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The X Family
Family X consists of a father, mother, and two children (ages seven and nine). Both parents work as lawyers but the mother is able to work partially at home, which gives her more time to care for her children when they come home from school. Sometimes she works late and her husband takes over the 'second shift' of overseeing the children's homework in the evening.
Mealtimes are described as rushed by the mother. Both children participated in afterschool activities year 'round, including gymnastics, soccer, and cheerleading (the girl) and karate and baseball (the boy). Lunch and snacks tended to consist of prepackaged foods although the mother said that she did make an effort to get healthier snack bars and fruits, versus fast food. She said that she tried to put a healthy meal on the table for her family every night but was only able…
Weber, J.R. (2005). Nursing diagnoses. Retrieved from:
Family Health Assessment
The Lial Family is composed of three individuals. Christy, the mother, is 38 years old, and she has twin daughters, Imani and Nia, who are both currently eight years old. They live alone together in an apartment in Mexico, while the girl's father, Dean, lives in New York. Dean is actively involved in their lives, providing monthly financial support and often communicates with his daughters, but does not maintain a primary relationship with Christy. Dean is married and he and his wife have a newborn son. Christy and Dean maintain an amicable relationship and communicate openly about the girl's needs. Grandparents on both sides are involved with the family and the girls have regular visits with all parties, despite the fact that they currently live in Mexico and their relatives are in Toronto and Trinidad. The family is very spread out, but the daughters report…
Those who happen to be disproportionately affected by hypertension according to Elliot (2007) are African-Americans. Family history of BP also plays a prominent role in the prevalence of hypertension. In the words of Elliot (2007), "data consistently indicate that BP levels are hereditable." What this means is that studies have clearly demonstrated that an individual's risk of high blood pressure is largely dependent on whether or not there is a history of hypertension in his or her family.
Other contributing factors in this case include but they are not limited to education, diet, alcohol and tobacco use. Individuals who ingest high amounts of sodium effectively decrease or lower the ability of their bodies to retain fluid. This in turn triggers an increase in their blood pressure. It is also important to note that high levels of alcohol intake have been associated with increased risk of blood pressure. For this reason,…
American Heart Foundation. (2012, April 4). Potassium and High Blood Pressure. Retrieved April 23, 2013, from: http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/PreventionTreatmentofHighBloodPressure/Potassium-and-High-Blood-Pressure_UCM_303243_Article.jsp
Blonna, R., Loschiavo, J. & Watter, D.N. (2011). Health Counseling: A Microskills Approach for Counselors, Educators, and School Nurses (2nd ed.). Sudbury, MA: Jones & Bartlett Learning.
Centers for Disease Control and Prevention. (2010). How to Prevent High Blood Pressure. Retrieved April 25, 2013, from: http://www.cdc.gov/bloodpressure/what_you_can_do.htm
Elliot, W.J. (2007). Clinical Hypertension: A Companion to Braunwald's Heart Disease. Philadelphia, PA: Elsevier Health Sciences.
7-11. Increase the proportion of local health departments that have established culturally appropriate and linguistically competent community health promotion and disease prevention programs and third: 7-2. Increase the proportion of middle, junior high, and senior high schools that provide school health education to prevent health problems in the following areas: unintentional injury; violence; suicide; tobacco use and addiction; alcohol and other drug use; unintended pregnancy, HIV / AIDS, and STD infection; unhealthy dietary patterns; inadequate physical activity; and environmental health. (Healthy People, ND) Though there are clearly other substantive goals for this demographic there is a clear sense that these three objectives serve the population well, and of coarse can be expanded to include other risk factors as well as screening for homeless and preexisting problems related to poverty.
Healthy People "Leading Health Indicators" http://www.healthypeople.gov/LHI/lhiwhat.htm
Healthy People Search Objectives
Burg, M.A. (1994). Health Problems of Sheltered Homeless…
Burg, M.A. (1994). Health Problems of Sheltered Homeless Women and Their Dependent Children. Health and Social Work, 19(2), 125. Retrieved September 2, 2007, from Questia database: http://www.questia.com/PM.qst?a=o&d=5000210693 www.questia.com/PM.qst?a=o&d=5001783266
Fischer, R.L. (2000). Toward Self-Sufficiency: Evaluating a Transitional Housing Program for Homeless Families. Policy Studies Journal, 28(2), 402. Retrieved September 2, 2007, from Questia database: http://www.questia.com/PM.qst?a=o&d=5001783266
Healthy People "Leading Health Indicators" http://www.healthypeople.gov/LHI/lhiwhat.htm
Healthy People Search Objectives
When considering nursing practice for families, there is a tendency to think of the family as a static entity, existing as it is when first encountered -- and as frequently described in this paper. But families are not static; they evolve as people change and age. For any nurse who is fortunate enough to provide services to a family over a period of years, the challenge is to ensure the focus of care is appropriate to the changing needs of family members (Edelman & Mandle, 2010). For example, delivering healthcare to a family during the period from 2000 through 2013 would require a practitioner to navigate some of the most extreme socioeconomic shifts experienced in several generations. The implications for healthcare are substantive when people loose significant percentage of their accumulated wealth, or when they lose their job, or when any number of variables that diminish the circumstances…
Bialek, R., Duffy, G.L., & Moran, J.W. (2009). The Public Health Quality Improvement Handbook . Milwaukee: American Society for Quality, Quality Press.
Davidson, K.A. (2013, August 29). The most efficient health care systems in the world. The Huffington Post. Retrieved Edelman, C. And Mandle, C.L. (2010). Health promotion throughout the lifespan (7th ed.). St. Louis. MO: Mosby Co. And Rowe.
Kaakinen, J. Gedaly-Duff, V., Padgett-Coehlo, D., & Hanson, S.M., (2010) Family health care nursing: Theory practice & research (4th ed.). Philadelphia, PA: F.A. Davis ISBN 978-0-8036-2166-4.
Mui, Y.Q. (2012, June 11). Americans saw wealth plummet 40% from 2007 to 2010, Federal Reserve says. The Washington Post. Retrieved http://www.washingtonpost.com /business/economy/fed-americans-wealth-dropped-40-percent/2012/06/11/gJQAlIsCVV_story.html
Family Health Assessment of the Allen Williams Family
Nurses are frequently called upon to conduct family health assessments in order to develop wellness and family nursing diagnoses that can be used to improve family relationships and coping skills of family members (Smith, 2001). This paper presents the results of a telephonic family health assessment of the Allen Williams family (not their real name), comprised of Mr. Williams, aged 65 years (retired military), his wife, obin (a part-time bookkeeper), and their two adult children, Barry, aged 42 years (a certified management accountant) and Jerry, aged 40 years (an animal control officer). At present, Mr. and Mrs. Williams live in a modest three-bedroom ranch house in a Midwestern suburb and their two adult sons share a home in a nearby suburban community. The family health assessment of the Williams family was divided into eleven functional health patterns as follows: Values, Health Perception;…
Ade-Oshifogun, J. B. (2012, September). Model of functional performance in obese elderly people with chronic obstructive pulmonary disease. Journal of Nursing Scholarship, 44(3), 232-235.
Planken, M. J. & Boer, H. (2010, August). Effects of a 10-minute peer education protocol to reduce binge drinking among adolescents during holidays. Journal of Alcohol & Drug Education, 54(2), 35-38.
Smith, L. (2001, Summer). Evaluation of an educational intervention to increase cultural competence among registered nurses. Journal of Cultural Diversity, 8(2), 50-54.
Weber, J. R. (2014). Nurses handbook of health assessment (5th ed.). Philadelphia: Wolters Kluwer Health.
Mr. T is the 95-year-old patriarch of the T. family. His wife and mother of their two children is Mrs. T, who is 92 years of age. Mr. And Mrs. T have two children, Wilma and Leon; ages 60 and 62 respectively. After a thorough debriefing about the nature of the family assessment as part of a community-nursing project, I received informed consent. They were assured privacy and confidentiality.
The universal health care requisites explored as part of the family assessment included food/nutrition, elimination, activity/rest, solitude/social interactions, hazards to human life, functioning, and overall well being. Both husband and wife were quick to affirm their lives are full of joy and fulfillment at having a family and raising two healthy kids. No substance abuse was reported, but the children in the family have been known to eat junk food. The family has several animals as pets…
High Risk Family Health Assessment and Promotion
High-Risk Family Assessment Health Promotion
Children of alcoholics and of individuals who abuse other substances are reported as a population "without a clear definition." (COAF.org, 2012) ehavior in families where alcohol and other drugs are abused is characterized by unpredictability and unclear modes of communication with chaos defining the family life and home environment. The range of behavior is stated to be such that is "from loving to withdrawn to crazy." (COAF.org, 2012) There may be little in the way of structure and rules and these are at best inconsistent and even nonexistent in some homes. Children do not know that the behavior and mood of their parents is based upon the volume of alcohol they have consumed or the amount of drugs that they have taken and the result is children that are scared and lack security. These children spend much time…
Adrian, Manuelle (2003) How Can Sociological Theory Help Our Understanding of Addictions? Substance Use and Misuse. Vol.38, No.10. Retrieved from: http://mona.uwi.edu/spsw/downloads/coursemat/SW24D/2008-2009/sem2/drug%20theories.pdf
Assessment of Families: Nursing Process Applied to Families as a Client (nd) Retrieved from: http://web2.aabu.edu.jo/tool/course_file/lec_notes/1001461_bhhhhn%20nju8mhyyuuuggggg46z.pdf
Fertman, CI, Allensworth, DD and Auld, ME (nd) What are Health Promotion Programs? Foundations of Health Promotion Programs -- Part One. Retrieved from: http://media.wiley.com/product_data/excerpt/51/04702415/0470241551.pdf
Structural Functionalism (nd) Retrieved from: http://www.umsl.edu/~keelr/3210/3210_lectures/structural_functionalism.html
Family structure can be defined as the number of members in a family and their organization. It is also the way in which the family members' interactions are designed. It is important that one knows the different roles of members in various family structures, and their descriptions in order to understand the way the members relate. I, for one, am a member of a nuclear kind of family. This is the kind that comprises a marital pair of opposite sex, and children, adopted or biological, sharing a home. The society regards nuclear families as the one in charge of shaping children's adaptation of the values of their society. This is primary socialization. Nuclear families also have the duty of stabilizing the character of adults, especially on the marital pair's emotional security. Our group has people from various family structures, which have different impacts on our social lives (Holborn and Steel,…
Coe, S. (2013). Cultural Competency in the Nursing Profession. Retrieved June 27, 2016, from http://www.nursetogether.com/cultural-competency-nursing-profession
Holborn, M., & Steel, L. (2015). Functionalism and "the" Family: A Summary. Retrieved June 27, 2016, from http://www.earlhamsociologypages.co.uk/functfamsum.html
Mc Laughlin, L., & Braun, K. (1998). Asian and Pacific Islander cultural values: Considerations for health care decision-making. Health and Social Work, 23 (2), 116-126.
