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This information was obtained from the facilities giving dialysis and it was for the first two months only. The study excluded darbepoetin doses as it had only been administered to a few patients. Inpatient EPO doses were not easily determinable as they are not billed differently to Medicare. The use of outpatient EPO only may be underestimating the total use of the medication. The cohort dealt with the biasness by determining the amount of time a patient stayed in hospital. The calculations on the average dose of EPO for every patient per day was by adding the total dose for a whole month then separating it by the number of days of outpatient then multiplying by 30 to get the total of a calendar month. According to the medical reports the study used the right amount of doses. The study was not randomized as it was aimed towards the African-American…
Improving Computer-User Interface in Medical care
The use of computer information systems in the field of medicine has revolutionized the way patients receive medical care. Computer information systems have assisted medical practitioners to capture and transfer information quickly saving the time taken to treat patients. Storage of information has also been automated such that the medical personnel do not have to manually input and store the data. The management of medical organizations has been able to improve on the time take to diagnose an ailment and the accuracy of diagnosis. The presence of electronic health records in an organization improves the way the organization collects patient's information. The collection of debt is thus automated and accurate thus the medical organization can collect all its debts.
Computer user interface refers to the method used the organization to connect o the computer information system. This interface needs to be improved to ensure…
Health Care Advanced
Quality of Medical Care Defined and Other Dimensions of Quality Care and Their Importance
Quality is reported to be defined by the Institute of Medicine as:
"The degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge." (Feld, 2003, p.1)
The elements of quality care are stated to be those as follows:
(1) Recognition of patients at risk for diseases;
(2) Conduction of appropriate evaluation;
(3) Making the appropriate diagnosis;
(4) Starting the appropriate treatment;
(5) Scheduling the appropriate follow-up; and (6) Stimulating the appropriate compliance/adherence to treatment. (Feld, 2003, p.1)
The goals of quality care are decrease of the "complication rate, morbidity, mortality, and cost of care." (Feld, 2003, p.1) Changes since the days when the doctor knew best include a more informed population who are more highly educated and who possess more…
Donabedian A (1988) "The Quality of Care: How Can it be Assessed" JAMA, 260(12):1743-1748.
Donabedian A (2005) "Evaluating the Quality of Medical Care" Milbank Quarterly, 83(4):691-729.
How to Assess Quality of Care (2010) Healthcare Economist. 20 Jan 2010. Retrieved from: http://healthcare-economist.com/2010/01/20/how-to-assess-quality-of-care/
Ashton, CM, Kuykendall, DH, Johnson, ML, and Wray, NP (1999) An empirical assessment of the validity of explicit and implicit process-of-care criteria for quality assessment. Med Care 1999 Aug;37(8):798-808. PubMed. Retrieved from: http://www.ncbi.nlm.nih.gov/pubmed/10448722
When discussing medical care with Sara, one must keep in mind that she is alone now, having been married for 50 years, but now widowed. She seems to have a rather active social circle, and is more of a middle-of -- the road practitioner of Judaism. Her belief system is likely sensitive to end-of-life issues, but she seems to be a candidate for hospice, rather than palliative care due to her age and the progression of her illness.
In response to Sara's initial decision to have surgery and treat the cancer with chemotherapy, medical personnel would be required to allow her this choice, but ensure that the principles of fidelity and benevolence are followerd. In other words, tell Sara the truth about odds and any prognosis, as well as side-effects. Inform her in a way that is non-paternalistic so that she may make up her own mind about…
Edgedorf, L. (2005). Medical Ethics. New York: Greenhaven Pres.
Jewish Home Lifecare (2013). How Does Pallative Care Differ From Hospice Care? Retrieved from: http://www.jewishhome.org/our-services/palliative-care/how-does-palliative-care-differ-from-hospice-care
The author of this report has been asked to assess the options and mandates that exist when it comes to a six-year-old child has apparent contracted a case of meningitis. The mother is a Christian Scientist that refuses medical care while the father seeks treatment along with an independent consult. The course of action that should be taken is to be derived from that. As part of this situation, there are a couple of deliverables that will be given. First, the ethical dilemma in question will be identified. Second, the decision-making model that is to be used will be identified. Third, how the dilemma would be resolved will be identified. Fourth and finally, the dialog that would exist with the parents would be explained and detailed. While the biological mother generally has the right to raise her child as she sees fit, her decision to withhold medical care…
Fox, M. (2015). Doctor to Legislators: Refusing Medical Care Isn't Religious Freedom. NBC News. Retrieved 4 June 2015, from http://www.nbcnews.com/health/kids-health/doctor-legislators-refusing-medical-care-isnt-religious-freedom-n320031
Hall, H. (2013). Faith Healing: Religious Freedom vs. Child Protection. Science-Based Medicine. Retrieved 4 June 2015, from https://www.sciencebasedmedicine.org/faith-healing-religious-freedom-vs.-child-protection/
Law Info,. (2015). Health Insurance Resources: When Can a Parent Deny Medical Treatment to a Minor Child? - LawInfo. Resources.lawinfo.com. Retrieved 4 June 2015, from http://resources.lawinfo.com/insurance/health-insurance/when-can-a-parent-deny-medical-treatment-to-a.html
NIH,. (2015). Parental refusals of medical treatment: the harm principle as threshold for state intervention. - PubMed - NCBI. Ncbi.nlm.nih.gov. Retrieved 4 June 2015, from http://www.ncbi.nlm.nih.gov/pubmed/15637945
medical care sector, the decisions of what services should be produced, how they should be produced, how they should be distributed, and how to allow for growth and innovation must be made.
What combination of non-medical and medical goods and services should be produced in the macro-economy? In terms of guns or butter, the optimal balance of the production of non-medical and medical goods and services in the macro-economy would also include adequate provisions for defense. In sum, to the extent that this combination favored non-medical and medical goods and services in the macro-economy would be the extent to which defense spending would be diminished in the production-possibility frontier (Bandyopadhyay & Sandler, 2014).
What particular medical goods and services should be produced in the health economy? There is a growing recognition that preventive health care services are far more cost effective than reactive approaches that only intervene when people develop…
Bandyopadhyay, S. & Sandler, T. (2014). The effects of terrorism on trade: A factor supply approach. Review - Federal Reserve Bank of St. Louis, 96(3), 229-233.
Brown, C.E. & Ecoff, L. (2011, Winter). A systematic approach to the inclusion of evidence in healthcare design. Health Environments Research & Design Journal, 4(2), 7-10.
Chronology of events. (2015). National Institutes of Health. Retrieved from http://www.nih. gov/about/almanac/historical/chronology_of_events.htm.
Heller, B.R. & Nichols, M.A. (2001, March/April). Workforce development in nursing: Priming the pipeline. Nursing and Health Care Perspectives, 22(2), 70-73.
The author of this report has been asked to explore and flesh out some question relating to Leninger's Theory of Nursing, which has come to be known as the Cultural Care Diversity and Universality. Among the items to be addressed will be what theoretical framework will best support the philosophy, how the theory compares to organizational behavioral theory and philosophy and so forth. The assertions that will be offered will be given in bullet point format.
As stated in the introduction, Leninger's theory was and is still known as cultural care diversity and universality (Leininger, 1988).
The theory is about three decades old at this point and it has evolved and changed over the years (Leininger, 1988).
The theory was initiated from clinical experiences recognizing that culture, a holistic concept, was the supposed "missing link" as it relates to nursing knowledge and practice (Leininger, 1988).
Leninger advocated the…
Leininger, M. (1988). Leininger's Theory of Nursing: Cultural Care Diversity and Universality. Nursing Science Quarterly, 1(4), 152-160.
Health care policy usually is developed to address health care cost, quality, or access, or a combination of the three. Due to the nature of their interaction with patients, nurses are well situated to be effective, knowledgeable advocates for their patients. The impact of health policy and regulation when it comes to the nursing profession is not something that can be ignored. Healthcare issues are very complex and they involve the fields of economics and medicine and affecting the rights of individuals as well as accessing healthcare. Consumers' main concern is quality while the individual and corporations providers are mainly concerned about the economic survival (Heller, Oros, & Durney-Crowley, 2009).
