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This health history involves the health needs and characteristics of a 23-year-old Caucasian male. Reason for Care
The reason this patient is seeking care is multi-fold. He bears all the signs of an intravenous drug user and has an infection in his arm, clearly from injecting substances into his body with unclean needles or in unsanitary manners. The patient demonstrates an extreme shortness of breath, dry mouth, constricted pupils and seems disoriented, in conjunction with moments where he appears drowsy. When he walks, he has an extremely slouched appearance, as if his arms and legs are very heavy. His nose is frequently running and when asked about his weight loss, he provides unclear, unspecific answers. All the patient can attest to is the fact that he's lost 20 pounds in the last five months.
The reasons that patient is seeking care are articulated by him as follows: he…
Health History Examination
FUNDAMENTAL IN ADULT CARE
Individual Client Health History Examination of an Older Adult
Client/Patient Initials LNP Sex: F. Age
Occupation: free-lance researcher- journalist
Health History/Review of Systems
Neurological System -- the patient seldom suffers headaches or dizziness. She has no difficulty speaking or swallowing. She only takes vitamin and mineral supplements on a daily basis. She sits long hours before a computer because of her work, however. And thus experiences numbness in the legs and feet.
Head and Neck -- except for stiff neck due to computer work, she does not suffer from any significant causes in this area.
the patient is highly myopic and occasionally experiences visual migraine. She wears contact lenses but no medications.
Ears -- Nothing abnormal or disturbing about her hearing
Nose, Mouth and Throat -- no disturbing nose, mouth or throat discharges except for 3 defective teeth that need root canal therapy.…
Besdine, R.W. (2009). Evaluation of the elderly patient. The Merck Manual: Merck,
Sharpe & Dohme. Retrieved on July 18,2012 from http://www.merckmanuals.com/professional/geriatrics/approach_to_the_geriatric_patient/evaluation_of_the_elderly_patient.html
Christ, S. (2012). Physicals and health assessments. eHow: Demand Media, Inc.
Retrieved on July 19, 2012 from http://www.ehow.com/about_6164408_physicals-health-assessment.html
On Set: Patient, Diana Cates, age 47, has been suffering from Thyroidectomy. The patient cannot tolerate synthoid as it aggrevates and the central tremors even at lowest dose. Currently he has enlarged right thyroid.
How long: thyroid, Pt., thyroidectomy since 1993
Causes and Effects of Health Condition:
Quality of Health Condition:
It's located in the thyroid and it does not spread.
The thyroid problem affects her walking due to her weight and the pain. On a scale from 1 to 10, the condition is a 7 since it does seem to be worst when the patient walk which mostly during the day.
Early Stages of Health:
Timing: The patient's trouble began 1993 and it does not seem to be better or worse. As time goes by, the thyroid condition may be better with proper care.
Understanding: The patient has the…
nursing . I requesting NUSING KNOWLEDGE ON COMPEHENSIVE HEALTH HISTOY TAKING TECHNIQUES on PATIENTS TO PLEASE DO THIS WOK. PLEASE INCLUDE CITED SOUCES IN THIS ESSAY. PEPAE THIS ESSAY ACCODING TO APA GUIDELINES.
Comprehensive Health History Taking Techniques on Patients
Patient's health history stands out as paramount towards patient's treatment despite all the advances resulting to technological sophistication in medicine practices (Lloyd & Craig, 2007). In the recent past, medical advances have altered measures of diagnosing, determining and treating diseases. However, listening to patients and taking their medical history is arguably an important aspect towards assessment of ailments and patient treatment (Lloyd & Craig, 2007). In communicating with the patients, Nurses or Clinicians ought to uphold compassion, empathy and listening skills. These aspects will prevail to allow achievement of a comprehensive patient assessment and appropriate treatment. This paper presents a discussion on effective interview techniques, measures of conducting the interviews,…
Levinson, W., Lesser, C.S., & Epstein, R.M. (2010). Developing physician communication skills for patient-centered care. Health Aff (Millwood), 29(7), 1310-1318.
Lloyd, H., & Craig, S. (2007). A guide to taking a patient's history. Nursing Standard, 22(13), 42-48.
Stewart, M. (2003). Questions about patient-centered care: answers from quantitative research. In Stewart M, et al. (eds): Patient Centered Medicine: Transforming the Clinical Method. Abington, UK:: Radcliffe Medical Press, 2003.
Building a health history with a new patient requires more than active listening and the development of trust and rapport. The intake interview and initial health assessment should be thorough, taking into account the area(s) in which the patient has lived, their workplace environment or work history, their family background and family health history, socioeconomic variables, and any other relevant environmental factors that may impact personal health. Of course, demographic variables like age, ethnicity, and gender will all be taken into account when building a health history with a new patient. Communication techniques and interviewing style, risk assessment instruments, and the specific questions to be asked would also vary considerably depending on the patient. Consider the following example of a pre-school aged white female living in a rural community:
A pre-school aged white female needs to be interviewed with a parent or legal guardian present for practical, legal, and ethical…
Goetzel, R.Z., Staley, P., Ogden, L, et al. (2011). A framework for patient-centered health risk assessments. CDC. https://www.cdc.gov/policy/hst/HRA/FrameworkForHRA.pdf
“Health Risk Assessments,” (n.d.). Stratis Health. https://www.stratishealth.org/documents/HITToolkitcoordination/4-Health-Risk-Assessments.pdf
Female Health History Interview
Born: July 15, 1961 in Denver, Colorado
Marital Status: Widow
Race/Ethnic Origin: Caucasian (European)
Source and Reliability: Phyllis is honest and her information is reliable
Reason for Seeking Care: She has several health issues that concern her
Present Health or History of Present Illness: She is overweight and has high blood pressure
In general Phyllis has been healthy but she has had high cholesterol, skin cancer, a peptic ulcer, and genital herpes
Childhood Illnesses: Phyllis had measles and scarlet fever
Accidents or Injuries: she was in a serious car accident at 33; she suffered major contusions to her face, broken ribs and lacerations to her legs
Serious or Chronic Illnesses: she had scarlet fever as a child but has no after effects
Hospitalization: she was hospitalized after the car accident for three weeks
isk Involved in Poor Chart Documentation: An Overview in Total Quality Management
Poor chart documentation in the behavioral health field is a concern for risk management and a critical area for total quality improvement. Poor chart documentation can lead to an audit by accrediting bodies and in severe circumstances lead to discharge. There are many legal ramifications associated with poor chart documentation. This paper will highlight the importance of poor chart documentation, the consequences of poor documentation, and suggest possible tools for resolving documentation errors. The best tool for eliminating chart documentation risk is developing a risk management system appropriate to the health care setting.
