The starting point of our healthcare system can be found to the beginning of the twentieth century. Medical technology was advancing rapidly, and opportunities grew with them. Training, performance, and skill all improved substantially. Hospitals became centers for specialized medicine, surgery, and research. With all of this, the cost of medical care began to ascend and would continue to rise above the cost of living for the rest of the century. By the end of the 1920’s, both the middle class and the poor found themselves struggling to deal with growing medical costs.
In 2007, the House of Representatives passed the Children’s Health and Medicare Protection Act which included a provision that eliminated the whole hospital exception for all new or addition to existing physician-owned specialty hospitals (Perry, 2012). Next, in the same way, another similar provision was passed in 2008 (Perry, 2012). But, unfortunately, none of these bills were enacted (Perry, 2012) which attributed to a further growth of the threat to the ability of public hospitals to bring enough revenue to be able to afford their charitable community services.
In efforts to save money, states looked primarily at the benefits of managed care, which was becoming a successful delivery and financing system (Ruggie 1996). Medicaid patients had a history of using emergency rooms for problems such as colds, flues, and other minor illnesses. Medicaid paid $75 for an emergency room visit in 1995, but only $29 for a physician’s office visit (Lutz 1995). Medicaid officials hoped that placing the patient in contact with a primary care physician would encourage the use of preventative medicine, thereby holding down costs.
According to the Centers for Disease Control and Prevention (CDC) in 2011 there were nearly 140 million emergency department visits within the United States, and 34 million of those visits were considered non-emergency. (Centers for Disease Control and Prevention , 2011). The article focused on the case study The Brooklyn Health Care Improvement program, the focus was to determine whether the use of the Emergency Department was being used based on preference, the lack of knowledge, or lack of access to a primary care provider (PCP). Within the Northern and Central area, there were 11,546 patients surveyed over the course of four weeks.
Hospitals are a necessary part of every individual's life. When one thinks of hospitals, help comes to mind (Hospitals Struggle to Keep Their Promises). Neither a person's age, ethnicity, nor economic background should matter when it relates to access to healthcare. Everyone will need hospital care at one point in their lives, no matter how healthy one may think he or she is. That is the reality. Unfortunately, many of these organizations are in danger. "Hospitals are experiencing a period of financial duress unprecedented in recent history. The number of hospitals that have closed their doors is at an all-time high, and many more might close within the next few years" (Moore et al, 1999). It is ironic to think that the institutions such as Faith Community Hospital that provide healthcare and even save lives, face severe problems. Problems that must be addressed early to avoid jeopardizing an individual's access to healthcare should those same problems lead to the hospital's demise.
According to the Centers for Disease Control and Prevention (CDC) (2012), the average time patients spend in the U.S. emergency department (ER) before they can see a doctor has increased to 25% between 2003-2009. The main cause of longer wait times (WT) in the ER is overcrowding. Overcrowding has been found to be closely related to both subjective and objective patient satisfaction (Miro’ et al, 2003). Longer wait times in the ED is such an important issue because its consequences are detrimental not only to the ER patients, but also to providers. As a health care provider, decreasing patients’ WT in the ED is essential, although challenging, to improve patient’s health outcomes and increase patients’ satisfaction. Although it is a very challenging issue to tackle, hospitals that have initiated some quality improvement (QI) strategies are experiencing some positive outcomes in that area of care. The outcomes are measured by decreased waiting times, improved patients’ clinical outcomes and increased patients’ satisfaction.
Weinick, R. M., Burns, R. M. & Mehrotra, A. (Sept 2010). ‘Many emergency Department visits could be managed at urgent care centers and retail clinics’. Chevy Chase, 29(9), 1630-37.
Health disparities, that exists among individuals who reside in rural communities, is significant to availability and access to health care. Access to affordable health care lacks in isolated areas. According to Francis, Scaife, Zahnd, Cook, and Scheeweiss (2009), rural residents “define their health as fair to poor” (Francis, Scaife, Zahnd, Cook, & Scheeweiss, 2009, p. 3555). This is due to healthcare professional shortage, low income status, and its geographic locations. Residents are faced to travel several miles to seek a health care provider for effective treatment. Although they may find a health care provider, cost without proper health insurance to cover medical bills becomes a burden. The increased rate of poverty within rural communities “forces residents to choose between basic human needs, such as shelter or food, and seeking healthcare” (Crosby, Wendel, Vanderpool, & Casey, 2012, p. 54). This causes non-compliance to receiving health care, which increases health complications. However, government assistance programs, such as Medicaid and Medicare,
Trzeciak, S. & Rivers, E. (2003). Emergency department overcrowding in the United States: An emerging threat to patient safety and public health. Emergency Medicine Journal, 20, 402−405. doi: 10.1136/emj.20.5.402
During this week at KLH my nursing skills were challenged as I began to administer medications. Although my experience was a rather positive one, I quickly realized how many factors play a role in ensuring the medication process runs smoothly and safely. By preparing my drug cards that pertained to my client ahead of time, I was able to have a general understanding of the drug and what assessments I would need to perform prior to administration. This made me more confident and comfortable while going through the process at my patient’s bedside.