One public policy that is influencing my nursing practice and I is the Medicaid policy. This is a social health program meant for families and individuals that have low income and resources. This is an insurance program by…
Coffman, J.(2010). Evaluation Based on Theories of the Policy Process. Retrieved July 16, 2014 from http://www.hfrp.org/evaluation/the-evaluation-exchange/issue-archive/advocacy-and-policy-change/evaluation-based-on-theories-of-the-policy-process
Heller, B., Oros, M & Durney-Crowley, J.(2009). Impact of Health Policy. Retrieved July 16, 2014 from http://www.nursezone.com/Student-Nurses/student-nurses-featured-articles/Impact-of-Health-Policy_18566.aspx
Medical Case Study
Florence (F) is a 43-year-old woman who is two days post-operative, following an appendectomy. She has a history of arthritis, and currently takes 10mg of prednisone daily. She is allergic to penicillin. She weighs 46 kg (101.5 lbs.) and is 168cm tall (5'6"). This puts her slightly underweight for her age and height, at least 18-25 pounds (Height and Weight Chart, 2010). While doing a route in dressing change, nurse notice a yellow discharge emanating from the wound.
Identify and discuss the importance of obtaining information during a nursing admission in relation to post- operative assessment. In modern healthcare, a nurse must first and foremost try to understand and utilize a systematic and synergistic model of data collection and assessment. Human beings are complex creatures, and the more data one has, the easier it will be to ensure that a proper diagnosis is made. A systematic assessment…
Height and Weight Chart. (2010). HealthCheck Systems. Retrieved from:
Prednisone and Other Corticosteroids: Balance the Risks and Benefits. (2011). The Mayo
Clinic. Retrieved from: http://www.mayoclinic.com/health/steroids/HQ01431
Care Case Study
Slide 1 Footnotes
There have been enormous changes due to introduction of various cultural elements in the continuum of care. Before, when people were admitted to assisted living facilities or hospital settings, there were very little cultural elements outside of the majority culture which had sponsored the facility. For example, if a facility was associated with some sort of church or temple, there were elements of that religion present, but there was little alternatives for members of other cultures or religions.
Yet, today, there are now a much wider array of cultural elements available in assisted living homes and hospital facilities. Assisted living programs are regulated on the level of the state.
As such, different states have different types of programs and policies that impact the degree to which cultural characteristics are included or excluded within various assisted living facilities. Some programs encourage cultural elements of patients…
ALFA - Assisted Living Federation of America. (2009). Assisted Living Regulations and Licensing. Retrieved from http://www.alfa.org/State_Regulations_and_Licensing_Informat.asp
Medicare Payment Advisory Commission. (2011). Report to the Congress: Medicare Payment Policy. Retrieved from http://www.medpac.gov/documents/Mar11_EntireReport.pdf
National Caregivers Library. (2012). Independent Living Facilities. Retrieved from http://www.caregiverslibrary.org
Next Step in Care. (2012). Reducing the Stress of Hospitalization for Patients with Dementia and their Family Caregivers: A Guide. Family Caregiver Alliance. Retrieved from http://caregiver.org/caregiver/jsp/content_node.jsp?nodeid=2449#researchpractice
Although there are several considerations one must weigh prior to defining medical care quality, one of the most effective definitions of this term is that care which ultimately achieves the greatest benefit while taking the lowest risk in doing so. In many ways, this notion is at the heart of the Affordable Care Act, for the simple fact that one of the principle components of this act is to emphasize preventative care since insured people's "policy will cover more than 60 preventive tests and treatments as required" (Glasserman and Hensel, 2013). Virtually no one can argue with the fact that there is a low risk associated with providing preventative care and, if implemented correctly in a safe care delivery model, it can also achieve the greatest benefit to individual health care patients, the system itself, and to the country as a whole. Thus, the prudent researchers of medical…
Centers for Disease Control and Prevention. (2013). Affordable Care Act helping prevent disease. www.cdc.gov. Retrieved from http://www.cdc.gov/features/AffordableCareAct/
Glasser, M. Hensel, B. (2013). Preventive care services and the Affordable Care Act. www.nbclosangeles.com. Retrieved from http://www.nbclosangeles.com/news/local/Preventive-Care-Services-and-the-Affordable-Care-Act-223984451.html
When most people are asked 'what do nurses do," there is a strong likelihood that the word 'caring' will arise in the conversation. Many nurses, particularly new nurses, identify caring as one of the personal qualities that attracted them to the profession. However, caring can be a very nebulous concept, as even non-nurses give 'care' to others and non-nurses can be 'caring' people. Nursing, in an effort to create an empirical and academic basis for itself as a discipline has fought against the idea that nursing is just about caring. However, it cannot 'ignore' the idea of caring, given that one of the concepts that distinguishes nursing from other forms of medical care is its patient-centric and individualistic perspective.
I have chosen caring as the concept I will focus on in this paper, with a specific focus on Jean Watson's Theory of Caring, given that it is one of…
Cara, Chantal. (2011).A pragmatic view of Jean Watson's caring theory.
Universite de Montreal. Retrieved www.humancaring.org/conted/Pragmatic%20View.doc
Giguere, Barbara. (2002). Assessing and measuring caring in nursing and health science. Nursing Education Perspectives. Retrieved http://findarticles.com/p/articles/mi_hb3317/is_6_23/ai_n28962844/
Gross, Terry. (2011). Grant Achatz: The chef who lost his sense of taste. Fresh Air. NPR.
Evolution of Health Care Information Systems Physician's Office Operation
Filling in the hole of health care information technology will endorse safe, capable, patient-centered, and patient care that is fruitful in a timely way. In this essay, the theme is to look into two modern health
care organizations and then compare and contrast many characteristics that will involve the kind of evidence systems are using at the moment, investigate the transmission of information 20 years ago and how the substitute of data today. Furthermore, this essay will cover two major events and technology developments that have inclined present Health Care Informational Services practices.
Compare and Contrast Doctor's Workplace Operation
These day's doctor's office operation is familiarizing to the health care reform that was sanctioned in 2010 by the Obama organization. During sometime in October of 2013, the exchanges in health insurance was available on the market for customers on order to…
Burke, D., Wang, B., & Wan T.T.H. & Diana, M. (2009). Exploring Hospitals' Adoptionof IT. Journal of Medical Systems, 21(9), 349 -- 355.
Callen, J., & Braithwaite, J. & . (2008). Cultures in Hospitals and TheirInfluence on Attitudes to, and Satisfaction with, the Use of Clinical InformationSystems. Social Science and Medicine, 65(4), 635-639.
Finchman, R., & Kohli, R. & . (2011). Editorial Overview -- The role of IS inHealthcare. Information Systems Research, 22(3), 419-428.
Medical trauma triage management requires skillful curriculum development, which in turn depends on an assessment of needs and an anticipation of potential barriers to implementation. The initial needs assessment has revealed required resources of about four or five medical services providers such as physician assistants and nurse practitioners. Support personnel may be provided, but an additional challenge will arise when implementing the curriculum in a real world setting such as a trauma center, emergency room, or intensive care unit. Adequate space and time must be carved out for the curriculum implementation, without disturbing standard operating procedures. At the same time, improving trauma triage management will ultimately facilitate patient service delivery and maximize care outcomes, goals that should continually be communicated to the institutional administration as well as all participants in the program.
Each phase of the ADDIE model, an industry benchmark for curriculum development, "requires constant evaluation," (Allen, 2006, p.…
Allen, W.C. (2006). Overview and evolution of the ADDIE training system. Advances in Developing Human Resources 8(4): 430-441.
Bass, E.B. (n.d.). Step 1: Problem identification and general needs assessment.
Swanson, R.A. & Holton, E.F. (2009). Training and development practices. Chapter 12 in Foundations of Human Resource Development.
Medical Home Model and Health Disparity
Nursing esearch Proposal
The Impact of the Medical Home Model on Health Disparities
The Impact of the Medical Home Model on Healthcare Disparity
Medical homes are primary care practices where a physician or NP establishes a long-term care relationship with patients and provide patient/family-centered, coordinated, and culturally-sensitive care (AANP, n.d.; Strickland, Jones, Ghandour, Kogan, & Newacheck, 2011). The benefits include improved healthcare access, quality, and safety. A number of states have enacted statutes supporting the medical home model after research findings revealed health disparities for racial and ethnic minorities were reduced (NCSL, 2013).