Healthcare Administration and Leadership
Health care in the United States has progressed and improved to the point at which providers in all health care settings have defined and developed at least 4 major areas of importance for effective health care. Knowledgeable health care leaders have identified Quality and Safety; Community Health; Health Care Access and Coverage; and Leadership and Governance as key areas that must be constantly addressed and improved to provide optimal health care. The Human Research and Educational Trust has provided significant leadership in those 4 areas since its establishment approximately 60 years ago. By developing studies and assessments, as well as uniting health care leadership across the nation, HRET has exerted a great impact on health care in America.
Two of the HRET's Major Areas and Why Each Area is Important to Health Care Administrators
The four major areas addressed by the Health Research and Educational…
Family Wellness Diagnosis, Nursing
I opted to interview a family of two parents (married heterosexuals) who have two children. Both children are in their late teens. Both parents work. She is a freelance writer and he is a sales clerk at a retail home goods store. Both are in their late forties. He is about 5'11; she is 5'6." Their heights and weights appear appropriate though he claims that at 180 he feels a little overweight. She is about 140. She is originally from Guatemala and he is from the mid-west of the U.S. The children are both boys. Bruce, age 19, is away at college. The other, Erick, graduated from high school last year and has been working at a local golf course while waiting to decide what he wants to study at a community college. I spoke with Bruce over the telephone for about 15 minutes. He confirmed…
Care Plan (no date). Assessment Using Functional Health Patterns. Downloadable from http://www.delmarlearning.com/companions/content/0766822257/apps/appb2.pdf .
Doenges, M. And Moorhouse, M.F. (2003). Application of Nursing Process and Nursing Diagnosis: An Interactive Text for Diagnostic Reasoning. F.A. Davis Company, Philadelphia, PA.
Life Nurses (2009). Nursing Assessment. Viewable at http://www.lifenurses.com/nursing-assessment/.
Family-focused Functional Health Pattern Questions:
Specific recommendations for family therapists who employ parent training techniques are offered.
Summary and Conclusion
While Rogers does not completely define precisely the 'human' it is easily understood to be that of all aspects of the individual therefore, the environmental/ecological interaction theory, while not perfect is a good basis for the provision of healthcare to families by the nursing professional. Every aspect of the lives of a family illustrated through the interactions between the individuals and the community, neighborhood, place of employment, daycare institutions or school, laws, safety precautions, travel, mode of travel, mode of living, housing environment and indeed all elements expressed by the Macro, Micro, Meso, and Exo Levels effect the individuals. The individuals affect the environment and the elements contained therein as well through either actions or even inactions. These two facts clearly demonstrate the validity of the theory and the theoretical framework base described in this…
Sandelowski M. Troubling distinctions: a semiotics of the nursing; as cited by Joan Engebretson in Document entitled Hands-on: The Persistent Metaphor in Nursing, Holistic Nursing Practice Vol.16 No.4 07-01-2002 ISSN 09979311.
The Ecological Theory (nd) Online available at www.unt.edu/cpe/module1/blk1.htm
The Theoretical Matrix for a Rogerian Nursing Practice" by E.A.M.Barrett 2000, Theoria: Journal of Nursing Theory, 9 (4) p.3-7. Copyright 2000 by the Swedish Society for Nursing Theories in Practice, Research, and Education. Reprinted with permission. http://medweb.uwcm.ac.uk/martha/theory.htm
Meyers, S.A. An Ecological Approach to Enhancing Parenting Skills in Family Therapy "http: Kluwer Academic Publishers. http://www.ingentaconnect.com/content/klu/coft/1998/
Figure 1 portrays the state of Maryland, the location for the focus of this DR.
Figure 1: Map of Maryland, the State (Google Maps, 2009)
1.3 Study Structure
Organization of the Study
The following five chapters constitute the body of Chapter I: Introduction
Chapter II: Review of the Literature
Chapter III: Methods and Results
Chapter IV: Chapter V: Conclusions, Recommendations, and Implications
Chapter I: Introduction
During Chapter I, the researcher presents this study's focus, as it relates to the background of the study's focus, the area of study, the four research questions, the significance of the study, and the research methodology the researcher utilized to complete this study.
Chapter II: Review of the Literature in Chapter II, the researcher explores information accessed from researched Web sites; articles; books; newspaper excerpts; etc., relevant to considerations of the disparity in access to health care services between rural and urban residence in Maryland…
Potter, S. (2002) Doing Postgraduate Research. London: Sage.
Qualitative research: Approaches, methods, and rigour, (2008, Nov. 7). Microsoft PowerPoint Qualitative Research AdvC08 RS.PPT. Retrieved March 10, 2009 from www.unimaas.nl/bestand.asp?id=11629
Wolvovsky, Jay. (2008). Health disparities: Impact on Business and Economics Summit. Maryland's healthcare at a glance. The Heart of Community Health Baltimore Medical Syste. Retrieved March 10, 2009 at http://dhmh.maryland.gov/hd/pdf/2008/oct08/Jay_Wolvovsky.pdf
Health and Social Justice Issue in Saharan Country
Mali occupies the fourth position among the poorest nations of the world. Mali is still plagued by a multitude of financial tribulations with an economy in shambles, the country's liability approximately equivalent to its GDP, at the mercy of the international donor groups, insufficient revenues of the state exchequer and pressure from various coterie groups voicing their demands. (Mali Human ights Practices: U.S. Department of State, 1994) However, at the same time it a nation that boasts of a rich and hoary tradition. It is popular as a country marked by its multihued varied populace and harmonic tunes. Currently, it is confronted with a massive menace like AIDS, Noma and a host of tropical diseases. Mali has the world's lowest adult literacy rate of less than 25%. The country's education system is inadequately formed, especially at the primary stage. A United Nations…
Condom Vending Machine. (March 01, 2004) "Mali, AIDS and Condoms" Initial Research Report. Retrieved at http://dtm.media.mit.edu/dtm/dtm04/projects/condom/archives/000145.html. Accessed on 11 July, 2004
Dao, S. (Jan 7-8, 2004) "HIV Treatment in Mali, PNLS/GAIA" AIDS Vaccine Conference, Bamako, Mali.
Johnston, Timothy; Faure, Sheila Dohoo; Raney, Laura. (June 1998) "The World Bank and the Health Sector in Mali" Report No. 18112.
Mahe A; Prual A; Konate M; Bobin P. (Sep-Oct, 1995) "Skin Diseases of Children in Mali: A Public Health Problem" Tropical Medical Hygiene. Volume: 89: No: 5; pp: 467-70
The public clinics have long queues
There is a family care trend with humane treatment in private clinics
More modern equipment even attracts lower wage earners
Small sized private clinics seem to be the wave of the future in Beijing
November 15, 2010: every child in Beijing schools received a dental checkup and a new toothbrush and paste with instructions for brushing
The annual health care event in Beijing last May cited pampered only children who are given sugary and fatty foods by indulgent parents and grandparents as reason that dental health is falling among youngsters.
Industry special: Pain relief toothpaste said to be a boon to one in three in China
Proctor and Gamble's statement that use of their dental products is increasing and private dental clinics shows increased awareness
Rural Areas Problematic
Too few practitioners
Less awareness due to literacy levels and education
Low income does…
Heritage Assessment Tool
Heritage Assessment Tool: Cultural values and health beliefs
Cultural sensitivity is an integral part of effective nursing. Although the definitions of concepts such as 'health' and 'wellness' might seem on their surface to be self-evident, these notions are, in fact, highly mutable and particular to the individual and his or her culture. Cultural insensitivity can result in patients becoming alienated from the medical system and this results in poorer, ineffectual care. One of the reasons instruments such as the Heritage Assessment Tool can be so useful is that it can be a clear and efficient way to establish the culturally-contextual health beliefs of a patient whose experiences and values that are different those of the physician, nurse, or other healthcare provider treating the patient.
The first family I interviewed was a Chinese-American household. Although the family was relatively assimilated and the children were second-generation residents…
4 million young people); e) Americans that are uninsured and that have "preexisting conditions" can as of now get insurance through the "Pre-Existing Condition Insurance Program" (PCIP); f) 46 states are using Affordable Care Act resources to "crack down on unreasonable premium increases" (hite House).