Poor chart documentation costs behavioral health providers thousands of dollars in malpractice costs every year. Errors related to chart documentation can be severe; a patient can suffer an untimely death for example. In fact, statistical evidence suggests that each year thousands of patients…
Aron, DC. & Headrick, L.A. (2002). Educating physicians prepared to improve care and safety is no accident: It requires a systematic approach. Quality and Safety in Health Care, 11, 168-173.
Burke, M., Boal, J., & Mitchell, R. (2004). Communicating for better care. American Journal of Nursing. 104(12), 40-47.
American Society of Healthcare Risk Management, American Hospital Association. (2004). The
growing role of the patient safety officer: Implications for risk manager. Chicago: American Hospital Association.
Stated to be barriers in the current environment and responsible for the reporting that is inadequate in relation to medical errors are:
Lack of a common understanding about errors among health care professionals
Physicians generally think of errors as individual that resulted from patient morbidity or mortality.
Physicians report errors in medical records that have in turn been ignored by researchers.
Interestingly errors in medication occur in almost 1 of every 5 doses provided to patients in hospitals. It was stated by Kaushal, et al., (2001) that "the rate of medication errors per 100 admission was 55 in pediatric inpatients. Using their figure, we estimated that the sensitivity of using a keyword search on explicit error reports to detect medication errors in inpatients is about 0.7%. They also reported the 37.4% of medication errors were caused by wrong dose or frequency, which is not far away from our result of…
Discussion Paper on Adverse Event and Error Reporting In Healthcare: Institute for Safe Medication Practices Jan 24, 2000
Patient Safety/Medical Errors Online at the Premiere Inc. page located at: http://www.premierinc.com/all/safety/resources/patient_safety/downloads/patient_safety_policy_position_2001.doc
Medstat / Shortell, S. Assessing the Impact of Continuous Quality Improvement on Clinical Practice: What It Will Take to Accelerate Progress.
Health Policy Monitor (2001) A Publication of the Council of State Governments Vol. 6, No. 1 Winter/Spring 2001 PO18-0101
Even in the second half of the 17th century did doctors prescribe apparently absurd remedies such as viper's flesh, red coral, sweet almonds, and fresh flowers for diabetes sufferers (DiabetesHealth.com). Of course, these had little effect, and sufferers were generally condemned to death. The first breakthrough before the 1920s came in the form of Dr. John Rollo, who built on the work of Dr. Dobson of Liverpool to prescribe the first relatively successful treatment of the disease: a diet that was high in fat and meat and low in grains and breads. This improved the prognosis significantly, and for the first time in history could diabetes sufferers expect an extended life.
The year 1921 saw a miraculous discovery that would change the treatment of diabetes forever (Sattley). The surgeon Frederick Banting and his assistant Charles Best were instrumental in the discovery of insulin as an effective treatment for the disease.…
Canadian Diabetes Association. The History of Diabetes. 2009. http://www.diabetes.ca/about-diabetes/what/history/
Diabetes Health. History of Diabetes: From Raw Quinces & Gruel to Insulin. http://www.diabeteshealth.com/read/1992/11/01/25/history-of-diabetes-from-raw-quinces-and-gruel-to-insulin/
Health.Savvy. A Timeline of the History of Diabetes. Feb 8, 2008. http://health.savvy-cafe.com/a-timeline-of-the-history-of-diabetes-2008-02-08/
Sattley, Melissa. The History of Diabetes. Dec. 17, 2008. Diabetes Health. http://www.diabeteshealth.com/read/2008/12/17/715/the-history-of-diabetes/
Patient portals, electronic medical records, and personal monitoring devices are three of the most revolutionary technologies in the healthcare sector. Each of these technologies presents patients with the potential to empower themselves, taking control of their own healthcare outcomes, and taking part in their overall healthcare goals. These technologies also streamline healthcare administration and minimize medication and billing errors. However, each of these technologies is also constrained by a range of issues related to accessibility, with potent socioeconomic class disparities evident. Security and standardization of healthcare technologies are also proving problematic. Patient portals, electronic medical records, and personal monitoring devices are all technologies that have the potential to radically improve the quality of healthcare and patient outcomes, as well as improve overall patient experiences. Because of their abundant benefits, these technologies need to be embraced and promoted through effective public health policies. Otherwise, disparities will continue to threaten to exacerbate…
Health Information System
Promoting Action Design esearch to create value in healthcare through IT
ecently there has been varying proof showing that health IT reduces costs while improving the standard of care offered. The same factors that had caused delays in reaping benefits from IT investment made in other sectors (i.e. time consuming procedural change) are also very common within the healthcare sector. Due to the current transitive nature of the Healthcare sector, new IT investment is likely not going to provide maximum value unless this new investment is backed up with a total reform of healthcare delivery. The overall ability of healthcare IT value researchers to add value to practice will be severely limited as a result of the traditional ex-post approach to measuring IT and the fact that government spurs significant investment. It may be risky to generalize or compare results from traditional IT value research with those…
Fichman, R., Kohli, R., & Krishnan, R. (2011). The role of information systems in healthcare: Current research and future trends. Information Systems Research, 22(3), 419-428.
Goh, J.M., Gao, G., & Agarwal, R. (n.d.). Evolving work routines: Adaptive routinization of information technology in healthcare. Information Systems Research, 22(3), 565-585.
Hoffnagel, E., Woods, D., & Leveson, N. (2006). Resilience engineering: Concepts and precepts. Abingdon: GBR: Ashgate Publishing.
Jones, S., Heaton, P., Riudin, R., & Schneider, E. (2012). Unraveling the IT productivity paradox lessons for health care. The New England Journal of Medicine, 366(24), 2243-2245.
Health Promotion and Preventative Care Plan
The purpose of this paper is provide information about the process of conducting a health assessment and a care plan based on the findings of the several assessments that were conducted for the benefit of the patient. The paper will describe the health history consisting of a review of systems, and will provide information about the assessment and its relevance to the plan of care developed for the patient.
The patient (CM) is a 24-year-old single black female who was born in the Democratic epublic of Congo (DC) and arrived in the United States three years ago to pursue an education. CM lives at home with her siblings, nieces and nephews, and her parents who just moved to the U.S. five months ago from the DC. CM works in retail and has been working extra shifts in order to help with the expenses of…
Gulanick, M. (2012). Knowledge deficit: Patient teaching, health education. Elsevier Publishing.
Jarvis, C. (2012). Physical examination and health assessment (6th ed.). St. Louis, MO: Elsevier.
History Of Health Care Mandate
The signing of the Affordable Care Act (ACA) by President Obama must be considered a landmark event in the history of the nation regardless of how one views the constitutionality of the legislation. Passage of the legislation marked the end of a long and acrimonious debate and brought the United States in line with the rest of the developed world in terms of providing universal health coverage to its citizens (Orszag, 2010). Unfortunately, the debate over the constitutionality of the ACA did not end with Obama's signing of the legislation as within days several different states filed suit against the law's requirement that most Americans purchase health; against the health care mandate.
