion Questions Health Care

Healthcare: Discussion Questions

Discussion Questions: Healthcare

Numerous policies have been developed and implemented in a bid to improve the quality of care, and to make healthcare more accessible to patients. The Donabedian model presents a clear picture of how health policies ought to be structured to improve the quality of care. This text presents an overview of the main components of the Donabedian model, and the process of policy analysis.

The author stated the major steps in the policy analysis process. Which step do you think is the most important? State reasons using one policy analysis example

Policy analysis can be defined simply as the process of identifying and evaluating policies that that are intended to resolve physical, economic, or social problems facing a particular target population. McLaughlin and McLaughlin (2014) argue that the process of policy analysis involves four major steps -- problem identification, process definition, process analysis, and qualitative analysis. In the problem identification phase, policy analysts determine whether a problem indeed exists, the causes of the same, whether the same can be resolved through public policy, and what the expected results are should such policy be implemented (McLaughlin & McLaughlin, 2014). The process definition stage basically involves determining what the current situation is, that is, what policies are currently in place to address the same. Then follows the process analysis stage, where the analyst focuses on determining whether the policies currently in place (if any) are actually helping to address the identified problem, and how the effectiveness of the same could be increased through new technologies, new polices, and so on (McLaughlin & McLaughlin, 2014). The final stage, the qualitative analysis stage, focuses on assessing the technical, political, economic and financial feasibility of the proposed policy (if new) or policy changes in terms of how well they would help in realizing the desired outcomes (McLaughlin & McLaughlin, 2014).

The problem identification stage is the most important of the four stages -- the accurate identification of the underlying problem and its causes forms the foundation for a successful policy analysis, and an effective and efficient outcome for the entire process (Bardach, 2012). The whole policy analysis process is based, in fact, on the identified problem -- after all, if no problem has been identified, then there would be no need to develop a policy. Moreover, if the underlying problem is accurately identified, the analyst stands better chances of correctly determining why the existing policies have not been effective, and consequently, what new aspects need to be added to make the new policy or modify the existing policy to become more effective.

We, for instance, could take the example of a state-funded obesity-prevention policy for children -- first, we will need to verify that a problem requiring attention through policy indeed exists, for instance, that over 25% of children below the age of 12 in the state are overweight and obese. Identifying the problem provides a basis for us to develop policy and to then proceed to the subsequent stages of policy analysis. It also helps the analyst correctly identify the causes of the identified problem (child obesity in this case), and match the same to the policies already in existence so as to determine why such policies have not worked as effectively as they should. In our case, for instance, it could be because the policies focus only on increasing physical activity and healthy eating in school, but do not address the lack of parental education and awareness on healthy living as a cause of obesity. This kind of matching would essentially help the analyst know which direction to take in order to make the same more effective in realizing its desired objectives. Simply stated, therefore, problem-identification provides a sense of direction for the analyst's evidence-gathering activities (Bardach, 2012).

Question 2: The author identifies several factors in the 'Donabedian Model of Quality Assessment 1980', which element in the model is the most important? Why do you think so?

Avedis Donabedian proposes three different frameworks for evaluating health services and assessing the quality of care. His 1980 model assesses the quality of care based on three core concepts -- a structure, a process, and an outcome (McLaughlin & McLaughlin, 2014). The structure covers the financial, physical and human resources that enable practitioners to deliver quality care to patients (McLaughlin & McLaughlin, 2014). The process component is based on the interaction between practitioners and their patients -- it measures the quality of care based on the set of activities, for instance, treatment plans that go on between patients and practitioners (McLaughlin & McLaughlin, 2014). Finally, there is the outcome component, which measures the quality of care based on the change in the patient's health status following the delivery of care (McLaughlin & McLaughlin, 2014). The patient's health status in this case is measured in terms of their health-related behavioral change, their knowledge of health-related issues, and their won satisfaction.