As a nurse practitioner I am interested in how effective a medical home model would be in reducing healthcare disparities, especially for racial and ethnic minority children residing in underserved communities. Nurse practitioners have traditionally practiced in underserved communities and will continue to do so; therefore, any strategy that could improve…
AANP (American Association of Nurse Practitioners). (n.d.). Medicare legislation: Fact sheet: The medical home -- What is it? How do nurse practitioners fit in? Retrieved from: http://www.aanp.org/legislation-regulation/federal-legislation/medicare/68-articles/349-the-medical-home .
Abrams, M., Nuzum, R., Mika, S., & Lawlor, G. (2011). Realizing health reform's potential: How the Affordable Care Act will strengthen primary care and benefit patients, providers, and payers. The Commonwealth Fund. Retrieved from: http://www.commonwealthfund.org/~/media/Files/Publications/Issue%20Brief/2011/Jan/1466_Abrams_how_ACA_will_strengthen_primary_care_reform_brief_v3.pdf .
NCSL. (2013). Health disparities: State laws. Retrieved from: http://www.ncsl.org/research/health/health-disparities-laws.aspx .
Strickland, B.B., Jones, J.R., Ghandour, R.M., Kogan, M.D., & Newacheck, P.W. (2011). The medical home: Health care access and impact for children and youth in the United States. Pediatrics, 127(4), 604-11.
Medical ID Theft and Securing EPHI
Medical Identity Theft
Medical information can be stolen by 1) the bad guys getting sick and using a victim's information to obtain services, 2) friends or relatives use another friend's or relative's information to obtain treatment, 3) when professionals, such as physicians, fabricate services that did not exist, 4) organized crime, and 5) innocent or not so innocent opportunists (Lafferty, 2007). ad guys that get sick can take a victim's insurance information to obtain services for treatment. Professionals can fabricate false claims to cover medical errors. Opportunists have access to patient data and the ability to steal, use, or sell that information.
Effective security requires clear direction from upper management (Whitman). Assigning security responsibilities and access controls with audit controls to organizational elements and individuals helps to place accountability on individuals. They must formulate or elaborate security policies and procedures based on the organizational…
HIPAA Security Series. (n.d.). Retrieved from HHS.gov: http://www.hhs.gov/ocr/privacy/hipaa/administrative/securityrule/techsafeguards.pdf
Hoffman, S. & . (2007). SECURING THE HIPAA SECURITY RULE. Journal of Internet Law, 10(8), 1-16.
Lafferty, L. (2007). Medical Identity Theft: The Future Threat of Health Care Fraud is Now. Journal of Healthcare Compliance, 9(1), 11-20.
Whitman, M. & . (n.d.). Case B: Accessing and Mitigating the Risks to a Hypothetical Computer System, pages B1-B24 .
How do these companies provide care?
Aetna provides care by being a health insurance company that offers a range of services in the field of medical, pharmaceutical, dental, behavioral group, long-term care, and plans for those who are disabled. Humana is also a health insurance company that offers its services in numerous states. United Health Group operates two businesses, known as United Healthcare and Optum, and similar to the two aforementioned companies, it offers health insurance to individuals, which includes seniors.
What types of plans do they have?
Aetna offers various types of plans under its various insurance, which as mentioned before, include medical, dental, vision, medicare, disability, pharmacy, life, student, behavioral health, health expense funds, and wellness products and discounts. Under medical insurance, a person can get a quote via state, which may include individual HMO health benefits plan or QPOS individual advantage health benefits and health…
Aetna - Health Insurance, Dental, Pharmacy, Group Life and Disability Insurance. (n.d.). Aetna - Health Insurance, Dental, Pharmacy, Group Life and Disability Insurance. Retrieved December 19, 2011, from http://www.aetna.com
HUMANA - Guidance when you need it most. (n.d.). HUMANA - Guidance when you need it most. Retrieved December 19, 2011, from http://www.humana.com/
UnitedHealth Group - Featured News - Products & Services. (n.d.). UnitedHealth Group - Featured News - Products & Services. Retrieved December 19, 2011, from http://www.unitedhealthgroup.com
The results of this analysis highlight the need for hospitals to fine-tune their discharge process to reduce readmissions, and support the expenditure of additional resources for this purpose as a cost-effective intervention; as an example, author cites a hospital in Iowa that implemented a rigorous post-discharge planning process for patients with heart failure and 30-day readmission rates were reduced by 3-9% during the 3-month period following implementation.
The research showed that many elderly patients who suffer from congestive heart failure also suffer from a wide range of comorbid conditions, including diabetes and hypertension. These patients can be reasonably expected to require periodic or even frequent treatment in emergency departments and/or hospitalizations for these conditions, making the need for effective and seamless post-discharge planning especially important. In this regard, the research also showed that there are some valuable evidence-based practice guidelines available, though, that can help clinicians better coordinate post-discharge…
These examples highlight that technology is always a tool, a way of enhancing human judgment -- we must not mistake it as a replacement for good nursing practice.
After all, the use of a computer is no substitute for a medical education. Anyone who works in a hospital can see this -- the increased accessibility of information through the Internet also means that patients often come in, convinced that they are suffering from a serious illness, allergy, or condition, based more upon a diagnosis Googled on WebMD, rather than upon the fact that they saw a doctor! If a computer alone was required to diagnose, everyone would have a degree!
Don't get me wrong -- I use technology every day in my life, and thank my lucky stars, and my patient's lucky stars, that it is so ubiquitous. When health care providers wish to communicate, the use of cell phones…
In this case, that power dynamic was only exacerbated by the fact that the entire MSICU nursing team had never received training in management of the type of clinical issues presented and by the fact that they were excluded from any consultation in connection with a post-operative management plan.
Therefore, it is recommended that the institution immediately implement a policy of "see something, say something" according to which all members of healthcare teams are encouraged to speak up irrespective of power differentials. Furthermore, that protocol must include a statement of policy insulating any member of a healthcare team who does voice a legitimate concern in good faith from any retaliation or other negative response that could conceivably deter such diligence. Finally, the record of this case also indicates the immediate need for protocols requiring all members of the healthcare team to identify themselves to other members of the team, especially…
Bosk, Charles L. (2003). Forgive and Remember: Managing Medical Failure.
Gawande, Atul. (2008). Better: A Surgeon's Notes on Performance.
Groopman, Jerome. (2008). How Doctors Think.
Timmermans, Stefan. (2003). The Gold Standard: The Challenge of Evidence-Based
In addition the effect of bill has changed the documentation awarded through the state as of a certificate toward a license and authorizes a doctor to pass on duties to a PA with the purpose of managing physician's scope of performance however Another effect of bill has enabled Indiana's doctor assistants to widen their area of the health care services and also provided an innovative average of patient care (Stephanie, Matlock (27 April, 2007). Health care bills gives right to patient to know what health care should be known by the plan as well as several limits on care, kinds of health care be not enclosed, any treatment diagram required to endorse in advance. Yearly planning about on disburse to physician and health providers, file a complaint regarding any, disagreement between patient and the plan, and also procedure to make complaint, allowance to access emergency room twenty four hours a…
American-Speech Language Hearing Association. (2007) Characteristics of Licensure Law. Retrieved on November 29, 2007 from www.asha.org
New York State. (April 2007) Managed Care Bill of Rights. Retrieved on November 29, 2007 from www.health.state.ny.us
Federal Trade Commission. (October 21, 2002) FTC staff opposes Ohio Bill to Allow Physician Collective Bargaining. Retrieved on November 29, 2007 at http://www.ftc.gov/opa/2002/10/physicians.shtm
Girardin, Pierre. Internet Health Services: A Case Study. Retrieved on November 29, 2007 from https://www.isoc.org/inet96/proceedings/h5/h5_2.htm
In spite of research gaps, medical robotics is a growing trend in the United States.
Advances in Medical Robotics (Diana, 2011)
Hybrid Assistive Limb 5 (HAL5) is an artificially powered ecoskeleton that helps double the amount of weight someone can carry unaided.
DaVinci Si HD Surgical System performs minimally invasive surgery through superior visualization and greater precision, with incisions of one to two centimeters causing less pain and speedier recovery. It reduces the hospital stay to one half and costs one third less.
Sofie incorporates force feedback allowing a surgeon to feel the pressure they apply making sutures and pushing tissue aside. Sofie is expected to develop in five years.
Cyberknife Robotic Radiosurgery System is a non-invasive alternative to surgery for treatment of cancerous and non-cancerous tumors.