The health care mandate was first offered as an option by the conservative think tank, the Heritage Foundation, as an option to the single-payer system that had been historically supported by Democrats and…
Block, S. (2010, April 29). IRS Lacks Clout to Enforce Mandatory Health Insurance. USA Today, pp. www.usatoday.com/money/perfi/insurance/2010-04-29 healthirs28_CV_N.htm?loc=interstitialskip.
Jost, T.S. (2010). Health Insurance Exchanges and the Affordable Care Act: Eight Difficult Issues. Lexington, VA: Washington and Lee University School of Law.
Orszag, P.R. (2010, August 12). Health Care Reform and Cost Control. New England Journal of Medicine, pp. 601-603.
Ponnuru, R. (2012, March 27). The History of the Individual Mandate. Retrieved from National Review Online: http://www.nationalreview.com/corner/294585/history-individual-mandate-ramesh-ponnuru
In the wake on new and very contentious health care reform, many firms have undergone extensive transformations. These transformations have been predicated on both cost control and quality management. In particular quality management has had a profound impact on the underlying business operations of many health care firms. For one, firms are now finding methods in which to enhance the overall patient experience while also mitigating potential loses due to negligent means. The focus on quality management has also made firms more efficient in regards to the overall delivery of service. In particular, my firm has done extensive work with reducing elderly accidents within the facility. This quality management initiative has not only reduced costs associated with accidents, but it also has enhanced the trust and patient experience of all stakeholders within the firm (Kelly, 2011).
Identify the milestone you chose in the history of quality improvement in…
1) Draper, Elaine, Joseph LaDou, and Dan J. Tennenhouse. 2011. "Occupational Health Nursing and the Quest for Professional Authority," New Solutions 21, 47 -- 81
2) Kohn, L.T., Corrigan, J.M., & Donaldson, M.S. (Eds). (2000). To err is human: Building a safer health system. Washington, D.C.: National Academy Press.
3) Kelly, D.L. (2011). Applying quality management in healthcare: A systems approach (3rd ed.). Chicago, IL: Health Administration Press
4) Lucia, Patricia R.; Otto, Tammy E.; Palmier, Patrick A. (2009). "Chapter 1
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.
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 Management (Discussion questions)
The Emergency Medical Treatment and Labor Act (EMTALA) is a law governing how and when patients may be denied treatment or moved from one hospital to another in cases of extreme medical conditions. EMTALA was legalized as a component of the 1986 consolidated budget reconciliation (ichards & athbun, 2009). Sometimes, it is known as the CONA law. This generalized name has generated other laws. A common provision under the COBA name is the statute that governs continuation of benefits derived from medical insurance after job termination. The principal provision of this statute is as follows:
Patients visiting the emergency unit seeking treatment or examination for medical conditions must be given the required medical screening diagnosis. This will be helpful in identifying if they are suffering from emergency medical conditions. In case they are, then hospitals are obliged to either furnish them with appropriate treatment…
Davis, N.A., & Cleverley, W.O. (2010). Essentials of health care finance: A workbook for health information managers. Chicago, Ill: American Health Information Management Association.
Ferenc, D.P. (2013). Understanding hospital billing and coding. St. Louis, Mo: Elsevier.
Richards, E.P., & Rathbun, K.C. (2009). Medical care law. Gaithersburg, Md: Aspen Publishers.
Institute of Medicine (2013). Emergency medical services at the crossroads. Washington, D.C: National Academies Press.
History Of Health Care
Few professions offer the opportunity to make a difference in the lives of others on a daily basis. Health care is one of those professions. There are life and death situations, but there are also quiet moments such as routine office visits in which health care professionals can make a difference to someone with a kind and genuinely caring demeanor. Being a health care professional is more than a career. It is a choice one makes as someone who cares deeply about fellow human beings. Personally, I have always had a desire to make others feel comfortable, secure and cared for. I am interested in how this aspect of health care evolved. Health care professionals treat illness and injuries but it must be remembered that along with those are whole human beings who may be frightened, confused or angry. The emotional aspects of patient care have…
Kret, D.D., 2011. The qualities of a compassionate nurse according to the perceptions of medical-surgical patients. MEDSURG Nursing 20(1), pp. 29-36.
Oreopoulos, D.G. (2001). Compassion and mercy in the practice of medicine. Humane Medicine
Health Care 1 (1). Retrieved from http://www.humanehealthcare.com/Article
The American Public Health Association (APHA) is founded. This organization is concerned with the social and economic aspects of health problems.
The National Quarantine Act is signed into law. This legislation is designed to prevent entry into the country of persons with communicable diseases.
1899 the National Hospital Superintendent's Association is created. It later becomes the American Hospital Association.
Patel & ushefsky, 1995, p. xvii)
The seeds of health care legislation and centralization began before 1875 but began to take hold as the most accepted manner in which to ensure safe and scientifically founded health care for many and to begin to ensure that diseases that commonly plagued a newly urbanized and highly stressful environment of mass immigration could be dealt with, in a more centralized and practical manner. Founded earlier in 1847, the American Medical Association began to have a concrete and centralized role in the health care decisions…
http://www.questia.com /PM.qst?a=o&d=5001282891' target='_blank' REL='NOFOLLOW'>
arity: Health Care EIT is one of many luxury and acute care investment properties on the market.
Imatability: Given the lack of available credit for starting new property ventures and construction, the company's current facilities do give it an advantage. Financial barriers to industry entry are higher than they were in the past. This can act as a barrier to 'imatiblity' of its business model.
Organization: Health Care EIT has a fairly concentrated organizational structure. While this can be an advantage in terms of assuring consistency of service, it can also result in narrowness of vision, such as (perhaps) a tendency to focus too much on high-end offerings, when seniors may have less financial leverage than in the past.
Sources, rarity, and imatability of cost advantages
Economies of scale may be possible, given the size of Healthcare EIT. Unlike some of its competitors, the company was an early, first mover…
Executive Officers. (2010). Health Care. REIT. Retrieved November 3, 2010 at http://www.hcreit.com/about-hcn/executive-officers
History (2010). Health Care. REIT. Retrieved November 3, 2010 at http://www.hcreit.com/about-hcn/history
ecause unions retain the exclusive right to negotiate on behalf of its members, the individual worker may have little recourse to easily address incompetent leadership.
The Disadvantages of Unionized Labor for Healthcare Employers:
The primary disadvantages of unionized labor for healthcare employers correspond to the relative loss of control over issues and workplace elements commonly transferred to workers (through their unions), which accounts for the traditional resistance with which many employers responded to unionization attempts. On the one hand, unionized workforces are able to secure better pay and benefits from employers than would have been available to workers without union representation; likewise, employers must cede control over many aspects of operational and personnel decisions traditionally within administrative control.
On the other hand, particularly in light of the beneficial effect that unionized nursing has had on the quality of patient care and reduction in patient mortality, it is difficult to conceive…
Daft, R. (2005) Management (7th ed.) Mason: Thomson South Western.
