Health Care System

Response to classmate

Hello, great post!! I agree with you; where healthcare services are fragmented, there is bound to be a waste of resources, replication of services, and redundancy in spending. This will only lead to patients getting replicated services, not to mention not knowing what would work best for them. Jesus said that a house divided cannot stand (Mathew 12:25), and this is so surreal with the current healthcare system in the US. With so many fragments, it is no wonder we have the least-performing yet most expensive healthcare system among developed countries. When healthcare players come together, they will share knowledge on the local community health needs, as you have rightly mentioned. Each will gain a clearer perspective and address the needs more effectively (Mathew, 2018). By having knowledge of the needs of the community, the healthcare providers will also be in a better position to channel resources in a prudent way and establish a system that does not leave any patient out. Not-for-profit hospitals are indeed not fulfilling their purpose of serving the benefit of the public, and thus, as you have stated, better integration of healthcare facilities would allow for improved patient education (Caffrey et al., 2018).

Some of the healthcare integration strategies that have been successful include PRISMA, a Canadian model designed to integrate service delivery for community-dwelling people with a moderate-to-severe impairment who need coordination between two or more services. Chains of Care is an integrated care model developed in Sweden to link primary, hospital, and community care through integrated pathways based on local agreements between providers. Kaiser Permanente (KP) is a virtually integrated system consisting of three interrelated entities: a non-profit health plan that bears insurance risks (Kaiser Foundation Health Plan), self-governed for-profit medical groups of physicians (Permanente Medical Groups), and a non-profit hospital system (Kaiser Foundation Hospitals). (WHO, 2016)

References

Caffrey, A., Pointer, C., Steward, D., & Vohra, S. (2018). The Role of Community Health Needs Assessments in Medicalizing Poverty. Journal of Law, Medicine & Ethics, 46(3), 615–621. https://doi-org.ezproxy.ccu.edu/10.1177/1073110518804212

Matthew, D. B. (2018). Next Steps in Health Reform: Hospitals, Medicaid Expansion, and Racial Equity. Journal of Law, Medicine & Ethics, 46(4), 906–912. https://doi-org.ezproxy.ccu.edu/10.1177/1073110518821988

WHO (2016). Integrated Care Models: An Overview. http://www.euro.who.int/__data/assets/pdf_file/0005/322475/Integrated-care-models-overview.pdf

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Health Care System

Peer Responses

I would like to respond to fellow student’s discussion post regarding the following question.. Thank you

Health Care System

• Describe what would happen to the overall community health if the various acute care settings, local primary care providers, and the community agencies had a network that could talk to each other and would do so on a regular basis. How would this impact an ACA requirement of not-for-profit hospitals in that region? Write 300 words and comment on two other postings (100 words each). 

Readings for the assignment are:

Nash, D. B., Clarke, J. L., Skoufalos, A., & Horowitz, M. (2012). Health care quality: The clinician’s primer.

• Chapters 19-21

Harvard Business Review (2011). Harvard Business review on fixing the healthcare from the inside & out.

• Pages 133-220

Classmate’s Post

Overall community health would improve if there were greater integration and collaboration between acute care settings, local primary care providers, and the local community agencies.  The greater integration of these health care players would allow for local health care providers to gain a community perspective through shared knowledge of what the health care needs of the local community are and then collaboration to formulate the best ways to address the health care needs of the local population (Matthew, 2018).  Furthermore, when healthcare is fragmented there is redundant spending on programs like smoking cessation, which can cause patient confusion on what treatment they should utilize, but with integration it allows for a unified message and provides multiple avenues where a patient can access solutions to their health care needs.

The more knowledge that hospitals have in regards to the local community the more equipped they are to address social risk factors such as homelessness and other root causes for hospital visits (Matthew, D. B. (2018).  “For example, the Corporation for Supportive Housing reports that hospitals have invested nearly $100 million in housing development for people experiencing homelessness and in turn have reduced emergency department visits” (Matthew, 2018).  “Whoever oppresses a poor man insults his Maker, but he who is generous to the needy honors him” (Proverbs 14:31, NIV).  With a more integrated health care system the risk factors for local health problems can be identified, which is illustrated in New York City where Filipino immigrants were identified as having rates of hypertension of over 50% and that being uninsured, or having a family history of hypertension were common root problems for this local population (Ursua et al., 2013).

Having more detailed information on how to address local health care issues allows hospitals, health care providers, and local community agencies to focus their attention and resources on the main health care problems facing the local population as well as establish a more patient centered health care system.  Integration allows for a system of learning where all of the heath care players can contribute their information and there is a collaborative effort to determine the best solutions.  The benefits of integration can be seen from a financial perspective showing that integrated physician groups provide more cost efficient care than their non-integrated counterparts (Shortell, & McCurdy, 2010).

Non-profit hospitals are already required by the ACA to “conduct a community health needs assessment (CHNA) at least once every three years” (Pan, 2013).  However, if there was more integration within the health care system perhaps this could be done every year, which would allow hospitals, physicians, and community agencies to have updated knowledge of the local health care needs of the community along with identifying useful treatments that yielded successful patient outcomes.  The ACA also mandates that non-profit hospitals should serve as a public benefit but “this purpose is not being fulfilled with hospitals’ spending the majority of their community benefit dollars on unreimbursed patient care” (Caffrey, Pointer, Steward, & Vohra, 2018).  Also, greater integration would allow for enhanced patient education so that patients can utilize primary preventative care measures in regards to their dietary choices and use of alcohol, or cigarettes (Wiley, & Matthews, 2017).  What are some examples of health care integration strategies that have been successful?

References

Caffrey, A., Pointer, C., Steward, D., & Vohra, S. (2018). The Role of Community Health Needs Assessments in Medicalizing Poverty. Journal of Law, Medicine & Ethics, 46(3), 615–621. https://doi-org.ezproxy.ccu.edu/10.1177/1073110518804212

Matthew, D. B. (2018). Next Steps in Health Reform: Hospitals, Medicaid Expansion, and Racial Equity. Journal of Law, Medicine & Ethics, 46(4), 906–912. https://doi-org.ezproxy.ccu.edu/10.1177/1073110518821988

Ursua, R., Islam, N., Aguilar, D., Wyatt, L., Tandon, S., Abesamis-Mendoza, N., … Trinh-Shevrin, C. (2013). Predictors of Hypertension Among Filipino Immigrants in the Northeast US. Journal of Community Health, 38(5), 847–855. https://doi-org.ezproxy.ccu.edu/10.1007/s10900-013-9689-6

Shortell, S. M., & McCurdy, R. K. (2010). Integrated health systems. Information Knowledge Systems Management, 8(1–4), 369–382. https://doi-org.ezproxy.ccu.edu/10.3233/IKS-2009-0147

Wiley, L. F., & Matthews, G. W. (2017). Health Care System Transformation and Integration: A Call to Action for Public Health. Journal of Law, Medicine & Ethics, 45, 94–97. https://doi-org.ezproxy.ccu.edu/10.1177/1073110517703335