Nursebot is designed to specifically help elderly deal with daily activities allowing them to live at home.
RIA is designed to…
Davies, B. (2006). Essay: Medical robotics -- a bright future. The Lancet, vol 368, doi:10.1016/S0140-6736(06)69929-7, S53-S54.
Diana, a. (2011, Jan 29). 12 Advances in Medical Robotics. Retrieved from InformationWeek Healthcare: http://www.informationweek.com/healthcare/patient/12-advances-in-medical-robotics/229100383
Huang, G.P. (2006). Robotics and clinical research: Collaborating to epand the evidence-based for rehabilitation. JRRD, 43(5), xiii-xvi.
Seaman, a. (2013, Jan 4). Racial gaps in access to robotic prostrate surgery. Retrieved from Yahoo Health: http://health.yahoo.net/news/s/nm/racial-gaps-in-access-to-robotic-prostrate-surgery
The facts that you have provided indicate extremely troubling circumstances that could seriously jeopardize the welfare of your organization. It is well-settled law that entities contracting for the services of subsidiaries are legally responsible for legal and ethical improprieties committed by those subsidiaries irrespective of whether or not the contracting organization had any specific involvement in or knowledge of those actions. Accordingly, we would strongly advise that you take immediate action to rectify the situations described in the manner outlined in our recommendations below.
To avoid the potentially serious criminal, civil, and financial consequences arising under MWHC's respondeat superior responsibility to prevent fraud and abuse in connection with its association with subsidiaries, it is hereby recommended that MWHC immediately:
1. Instruct the subsidiary to cease and desist from offering its contracted home health agency employees compensation of any kind in connection with client durable medical equipment (DME) orders from…
Reid, T. (2009). The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care. New York: Penguin Group.
USDHHS. (2004). U.S. Department of Health and Human Services-Office of Inspector
General-Statement of Organization, Functions -- and Delegations of Authority.
Federal Register. Vol. 69, No. 127; July 2, 2004. Retrieved November 14, 2010,
Medical l Nursing
The United States has the largest number of professional nurses in the world totalled 3 millions approximately. Despite the available large number of professional nurses, there is still imbalance between the supply and demand for nurses in the United States. Demand for the professional nurses has outnumbered the supply. Typically, critical nursing shortage has become a serious issue in the United States, and the production capacity is lagging based on the estimated future needs. The concept of nursing shortage refers to the situation where the demand for nurses outnumbers the supply. The worsening nursing shortage in the United States has created the demand for more nurses to fill the gap. Many private and public sectors healthcare leaders have advocated for the serious solution to boost the supply of nurses. One of the solutions advocated is that the U.S. should facilitate the migration of foreign graduate…
Aiken, L.H. (2007). U.S. Nurse Labor Market Dynamics Are Key to Global Nurse
Sufficiency. Health Service Research.42(3):1299-1320.
Brush, B.L. Sochalski, J. & Berger, A.M. (2004). Imported Care: Recruiting Foreign Nurses
to U.S. Health Care Facilities. Health Affairs. 23(3):78.87.
Nurses are required to make many immediate decisions in their assigned duties. Unfortunately, in recent years, patient care has often been compromised as a nursing shortage crisis has escalated to epic proportions. Increased patient loads have resulted in often hasty nursing decisions as responsibilities and hours worked have increased. Although precious time must be spread thin to accommodate higher numbers of patients, nurses must exercise their morals through consistency in ethical behaviors. According to Peggy Chinn (1), "Many ethical issues, such as end-of-life decision making, have increased in complexity. Other issues, such as advocacy and choice, have changed in certain respects but are more clearly centrally situated within nursing's ethical domain."
As a result, nurses are held accountable for a variety of decisions in nursing practice and in many instances, a patient's life depends on such decisions to survive. Gastmans (496) states that "Generally, the goal of nursing…
Chinn, P. (2001). Nursing and ethics: the maturing of a discipline. Advances in Nursing Science
Erlen, J. (2001). Moral distress: a persuasive problem. Orthopaedic Nursing 20(2): 76-80.
Erlen, J. (2001). The nursing shortage, patient care, and ethics. Orthopaedic Nursing 20(6):
Gastmans, C. (2002). A fundamental ethical approach to nursing: some proposals for ethics education. Nursing Ethics 9(5): 494-507.
Medical Use of Marijuana
Increasing use of medical marijuana
Having looked at the various areas that medical marijuana has been brought into use and the various forms in which marijuana is administered, it is also important to take note of the various challenges that come with it. There have been various researches that have been conducted that covers the medical as well as the ethical side of the medicinal marijuana, and there have been a dilemma in the balance of the two sides on whether to institutionalize the drug or to stop it, and even on whether the medicinal use can be made to work without the proneness to abuse as is the case at the moment.
Medicinal marijuana has neither medical nor ethical standing within the contemporary society where drug abuse is one of the biggest worries of governments across the world and the alternative medicines that medical research…
Medical Associates is a large for-profit group practice. Its dividends are expected to grow at a constant rate of 7% per year into the foreseeable future. The firm's last dividend (D0) was $2, and its current stock price is $23. The firm's beta coefficient is 1.6; the rate of return on 20-year T-bonds currently is 9%; the expected rate of return is 13%. The firm's target capital structure calls for 50% debt financing, the interest rate required on the business's new debt is 10%, and its tax rate is 40%.
You are to write a report that answers the following:
Calculate Medical Associates' cost of equity estimate using the DCF method.
Next years expected dividend = $2 * 1.07 = 2.14
Current Stock Price = $
E (Rc) = 2.14/23 + .07 = .1630 = 16.3%
Calculate the cost of equity estimate using CAPM.
R (Rc) = .09 + (1.6…
As mentioned earlier, the desired outcome of nursing care is comfort and there are many articles in which the researchers have talked about the needs of the patients and the things that alter the comfort of the patients. Kolcaba suggested that the cancer patients who are terminally ill can benefit from comfort care as it pays attention to the perspective and needs of the patients. Through such kind of care, the patient is not only provided with pain relief, but the depression of the patient is also addressed adequately. As she said that patients who are not in pain but are depressed seek comfort in the transcendental sense as well as in the psycho-spiritual sense (Kolcaba, 1992 p 4). In some of her works, she has explained the use of the instruments and their application by the nurses. Kolcaba reckons that the instruments presented by her to evaluate the comfort…
Kolcaba K. (1994). A theory of holistic comfort for nursing. Journal of Advanced Nursing, 19(10): 1178-1184.
Kolkaba, K. (1992). Holistic comfort: Operationalizing the construct as a nurse-sensitive outcome..Advances in Nursing Science, 15 (1), pp. 1-10.
Kolkaba, K. (1997). The primary holisms in nursing..Journal of Advanced Nursing, 25 pp. 290-296.
Kolkaba, K. And Fisher, E. (1996). A holistic perspective on comfort care as an advance directive..Critical Care Nursing Quarterly, 18 pp. 66-76.
How can eliminating abbreviations reduce errors?
In the medical profession, time is everything. To make documentation as expeditious as possible, a series of abbreviations have been accepted in records. This has been considered an acceptable practice as much as calling a registered nurse an "RN." The problems occur when people are unclear about the abbreviations mean or if a set of letters can have more than one meaning. For example, there is the abbreviation "CA" which means cancer and then "Ca" which is calcium. Another example is "a" which can mean both "artery" and "before" (Medical 2011-page 1). It is very easy to misread abbreviations when medical staff is in a hurry. Imagine the problem if a "q.w." which is take weekly was confused for a "q.v." which is take as one wishes. If the terms were written out rather than abbreviated, these potentially dangerous situations could be…
Berman, Jules. (2008). "Specified Life." Biomedical Informatics.
Greenall, Julie (2006). "Safe Medication Practices." Hospital News.
"Medical Abbreviations Glossary." (2011). JD-MD.
Initial Patient Analysis
Discomfort in lower back.
Patient is a 78-year-old woman presented as disheveled, with bug bites throughout her body, and exuding a foul odor. Cognitively, she orients only to her name with a BMI of 30 and a minimal understanding of the English language. She is able to nod "yes" or "no" to questions, but calls the nurse "Mother." She is unsteady on her feet, and has a fine "pill-rolling "tremor in her left hand. He legs are quite cool to the touch, hairless, and toe capillary refill is greater than 2 seconds.