Nevins, J., Commager, H. (1992) a Pocket History of the United States.
New York: Pocket Books
Seago, J., Ash, M. (2002)
(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
The expectations for these kinds of changes will be to see gradual shifts at first. Where, it may not seem like anything is changing at the facility. However, over the course of time, these kinds of changes will be obvious in the quality of treatment that is being provided will improve. As a result, the strategy will take approximately one year to fully implement a change in the atmosphere of the operating environment.
To ensure that these improvements can continue to be built upon a new system will be introduced of monitoring for shifts that are occurring. In this case, the committee that was established to implement these changes will become way of: monitoring the kinds of treatment that is being provided and the challenges that are facing the facility. This will be accomplished by having outside consultants conduct anonymous surveys of patients, staff members and within the community. They…
Online Customer Surveys. (2011). Key Survey. Retrieved from: http://www.keysurvey.com/solutions/healthcare-surveys.jsp
SWOT Analysis. (2010). Quick MBA. Retrieved from: http://www.quickmba.com/strategy/SWOT/
Badrick, T. (2002). Role of External Management. Clinical Leadership, 16 (5), 281 -- 286.
Bennis, W. (1969). Organizational Development. New York, NY: Addison Wesley.
Health Care Past, Current, And Future
The health of any nation should be a top priority for leaders and elected political representatives, but in the United States it took several centuries for the nation to begin to come to terms with providing health care for its citizens. This paper covers the gradual implementation of health care services and doctor training facilities in the U.S., and also covers the recent attempt by President Barack Obama to reform a chaotic, poor-functional and expensive health care system. Thesis: It is a scandal of massive proportions that a well-functioning, citizen-friendly universal health care system cannot be instituted in America, the world's most democratic superpower. Until the divisive and toxic political climate can be reformed, there is no chance of major reforms -- or for universal health care coverage -- in these United States.
Past Health Care Services -- Early America
Health care in colonial…
Daly, John. (2005). Professional Nursing: Concepts, Issues, and Challenges. New York:
Springer Publishing Company.
Gorsky, Martin. (2010). Good Health for America? History Today, 60(2), 1-6.
McCarthy, Robert L., and Schafermeyer, Kenneth W. (2007). Introduction to Health Care
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.
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.
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
The information contained in Health ars is of tremendous benefit to all readers. e need to take more control over our own health, especially given the rising cost of health care insurance and the exorbitant prices of doctor and hospital bills. Preventing problems depends largely on paying attention to our genetic history: finding out what problems our mothers, fathers, and grandparents and adapting our lifestyle accordingly. Reading Day's book also encourages readers to learn more about common problems and possible solutions that involve diet and lifestyle changes. Taking responsibility for our health is one of the main themes in Health ars. Readers should take heed of what Day believes to be a crisis in modern medicine: the inability or unwillingness to practice common sense prevention.
I would recommend Health ars highly for several reasons. First, I believe that the health care crisis might be one of the most important problems…
Day, Phillip. Health Wars. Credence, 2001.
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
Health Care eform:
One of the major topics that have had a long history in the United States is health care reforms, which has been characterized by huge debates. Following decades of failed attempts by various Democratic presidents, a new law was enacted by President Obama to overhaul the country's health care system. The enactment of this legislation came after a year of harsh partisan combat with the purpose of ensuring access to health care insurance for millions of Americans. In addition to being the most controversial topic, health care reform law was the largest single legislative accomplishment of President Obama. Notably, this legislation will cost America's government approximately $940 billion over the next decade based on an analysis by the Congressional Budget Office. The office has also estimated that the law will lessen federal deficit by about $138 billion during the same period and a further reduction of the…
Cannon, M.F. (2010, March 1). The Best and Worst Health Care Reform Ideas. Retrieved December 15, 2011, from http://dailycaller.com/2010/03/01/the-best-and-worst-health-care-reform-ideas/
Cohn, J. (2011, January 20). About that Whole "Replace" Thing & #8230; Retrieved December 15,
2011, from http://www.tnr.com/blog/jonathan-cohn/81821/about-whole-replace-thing
"Health Care Reform.." (2011, November 15). The New York Times. Retrieved December 15,
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 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.
When considering the ever-changing and highly competitive economic landscape of the modern world; governments, businesses and institutions must remain diligent in their care and compassion for their citizens and staff members. With the current exponential growth and advancement of technology and the computerization of business and learning, voters, workers and consumers have become much more connected to the organizations they patronize (Kurzweil). Accordingly, these important groups are faced with the continuous task of finding new ways to understand and subsequently accommodate the needs of their followers, while simultaneously securing lucrative business models and job environments. One of the most important needs presented in all demographics is reliable healthcare. Thus, with the inelasticity in the demand for healthcare, countries need to determine an applicable system, whereby citizens can have access to the medical services they will inevitably need. Collective access to healthcare represents the main problem in field of…
Blumenschein, K. And M. Johannesson. "Economic Evaluation in Healthcare. A Brief History and Future Directions." Journal of Pharmacoeconomics 10.2 (1996): 114-122.
Cox, Malcolm, et al. "Health Care Economics, Financing, Organization and Delivery." Family Medicine January 2004: 20-30.
Hamburger, Tom and Kim Geiger. "Healthcare Insurers Get Upper Hand." The Los Angeles Times 24 August 2009.
Jeremiah Hurley. "An Overview of the Normative Economics of the Health Sector." Journal of Health Economics 1.1 (2000): 55-118.
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.
This research focuses on the health impacts of the Industrial evolution on various sectors of the British population, and hypothesizes that working class and poor laborers suffered from poorer health than their wealthier counterparts due to exposure to pollution and to lack of exposure to a varied diet.
Public health and the public health system existing in the 21st century is unrecognizable from what existed just a century before. As Wohl (1983) points out, poverty, ignorance, and poor sanitation plagued British public health throughout the Victorian era. It is important to understand what prompted the changes that led to increased knowledge, awareness, and application of ethical principles in health care. Armed with this knowledge, the bioarchaeologist and health care specialists alike can work together to transform health care outcomes in the future.
In particular, the Industrial evolution impacted individual and public health in significant and measurable ways. Coal…
Wohl, A.S. (1983). Endangered Lives: Public Health in Victorian Britain.London: J.M. Dent.
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
Health Care eform:
In March 2010, after protracted public and political debate, the Patient Protection and Affordable Care Act (PPACA) was enacted into law by President Barack Obama. This legislation was one of the many health care reforms initiatives that have sought to rectify major features of the health care system in the United States such as service delivery, care coordination, and financing. Since its enactment, PPACA is considered as a milestone along the historical continuum of health care reform in America. Generally, health care reform in the United States is an issue that has continued to evolve based on the ever-growing health care needs of the population. However, this issue has been characterized with several challenges that are mainly influenced by the public's response to reform efforts.