There are additional benefits that result from the Affordable Care Act will come into play in 2014, according to the hite House. Those include a new competitive insurance marketplace that will be established. In that new marketplace will be state-run health insurance exchanges where "million of Americans and small businesses will be able to purchase affordable coverage" and have the same healthcare choices as "Members of Congress," the hite House explains.
As to the federal fiscal benefits from the Affordable Care Act, the Government Accountability Office (GAO) reports that healthcare reform can reduce the national debt / deficit by $145 billion by 2019 and by…
Lampert, Jacqueline Garry. (2009). The Need for Health Care Reform by the Numbers. The Democratic Policy Committee. Retrieved March 29, 2011, from http://www.dpc.senate.gov/dpcdocpr.cfm?doc_name=fs-111-1-90 .
Obama, Barack. (2009). Why We Need Health Care Reform. The New York Times. Retrieved March 29, 2011, from http://www.nytimes.com .
Singletary, Michelle. (2011). Denied insurance under new health-care law? File an appeal, the GAO says. The Washington Post. Retrieved March 30, 2011, from http://www.washingtonpost.com .
The White House. (2011). Health Reform in Action / the Affordable Care Act. Retrieved March
Osteoporosis and the Health Belief Model
Discuss the Health Belief Model
The Health Belief Model was initially a systematic mode of predicating and thus preventing health behavior. By focusing on the relationship between the practices and the behaviors of health services it aimed to create a theoretical presentation of the same. Later it was revised to motivate the general health for the 'purpose of distinguishing illness and sick-role behavior from health behavior'. [Brown, 1999] The HBM is essentially a concept that integrates psychological motivators with physical and social settings. Its said to have been initiated in 1952 by three socio-psychologists, Godfrey Hochbaum, Stephen Kegels and Irwin osenstock. During the 1950's the society realized a need to prevent disease rather than cure it. The U.S. Public Health Service was more concerned with preventing outbreaks which would have a nationwide impact than with trying to solve and cure the symptoms that individuals…
Brown, Kelli M. [January 11, 1999] HEALTH BELIEF MODEL Community and Family Health University of South Florida
Bandura, A. (1977). Self-efficacy: toward a unifying theory of behavior change. Psychological Review, 84, 191-215.
National Osteoporosis Foundation [NOF]. (1999a). NOF Physician's Guide: impact and overview [Online]. Available: http://www.nof.org/physguide/impact_and_overview .
National Osteoporosis Foundation [NOF]. (1999b). Osteoporosis Fast Facts [Online]. Available: http://www.nof.org/osteoporosis/stats.htm .
healthcare services, many people could encounter some form of discrimination on the basis of their race, gender, or even sexual orientation. Discrimination in healthcare may seem like it is not something that is a major issue. However, it absolutely does come up in many situations, states and environments. hether based on gender, religion, race or sexuality, discrimination happens at overt or implied levels all of the time. In other situations, there are huge disparities in healthcare outcomes from one group to another and many experts say that this can only come from systemic or sporadic instance of racism from the healthcare sphere, from society in general or a combination of the two. hile most people get very good care, there are situations where the healthcare and/or government sectors fall short. It is important to note that although people are not always aware of this; there are various laws that seek…
Cornell Law School. (n.d.). 11 U.S. Code Section 507 - Priorities. Retrieved from www.law.cornell.edu: https://www.law.cornell.edu/uscode/text/11/507
Cornell Law School. (n.d.). 18 U.S. Code Section 152 - Concealment of assets; false oaths and claims; bribery. Retrieved from www.law.cornell.edu: https://www.law.cornell.edu/uscode/text/18/152
lawschoolcasebriefs.net. (2002). Access Now, Inc. v. Southwest Airlines Co. Retrieved from www.lawschoolcasebriefs.net: http://www.lawschoolcasebriefs.net/2013/12/access-now-inc-v-southwest-airlines-co.html
State of California. (n.d.). California Corporations Code. Retrieved from www.leginfo.ca.gov: http://www.leginfo.ca.gov/.html/corp_table_of_contents.html
Health of Indigenous Australian Using Ecological and Holistic Health Paradigm
Patterns of health and illness
Impact of Broader Environments
Health is a basic component of human life that comprises of multiple facets. The description of health has witnessed dramatic change during past few years, as it has become a holistic phenomenon. Previously, it was considered that a healthy person is the one who does not suffer from any ailment or illness. However in recent times, the physical, psychological and communal aspects of human life have been amalgamated to give a broader perspective to human health which is identical to the concept of indigenous communities (Hjelm, 2010).
Numerous organizations are working extensively for providing adequate health care to the world population since many decades. However, it is appalling to notice that discrimination on social, economic and…
Australian Institute of Health and Welfare 2012, Australia's health 2012, AIHW, Australia.
Biddle, N & Yap, M 2010, Demographic and Socioeconomic Outcomes Across the Indigenous Australian Lifecourse: Evidence from the 2006 Census, ANU E. Press, Australia.
Caltabiano, ML & Ricciardelli, L 2012, Applied Topics in Health Psychology, John Wiley & Sons, Great Britain.
Carson, B, Dunbar, T & Chenhall, RD 2007, Social Determinants of Indigenous Health, Allen & Unwin, Singapore.
All spending includes state and federal expenditures. Growth figures reflect increases in benefit payments and disproportionate share hospital payments; growth figures do not include administrative costs, accounting adjustments, or costs for the U.S. Territories.
Federal Fiscal Year: Unless otherwise noted, years preceded by "FY" on statehealthfacts.org refer to the Federal Fiscal Year, which runs from October 1 through September 30. for example, FY 2009 refers to the period from October 1, 2008 through September 30, 2009.
Urban Institute estimates based on data from CMS (Form 64) (as of 12/21/11).
From this entire chart, the entire increase in expenditure of…
Clark, Cheryl et al. "State Medicaid Eligibility and Care Delayed Because of Cost." New England Journal of Medicine, 368 (2013): 1263-1265. Print.
Ellwood, Marilyn Rymer et al. An Exploratory Analysis of the Medicaid Expenditures of Substance Exposed Children Under 2 Years of Age in California. U.S. Department of Health and Human Services, 1993. Print.
Goodnough, Abby. "October 25th." The New York Times. 25th October. 2012. Web. 29th March 2013. [ http://www.nytimes.com /2012/10/26/us/spending-on-medicaid-has-slowed-survey-finds.html?_r=0].
Grannemann, Thomas W. And Mark V Pauly. Controlling Medicaid Costs: Federalism, Competition, and Choice. Washington DC: American Enterprise Institute, 1983. Print.
Psychosocial Model of Health
Use questions 2, 3, 5, 11, and 12
Many times a health professional will look at a health issue and see only the problem at hand. The difficulty with this approach is that most health problems affect the entire person whether or not the issue is localized or not. The psychosocial model of health looks at more than an individual's physical state to determine how they will respond to treatments in the short- and long-term. A patient's psychological well-being and their support system are as important as a willingness to see a treatment through to the end. The following paper looks at two patients and whether they were well-served from a psychosocial perspective, and, if not, what improvements could be made to serve the patient better.
In the documentaries, two of the patient interviews stood out as especially relevant to this discussion. One of these…
Back, A.L., Arnold, R.M., Baile, W.F., Fryer-Edwards, K.A., Alexander, S.C., Barley, G.E., Gooley, T.A., & Tulsky, J.A. (2007). Efficacy of communication skills training for giving bad news and discussing transitions too palliative care. Arch International Medicine, 167, 453-459.
Douglass, J.L., Sowell, R.L., & Phillips, K.D. (2003). Using Peplau's Theory to examine the psychosocial factors associated with HIV-infected women's difficulty in taking their medications. Journal of Theory Construction & Testing, 7(1).
Ellingson, L.L. (2002). Introduction to the field of healthcare communication. Communication Research Trends, 21(3).
Holland, D.J., Bradley, D.W., & Khoury, J.M. (2005). Sending men the message about preventive care: An evaluation of communication strategies. International Journal of Men's Health, 4(2).
For a long time, the Health Care concern has been a centre of discussion in the society as well as among the representatives in a bid to find out which would be the best way to cushion Americans from the ever increasing burden of having to take care of themselves medically. Efforts have been made but still there is no single solution to the issue hence a combined effort between the citizens and the government is very essential in ensuring that the ultimate goal is achieved and each American has adequate Health care assurance. This is the aim of the Health eforms that was passed into law at the behest of the current president, Obama.
Provisions of the Health eform
There are several benefits that the Health eforms are expected to bring to the American population in general. One of the central changes is the fact…
Ben LaBolt, (2010). Senator Obama Introduces Bill to Strengthen Emergency Medical Care
Systems. Retrieved November 13, 2011 from http://www.emsvillage.com/articles/article.cfm?id=2185
Bill Atkinson, (2010). What Obama's health care bill means for EMS. Retrieved November 13,
2011 from http://www.ems1.com/ems-advocacy/articles/779154-What-Obamas-health-care-bill-means-for-EMS/
Health Structures in Government Levels
Health at different Government Levels
Health Structures at Government Levels
Health at Government Levels
A national government has a task in ensuring quality health assurance standards across its region are up-to-date. Similarly, increased rates of unexpected epidemics have put governments under the surge of dealing accordingly with factors that can affect the nation directly and indirectly. Different governmental levels of health are identified and objectified in various agency websites. In this context, I have identified with a state level website; Illinois Public Health Institute website. Information presented to the website articles prioritizes in reducing and preventive, curative diseases, complementing health policies and championing for environmental changes.