Past Medical History
Unknown, but patient appears to be in distress both physically and psychologically.
Poor, disheveled, may not be receiving adequate care or living in an environment with enough food or warmth. BMI of 30 is technically obese, which also may indicate the patient is not…
Hypoglycemia. (2012). Web MD. Retrieved from: http://symptoms.webmd.com/#./conditionView
Michael, K. And Shaughnessy, M. (2006). Stroke Prevention and Management in Older
Adults. Journal of Cardiovascular Nursing. 21 (55): 521-26.
Mohr, J., et al. (2004). Stroke: Pathopshyciology, Diagnosis and Management. New York: Churchill Livingstone.
According to the work of Fulford (1994) in an Oxford Practice Skills Project eport "Three elements of practice (ethics, law and communication skills) are approached in an integrated teaching programme which aims to address everyday clinical practice. The role of a central value of patient-centered health care in guiding the teaching is described. Although the final aim of the teaching is to improve the actual practice, we have found three 'sub-aims' helpful in the development of the programme. These sub-aims are: increasing students' awareness of ethical issues; enhancing their analytical thinking skills, and teaching specific knowledge. (Hope, 1994)
In the work of Miles, et al. (1989) entitled "Medical Ethics Education: Coming of Age it is stated that "medical ethics education is instruction that endeavors to teach the examination of the role of values in the doctor's relationship with patients, colleagues and society. It is one form of a broad curricular…
Fryer-Edwards, PhD (2005) Tough Talk: Helping Doctors Approach Difficult Conversations - Resources for Teaching- Domains for Small Group Teaching Prelude 3 Department of Medical History and Ethics University of Washington School of Medicine.
Siegler, Mark MD (2001) Lessons from 30 Years of Teaching Clinical Ethics AMA Journal 2001 October.
St. Onge, Joye (1997) Medical Education Must Make Room for Student-Specific Ethical Dilemmas" Canadian Medical Association Journal 15 Apr 1987, 156(8).
Hicks, L. et al. (2001) Understanding the Clinical Dilemmas that Shape Medical Students' Ethical Development: Questionnaire Survey and Focus Group study. BMJ Journal 2001;322-709-71- 24 march 2001.
My predilection for working under stress prepares me psychologically for the unique and demanding profession. The college professor who advised that my disposition and talents lend themselves to a career in osteopathy told me that osteopaths need to be creative as well as analytical: to assess situations and make decisions that synthesize years of prior knowledge and experience. I believe I possess the qualities that would prepare me for a successful and rewarding career as an osteopathic physician.
As I seek entry into your esteemed medical school program with a focus in osteopathy, I can assure you of my capacity to meet challenges with poise and calm. My business experience has prepared me for the demands of medical school: owning a business while attending school full-time has not deterred nor tired me physically. I look forward to participating in your program; I assure you that I will represent your school…
It is the dimension of knowing that connects with human experiences that are common but expressed and experienced uniquely in each instance. It is ultimately the processes of envisioning and rehearsing nurture artistic expression (Chinn, Kramer, & Chinn, 2008).
Empiric knowledge in nursing consists of knowledge development along with highlighting the role of conceptualizing and structuring ideas into knowledge expressions such as theories and formal descriptions. Theories and formal descriptions become shared as empiric knowledge in a discipline and serve to enable scientific competence in practice (Chinn, Kramer, & Chinn, 2008).
It is thought that if knowledge within any one pattern is not critically examined and integrated within the whole of knowing, that uncritical acceptance, narrow interpretation, distortions, and partial utilization of knowledge will occur. When the patterns are used in isolation from one another, the potential for synthesis of the whole is also lost. The formal expressions of knowledge…
Behm, Kathy, Comrie, Rhonda, Crane, Judy, Johnson, Charlotte, Popkess, Ann, Verbais, Chad,
Yancey, Val, Carstens, Belinda, Keene, Carol, Davis, Doris, and Durbin, Christine.(n.d.).
Knowledge Development: Patterns and Outcomes. Retrieved from Web site:
Medical Care Services
The current delivery of health care services represents one of the most important subjects for discussion both in the Obama Administration as well as the epublican one and the Administrations that preceded the Bush one. egardless of political color, it must be pointed out that the health care system in the United States does not only depend on the ideological orientation, but also on the people and their own beliefs in terms of human action and interaction. It is a clear fact that "Ten years ago, the U.S. healthcare system was declared "broken," and it has not improved. Fixes promised by managed care have not materialized. Premiums are rising. Hassles for patients and physicians abound. Nearly 45 million Americans are uninsured." (Garson, 2000)
One of the most severe problems facing the health care system in the United States is the discussion that is being held between those…
Garson, Arthur. "Current Perspective. The U.S. Healthcare System 2010. Problems, Principles, and Potential Solutions" 2000. Available at http://circ.ahajournals.org/content/101/16/2015.full#sec-7
ImpediMed. "Pre-emptive vs. Reactive Models of Care: Pre-emptive Care Model Prospectively Managing Lymphedema in Breast Cancer Patients" 2012. Available at http://www.impedimed.com/knowledge-center/health-insurance-providers/pre-emptive-versus-reactive-models-of-care.htm
Yale School of Medicine. "The PA Profession." 2013. Available at http://medicine.yale.edu/pa/profession/index.aspx
Despite of the receipt of federal funding to assist in the set-up of an insurance exchange program, the Minnesota legislature is not cooperating with the Governor Drayton's plans to design a program. Instead, in a classic example of partisan politics, the legislature is going forward with its own plans to design an exchange program. In doing so, the legislature is placing the State of Minnesota in a position of possibly losing the grant provided by the federal government. According to the grant provisions, the state must show it can operate an effective exchange program by the end of calendar year 2012 or the federal government under the terms of ACA will impose a one size fits all exchange on the state. Even the state's most conservative political groups oppose this happening and advocate that the state's executive and legislative branches cooperate in formulating an acceptable state exchange program.
Berkel, Jessica Van. "HCMC fights back against Pawlenty's GAMC Cuts." 3 December 2009. Minnesota Daily . http://www.mndaily.com/2009/12/03/hcmc-fights-back-against-pawlenty%E2%80%99s-gmac-cuts . 7 April 2012.
Gray, Virginia. "Incrementing Toward Nowhere: Universal Health Care Coveragein the States." Publius (2010): 82-113.
Harrington, Scott E. "The Health Insurance Reform Debate." The Journal of Risk and Insurance (2010): 5-38.
Minnesota Department of Human Services. "General Assistance Medical Care." 11 September 2011. http://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&Redirected=true&dDocName=id_006257 . 7 April 2012.
Martin Army Medical Center, Fort Benning, Georgia and St. Francis Medical, Columbus Georgia
Because resources are by definition scarce, it is important for tertiary healthcare providers to develop healthcare delivery structures that are efficient and effective. Since every healthcare organization is unique, though, these delivery structures can vary widely in scope and purpose. To gain some fresh insights into the healthcare delivery structures that are used by civilian and military health facilities, this paper provides a comparison of Martin Army Medical Center at Fort Benning, Georgia with St. Francis Medical in Columbus, Georgia, followed by a summary of the research and important findings in the conclusion.
eview and Comparison
Martin Army Medical Center, Fort Benning, Georgia
Health care delivery structure. Opened in 1958, this is a U.S. Department of Defense facility operated by the U.S. Army that offers inpatient, outpatient and emergency services. At present, Martin Army Medical Center 250-bed,…
About St. Francis Hospital. (2012). St. Francis Hospital. Retrieved from http://www.
About us. (2012). Martin Army Community Hospital. Retrieved from http://www.martin.
Patient Centered Medical Homes (PCMH) are often confused as being actual "homes" for patients to be admitted in and given medical treatment and care. PCMH is actually a health care model based on which health care is provided to patients, under the supervision of physicians. The PCMH model of health care provides patients with continuous, comprehensive medical care, in order to increase the chances of achieving the goal of benefitting the patient with as much attention and medical care in order to maximize his/her health outcomes.
Over the years the PCMH model of health care has become widely adopted and preferred. This is because of the philosophy and approach that the model adopts in organizing and delivering the health care initiatives. The PCMH model is based upon delivering medical care and attention to patients with team-based health and medical experts that are focused strongly on the quality and the safety…
109-432, P.L. (2006, December 20). TAX RELIEF AND HEALTH CARE ACT OF 2006. Public Law 109-432 (109th Congress) .