Principal Features of U.S. Health Care System:
The Patient Protection and Affordable Care Act (PPACA), which is commonly known as the Affordable…
Bodenheimer, T., & Grumbach, K. (2012). Understanding health policy: a clinical approach (6th ed.). New York, NY: McGraw-Hill Medical.
"Key Features of the Affordable Care Act by Year." (n.d.). Features of the Health Law.
Retrieved from U.S. Department of Health & Human Services website: http://www.hhs.gov/healthcare/facts/timeline/timeline-text.html
Leflar, R.B. (2013, July 12). Reform of the United States Health Care System: An Overview.
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
Not only do these practices discourage preventative care and monitoring, they also diminish the quality of the good that insured individuals are buying from the health insurance companies. Insured individuals are paying for insurance and paying for most of their healthcare costs in addition because of the exorbitant deductibles. PPACA's prohibition of these practices ultimately forces health care companies to raise the bar and give health insurance customers more value for money.
Public-Private Partnerships Prevent ureaucratization of Health Care
There are widespread misconceptions that the PPACA will provide health insurance through some government-run bureaucracy. Actually, PPACA is built on close cooperation between health insurance companies and the government. Under PPACA, the government does not operate hospitals nor does it provide medical insurance to individuals. Actually, it requires individuals to carry some form of private health insurance or suffer a penalty. The only time the government becomes involved is when an…
Patient Protection and Affordable Care Act. Public Law 111 -- 148. Available at http://www.gpo.gov/fdsys/pkg/PLAW-111publ148/pdf/PLAW-111publ148.pdf
Patient Protection and Affordable Care Act - Summary. http://thomas.loc.gov/cgi-bin/bdquery/z-d111:HR03590:@@@L&summ2=m&summary
"An Analysis of Health Insurance Premiums Under the Patient Protection and Affordable Care Act,
Letter to the Honorable Evan Bayh." Congressional Budget Office. Douglas W. Elmendorf. November 18, 2009. Available at http://cbo.gov/ftpdocs/107xx/doc10781/11-30-Premiums.pdf .
Contracts with doctors often contain a clause which doesn't allow the doctors to discuss
Health care 7 with their patients financial incentives to deny treatment or about treatments not covered by the plan (Glazer, 1996). This has caused many consumers, especially those with chronic illnesses, to form organizations with the American Medical Association and physician specialty groups to promote legislation forbidding "gag rules" (Glazer, 1996). One group, Citizen Action, has 3 million members and "has been lobbying in state legislatures for laws that would require plans to disclose how they pay their doctors; give patients the right to choose specialists outside the plan; and provide appeals for patients who get turned down for expensive treatments" (Glazer, 1996).
The doctor-patient relationship is also affected if a patient must switch to a new doctor under managed care. Having a longterm relationship with a primary doctor is important because he or she is…
Bennett Clark, Jane (1996, July). What you should ask your HMO.
Kiplinger's Personal Finance Magazine. pp. 92-93.
Glazer, Sarah (1996, April 12). Managed Care. CQ Researcher, 6,
Koop, C. Everett (1996, Fall). Manage with care. Time. pp. 69.
Nurses, who have first hand knowledge and understanding of how to live healthy and how to take proper care of themselves, are far better equipped to teach others about these concepts. Certain populations can benefit greatly from prevention, especially those who are prone to specific types of diseases or conditions.
One of the most common behaviors that leads to many chronic and often very damaging health conditions is smoking. Smoking can cause a multitude of diseases and conditions from emphysema to heart disease to lung cancer (Chapman, 2007). The list goes on and on. But smoking is 100% preventable and nurses need to understand not only how to treat these smoking-related diseases but how to more importantly discourage and prevent people from smoking in the first place. Many nurses agree that this behavior leads to many of the worst case scenarios for people with pre-existing chronic conditions. It is therefore…
Chapman, Simon. (2007). Public Health Advocacy and Tobacco Control: Making Smoking
History. Blackwell Publishing, New York, NY. Pp. 55-56.
Chung, Daniel C. (2008). "Stool DNA Testing and Colon Cancer Prevention: Another Step
Forward." Annals of Internal Medicine, Vol. 149, No. 7. pp. 509-510.
"Studies of the relationship between managed care penetration in the health care market and expenditures for Medicare fee-for-service enrollees have demonstrated the existence of these types of spill over effects" (Bundorf et al., 2004).
Managed care organizations generate these types of spillover effects by increasing competition in the health care market, altering the arrangement of the health care delivery system, and altering physician practice patterns. Studies have found that higher levels of managed care infiltration are linked with lower rates of hospital cost inflation and lower physician fees are consistent with competitive effects. "Other studies demonstrate the impact of managed care on delivery system structure including hospital capacity, hospital admission patterns, the size and composition of the physician workforce and the adoption and use of medical equipment and technologies. More recent evidence has linked market-level managed care activity to the process, but not the outcomes of care" (Bundorf et al.,…
Altman, D.E. And L. Levin. (2005). The Sad History of Health Care Cost Containment as
Told by One Client. Health Affairs, 24(1).
Bodenheimer, T. (2005). High and rising health care costs. part 1: Seeking an explanation.
Annals of Internal Medicine, 142(10), 847-54.
" (AAF, nd)
The Health Maintenance Organization further should "…negotiate with both public and private payers for adequate reimbursement or direct payment to cover the expenses of interpreter services so that they can establish services without burdening physicians…" and the private industry should be "…engaged by medical organizations, including the AAF, and patient advocacy groups to consider innovative ways to provide interpreter services to both employees and the medically underserved." (AAF, nd)
One example of the community healthcare organization is the CCO model is reported as a community cancer screening center model and is stated to be an effective mechanism for facilitating the linkage of investigators and their institutions with the clinical trials network. It is reported that the minority-based CCO was approved initially by the NCI, Division of Cancer revention Board of Scientific Counselors in January 1989. The implementation began in the fall of 1990 and the program was…
Principles for Improving Cultural Proficiency and Care to Minority and Medically-Underserved Communities (Position Paper) (2008) AAFP -- American Academy of Family Physicians http://www.aafp.org/online/en/home/policy/policies/p/princcultuproficcare.html
Volpp, Kevin G.M. (2004) The Effect of Increases in HMO Penetration and Changes in Payer Mix on In-Hospital Mortality and Treatment Patterns for Acute Myocardial Infarction" The American Journal of Managed Care. 30 June 2004. Issue 10 Number 7 Part 2. Onlineavaialble at: http://www.ajmc.com/issue/managed-care/2004/2004-07-vol10-n7Pt2/Jul04-1816p505-512
Darby, Roland B. (2008) Managed Care: Sacruificing Your Health Care for Insurance Industry Profits: Questions You must ask before joning an HMO. Online available at: http://www.rolanddarby.com/br_managedhealth.html
The infant mortality rate is of 8.97 deaths per 1,000 live births. This rate places Kuwait on the 160th position on the chart of the CIA. The adult prevalence rate of HIV / AIDS is of 0.1 per cent.