Website Article eview
The Illinois Public Health institute articulates its review and implication to health quality through partnership programs. The website has supported state-oriented health involvement in ameliorating health levels, in Illinois. The institution has show-cased partnering programs with…
Baum, F and Kahssay, H.M. Health development structures: an untapped resource. World Health Organization. Vol 1 Issue 1. Pg 96-114.
Ladeia, M.L., Jacob, P., Borges, M.C., Rogero, M. M and Ferreira, S.R.G. (2011). Studies of Gene variants related to Inflammation, Oxidative, Stress, Dyslipidemia and Obesity: Implications for a nutrigenetic approach. Journal of Obesity. Vol 1, Issue 1. Pg 1-31.
5th March 2012. Illinois Public Health Institute. Retrieved from URL http://www.iphionline.org / Accessed on 27th March, 2012.
Expressive functioning is related to communication such as emotional, verbal, and nonverbal communication, problem solving and roles within the family. Beliefs within the family are also a part of expressive functioning.
For the purpose of the Calgary Family Assessment Model, a family is defined as who they say they are. It is very important that the clinician performing the assessment not assign their own beliefs upon what he or she believes a family is, and take into account what the patient feels about family as to the patient is may mean not only the people who actually live within the household but can also address past, present and future emotional attachments.
Calgary Family Intervention Model:
The immediate family is composed of Mr. Herbert Schelley (the patient), Mrs. Annette Schelley (his wife), and their son Thomas Schelley. The extended family consists of the Schelley's two married daughters, their husbands and their…
Brownwald H. ed. (2003) Harrison's Textbook of Internal Medicine, 15th edition,
McGraw-Hill, New York
Clement S. (2004) Guidelines for glycemic control. Clin Cornerstone. 6(2):31-9
Echeverry D.M., Dike M.R., Washington C., Davidson M.B.. (1995). The impact of using a low-literacy patient education tool on process measures of diabetes care in a minority population J. Natl Med Assoc. (11):1074-81
Through the use of statistical modeling the researcher was able to arrive at the validation of their hypothesis.
Assessment of esearch Findings
Based on the results of the statistical modeling used in conjunction with the Household Component of Medical Expenditure Panel Survey (MEPS) data set, it was found that tax subsidies do not have a differentially large or targeted effect on the prevalence of high burdens (Selden, 2008). Selden (2008) defines burdens as cash and wage equivalents of employer premium contributions. The results show that tax subsidies assist those above the poverty line more than those below it. The study is concluded prior to explaining why this is so, yet the author contends there are many other factors in addition to tax-based subsidies that have an impact on those below the poverty line being able to afford medical care even with tax-based subsidies.
This research study shows that at…
Selden, T. (2008). The effect of tax subsidies on high health care expenditure burdens in the United States. International Journal of Health Care Finance and Economics, 8(3), 209-23.
As one commentator notes; "What this adds up to is, in my view, a significant shift in the balance of work and family life. oles are changing, the nature of care is changing, and the stress related to juggling the balance is increasing (Edgar, 1997, p. 149)
A number of statistics also help to outline the nature of the family structure in a developed economy like Australia. In terms of workforce participation, the figures are as follows: "….86% for fathers and 56% for mothers in two-parent families, and 65% for male and 43% for female sole parents"(Edgar, 1997, p.151). This is also indicative of a shift in the role of the female as solely a homemaker. "In 1993, 53% of couples with dependent children were both employed & #8230;" (Edgar, 1997, p. 151). Therefore, there are still imbalances and disparities in terms of the family structure and this is a…
Anderson, G.L. (Ed.). (1997). The Family in Global Transition. St. Paul, MN: Professors
World Peace Academy. Retrieved October 1, 2009, from Questia database: http://www.questia.com/PM.qst?a=o&d=59215755
Baile, S. (1990). Women and Health in Developing Countries. OECD Observer, a (161),
18-20. Retrieved October 1, 2009, from Questia database: http://www.questia.com/PM.qst?a=o&d=98938035
Health Care Communication
Background- Within the modern nursing paradigm, there must be a clear link between a health outcome and the process that helps ensure those outcomes. Typically, outcomes are classified in terms of preventability, impact, severity and an overall holistic view of the client's safety issues. Positive behaviors that impact individuals either rescue or protect patients from potential or actual events. This is also part of the issue with modern communication and dissemination of information to patients, stakeholders, and the community (Burns and Grove, 2005).
At the heart of healthcare as an institution is, of course, the need to care for the sick and the injured. However, in the contemporary model of healthcare, effective communication during a crisis is not only important, but also vital. Communication by healthcare professionals takes the concern and worry out of the situation; offers a quicker resolution, makes better control of information possible, earns…
Alligood, et.al. (2002). Nursing Theorists and their Work. Philadelphia: Mosby.
Burns, N. And Grove, S. (2004). The Practice of Nursing Research. St. Louis:
D'Antonio, P., et al., eds., (2007). Nurses Work: Issues Across Time and Place. New York:
Furthermore, and despite its popularity as a tourist destination because of its natural beauty, the Appalachians are not a sterile environment by any means and the people who live there have higher risks for certain types of conditions than their counterparts elsewhere. According to Bauer and Growick (2003), "Americans who live in Appalachia experience unique and different ways of life than most Americans. Appalachian culture runs from the bottom half of the State of New York through the mountains of West Virginia and Southeast Ohio to the flatlands of Alabama. This area of the country offers different perspectives and challenges to life. Because of the geographical vastness and uniqueness of the Appalachian culture, many people with disabilities who live in Appalachia are unable to access rehabilitative services and agencies" (emphasis added) (p. 18).
Likewise, many rural residents throughout Appalachia may have septic tanks and will lack access to other…
Anguiano, R.P., & Harrison, S.M. (2002). Teaching cultural diversity to college students majoring in helping professions: The use of an eco-strengths perspective. College Student Journal, 36(1), 152.
Barrett, E., Hackler, R., Highfill, K.A., Huang, P., Jiang, X., Monti, M.M., & Peipins, Lucy. (2002). A Norwalk-like virus outbreak on the Appalachian Trail. Journal of Environmental Health, 64(9), 18.
Bauer, W., & Growick, B.M. (2003). Rehabilitation counseling in Appalachian America. The Journal of Rehabilitation, 69(3), 18.
Brown, J.W., & May, B.A. (2005, April). Rural Appalachian women's formal patterns of care. Southern Online Journal of Nursing Research, (2)6, 1-21.
(Wolf, 2008) When you put all of these different elements together, it means that denying health care services to undocumented workers and their families will cause their underlying levels of health to slowly deteriorate. If something serious does occur, these people will more than likely be forced to fend for themselves.
Conducting research in these two areas would be beneficial in influencing health care policy / outcome by: highlighting the overall human cost of the problem on the industry and society. Where, the act of denying them access to health care and the lingering effects could be considered a human rights issue. As a result, the research that would be conducted would be beneficial, in highlighting the overall harsh conditions that these families are forced to endure. Once you present the situation in this light, this will shift the debate from one of a cost issue to being about: basic…
Health Care for Undocumented Immigrants. (2008). Medical News Today. Retrieved from: http://www.medicalnewstoday.com/articles/56809.php
Aparico, A. (2004). Costs of Care and Lack of Health Insurance. Immigrants, Welfare Reform and Poverty Policy. (pp. 73 -- 77). Westport, CT: Praeger.
Wolf, R. (2008). Rising Health Care Costs. USA Today. Retrieved from: http://www.usatoday.com/news/washington/2008-01-21-immigrant-healthcare_N.htm
(Health Insurance Coverage, 2009). This is just a little higher than what was reported in the state of Pennsylvania over the last two-year period, which was at 25% (Krawczeniuk, 2009). "The number of uninsured rose 2.2 million between 2005 and 2006 and has increased by almost 8 million people since 2000" (Health Insurance Coverage, 2009).
Most Americans are provided with health insurance coverage through their employers. But in today's society employment is no longer a guarantee of health insurance coverage. "As America continues to move from a manufacturing-based economy to a service economy, and employee working patterns continue to evolve, health insurance coverage has become less stable. The service sector tends to offer less access to health insurance than the manufacturing sector does. Further, an increasing reliance on part-time and contract workers who are not eligible for coverage means fewer workers have access to employer-sponsored health insurance" (Health Insurance Coverage,…
Descriptive Statistics. (2006). Retrieved May 5, 2009, from Research Methods Knowledge Base
Web site: http://www.socialresearchmethods.net/kb/statdesc.php
Health Insurance Coverage. (2009). Retrieved May 5, 2009, from National Coalition on Healthcare Web site: http://www.nchc.org/facts/coverage.shtml
Krawczeniuk, Borys. (2009, March 26). Study Finds Health Care Gaps. Times-Tribune, The
Pender's is a theory of preventive medicine, for the healthy rather than the chronically ill. However, in an age where lifestyle-related disease are on the rise, it can provide an important function, particularly for nurses facing an epidemic of pre-diabetic and diabetic adolescents reared on poor diets and little physical activity. Some might protest that the genetic component to even Type II Diabetes, or obesity in general, might be unacknowledged in the model, but Pender would no doubt respond to her critics that although it is true that certain individuals have a greater predisposition to certain lifestyle diseases, everyone can act within those parameters to improve their life with preventative medicine, as counseled by her model.
McEwen & illis. (2007). "Chinn & Kramer Model." From Chapter 5 of Theoretical bases for nursing.