Backer, L.A. (2009). Building the Case for the Patient-Centered Medical Home. Family Practice Management 16 (1), 14-18.
De Geest, S., Moons, P., Callens, B., Gut, C., Lindpaintner, L., & Spirig, R. (2008). Introducing advanced practice nurses/nurse practitioners in health care systems: a framework for reflection and analysis. Swiss Medical Weekly (138), 621-628.
NASHP. (2013, April). Medical Home & Patient-Centered Care. Retrieved from The National Academy for State Health Policy: http://www.nashp.org/med-home-map
Flows in Health Care
Since the government had started the practice of handing over major departments to private sector like health care and education, these areas are now more focused on employing techniques that can draw major profit flow. On examining the three crucial aspects of profit earning such as the number of patients, quality of staff and management, we come to a conclusion that all three areas go side by side and need to be checked upon regularly (Michael, 2006 ).
The numbers of patients are important, to a hospital; patients are the customers who are taking advantage of the health care services provided by that respective hospital. Another item that is associated to the number of patients is the type of patients coming in which is directly associated with the services that a hospital is providing at that particular time. In order to earn more profit in this…
Del. Donna M., Christensen M.D. (Oct 2003). Women on the Cutting Edge of Health Care and Research. Ebony, 82.
Funtleyder, L. (2008). Healthcare Investing: Profiting from the New World of Pharma, Biotech, and Health Care Services. McGraw-Hill Professional.
Harry A. Sultz, Kristina M. Young. (2010). Health Care USA. New York: Jones & Bartlett Learning.
Leiyu Shi, Douglas A. Singh. (2011). Delivering Health Care in America. Jones & Bartlett Publishers.
Provide sustained technical assistance (Expert Panel Meeting: Health Information Technology: Meeting Summary, 2003)
Evaluation of the process in rural and small communities includes: (1) scope of the project; (2) goals; (3) critical success factors; and (4) technical assistance." (Expert Panel Meeting: Health Information Technology: Meeting Summary, 2003) Community grants have been focused on the provision of 'personal digital assistant (PDA) systems in assisting with the decision support role. The initiative is stated to include: (1) development of toolkits; (2) leveraging known tools; (3) developing capacity; and (4) disseminating best practices. (Expert Panel Meeting: Health Information Technology: Meeting Summary, 2003)
Ormond, Wallin, and Goldenson report in the work entitled: "Supporting the Rural Health Care Safety Net" (2000) state: "The policy - and market-driven changes in the health care sector taking place across country are not confined to metropolitan areas. Rural communities are experiencing changes impelled by many of the same forces…
Healthcare and Healthcare Insurance Country Report: India (2004) Tata Consultancy Services and Microsoft. WebHealthCentre.com. 2004 August. Online available at http://download.microsoft.com/documents/customerevidence/7144_WebHealth_CS.doc
Expert Panel Meeting: Health Information Technology (2003) Agency for Healthcare Research and Quality (AHRQ) 23-24 July 2003. Online available at http://www.ahrq.gov/data/hitmeet.htm
Silberman, P. And Slifkin, R. (nd) Innovative Primary Case Management Programs Operating in Rural Communities: Case Studies of Three States. Working Paper No. 76 North Carolina Rural Health Research and Policy Analysis Program.
Ormond, Barbara a.; Wallin, Susan Wall; and Goldenson, Susan M. (2000) Supporting the Rural Health Care Net. 15 May 2000 Urban Institute
"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.
Schneck Medical Center
Provide a description of the company, its mission, and values
SMC (Schneck Medical Center) is a nonprofit healthcare organization that provides specialized and primary care services. The center was established in 1911 with a donation of five thousand dollars and a land from Mary Schneck (Jcr, 2007). It was established in memory of the founder's Husband to provide healthcare requirements to people of Jackson County. Initially, the center had a seventeen-bed capacity but it has now developed to ninety five-bed capacity. SMC celebrated its 100th centenary in 2011. This medical center is located in Jackson Country where it provides medical services to people of this area and the surrounding communities. Schneck Medical Center provides a full continuum of primary care services (Jcr, 2007). Particularly the medical center focuses on the health of women, noninvasive cardiac care, bariatric surgery, cancer care and joint replacement. Schneck Medical Center provides…
Biller, J. (2008). The interface of neurology & internal medicine. Philadelphia: Wolters Kluwer Health/Lippincott Wiliams & Wilkins.
Cribb, A. (2005). Health and the good society: Setting healthcare ethics in social context. Oxford: Clarendon Press.
Rahman, N., & de Feis, G.L. (2009). Strategic decision-making: models and methods in the face of complexity and time pressure. Journal Of General Management, 35(2), 43-59.
Johnson, K., Uecke, R., & Austin, R.(2006). The essentials of project management. New York: Harvard Business Press.
To analyze and compare the U.S. healthcare, internationally, it is important to know what really constitutes a good health care system. The U.S. Institute of Medicine describes this quality as, "the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge." This system, in its broad sense, should comprise of two main branches of preventative and curative medicine, both of which should cover different aspects of health, such as travel medicine, school health, occupational health, mental health, reproductive health and so on. Furthermore, a well established health care system does not act independently but in co-ordinance with other industries, such as the agricultural industry. Therefore, since a well developed nation has better access to proper sanitation, housing and adequate nutrition, it is more likely to have a better developed health care system. Other factors,…
Atrash, H.K., Alexander, S., & Breg, C. (1993, Feburary 05). Maternal mortality in developed countries: not just a concern of the past Obstetrics and Gynecology, 15(3), Retrieved from http://www.inamay.com/?page_id=86
Docteur, E. & Berenson, R.A. (2009, August). How does the quality of u.s. health care compare internationally?. Timely Analysis Of Health Policy Issues, Retrieved from http://www.urban.org/uploadedpdf/411947_ushealthcare_quality.pdf
Health care for all: a frameworkfor moving to a primary care-based health care system in the United States. (2011). American Academy Of Family Physicians, Retrieved from Kurt, H. (2008). A success story in american health care: eliminating infections and saving lives in michigan. Healthreform.gov
Mark A., S., McGlynn, E.A., & Brook, R.H. (1998). How good is the quality of health care in the United States? The Millibank Quarterly, 76(4), retrieved from http://www.milbank.org/760401.html
Africans had poor health care in the 1950s
There is much that still remains swept under the proverbial carpet about America's treatment to its African immigrants. One of the chapters, little known and often left untold has only recently started to emerge and concerns American health care system and its using Blacks as guinea pigs.
Attorney and author Vernellia . Tandall tells the story in her book 'Dying While Black' showing how America's health care system was built on the bodies of African-American individuals from the 19th century continuing to present days. Some f the information is unbelievable at best shocking at worst such as her allegations that AIDS was created by a government-sanctioned health care for the purposes of medical advancement.
Countless stories from Black residents of both North and South tell about how they were unwillingly and unknowingly abducted and exploited for medical experiments. There were the 'night…
Brooking Institute (2008) "Meeting the Dilemma of Health Care Access" (PDF). Opportunity 08: A Project of the Brookings Institution. Retrieved on 2/19/2011
Orlando Sentinel. (Dec., 04. 1993). Clinic On Wheels To Take Health Care To Elderly Poor . retreived 11/7/2011 from http://articles.orlandosentinel.com/1993-12-04/news/9312040190_1_clinic-project-care-seniors
Skloot, H. (2010) The immortal life of Henrietta Lacks NY. Random House.
Access to Health Care in USA
This research paper focuses on the degree of accessibility to the health care services in the U.S.A. Accessibility refers to the ability of an individual to meet health care needs and to acquire the needed medical services on time. It then discusses the findings of the research. The suggestions for the elimination of the prevailing problems in the health care system are also given in the preceding paper.
