Health Policy Economics Class Essay

Pages: 8 (2850 words)  ·  Bibliography Sources: 10  ·  File: .docx  ·  Level: College Senior  ·  Topic: Healthcare

SAMPLE EXCERPT . . .

The National Association of Community Health Centers argues that over 18 billion dollars are wasted each year for visits to emergency rooms that are avoidable as a result of being treatable in non-urgent or primary care settings. This figure is calculated on the assumption that 35% of all visits to emergency rooms are avoidable, by far a conservative estimate. Furthermore, overutilization of emergency rooms drives health care costs high and also decreases the quality of care significantly. As the overcrowding of emergency rooms causes increase in health care costs for the providers, many are switching off their emergency departments since they are becoming too expensive to run. Moreover, as waiting times in emergency rooms are increasing, the patient perceptions of emergency room health care quality are decreasing which threatens the future of health care departments.

Possible solutions

1. Health care homes

Health care homes are possible solutions to the crisis facing emergency rooms as a result of their overutilization. A health care home is a practice which is home-based rather than the more common institutional-based care. Here, the patient receives majority of their health care in a manner that is continuous, regular and patient-centered which improves their health outcomes and helps to keep the cost of health care sufficiently low. By providing patients with a health care home, they are less likely to suffer from a costlier illness later in life and this decreases their chances of going to emergency rooms to receive health care.

2. Retail clinics

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Retail or walk-in health clinics, also known as convenience care clinics, are usually located in pharmacies and drug stores can also help to reduce the utilization of emergency rooms. As studied by Gupta and Wang (2008)

TOPIC: Essay on Health Policy Economics Class. Master Assignment

, these retail clinics cost roughly one-fifth of an emergency room visit and it is estimated that 10% of all emergency room visits can be provided with adequate care by retail clinic staff. Another study identified the retail clinic as a solution for simple acute care for many of those who may visit emergency rooms. On the negative, retail clinics have been seen to eliminate the traditional physician-patient relationship since a study found that out of 125,000 visitors to retail clinics, less than 10% were willing to visit a hospital or emergency department Charatan, 2008()

3. Telehealth

Telehealth provides patients with 24-hour access to physician services via the use of telephones which helps to reduce the number of avoidable visits to emergency rooms from 41% to just 8%. Telehealth involves telephone consultation services coupled with telephone triage services where nurses operate triage programs to provide patients with prompt medical advice. The latter has been seen to reduce utilization of emergency rooms by more than 4% and has saved more than 400,000 dollars for emergency departments. Telehealth has, however, been criticized to lead to a significant increase in the mortality rate of patients as a result of their reliance on these services for chronic conditions.

Solution and its implementation

Health care homes are the chosen solution for this problem. For the solution to be a success, as the access to health care homes is expanded, patients should also be provided with increased access to health insurance. Studies in this field have shown that though health care homes may increase access to primary care thus leading to decreased utilization of emergency rooms, for it to make a greater impact on health care costs, it should be coupled with increased insurance coverage. This should be designed as a gradual process whereby additional homes are added gradually as the progress is evaluated. Additionally, in the implementation, two types of health care homes should be set up. The first is the primary care chronic conditions healthcare home which comprises of federally qualified health centers that receive federal aid and grants, rural health centers and physician practices. The second group is the community mental health center healthcare home which comprises of community mental health centers and their affiliates. This group will address behavioral health needs that address medical problems facing the patients such as schizophrenia that may cause other conditions such as cardiovascular and pulmonary complications and other infectious diseases. This is the implementation that was chosen for Missouri which is the first state to implement health care homes.

Health care homes should be staffed with allied professionals and other paraprofessionals such as physician assistants, medical technicians and nurse practitioners since it is difficult to ensure the availability of primary care physicians for these health care homes. They should also be coupled with strategies such as wellness, health education and prevention measures for the treatment and rehabilitation of patients.