Pender, Nola J. (2003). "Most frequently asked questions about the Health Promotion
Model and my professional…
McEwen & Willis. (2007). "Chinn & Kramer Model." From Chapter 5 of Theoretical bases for nursing.
Pender, Nola J. (2003). "Most frequently asked questions about the Health Promotion
Model and my professional work and career." Last modified 4 Aug 2006. Retrieved 14 Sept 2007 at http://www.nursing.umich.edu/faculty/pender/pender_questions.html
Pender, Nola J., Murdaugh, C.L., & Parsons, M.A. (2002). "Assumptions and theoretical principles of the Health Promotion Model." Retrieved 14 Sept 2007 at http://www.nursing.umich.edu/faculty/pender/HPM.pdf
Day treatment programs can provide services at less cost because the patient goes home at night after being treated during the day, which often is used for rehabilitating chronically ill patients (Sharfstein, Stoline, & Koran, 1995, p. 249). The mere fact of having more choice benefits some patients by giving them more say in their care.
Patient-focused care involves a method for containing in-patient costs for hospitals and for improving quality by "restructuring services so that more of them take place on nursing units rather than in specialized units in other hospital locations, and by cross-training staff on the nursing units so that they can do several 'jobs' for the same small group of patients rather then one 'job' for a large number of patients" (Kovner, 1995, p. 186). Kovner notes a number of barriers to this type of care. One reason has been that hospitals have not had to…
Doctors Say Managed Care Strains Patient Relationships (1997, June 9). Westchester County Business Journal 36(23), p. 24.
Kovner, a.R. (1995). Hospitals. In Jonas's Health Care Delivery in the United States, a.R. Kovner (ed.), pp. 162-193. New York: springer Publishing.
Moore, G.T. (1991,
April 24). Let's provide primary care to all uninsured Americans ? now! JAMA, pp. 2108-2109.
Family Practice Spec. ICD Codes
Much of the treatment scope associated with the specialty family practice revolves around prevention. In other words the family practice provider often sees individuals when they are not ill at all but need health care access to determine normal values and a general state of health for developmental purposes in children and sometimes for school or vocational reasons in adults. Family practice often sees multiple minor injuries as well. Family Practice can also manage as a primary care provider many chronic conditions or disorders with or without intervention of a specialist, such as diabetes mellitus types 1 and 2, hypertension, hyperlipidemia, heart diseases of various kinds and most minor infections. Below is a list of just a few diagnostic codes for some of these commonly seen disorders and/or cases seen in the family practice specialty.
outine Physicals exams for Adults
outine general medical examination at…
Endres, Chris "Free online searchable ICD9 Codes," retrieved November 25, 2011 at http://icd9cm.chrisendres.com/
Taylor, R.B. (2002) Manual of family practice. Philadelphia, PA: Lippincott, Williams & Wilkins.
Health eform Act
The work of Flanagan, Miller, Pagano, and Wood (2010) entitled "Employee Benefit Plan eview -- Meyerowitz, Health care eform Is Here -- Now What?" states that health care reform laws are expected to have an impact that is significant in nature and this is on the health insurance industry as well as on employee benefit issues as well. The Patient Protection and Affordable Care Act (PPACA), which was then supplemented and modified, less than one week later, by the Health Care and Education Tax Credit econciliation Act (HCEA)." (Flanagan, Miller, Pagano, and Wood, 2010) Those two laws are referred to as "Health Care eform" or "Health eform Laws." (Flanagan, Miller, Pagano, and Wood, 2010) The Health eform Laws are reported, while being extremely lengthy and in depth and very detailed to "leave open a host of issues that will have to be resolved either through agency regulations…
Current Internal Revenue Code (Standard Federal version), SEC. 45R. EMPLOYEE HEALTH INSURANCE EXPENSES OF SMALL EMPLOYERS (2010) WK_ Current Internal Revenue Code SEC 45R EMPLOYEE HEALTH INSURANCE EXPENSES OF SMALL EMPLOYERS.pdf
Part III - Administrative, Procedural, and Miscellaneous Section 45R -- Tax Credit for Employee Health Insurance Expenses of Small Employers Notice 2010-44
National Tax Advisory (2010) What you need to know now about the tax aspects of health reform litigation. 6 Apr 2010.
IRS Rulings & Other Documents (2002-Current), Rev. Rul. 2010-13, Internal Revenue Service, (May 3, 2010) WK_ IRS Rulings Other Documents 2002-Current Rev Rul 2010-13 May 3, 2010.pdf ©2010 Wolters Kluwer.
Such equipment should be adequate to ensure personnel are protected from chemical exposure to the eyes, skin, and respiratory tract. PPE may be upgraded or downgraded by the site industrial hygienist, HSM, or qualified Site Safety Officer based upon site conditions and air monitoring results (Levin, et al., 2002)
Work practice and administrative controls
Administrative controls or work practice controls are changes in work procedures such as written safety policies, rules, supervision, schedules, and training with the aim of reducing the interval, frequency, and sternness of exposure to hazardous chemicals or situations. Workers who handle hazardous chemicals in the workplace should be familiar with the administrative controls required fewer than 29 CF 1910.1200, and the OSHA Hazard Communication Standard. This controls are perhaps most important, because they impact your people directly. On the one hand, they are the simplest, since all it takes is education. On the other hand, education…
Annual report on 9/11 health (September, 2009). Retrieved on March 20, 2010 from http://www.nyc.gov/html/fdny/pdf/2009_wtc_medical_working_group_annual_report.pdf
Burright, D. et al., (1999). Evaluation guidelines for air sampling methods utilizing chromatographic analysis. OSHA Salt Lake Technical Center, U.S. Department of Labor: Salt Lake City, UT.
Harris, J.S., (ed.) (1997). Occupational medicine practice guidelines: Evaluation and management of common health problems and functional recovery in workers. The American College of Occupational and Environmental Medicine. Beverly, Mass.: OEM Press.
Levin, S. et al.,. (2002). Health effects of World Trade Center site workers. America Journal of Industrial Medicine 42:545 -- 547.
As a result, millions of Americans remain unable to bear the heavy financial toll of medical expenses. Indeed, the problem of a lack of insurance for many is related to the problem of the cost of healthcare. So confirms the article by Consumer Reports (CR) (2008), which finds that "health-insurance premiums have grown faster than inflation or workers' earnings over the past decade, in parallel with the equally rapid rise in overall health costs. Industry spending on administrative and marketing costs, plus profits, consumes 12% of private-insurance premiums." (CR, 1) This reiterates the case that the undue imposition of costs by the healthcare industry -- a reflection of a free-market industry with little to no regulatory oversight -- has negatively impacted the accessibility and quality of healthcare for many of the poorest users.
Moreover, these users are most vulnerable to the long-term economic damages provoked by unexpected healthcare costs. So…
Bureau of Labor Education (BLE). (2001). The U.S. Health Care System: Best in the World, or Just the Most Expensive? The University of Maine.
Childress, M. (2010). Poverty is on the Upswing, but Metric is Out of Date. The Washington Independent.
Cockerham, W.C. (2004). Medical Sociology and Sociological Theory. The Backwell Companion to Medical Sociology.
Consumer Reports (CR). (2008). High Health Care Costs. Consumer Reports Health.org.
On the contrary, a comprehensive medical care solution that tackles the main issues driving up health care costs in America is possible. The main problem experienced by the average American is that health insurance premiums are cost prohibitive for the middle-class, but being uninsured can bankrupt a family forced to deal with even a minor catastrophic illness. Therefore, a national health insurance program has to be part of the solution. However, one cannot overlook the role that unpaid medical bills and exorbitant malpractice premiums also play in the modern healthcare crises. As a result, the solution must include a way to reduce malpractice premiums through tort reform, and a way to reduce the percentage of medical bills that go unpaid. The proposed three-prong approach would tackle all of those issues, without forcing any unwilling person to participate in a nationalized healthcare program.
American Tort Reform Association. "Medical Liability…
American Tort Reform Association. "Medical Liability Reform." ATRA Issues. 2007.
American Tort Reform Association. 6 Nov. 2008 http://www.atra.org/show/7338.
Kershaw-Staley, Tracy. "Miami Valley Hospital Files Lawsuit Over Unpaid Medical Bills."
Dayton Business Journal. 2008. Dayton Business Journal. 6 Nov. 2008 http://dayton.bizjournals.com/dayton/stories/2008/01/07/story5.html .
Healthcare Case Study Schuylkill County, PA
County Overview - Schuylkill County, Pennsylvania is located in the heart of the anthracite Coal region of Pennsylvania where the Schuylkill iver originates. Pottsville is the county seat, and the county showed a population of just under 150,000 as of 2010 with a density of 190 persons per square mile. The total area of the county is 782 square miles, almost all land, less than 1/2 a per cent water. The county's history, likely due to large coal deposits, focused on the railroad and industrialization (Schuylkill Chamber of Commerce, 2011).