Health Care: Access to Health Care in United States of America
To achieve a long-lasting life and to save oneself from major diseases it is important that people have an easy access to the medical and health care services. Access to the health care services means that individual gets timely health services to attain the best heath results. In other words it refers to the ability of an individual to meet health needs and to acquire…
Albert, R. (2009). The U.S. Health Care Rip-Off. Retrieved May 16, 2013, from http://rendezvous.blogs.nytimes.com/2013/03/03/the-u-s-health-care-rip-off/
Alex, E. (2012). Health Care Access Worsened For Americans Since 2000: Report. Retrieved May 16, 2013, from http://www.huffingtonpost.com/2012/05/07/health-care-access-urban-institute_n_1497658.html
Maria, E. (2012). Benefits of the United States Health Care System. Retrieved May 17, 2013, from http://www.ehow.com/list_7411670_benefits-states-health-care-system_.html
Maryann, B (2011). Health Care Systems: Three International Comparisons. Retrieved May 17, 2013, from http://www.stanford.edu/class/e297c/poverty_prejudice/soc_sec/health.htm
However...generally a vast difference exists between what healthcare providers understand and what laypersons are able to comprehend. This immeasurability of knowledge was evident in the participants' narratives and was exacerbated by the conveying of "false hope" or "false optimism" to patients and patients' family members.
Seconding Robichaux's argument is ackstrand's (2006) findings that hospital-based EOL programs are not the "ideal" form of healthcare that elderly patients should receive, according to a survey of nurses. For the nurses, "no patient should face death alone," which ultimately happens when patients are confined in a hospital facility receiving palliative care. Comparing ICU EOL care against the hospice and nursing home care programs, 'dying with dignity' is remote in this kind of program, since "[t]he ICU is no place to die. It would be nice to have a comfortable, quiet, spacious room for those who are dying. Let everyone in and let the rest…
Anderson, R. (2003). "Nursing home quality, chain affiliation, profit status, and performance." Journal of Real Estate Research, Vol. 25, Issue 1.
Backstrand, R. (2006). "Providing a "good death": critical care nurses' suggestions for improving end-of-life care." American Journal of Critical Care, Vol. 15, Issue 1.
Elliot, D. (2006). "Determining the financial impact of hospice." Healthcare Financial Management, Vol. 60, Issue 7.
Imhof, S. (2005). "What do we owe the dying? Strategies to strengthen end-of-life care." Journal of Healthcare Management, Vol. 50, Issue 3.
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.
Healthcare and Economics:
Health care costs have continued to increase in the past few decades despite of the numerous health reform initiatives. Currently, these expenditures account for more than 18% of GDP in the United States, a percentage that is expected to continue rising significantly. Actually, it's projected that the share will rise to 34% of GDP by 2040 if health care costs continue to increase at historical rates. The increased health care costs have considerable impacts on households, insurance companies, and government budgets. For instance, households with employer-financed health insurance will have a progressively minimal portion of their total compensation in the form of take-home pay. On the other hand, a progressively larger fraction of compensation will be in the form of employer-provided health insurance. Governments will be forced to cater for more than 50% of health care expenditures if they continue to increase at historical rates. Therefore, the…
Harrington, L. (2011, May). Career Scope: Balancing Quality and Costs During Economic
Downturns. Nursing Management, 42(5), 46-48. Retrieved from http://www.nursingcenter.com/lnc/JournalArticle?Article_ID=1163319&Journal_ID=54013&Issue_ID=1163211
Philipson, T. (2013, October 31). Obamacare or Not, Healthcare Costs are Set to Soar. Forbes.
Retrieved December 3, 2013, from http://www.forbes.com/sites/tomasphilipson/2013/10/31/obamacare-or-not-healthcare-costs-are-set-to-soar/
Beard, C., Weisberg, .B., & Primack, J. (2012). Socially anxious primary care patients' attitudes toward cognitive bias modification (CBM): a qualitative study. Behavioural and cognitive psychotherapy, 40(05), 618-633.
This study shows how traditional methods of approaching patients with information can cause confusion and thus create barriers to accessing patient knowledge in primary care settings. The study focused on working with primary care patients suffering from anxiety and how they reacted to cognitive bias modification (CBM) for that anxiety. Upon initial discussion of the treatment, most participants showed that they understood. However, it was clear by the end of the treatment that the program was not clarified enough to patients prior to treatment and that created a knowledge barrier that caused the treatment not to work as successfully as previously tested. Better methods for communicating the treatment within the primary care setting must be developed to bring down these…
Beard, C., Weisberg, R.B., & Primack, J. (2012). Socially anxious primary care patients' attitudes toward cognitive bias modification (CBM): a qualitative study. Behavioural and cognitive psychotherapy, 40(05), 618-633.
Beckman, H.B., Wendland, M., Mooney, C., Krasner, M.S., Quill, T.E., Suchman, A.L., & Epstein, R.M. (2012). The impact of a program in mindful communication on primary care physicians. Academic Medicine, 87(6), 815-819.
Cheung, P.T., Wiler, J.L., Lowe, R.A., & Ginde, A.A. (2012). National study of barriers to timely primary care and emergency department utilization among Medicaid beneficiaries. Annals of emergency medicine, 60(1), 4-10.
Crabtree, B.F., Nutting, P.A., Miller, W.L., McDaniel, R.R., Stange, K.C., Jaen, C.R., & Stewart, E. (2011). Primary care practice transformation is hard work: insights from a 15-year developmental program of research. Medical care, 49(Suppl), S28.
Critics of American healthcare administration point to less wealthy countries worldwide - Canada, most notably - where all routine healthcare costs have been absorbed by the government (Madore 2003) for decades. Clearly, American citizens have expressed their vocal concerns for a similar national healthcare plan, which many believe is far more important to the health and well-being of the People than the vast expenditure of taxpayer funds on global conflicts of dubious importance to Americans in remote regions of the world and on humanitarian aid and medical care, to foreign people.
Madore, O. (2003) the Canada Health Act: Overview and Options
Canadian Library of Parliament online. etrieved January 12, 2008, at http://www.parl.gc.ca/information/library/prbpubs/944-e.htm
Madore, O. (2003) the Canada Health Act: Overview and Options
Canadian Library of Parliament online. Retrieved January 12, 2008, at http://www.parl.gc.ca/information/library/prbpubs/944-e.htm
health care debate that has been going in the United States. It discusses the Obama Care Act and how it impacts the society. Functionalist perspectives and theories are utilized in analyzing the situation and what outcomes are expected. The major themes and concepts of the functionalist theory are discussed in detail.
The Health Care reform proposed by the Obama Administration has long been the area of debate in America and in countries all over the world. The Patient Protection and Affordable Care Act go on to cut down the number of people who are not insured. It requires small businesses to provide medical insurance to all the people working in the business. The employers are obliged to provide a good quality medical insurance. Failure of the small business to provide a good health care system will result in a penalty for any employee that goes uninsured. This act applies to…
Berkman, L. et al. (2000) from social integration to health: Durkheim in the new millennium. Social Science & Medicine 51 (2000), 51 p.843-857.
Gerhardt, U. (1979) The Parsonian paradigm and the identity of medical sociology. The Sociological Review, 27 (2), p.229-251.
Napsha, J. (2011) Small Business Owners Fret over Health Care Law's Fallout . Tribune-Review/Pittsburgh Tribune-Review, 24th March.
Unknown. (2012) Supreme Court Ruling Dooms Small Business; Obamacare Increases Taxes and Red Tape Burden . The Washington Times, 29th June.
Ethics in a Long-Term Healthcare Business
Ethics in the health care industry spans a wide spectrum of activities and most of the obligations are cast by law on the professionals and the second by the common practice and morals of the profession. Both are important to the progress of the institution and also the health care industry. Compliance of statutes is of primary importance.
There are many rules and statutes that must be complied with by all organizations and one such recent legislation is the hospital information access system. The HIPAA rules apply to all personnel in the system and extend to laboratory technicians, and lawyers and insurers. The culpability comes if the information was disclosed to a third party who did not have an association with the entity -- the clinic and was permitted to access the information. In such cases where the physician discloses information to another…
Andre, Claire; Velasquez, Manuel. (2013) "Aged-Based Health Care Rationing" Retrieved 8
June, 2013 from http://www.scu.edu/ethics/publications/iie/v3n3/age.html
Chaikind, Hinda R. (2004) "The Health Insurance Portability and Accountability ACT
(Hipaa): Overview and Analyses" Nova Publishers.
