This paper surveys several pressing but often overlooked healthcare issues in the United States beyond chronic illness. It examines the scale of preventable adverse drug events in hospitals and long-term care settings, the growing threat of MRSA infections in clinical environments, the crisis of the uninsured and underinsured population, and the emerging problem of medical identity theft. The paper also addresses the looming workforce shortage in eldercare and nursing, arguing that resolving these interconnected challenges will require a significant shift in government priorities and increased public engagement with healthcare policy.
When people think of healthcare concerns, they most often first consider chronic illnesses that can cause a much lower quality of life or an earlier death than normal. However, there are a number of other healthcare issues that people should be aware of and that need to be addressed in the United States. Several of these problems β while less visible than chronic disease β carry enormous consequences for patient safety, financial security, and the long-term sustainability of the healthcare system.
One of these areas is the quality of hospital care. Technically, healthcare is making significant advances. There is equipment today that can miraculously help people recover or prolong their lives. However, there is another side of hospital care that, due to budgetary pressures, is increasingly becoming a major issue.
Adverse drug events (ADEs) in hospitals β injuries or harm resulting from the wrong medicine or an incorrect quantity of medicine β occur at alarmingly high rates. According to a 2006 brief by the Institute of Medicine (p. 2), one study estimated 380,000 preventable ADEs in hospitals each year, while another estimated 450,000, figures that may themselves be underestimates. In other settings, the problem is equally troubling: one study calculates that 800,000 preventable ADEs occur each year in long-term care facilities, and research on outpatient Medicare patients finds approximately 530,000 preventable ADEs each year in that population as well. Furthermore, none of these studies includes errors of omission β that is, failures to prescribe medication in cases where it should have been prescribed. Taking all of these figures into account, there could be at least 1.5 million preventable ADEs occurring in the United States each year.
There are also certain illnesses that patients can acquire when visiting a hospital for entirely unrelated purposes, even for routine reasons. MRSA (methicillin-resistant Staphylococcus aureus) is a subject of considerable scientific and public concern. First recognized in the early 1960s, MRSA proved to be an uncommon cause of infection for several decades. However, it grew rapidly in significance during the 1980s, with some strains becoming epidemic in nature by the 1990s.
Today, the prevalence of MRSA infections is a major concern, especially within certain clinical settings such as intensive care units (ICUs), where patients are especially susceptible and where the procedures and techniques used can facilitate bacterial transmission. A study of 249 patients staying in an ICU for more than 48 hours found that 8.4 percent developed MRSA infections, primarily bloodstream infections, but also pneumonia and surgical-site infections (Williams, 2006, p. 8).
"46 million uninsured Americans and rising costs"
"Emerging fraud threat in electronic healthcare systems"
"Looming nursing and eldercare staffing deficit"
Williams, D. (2006). Material surfaces and MRSA: It appears that our hospitals are facing serious threats from antibiotic-resistant bacteria, especially methicillin-resistant Staphylococcus aureus (MRSA). Medical Device Technology, 17(7), 8β10.
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