The county experienced the high point of its population during the 1920s and 1930s, and has been losing people ever since, most between 1950 and 1970, with about a 1-2% population loss since the turn of the century. This is likely due to the lack of appropriate jobs and opportunities within the county. Schuylkill…
County Health Statistics - Healthcare 2010. (2009, March). Retrieved from Pennsylvania Department of Health: http://www.portal.state.pa.us/portal/server.pt-in_hi_groupoperator_1=or&in_hi_req_objtype=18&in_hi_req_objtype=17&in_hi_req_objtype=512&in_hi_req_objtype=514&in_hi_req_objtype=43&in_hi_req_objtype=1&in_hi_req_apps=7&in_hi_req_page=10&in_ra_topoperator=or&
Comprehensive Plan. (2010, March). Retrieved from City of Pottsville, PA: http://www.city.pottsville.pa.us/html/cp1.htm
Election Statistics. (2010, June). Retrieved from Pennsylvania Department of State: http://www.dos.state.pa.us/portal/server.pt/community/running_for_office/12704
Schuylkill County. (2010, June). Retrieved from Sperling's Best Places USA: http://www.bestplaces.net/economy/county/pennsylvania/schuylkill
Information technology and computers have also begun to affect, in ways that are both bad and good, family life, community life, education, freedom, human relationships, democracy, and many other issues. By looking into the broadest sense of the word it can be seen that cyber ethics should actually be understood as a branch of applied ethics, and ethics should be something that is believed in by all that provide medical information, whether via the Internet or in some other way, since providing false or fraudulent information could be damaging and potentially deadly for many people.
This particular branch of ethics analyzes and studies information technology and what type of ethical and social impacts it has. Within recent years this new field has led to countless courses, workshops, articles, journals, and many other ways of expression. With the World Wide Web becoming so popular when it comes to health care information,…
Bynum, T.W. (1999) the Foundation of Computer Ethics. A keynote address at the AICEC99 Conference, Melbourne, Australia, July 1999. Published in the June 2000 issue of Computers and Society.
Health Care Reform Federal Deficit
The American Health Care Crisis and the Federal Deficit
The United States spends more than any other country on medical care. In 2006, U.S. health care spending was $2.1 trillion, or 16% of our gross domestic product. At the same time, more than 45 million Americans lack health insurance and our health outcomes (life expectancy, infant mortality, and mortality amenable to health care) are mediocre compared with other rich democracies. We spend too much for what we get.
Nothing is new about these sobering realities. The Nixon administration first declared a health care cost crisis in 1969. Four decades later, the United States still has not adopted systemwide cost controls because the politics of health care make it extraordinarily difficult to control costs. I explain below why this is so (Marmor, et al., 2009).
The starting point for understanding the politics of cost control is…
1. Eakin, Douglas and Michael Ramlet. (2010) "Health Care Reform is Likely to Widen Budget Deficits -- Not Reduce Them." Health Affairs, 29, no.6:1136-1141. Eakin and Ramlet examine the underpinnings of the Congressional Budget Office's projection that enacting the Patient Protection and Affordable Care Act will decrease deficits, and conclude that it is built on a shaky foundation of omitted costs, premiums shifted from other entitlements, and politically dubious spending cuts and revenue increases. A more comprehensive and realistic projection suggests that the new reform law will raise the deficit by more than $500 billion during the first ten years and by nearly $1.5 trillion in the following decade. This is an excellent article with regards to my article, written by two policy commentators at the forefront of their field. This article shows expertise in medical economics and offers compelling, clear arguments for the increase in the federal deficit due to the massive spending on entitlements as a result of passing the Patient Protection and Affordable Care Act. They project deficits, opposing the Congressional Budget Office, through their insightful analysis.
2. Marmor, Theodore, Jonathan Oberlander, and Joseph White. (2009) "The Obama Administration's Options for Health Care Cost Control: Hope vs. Reality." Ann Intern Med. 150:485-489. Controlling the costs of medical care has long been an elusive goal in U.S. health policy. This article examines the options for health care cost control under the Obama administration. The authors argue that the administration's approach to health reform offers some potential for cost control but also embraces many strategies that are not likely to be successful. Lessons the United States can learn from other countries' experiences in constraining medical care spending are then explored. This article offers evidence for the lack of cost containment in the Obama administrations' plans for health reform. It gives a good analysis of the international scene in health care as well.
3. Collins, Sara, Michelle M. Doty, Karen Davis, Cathy Schoen, Alyssa L. Holmgren, and Alice Ho. (2004) "The Affordability Crisis in Health Care." Commonwealth Fund Biennial Health Insurance Survey. Published in 2004, The Commonwealth Fund Biennial Health Insurance Survey, conducted from September 2003 -- January 2004, presents new and timely information on where the American public stands on solutions to reform the health care system. The survey finds widespread support for federal efforts to extend health insurance to more people, as well as a widely held belief that the financing of health care should continue to be a shared responsibility among individuals, employers, and the government. The survey also uncovered potential reasons for such strong support for health care reform. Among the insured and the uninsured alike, there is concern that health care security in the United States is eroding. People are experiencing reductions in insurance coverage that are threatening their financial security.
4. Etheridge, Lynn (1984) "An Aging Society and the Federal Deficit." The Milbank Memorial Fund Quarterly. Health and Society, 521-543. This article serves as early warning sign of the deficit battles to come. It argues that the conflict between the growing needs of an aging society and a federal budget which cannot afford its current commitments has become one of the nation's most difficult government policy dilemmas. Assistance for the elderly through Social Security, Medicare, and other programs-is already the federal government's largest fiscal responsibility. In 1985 these programs will require nearly half of all domestic program spending an estimated $256 billion. The future costs of these commitments will rise rapidly well into the next century, accounting-with national defense and interest costs-for virtually all of the spending increases in the projected $200 to $300 billion deficits. Etheridge asserts that the decisions about the nation's assistance to the elderly -- and about reaffirmation, reform, and/or retrenchment of these commitments-will thus be central to the coming budget debates.
Health Policies Medicare
hen everyone in our country finally starts to reach the age of 65 years of age or older, then every person will become eligible for Medicare. It is clear that there are some elderly that are having minimum health concerns while others recurrently are dealing with medical issues for which they will have to seek out treatment by the doctor. However, research is starting to display that there are at least five top conditions that are enhancing on medical and drug spending. It is obvious that Heart disease circumstances are the number one medical issue that the those that are considered elderly are facing and that is becoming very costly to them. Most are unaware that the second one is the disease cancer and it could be internal or external for various elderly patients. Other issues such as joint ailments a lot of the times can cost…
Wenzlow, Audra T., et al. "Effects of a Discharge Planning Program on Medicaid Coverage of State Prisoners with Serious Mental Illness." Psychiatric Services 62.1 (2011): 73-8.
Sommers, Benjamin D. "Loss of Health Insurance among Non-Elderly Adults in Medicaid." Journal of General Internal Medicine 24.1 (2009): 1-7.
Verdier, James, and Allison Barrett. "How Medicaid Agencies Administer Mental Health Services: Results from a 50-State Survey." Psychiatric Services 59.10 (2008): 1203-6.
Harman, Jeffrey S., Allyson G. Hall, and Jianyi Zhang. "Changes in Health Care use and Costs After a Break in Medicaid Coverage among Persons with Depression." Psychiatric Services 58.1 (2007): 49-54.
Healthcare in the United States: Where We Have Been, Where We Are Going
The current healthcare crisis in America is not one that happened over night. It is one that has been building for more than a quarter century. There was a time in America when healthcare was a stellar institution: research, cures, technological advances, and treatments. The focus of healthcare was maintaining and improving the quality of life. Then, during the early 1980s, managed care became an entity between the physician, the patient, and the healthcare provider of hospital services. It began subtly, but has, today, become one of the most aggressive and successful business ventures of our time; and it has been the unmaking of a once stellar and progressive American institution.
Managed care is a "distinctly American" product (Birenbaum, 1997). It was legislation introduced by the Nixon Administration with the intent to regulate healthcare and to maintain…
Bernstein, A.B., Hing, E., Moss, A.J., Allen, K., Siller, A., and Tiggle, R. (2003). Health Care in America: Trends in Utilization. Hyattsville, MD: National Center for Health Statistics.
Birenbaum, A. (2002). Wounded Profession: American Medicine Enters the Age of Managed Care. Westport, CT: Praeger.
Birenbaum, A. (1997). Managed Care: Made in America. Westport, CT: Praeger.
Committee on Health Care Access and Economics Task Force on Mental Health (2009). Improving Mental Health Services in Primary Care: Reducing Administrative and Financial Barriers to Access and Collaboration. The Official Journal of the American Academy of Pediatrics, March, 30, 2009, pp. 1248-1251.
Health Promotion Lesson Plan
The concept of health promotion is thought of as "the science and art of helping people change their lifestyle to move toward a state of optimal health" (Dunphy et al., 2011, p 25). Serious heart conditions can be prevented, which is why it is so important to utilize community education techniques in order to help try to warn community members of the complications before they occur. This current lesson plan works to create three separate community lesson plans, based on specific age ranges. The age 18-29 focuses primarily on the use of social media and health advocacy efforts in association with the American Heart Association. For ages 30-49, there is also a focus on these two, combined with more community oriented issues, and for 50-60, there is much more of a focus on financial training along with community organized workshops.
Prevention has become a major issue…
References McLeod, Saul. (2010). Erik Erikson. Developmental Psychology. Simply Psychology. Web. http://www.simplypsychology.org/Erik-Erikson.html
It is imperative to persuade children to go outside and play and to educate them about exercise. They have to learn that there is such a thing as too much or too little. The best thing one can do for their kids is to take walks because it's beneficial to their health (the Media, 2007). Although a good argument can be made that it is not the media that leads women to get eating disorders and that it is instead society that perpetuates this, I think it could be said that one goes hand in hand with the other.