In terms of economy, Kuwait is a relatively open, small and wealthy economy. It relies extensively on oil exports -- petroleum exports for instance account for 95 per cent of the total export revenues as well as for 95 per cent of the federal income. The Kuwaiti representatives have recently set the goal of increasing the oil production per day. Currently, Kuwait is facing the pressures of the internationalized economic crisis -- which however, due to recent economic surpluses in Kuwait, affects the economy to a lower extent.
Simultaneously with the increase in oil production, the Kuwaiti authorities are also focusing on diversifying the economic activities in the sense of supporting…
Agency, Kuwait News. "Blair's "Kuwait Vision." 15 March 2010. Zawya.com. .
Al-Ansari, H. And S. AL-Enezi. "Health Sciences Libraries in Kuwait." Bulletin of the Medical Library Association 89.3 (2001): 287-93.
Al-Awadhi, Olusi, Al-Saeid, Moussa, et.al. "Incidence of Musculoskeletal Pain in Adult Kuwaitis." Annals of Saudi Medicine 25.6 (2005): 459=62.
Al-Baho, A. "Resident's Guide to the Curriculum for Training in Family Medicine." December 2008. Kuwait Institute for Medical Specialization. .
The issue of grey and black markets often arose as a result of the shortages of experienced health care personnel. The system could not adapt to a flexible environment as it was led by rigid official procedures and the mentality of the people who controlled it was commanding, their vision short-sighted and hardly beneficial in such a situation (Barr and Mark, 1996).
The breaking up of Soviet Union which brought crippling economic and political problems to the countries also aggravated the health care situation making it reach an all-time low. The collapse of the health care system ran by the government led to the belief that turning towards a market economy or more capitalistic notions and perceptions would have been a better idea. The competition in the private sector would have had improved efficiency and averted an inevitable collapse of the health care system in the Soviet Union. This transformation,…
Balabanova, D., Haerpfer, C., McKee, M., Pomerleau, J., Rose, R. (2004). Health service utilization in the former Soviet Union: evidence from eight countries. Health Services Research
Barr, D.A. And Mark G. (1996). The Current State of Health Care in the Former Soviet Union: Implications for Health Care Policy and Reform. American Journal of Public Health. 86, 3.
Lewis, M. (2002). Informal Health Payments in Central and Eastern Europe and the Former Soviet Union: Issues, Trends and Policy Implications. In Funding Health Care, European Observatory on Health Care Systems Series, edited by E. Mossialos, a. Dixon, J. Figueras, and J. Kutzin, pp. 184-205. Buckingham: Open University Press.
Mikesell, J.L. And Mullins, D.R. (2001), Reforming Budget Systems in Countries of the Former Soviet Union. Public Administration Review. 61. 5.
History Of Federal Involvement in the Delivery of Healthcare
Health Care History: The Hill-Burton Act
The Hill-Burton Act was a decidedly ambitious piece of legislation that was initially passed in 1946. The act was named after its chief proponents, Alabama's Senator Lister Hill (Thomas, 2008) and Ohio's Senator Harold Burton. Although the act was conceived of as a way of providing egalitarian access to improved medical facilities, it was actually created in times that were anything but. 1946 was the year after the end of World War II and racial segregation (as buttressed by Plessey v. Fergusson) (Wormser, 2002) was still rampant across the country. Moreover, the economic politics -- many of which are still in effect today -- in which federal, state and local legislation typically benefits those with the most economic resources of the day also helped to hamper the egalitarian spirit in which the Act was created.…
McBride, A. (2006). Brown v. Board of Education. www.pbs.org. Retrieved from http://www.pbs.org/wnet/supremecourt/rights/landmark_brown.html
Parks, P. (2010). What is the Hill-Burton Act? www.jdsupra.com Retrieved from http://www.jdsupra.com/legalnews/what-is-the-hill-burton-act-63450/
Thomas, K. (2008). Hill-Burton Act. Encyclopedia of Alabama. Retrieved from http://www.encyclopediaofalabama.org/face/Article.jsp?id=h-1439
Wormser, R. (2002). Plessy v. Ferguson. www.pbs.org. Retrieved from http://www.pbs.org/wnet/jimcrow/stories_events_plessy.html
The Tuskegee Syphilis Study still remains as one of the most outrageous examples of disregard of basic ethical principles of conduct not to mention violation of standards for ethical research. The suspicion and fear produced by the Tuskegee Syphilis Study are still evident today. Community workers often report mistrust of public health institutions within the African-American community. ecently Alpha Thomas of the Dallas Urban League testified before the National Commission on AIDS saying that many African-American people do not trust hospitals or any of the other community health care service providers because of that Tuskegee Experiment (esearch Ethics: The Tuskegee Syphilis Study, 2010).
In 1990, the Southern Christian Leadership Conference (SCLC), which is one of the country's major civil rights organizations, conducted a survey among 1056 African-American Church members in five cities. They found that 34% of the respondents believed that AIDS was an artificial virus, 35% believed that AIDS…
Bad Blood: The Tuskegee Syphilis Study. (2009). Retrieved March 9, 2010, from University of Virginia Health System Web site:
Boskey, Elizabeth. (2007). What Is the Tuskegee Syphilis Study? Retrieved March 10, 2010,
from About.com Web site: http://std.about.com/od/stdsinthemedia/f/tuskegeefaq.htm
Defined as the philosophical study of right and wrong action, Ethics is a predominant subject of concern in nursing (Michael Dahnke, 2006). Being presented with various situations, the ethical and cultural problems are a serious concern faced by the nursing and healthcare staff which needs to be catered to day in and out. There is no time tested methodology that can be applied here, since the every patient is different, with a different background history, therefore the ethical and cultural implications of each decision would also vary.
Importance of Ethical Theory to Nursing
Defining what is right and wrong is a very subjective approach and even that can change from scenario to scenario. Therefore it is important to have some form of umbrella under which the functioning of nurses takes place. It is under this rationale that the importance of ethical theory emerges in front of us.
DuAnne Foster Edwards, R.M. (1999, Feburary). The Synergy Model: Linking Patient Needs to Nurse Competencies. Retrieved September 30th, 2011, from American Association of Critical Care Nurses: http://www.aacn.org:88/wd/certifications/content/synpract2.pcms?pid=1&menu=
Green, D.B. (2001, July). Medical Ethics. Retrieved September 30th, 2011, from Priory.com: http://priory.com/ethics.htm
Michael Dahnke, H.D. (2006). Defining Ethics and Applying the Theories. In P.M. Vicki D. Lachman, Applied Ethics in Nursing (p. 3). New York: Springer.
Samar Noureddine RN, M. (2001). Development of the ethical dimension in nursing theory. International Journal of Nursing Practice, 2-7.