Healthcare Workplaces Today Considered True Boundaryless
The concept of the boundaryless organization demonstrates a trend in healthcare and elsewhere that claims that an organization is most effective when it is collaborating with all inside and outside interests to build a dynamic workplace that works best for everyone. The challenges might simply be information sharing but it can also take the form of communication for change. The health care field is an ever changing network of core and support personnel as well as a whole pool of individual consumers that utilize services and might have an important role to play in positive change. This work will briefly discuss the historical utilization of boundaryless organization tool by looking at what techniques have been most effective for sharing information and ideas, what techniques were ineffective in the past and at how these techniques might be used in the future i.e. how these techniques…
Heslop, L., & Sim, J. (2012). CALNOC demonstrates leadership in nursing outcomes research. Australian Nursing Journal, 19(8), 32.
Magaw, T. (2012). Independent hospitals see benefits. Crain's Cleveland Business, 33(11), 8.
Maiers, M., Westrom, K., Legendre, C., & Bronfort, G. (2010). Integrative care for the management of low back pain: use of a clinical care pathway. BMC Health Services Research, 10298.
Saba, G.W., Villela, T.J., Chen, E., Hammer, H., & Bodenheimer, T. (2012). The Myth of the Lone Physician: Toward a Collaborative Alternative. Annals Of Family Medicine, 10(2), 169-173. doi:10.1370/afm.1353
The subject of healthcare reform set the country ablaze last year, proving to be one of the most contentious issues that has swept through American political discourse in recent decades. One reason that healthcare reform might have proven to be such a contentious issue -- bringing out the worst and shrillest elements of the American public -- was that healthcare is one of the most important issues in the lives of many and even most Americans (Christensen and Jason, 2009).
All of us will face serious illness at some point in our lives, whether our own or that of a loved one. The fact that so many Americans do not have any healthcare at all or have very limited access to healthcare makes the issue a personal one, and this alone should have made it central to the public discourse. However, while the above was no doubt the…
Christensen, Clayton and Jason, Grossman. The Innovator's Prescription, New York: McGraw Hill, 2009.
Mahar, Maggie. Money-Driven Medicine: The Real Reason Health Care Costs So Much. New York:Harper/Collins, 2006.
Reid, T.R. The Healing of America: A Global Quest for Better, Cheaper and Fairer Health Care. New York: Penquin Books, 2009.
U.S. Health Care System is a series of geographically-determined networks. Established according to American beliefs and values, the system provides essentially two models of health care: the Market Justice Model, based on free enterprise and individual responsibility and ability/willingness to pay; the Social Justice Model, based on the public and equitable provision of basic health care services to all members. The two models are often in conflict with each other, with the Market Justice Model currently being the primary model.
Definition of a Health Care System
A "Health Care System" is commonly defined as "the complete network of agencies, facilities, and all providers of health care in a specified geographic area" (Mosby, 2008). Given that very broad definition, the United States has health care systems spanning such geographical areas as the entire nation, states, counties, cities, towns, villages and neighborhoods.
Implications of Beliefs and Values on a Health Care System…
Daniels, N. (2001). Justice, health and health care. Retrieved on June 9, 2012 from www.hsph.harvard.edu Web site: http://www.hsph.harvard.edu/benchmark/ndaniels/pdf/justice_health.pdf
Mosby. (2008). Mosby's Medical Dictionary, 8th ed. Philadelphia, PA: Elsevier Health Sciences.
Shi, L., & Singh, D.A. (2010). Essentials of the U.S. Health Care System, 2nd ed. Sudbury, MA: Jones and Bartlett Publishers.
Surowiecki, J. (2009, August 31). Status-quo anxiety. Retrieved on June 9, 2012 from www.newyorker.com Web site: http://www.newyorker.com/talk/financial/2009/08/31/090831ta_talk_surowiecki
Access to Healthcare:
For the last two decades, access to healthcare is an issue that has played a crucial role in leading the charge for health care reforms. Access to quality and comprehensive health care services is a crucial aspect for the realization of health equity and for enhancing the quality of health for every individual. Generally, the access to these services means the timely use of individual health services in order to accomplish the best health outcomes ("Access to Health Services," 2012). The achievement of the best health outcomes to access to personal health services requires three major steps i.e. gaining entry into the health care system, identifying a trustworthy health care provider, and accessing the services where they are needed.
Components of Access to Healthcare:
Access to personal health care services incorporates four major components i.e. coverage, workforce, timeliness, and services. Health care coverage is mainly provided through…
"Access to Affordable Healthcare." (2012, November 12). American College of Healthcare
Executives. Retrieved April 4, 2013, from http://www.ache.org/policy/access.cfm
"Access to Health Care." (n.d.). The Everett Clinic. Retrieved April 4, 2013, from http://www.everettclinic.com/About_Us/Legislative_Advocacy/Current_Health_Issues/Access%20to%20Health%20Care.ashx
"Access to Health Services." (2012). HealthyPeople.gov. Retrieved from the U.S. Department of Health and Human Services website: http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=1
Standards of Care/Mental Health/Cultural Competence
EMEGING STANDADS OF CAE/MENTAL HEALTH/CULTUAL
Sometime in 1999, the Surgeon General released Mental Health: A eport of the Surgeon General. Inside this report, it acknowledged that not every Americans, particularly minorities, are getting the equal mental health treatment, a discovery that provoked the Surgeon General to give out a supplemental report on differences in mental health care for individuals of color (Donini-Lenhoff, 2006). The addition, which was available in 2001, sends out one obvious message: culture does actually count. Cultural competency is considered to be one the vital ingredients in closing the differences hole in health care. It is looked as the way patients and doctors are able to come together and then talk about health issues without cultural differences stopping the conversation, nonetheless improving it. Fairly simply, health care services that are deferential of and receptive to the health beliefs, practices and cultural and…
Choi, H.M. (2006). ETHNIC DIFFERENCES IN ADOLESCENTS' MENTAL DISTRESS, SOCIAL STRESS, AND RESOURCES. Adolescence, 41(126), 263-83.
Donini-Lenhoff, F. (2006). HEALTH: Cultural competence in the health professions; insuring a juniform standard of care. The Hispanic Outlook in Higher Education, 65(45), 45.
Furler, J. & . (2012). Mental health: Cultural competence. Australian Family Physician, 39(5), 206-8.
Sawrikar, P. & . (2013). The relationship between mental health, cultural identity and cultural values in non-english speaking background (NESB) australian adolescents. Behaviour Change, 21(3), 97-113.
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
health care to an indigent population.
As illustrated by the case, there were many unique problems associates with delivering health care to the indigent population. First, communication was an issue plaguing all parties involved. Difficulty in regards to understanding overall objectives and health care plans made operations inefficient and costly. Massive errors resulted from communication issues that ultimately hindered the access and quality of health care to the indigent population. Communication is the foundation of delivering health care. Everyone, from owners to employees must be able to effectively communicate in order to offer the quality of health care needed to support the indigent population. Without simple and comprehensive forms of communication, the overall health care program will falter as stakeholders are unaware of the overall vision and plan for the health care system.
Education also is a very profound problem in delivering health care to the indigent population. The community…
1) "Cooper Green Hospital & The Community Care Plan" (2011, July 16) http://www.*****/Details/Cooper+Green+Hospital/43335
2) Swayne, L.E., Duncan, J., & Ginter, P.M. (2009). Strategic management of healthcare organizations (6th ed.). San Francisco: Jossey-Bass
3) Velasco, Anna (July 15, 2007) "Renovation transforming look of county hospital." Birmingham News
Care for Populations
When it comes to the well-being of the overall population, community and public health are both vital areas to consider. However, how the community rallies around its members and how it bands together in times of crisis are not the only kinds of issues that have to be looked at. Those are important, but it is the day-to-day workings of a community that provide more indication as to how it treats the population and whether an overall sense of well-being can be expected. How that same community responds to public health issues is also worthy of consideration. If a community does not take public health seriously, that could be very disastrous for the overall population. Sickness can spread quickly when people are not taking care of themselves and one another.
It also spreads when the people in a community are not focused on the severity of the…
Barzilai, G. (2003). Communities and law: Politics and cultures of legal identities. Ann Arbor: University of Michigan Press.
Chipuer, H.M., & Pretty, G.M.H. (1999). A review of the sense of community index: Current uses, factor structure, reliability, and further development. Journal of Community Psychology, 27(6): 643-658.
Cohen, A.P. (1985). The symbolic construction of community. Routledge: New York.
Garrett, L. (2000). Betrayal of trust: the collapse of global public health. New York: Hyperion.
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