The manner that the main stream media portrays women in the images that they depict has a definite influence on the way that women feel and how they believe that they need to look like. There is a constant barrage of overly think women seen in advertisements that lead women to…
Coakley, Tedra. 2007, "Eating disorders no longer discriminate," viewed November 24, 2010,
< http://www.iccjournal.biz/eating_disorders_no_longer_discr.htm >
"Cultural Roles." 2007, viewed 24 November 2010, < http://www.something-
ichard Mitchell and Professor Daniel Dorling from the University of Leeds and Dr. Mary Shaw from the University of Bristol on the parliamentary constituencies of Britain revealed a number of social policy scenarios. The study traced the impact of the variations to society that might be brought through the effective execution of three social and economic policies. Firstly, they examined the efficacy of the policy of modest redistribution of wealth to counteract the health inequalities. During the decades 1980s and 1990s there were a considerable variation in the wealth possessions of rich and poor reflected in the major variations in their health enumerated by mortality rates. The study revealed that by returning to the inequalities in wealth of 1983 about 7500 deaths annually could have been prevented. (educing health inequalities in Britain)
The study assessed the impact of such policy to be most effective in the Birmingham Ladywood constituency in…
Health inequalities kill thousands" (27 September, 1999) Retrieved at http://news.bbc.co.uk/1/hi/health/456807.stm . Accessed 3 September, 2005
Introduction to health inequalities" Retrieved at http://www.dh.gov.uk/PolicyAndGuidance/HealthAndSocialCareTopics/HealthInequalities/HealthInequalitiesGeneralInformation/HealthInequalitiesGeneralArticle/fs/en-CONTENT_ID=4079644&chk=8WiiZg. Accessed 3 September, 2005
Link BG; Phelan JC. (May, 2005) "Fundamental Sources of Health Inequalities" Policy
Challenges in Modern Health Care. pp: 71-84. Retrieved at http://www.rwjf.org/research/researchdetail.jsp?id=1944&ia=141 . Accessed 4 September, 2005
This is important, because utilizing technology to deliver various health care solutions will: increase collaboration, improve the underlying amounts of care and it can help to reduce costs. Once this takes place, it means that implementing various changes can be easier.
When a health care professional encounters an Asian patient in their practice, what are at least three characteristics he/she should consider in order to improve communication and cultural competence in delivering services to this patient and tell why those characteristics are important to consider.
Three characteristics that should be considered would include: family, communication and the concept of time. Family matters to Asian patients, as this is their foundation for strength and support. Communication is important, with these patients more focused on body languages and pauses (to signify substance vs. The actual words). Time will be different between the two cultures, as Asian patients will place less of an…
Cultural Values of Asian Patients. (2009). Dimensions of Culture. Retrieved from: http://www.dimensionsofculture.com/home/cultural_values_of_asian_patients_families
Define Culture. (2010). Roshan Institute. Retrieved from: http://www.roshan-institute.org/templates/System/details.asp?id=39783&PID=474552
Values. (2010). Business Dictionary. Retrieved from: http://www.businessdictionary.com/definition/values.html
Polls examining public support of the bill and specifically the public healthcare option vary significantly. ith regard to physicians, the New England Journal of Medicine surveyed over six thousand medical doctors and found there was a majority in favor of federally provided public healthcare insurance (Keyhani & Federman). Other polls have suggested an opposition to the public option (Marmor).
The public option would provide an affordable alternative to the current private health insurance options and would provide impetus for competition and positive change. hether "America's Affordable Health Choices Act of 2009" will be passed is currently uncertain. hat is certain is that the healthcare and health insurance system is currently not sufficient to provide healthcare support for nearly 48 million uninsured Americans. Alterations need to be made to increase access and affordability for those individuals who desire health insurance.
The healthcare and health insurance system in the United States…
Harrington, Charlene, Carroll L. Estes, and Cassandra Crawford. Health policy. Jones & Bartlett Publishers, 2004.
Keyhani, Salomeh, and Alex Federman. "Doctors on Coverage -- Physicians' Views on a New Public Insurance Option and Medicare Expansion." N. Engl J. Med 361.14 (2009): e24.
Kotlikoff, Laurence J. The healthcare fix. MIT Press, 2007.
Marmor, T. "The Obama Administration's Options for Health Care Cost Control: Hope vs. Reality." 7 Apr 2009. 1 Nov 2009 .
" ("Let My Baby Live..." NP) Other messages of the campaign were to stress the need to avoid high risk pregnancy, prior to age 18 or after age 35 and to stagger pregnancies by two years to help the maternal body recover and be strong enough to care for the developing infant and go through labor successfully. The campaign, promoting these ideas states that it has been successful in reaching its goals, and has currently reached 66% of the population in the regions where the campaign was launched. ("Let My Baby Live..." NP) There is not mention as to whether the campaign will end, or be expanded to a broader audience in Turkey.
Turkey's example program could serve as a template for other health issues that need to be expressed to the public in Turkey and in other nations with challenged health care delivery infrastructures and limited public knowledge of…
Brennan, Teresa. Globalization and Its Terrors. London: Routledge, 2003.
Kaul, Chandrika, and Valerie Tomaselli-Moschovitis, eds. Statistical Handbook on Poverty in the Developing World. Phoenix: Oryx Press, 1999.
Weiker, Walter F. The Modernization of Turkey: From Ataturk to the Present Day. New York: Holmes & Meier Publishers, 1981.
E-Health Project in Turkey" International Telecommunications Network Website Retrieved November 15, 2007 at http://www.itu.int/ITU-D/e-strategies/e-applications/Turkey_E-health/index.html
Two elements that are extremely useful in the examination of health care. In this regard therefore, quality is also differentiated along SES. Persons who are higher on the socioeconomic ladder experience better "desired health outcomes."
The access to quality health care also has cultural and SES elements to it. Dressler & Bindon (2000) identify cultural consonance as a factor in determining blood pressure in African-American communities. The implications of this work are that cultural elements play a big role in health care quality and access. Whites tend to have greater access to better health care than minority groups. This access is in terms of the proximity of quality physicians, medical services, and facilities.
The ethical implications of the differential access to health care are troubling (Kulczycki, 2007). This is primarily because a health care discussion is a life and death discussion. Quality health care is the right of every citizen,…
Dressler, W.W., Balieiro, M.C., & Dos Santos, J.E.(1988). Culture, Socioeconomic Status, and Physical and Mental Health in Brazil Medical Anthropology Quarterly, New Series, 12
Dressler W.W., & Bindon, J.R. (2000).The Health Consequences of Cultural Consonance:
Cultural Dimensions of Lifestyle, Social Support, and Arterial Blood Pressure in an African-American Community American Anthropologist, New Series, 102
Health Plan Dev
Health Plan and Health Organization Development
Five Key Events
There are a multitude of different historical events that have occurred in the modern era in a manner that has drastically changed the way in which health and the relationships between society and healthcare has been viewed. In Germany in 1883, Chncellor Otto van Bismarck managed to implement a national insurance-like healthcare scheme that ensured certain basic access to healthcare for many working-class Germans that would otherwise go without medical care. A second highly similar event occurred in England in 1911 with the establishment of a national health insurance program, which eventually became the National Health ervice of the United Kingdom that still provides healthcare services to the nation's citizens today.
The ocial ecurity Act of 1935 represents a major shift in the direction of healthcare policy in the United tates, as this legislation laid the groundwork for…
Socioeconomic and Legislative Influences
In the latter part of the nineteenth century and the first half of the twentieth century, industrialization began to create ever more stark and extreme differences in the living standards of individuals and families living at different rungs on the socioeconomic ladder. Medical care had become hugely more effective, but could not be afforded by many of the working class, and thus government increasingly saw a need -- and felt certain pressures -- to intercede and provide at least a minimum of care for its citizens. There are directly pragmatic economic benefits of such intercession; improved healthcare leads to increased productivity and reduced costs in other social spending, even potentially reducing criminality as fewer families would find themselves in destitute situations without reliable wage earners due to illness or injury. All of these socioeconomic factors have led to an increased sense of social and civic responsibility for healthcare, yet the initial and direct expense of such a system on a national level with universal coverage has been a dissuasive factor.
Healthcare organizations in the United States have been hugely impacted by several key pieces of twentieth century legislation, including the Social Security Act of 1935, the adjustments to Medicare and Medicaid made in 1966 and in subsequent years throughout the following decades. Currently, the Affordable Care Act is set to go into full enforcement in 2014, and healthcare organizations and insurance providers are already beginning to make adjustments based on these anticipated changes.
Health Care oles in Communication
Communication is a fundamental piece of health care education and has been shown to improve health outcomes, patient compliance, and patient satisfaction. Quality health care emphasizes knowledge and utilization of communication skills. Health care professionals often express anxiety and lack of confidence and are deficient in a creating a situations that are conducive to open and candid communication with patients (Kameg et. al., 2009).
Effective communication involves gathering information, establishing a relationship or connection with a patient, and supporting the person through words and other non-verbal forms of interactions. Effective communication involves not only the interactions between the staff and the patient but also the interactions between staff and the interactions between the staff in front of the patient. Many times the high demand for services in a health care facility cause the staff to overlook the importance of good communication skills and enables situations…
Beer, J.E. (2003). Nonverbal Communication: Communicating across cultures. Cultures at work. Retrieved May 29, 2011 from http://www.culture-at-work.com/nonverbal.html
Coiera, E. (2006, May). Communication systems in healthcarre. Clinical Biochemist Reviews. nursing.Vol. 27, Issue 2, 89-98. Retrieved May 28, 2011 from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1579411/
Gamble, T.K. & Gamble, M. (2006). Communication works. Burr Ridge, IL: McGraw-Hill.