4). Cooper and castle feel that the universal aims of the program, coupled with the program's redistributive intent, will prevent congressional fence-sitters from voting against a plan that is so obviously in the best interests of the vast majority of working Americans. Ultimately, the bill's appeal to social justice will bridge the partisan divide, and provide President Barack Obama with a firm foundation on which to build future change.
Of course, change, especially necessary change, is in the eye of the beholder, as are partisanship and bipartisanship. Cooper and Castle call their piece a "bipartisan view," but appear to spell out a largely Democratic approach to healthcare reform, one that seems specifically designed to entrench President Obama's position, and guarantee his reelection. They laud the expected, intended, or proposed actions of a man who has not yet taken office. Many of the authors' supporting arguments have already been rendered moot:…
Cooper, Jim; & Castle, Michael (16 January 2009). Health Reform: A Bipartisan View. Health Affairs 28, no. 2 w169-w172.
327). In short, the system 'worked' at this time for patients, hospitals, insurance companies, and the government.
lue Cross plans also benefited from special state-level legislation that allowed them to act as nonprofit corporations, to enjoy tax-exempt status, and to be free from the usual insurance regulations. Physicians, although they initially opposed all forms of health insurance, created lue Shield in deference to the demand for lue Cross insurance, and in fear of more government regulation if some costs were not borne by the industry (Thomasson, 2002, p. 237-338). World War II wage and price controls also meant that one of the primary incentives employers had to attract scarce reserves of high-quality employee was offering benefits, including health insurance (Thomasson, 2002, p. 240).
Supply and demand of services and labor thus both conspired as corollary historical forces to increase the prevalence of private insurance in the American model. The improved…
Blue Cross plans also benefited from special state-level legislation that allowed them to act as nonprofit corporations, to enjoy tax-exempt status, and to be free from the usual insurance regulations. Physicians, although they initially opposed all forms of health insurance, created Blue Shield in deference to the demand for Blue Cross insurance, and in fear of more government regulation if some costs were not borne by the industry (Thomasson, 2002, p. 237-338). World War II wage and price controls also meant that one of the primary incentives employers had to attract scarce reserves of high-quality employee was offering benefits, including health insurance (Thomasson, 2002, p. 240).
Supply and demand of services and labor thus both conspired as corollary historical forces to increase the prevalence of private insurance in the American model. The improved quality and supply of healthcare drove up demand and prices, which caused individuals to seek healthcare insurance. Physicians, in response to employer-created insurance, began to provide their own plans. Insurance plans made it favorable for hospitals to increase their supply of patients, and employers could attract scarce labor by offering insurance.
However, there is one problem with Thomasson's article -- were these innovations not present in at least some European countries, which also presumably experienced improved medical care, scarce labor during the war, and similar increases in costs of care. Were there not also potential savings for consumers and hospitals, based upon volume 'sales' of insurance-bearing patients to in-network providers? Without some comparison of conditions abroad in nations that did adopt government models, or more heavily subsidized forms of care, although Thomasson's explanation is persuasive and lucid in isolation, it is hard not to wonder if cultural resistance to government intervention in the U.S. might not play a role. Yet government intervention was more welcome in the 1930s than in the 1990s, when single-payer insurance was rejected by the U.S. government. The explanations for the resistance to widespread government support for healthcare in the U.S. during the Great Depression and World War II still does not have an entirely satisfactory explanation.
In 2004, a Ten-Year Plan to Strengthen Health Care was announced, primarily intended to improve access to medical services, decrease wait times, and update medical equipment and ensure accurate reporting and enhance public health promotion and prevention programs. Shortly thereafter, the Canadian Supreme Court affirmed the nation's health care philosophy and the immediate need to implement further improvements envisioned by the ambitious 2004 plan in striking down a Quebec law that had prohibited private medical insurance for covered services:
The evidence in this case shows that delays in the public health care system are widespread and that in some serious cases, patients die as a result of waiting lists for public health care...In sum, the prohibition on obtaining private health insurance is not constitutional where the public system fails to deliver reasonable services."
According to legal experts, the decision could "open the door to a wave of lawsuits challenging the…
Canadian Medical Association Journal.
1939 September; 41(3):
Chaoulli v. Quebec: Judgments of the Supreme Court of Canada Accessed, September 2, 2007, at http://scc.lexum.umontreal.ca/en/index.html
Kraus, C. (2005) Canada's Supreme Court Chips Away at National Health Care.
The relationship between the doctor and a possible patient is established when the physician asks the person for the first time as how he could be of possible help. This direct and simple enquiry is the beginning of the trust of the patient that has to be put in the physician for any treatment to proceed. The patient is in need of help at that time, and has to trust the professional for getting the help and the patients want to do it. They need a person to take care of them during their period of suffering from illness. This relationship between the patient and the physician in the financial sphere also involves the same amount of reliance, confidence and trust, as otherwise, not treatment can be undertaken. This makes it essential that the physicians clearly mention to the patients when there is any conflict of interest in…
"Changes in Health Care Financing and Organization: Deriving Best Practice Models for the U.S. Health Care Safety Net: A Cross-State Meta Analysis of Finance, Organization and Outcomes" Retrieved from http://184.108.40.206/search?q=cache:h3F83ojarhYJ:depts.washington.edu/eprc/areas/proposalnarrative%2520web.pdf+Changes+in+Health+Care+Financing+and+Organization+& ; hl=en Accessed on 7 June, 2005
'Health Administration Press" (March/April 2003) Journal of Health Care Management.
Volume 48, Number 2. Retrieved from http://220.127.116.11/search?q=cache:p36ZB3H0T4AJ:www.ache.org/pubs/jhm482.cfm+healthcare+finance+relationship+centered& ; hl=en Accessed on 7 June, 2005
"The Core Program: Trust and the Patient -- Professional Relationship" (September, 2000) The
Health Care Policy: Medicare
Medicare in the U.S. was formed in 1966 and is defined is one of the national social insurance program whose administration is vested in the federal government. The policy is dispensed through 30 private insurance organizations in the country. Medicare avails health insurance to Americans of ages 65 years and older that had worked and paid within the national system (Nadeau, Belanger & Petry, 2014). The policy avails health insurance benefits to different younger people with amyotrophic lateral sclerosis, disabilities, and end-stage renal disease.
Medicare availed health insurance to close to 47 million residents in 2010. 40 million of them were of 65 years and above while seven million were younger individuals with disabilities. The policy was the primary point of payment for close to 15.4 million inpatient cases in 2011 that was $182.7 billion (47.2%) of aggregate inpatient costs in the United States hospitals. Medicare…
Almgren, G.R. (2013). Health Care Politics, Policy and Services: A Social Justice Analysis. New York: Springer Publishing Company.
Barr, D.A. (2011). Introduction to U.S. Health Policy: The Organization, Financing, and Delivery of Health Care in America. New York: JHU Press.