Health Communication. (2010). Health communication. Healthy people 2010: Objectives for improving reproductive health. Office of Disease Prevention and Health Promotion. Retrieved May 29, 2011 from http://www.hhs.gov/opa/pubs/hp2010/hp2010rh_sec2_healthcomm.pdf
" (Arnold & Reeves, 2009). ith medical services price at the present time, illness or some kind of complicated to medical services may take people deprived of health insurance years to reimburse for bills that are medical. Furthermore, I believe that individuals who lost their jobs also are uninsured for the reason that their employer gave health insurance is no longer paying for them. I understand that based on the statistic; there are "way too many around 1 million workers that have lost their health reporting in the first three months of 2009. I think that helping people buy health insurance coverage with low-cost with offering the health plans options for the uninsured is the healthcare reform that is really needed now. In this way, individuals that are without health insurance will be able to afford paying their medical insurance to uphold their well-being.
In conclusion, with the increasing rapidly…
Arnold, P.J., & Reeves, T.C. (2009). International Trade and Health Policy: Implications of the GATS for U.S. Healthcare Reform. Journal of Business Ethics, 63(4), 34.
Belcon, M.C., Ahmed, N.U., Younis, M.Z., & Bongyu, M. (40-74.). ANALYSIS of NATIONAL HEALTHCARE SYSTEMS: SEARCHING for a MODEL for DEVELOPING COUNTRIES - TRINIDAD and TOBAGO as a TEST CASE. Public Administration and Management, 14(2), 10-14.
Bolduc, C.R. (2008). The impact of healthcare reform on HMO administrators. Hospital & Health Services Administration, 17(9), 23-45.
Reiboldt, M. (2010). The Industry Responds to the Passing of Healthcare Reform. The Journal of Medical Practice Management, 18(6), 327-328.
Health Care Access Ethical Dilemma
Access to health care services is not equitable in the United States. The 15% of Americans without health insurance coverage find it extremely difficult to access health care services (Trotochaud, 2006). This is an injustice that should be addressed. Patients going to rural health care facilities face myriad challenges that are occasioned by stigmatization. Stigmatization of illnesses that patients grapple with occasions ethical conflicts. In the process, patients' right to privacy and confidentiality are often violated. There are practical guidelines that can be used to minimize ethical conflicts. It is imperative that confidentiality and trust be made paramount under circumstances where healthcare professionals deal with patients with stigmatizing illnesses.
A typical example of confidentiality, overlapping relationships and lack of willingness to seek care can be attested to in a situation where a woman working at a local store finds out that her partner is HIV-positive…
Trotochaud, K. (2006). Ethical Issues and Access to Healthcare. Journal of Infusion Nursing,
Tummala, A. & Roberts, L.W., (2009). Ethics Conflicts in Rural Communities: Stigma and Illness. Hanover, NH: University Press of New England.
Healthcare spending by the New York State persistently surpasses its earnings. That difference continues to be expanding and is also anticipated to broaden unless of course there happen to be severe, continuous modifications in spending budget actions. Lieutenant Governor ichard avitch, in "A 5-Year Strategy to Deal with the State of New York's Spending budget Deficit" released during March 2010, approximated this structural disproportion within the state's spending budget to become no less than $13 billion. The structural inequality isn't simply the consequence of the economic downturn that started during 2007, and a commonly strengthening economic climate is not going to get rid of it.
To help the State of New York in providing the solutions and dedication to quality that its residents rely on, structural modifications are needed. The aim of this paper is actually to summarize one particular realignment - solving an outright inequity involving the state as…
California Public Employees' Retirement System, "Facts at a Glance: Health," September 2010, http://www.calpers.ca.gov/eip-docs/about/facts/health.pdf .
Citizens Budget Commission, Out of Balance: A Comparison of Public and Private Employee Health Benefits in New York City, December 2009, http://www.cbcny.org/sites/default/files/REPORT_Survey_12162009.pdf .
City of New York Office of Labor Relations, "New York City Summary Program Description, Health Benefit Program," 2010, http://www.nyc.gov/html/olr/downloads/pdf/healthb/full_spd.pdf.
Government Finance Officers Association, "Recommended Practices, Health Care Cost Containment 2004," http://www.gfoa.org/downloads/corbaHealthCareCostContainment.pdf .
Healthcare management (Strategic operations plan)
Several studies, including Kelly arnes, show that healthcare generally moves from "costly settings" such as hospitals into cheaper and more flexible options, such as retail clinics and mobile health
What this actually shows as a future trend is that the global recession has played an important role in defining the customer profile. Clients are no longer interested solely in the best available services, but in low-cost services. For this, they look at flexible options and, in the same context of flexibility, they look more and more towards customization. Customization includes customized treatments and customized location (home, hospital, clinics, mobile)
At the same time, the demand for innovation remains key. The Harvard usiness Review points to the demand for innovation in emerging markets, such as China and India, but this is also true, to a different degree, for the U.S. market
. Innovation can take different…
1. Barnes, Kelly. Factors affecting 2014 Medical Cost Trend. PriceWaterHouse Coopers. On the Internet at http://www.pwc.com/us/en/health-industries/behind-the-numbers/index.jhtml . Last retrieved on March 6, 2014
2. Top Trends in Healthcare, medicine & pharmaceuticals. What's Next. On the Internet at http://www.nowandnext.com/?action=top_trend/list_trends§orId=10 . Last retrieved on March 6, 2014
3. N.a. Megatrends in Global Health Care. On the Internet at http://hbr.org/web/extras/insight-center/health-care/globaltrends/2-slide . Last retrieved on March 6, 2014
4. Child Trends. (2013). Fertility and birth rates. Available at: http://www.childtrends.org/?indicators=fertility-and-birth-rates
(Menzel, 1990, p. 3) Fisher, Berwick, & Davis alude to the idea of integration in health care, with providers linking as well as creating networks of electronic medical records and other cost improvement tactics.
The United States and other nations over the last twenty or so years, have begun a sweeping change in health care delivery, regarding the manner in which health information is input, stored and accessed. Computer use in the medical industry has greatly increased over the last thirty years the culmination of this is fully networked electronic medical record keeping. (Berner, Detmer, & Simborg, 2005, p. 3) the electronic medical record trend began in the largest institutions first, as hospitals and large care organizations attempted to reduce waste and improve patient care, while the adoption has been much slower among physician's practices and smaller medical institutions. (Hillestad, et al., 2005, pp. 1103-1104) Prior to this time medical…
Resources, and Utilization
S. Department of Health and Human Services, 2011). Furthermore, subpart C explains the privileges and the protections of confidentiality that is attached to the patient's record along with much exception (U.S. Department of Health and Human Services, 2011).
The penalty for anyone who breaks confidentiality is imperative. In "November, 23, 2009" was increased to $11,000 (U.S. Department of Health and Human Services, 2011). This goes for anyone in the medical field or has access to this information. A person has to follow HIPAA precisely or face a huge fine. If one thought of this ahead of time, whether or not they own a business, then no issues would arise legally. However, sometimes this does occur, especially for those who want to harm another person, yet in the medical field the goal is not to do this to any individual, regardless, otherwise he or she could face losing their license in…
U.S. Department of Health and Human Services Civil Rights. (2011). Your health information privacy rights. Retrieved May 3, 2011, from U.S. Department of Health and Human
Services Civil Rights:
U.S. Department of Health and Human Services. (2011). Health information privacy. Retrieved May 3, 2011, from U.S. Department of Health and Human Services:
Families, Delinquency & Crime
The fundamental changes occurring to families in the 2st century can be classified into two different categories, depending on the internal or the external perspective that is used in the analysis. The external perspective proposes an analysis of the sociodemographic changes that have occurred to families under the impact of the external factors of the 2st century. The sociodemographic changes are characterized both by the numbers, by a quantitative reflection of families, and by the relationships that are formed within each family.
From the first perspective, the 2st century has imposed both changes in the number of families (some cultures, notably the Western ones, have encountered decreases in size because of an increased reluctance of individuals to get married) and in the formation of these family groups. As such, in many of these family groups, the norm has translated from a man-woman marriage as the basis…
1. Roopnarine, Jaipaul; Gielen, Uwe. 2005. Families in Global Perspective. Pearson Education.
2. Vaskovics, L.A. 1994. Family and household structures in the former GDR and the Federal Republic of Germany from 1980 to 1989 -- a comparison. Wiesbaden.
3. Aly, A.M.Y. 1999. Lectures on population, family and childhood issues. Alexandria: The Modern University Office.
Also, as care is prioritized, those individuals deemed to be in a less urgent need of care are given a lower priority, which results in a wait list. Finally, as physicians are compensated on the same level of salary, fewer people may be attracted to the profession for its financial rewards. In a public system, patients shop around less for providers because most providers charge the same fees. ithin a public system there is less 'siphoning' of middle-income people to higher-cost physicians with short waiting lists.
Visit: http://www.csc-surgery.com/contact.php.hatexactly is this hospital? hat would your policy response be?
According to its website, the Cambie Surgery Centre is a private healthcare clinic. The site notes that the "BC provincial government looks to private health care facilities like the Cambie Surgery Centre to help ease the long public wait lists." The hospital is a paying hospital that uses sophisticated technology to perform its…
Cambie Surgery Centre." Official website. 7 Apr 2008. http://www.csc-surgery.com/contact.php
Economies of scale." Investopedia. 7 Apr 2008. http://www.investopedia.com/terms/e/economiesofscale.asp
Economies of scope." Investopedia. 7 Apr 2008. http://www.investopedia.com/terms/e/economiesofscope.asp
Green, David G., Ben Irvine & Ben Cackett. "Health care in Germany." 2005.