Holtz, C. (2008). Global Health Care: Issues and Policies. New York: Jones & Bartlett Learning.
Moniz, C., & Gorin, S. (2013). Health Care Policy and Practice: A Biopsychosocial Perspective. New York: Routledge.
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
Starbucks has committed to provide healthcare coverage to employees who work at least 20 hours a week. This year, the cost will add up to over 200 million dollars for coverage of its over 80,000 employees. Schultz's perspective, differing from G is that the company's healthcare accounts for its very low employee turnover and high productivity. However, their generosity is even now bringing down their bottom line, Starbucks is attracting older workers who no doubt join the company for its healthcare benefits. As a result, Shultz notes that Starbuck's future healthcare costs will dramatically increase. Starbucks has seen that their insurance costs have had double digit increases in each of the past four years, and that this growth is completely "non-sustainable." Part of the reason that Starbucks is able to maintain its current healthcare policy is the relative newness of the company and its current lack of retirement healthcare costs.…
Moroni, R. (2005, August 29). Foreign Competition May Push U.S. Health Reform.
Grand Rapids Business Journal. 23 (36), p4-4, 1/3p. Retrieved September 21, 2006, from the EBSCO HOST Regional Business News database. (an 18097323).
Yip, P. (2005, October 18). General Motors health-care deal an example of changes over time. Dallas Morning News, the (TX). Retrieved September 21, 2006, from the EBSCO HOST Newspaper Source database. (an 2W62009610037).
Health Care -- Lean Philosophy on Cost Reduction and Quality Improvement
Lean Philosophy is initially traced back to Henry Ford's innovative assembly line, revolutionizing manufacturing while failing to provide true variety. Building on Ford's concepts Toyota management established a Lean Philosophy in the 1930's and 1940's that focused on production flow and waste elimination, resulting in rapid, low cost and high quality processes, along with simpler and more accurate management. These concepts were further elucidated by authors including James omack, who established the Lean Enterprise Institute in 1997.
The essential elements of Lean Philosophy are 5 principles including: defining the value sought by the customer; specifying the value stream of the product satisfying that value while challenging wasted steps; making a continuous flow of product through refined steps; creating "pull" (essentially meaning "customer demand/expectation") from step-to-step for continuous flow wherever possible; continually improve and refine the process to cut the…
Berk & Associates. (2011). Idea: Lean government. Seattle, WA: Washington State Auditor's Office.
Jimmerson, C. (2010). Value stream mapping for healthcare made easy. New York, NY: Productivity Press.
Lean Enterprise Institute. (2009). 5S - Visual workplace. Retrieved October 5, 2012 from www.lean.org Web site: http://www.lean.org/Workshops/WorkshopDescription.cfm?WorkshopId=39
Lean Enterprise Institute. (2009). Lean timeline. Retrieved October 5, 2012 from www.lean.org Web site: http://www.lean.org/WhatsLean/Timeline.cfm
They have a strong balance sheet that enables them to acquire capital easily and cheaply, but they are shifting their staff to physician ratio from 6.11 to 7.5, indicating that their administrative cost structure is going to increase dramatically as a result of their current expansion strategy. Whether or not this represents a weakness that can be exploited by MCMPC remains to be seen, but it may materialize as a weakness in the future. There is the threat, however, that given the declining morale at MCMPC some of the clinic's physicians may defect to Innovative in order to advance their careers and improve the professionalism of their working environment.
The external environment provides a number of challenges for MCMPC. The unfortunate reality is that the company is ill-equipped to address many of these challenges. They have proven unable to build the key resources in specialists and referrals, and they have…
Jonas Veterans Healthcare Program
Recognizing the tremendous commitment and sacrifices our veterans have made to serve our country, the Jonas Center is committed to do our part to support improved healthcare for this population (Jonas Center, N.d.).
The Jonas Center's vision is to foster new partnerships that help improve veterans' healthcare through nursing and we welcome all contributions to support our efforts.
• Program scope
Starting in the fall of 2012, the Jonas Center will support scholarships for 54 nurses to be trained at the doctoral level (PhD and DNP) on veteran-specific healthcare needs, ranging from clinical to policy to administration to education, to help ensure our veterans are receiving the best possible care. Scholar's research projects will be focused on priority veterans' healthcare need (as identified by the hite House and Veterans Administration).
• Program audience
Students, veterans, and the general public.
• Program background…
Jonas Center. (N.d.). History. Retrieved from Jonas Center: http://www.jonascenter.org/who-we-are/history
Jonas Center. (N.d.). Jonas Veterans Healthcare Program. Retrieved from Jonas Center: http://www.jonascenter.org/program-areas/scholars/jonas-veterans-healthcare-program
Unless the physicians can succinctly argue their case for care and services, the managed care entity will, for reasons of medical necessity, deny access to care and services.
What Cost-Added atio Based on Illegal Immigrant Population?
The argument by opponents that loopholes exist that would allow illegal immigrants to access Obama's proposed legislation on healthcare services is rendered moot in lieu of the fact that those illegal immigrants are currently receiving healthcare services Medicaid and through Immigration and Naturalization Services (INS). The Federal eimbursement of Emergency Health Services Furnished to Undocumented Aliens states:
"Section 1011 of the (Medicare Prescription Drug, Improvement, and Modernization Act (MMA) (P.L. 108-173)) MMA appropriated $250 million dollars in FY 2005 through 2008 for payments to eligible providers for emergency health services provided to undocumented aliens and other non-specified citizens who are not eligible for Medicaid (Centers for Medicare and Medicaid Services, 2009, found online, p.…
Birenbaum, A. (1997). Managed Care: Made in America, Praeger Publishers, Westport,
Birenbaum, A. (2002). Wounded Profession: American Medicine Enters the Age of Managed Care, Praeger Publishers, Westport, CT.
Centers for Disease Control and Prevention (2009). Uninsured Americans: Newly
The heated nature of the current political debate in the United States upon the subject of healthcare is testimony to the idea that far less than economic numbers, cultural wars govern how healthcare is perceived and administrated. All nations face the problem of cost containment of an increasingly expensive healthcare system. People are living longer, and the nations of the developed world have populations with a far higher median age than in the past. Medical technology is also more expensive. Thus, some form of 'rationing' (as politically unpalatable as the world may be) is required, either based upon need, or based upon who can pay. The United States stresses that individuals can 'choose' to have healthcare or not, and implicit in this assumption is that individuals who can 'merit' better jobs that provide healthcare are making one choice, while Americans who work several jobs that do not offer healthcare --…
Anderson, G .F. & J.P. Poullier. (1999).Health spending, access, and outcomes: trends in industrialized countries. Health Affairs, 18(3):178-192
Creese, Andrew. (1994). Global trends in health care reform. World Health Forum. 15.
Sanders, Jeffrey. Financing global health systems. Current issues facing global health systems.