Justification

Health care homes are bound to be successful in increasing access to primary health care for patients thus reducing the utilization of emergency rooms since they provide patients with a usual source of health care despite inequitable distribution of primary care physicians. These health care homes also include programs that redirect Medicaid spending to appropriate primary care providers instead of emergency departments which also significantly reduces spending on Medicaid reimbursement. This will create an avenue for the Medicaid program to encourage more people to join the programs as a result of the creation of a more efficient health care delivery system which greatly reduces the loss of Medicaid revenue. Medicaid savings will also come from improved health outcomes for patients as a result of fewer hospitalizations and visits to specialists. Olson (2010)

argues that regular users of health care homes visit emergency departments for emergent reasons 50% fewer times than nonusers.

References

Blackstone, E.A., Buck, A.J., & Simon, H. (2007). The Economics of Emergency Response. Policy Sciences, 40(4), 313-334. doi: 10.2307/25474342

Brailsford, S.C., Lattimer, V.A., Tarnaras, P., & Turnbull, J.C. (2004). Emergency and On-Demand Health Care: Modelling a Large Complex System. The Journal of the Operational Research Society, 55(1), 34-42. doi: 10.2307/4101825

Bristol, N. (2006). Overtaxed U.S. emergency care system needs reorganisation. BMJ: British Medical Journal, 332(7556), 1468. doi: 10.2307/25689667

Carey, K., Burgess, J.F., & Young, G.J. (2009). Single Specialty Hospitals and Service Competition. Inquiry, 46(2), 162-171. doi: 10.2307/29773415

Charatan, F. (2008). Walk-in Clinics at U.S. Retail Outlets Run into Problems Because of Slow Return on Investment. BMJ: British Medical Journal, 336(7654), 1150-1151. doi: 10.2307/20509833

Dranove, D. (2008). Code Red: An Economist Explains How to Revive the Healthcare System without Destroying It: Princeton University Press.

Grieb, J., & Clark, M.E. (2008). Regional Public Health Emergency Preparedness: The Experience of Massachusetts Region 4b. Public Health Reports (1974-), 123(4), 450-460. doi: 10.2307/25682073

Gupta, D., & Wang, L. (2008). Revenue Management for a Primary-Care Clinic in the Presence of Patient Choice. Operations Research, 56(3), 576-592. doi: 10.2307/25147213

Jason, F. (2009). Who Has the Cure? Hamilton Project Ideas on Health Care: Brookings Institution Press.

Jones, W.J., Reilly, B.J., & Broyles, R.W. (1992). COST CONTAINMENT, ACCESS, AND AMERICAN HEALTH FINANCING: GETTING BEYOND THE SHELL GAME. Journal of Health and Human Resources Administration, 14(3), 290-306. doi: 10.2307/25780499

Lambrew, J.M., Gordon, H.D., Carey, T.S., Ricketts, T.C., & Biddle, A.K. (1996). The Effects of Having a Regular Doctor on Access to Primary Care. Medical Care, 34(2), 138-151. doi: 10.2307/3766666

Lowe, R.A., Localio, A.R., Schwarz, D.F., Williams, S., Tuton, L.W., Maroney, S., . . . Feldman, H.I. (2005). Association between Primary Care Practice Characteristics and Emergency Department Use in a Medicaid Managed Care Organization. Medical Care, 43(8), 792-800. doi: 10.2307/3768297

McFarlane, L., & Prado, C. (2002). Best-Laid Plans: Health Care's Problems and Prospects: McGill-Queen's University Press.

McWilliams, J.M. (2009). Health Consequences of Uninsurance among Adults in the United States: Recent Evidence and Implications. The Milbank Quarterly, 87(2), 443-494. doi: 10.2307/20533151

Miller, A.M. (1993). Health Care Reform: Clarifying the Concepts. Journal of Community Health Nursing, 10(4), 199-211. doi: 10.2307/3427140

Moon, S., & Shin, J. (2005). RACIAL DIFFERENCES IN HEALTH CARE USE AMONG MEDICARE ONLY AND DUAL ELIGIBLES. Journal of Health and Human Services Administration, 28(3), 326-345. doi: 10.2307/25790659

Olson, L.K. (2010). The Politics of Medicaid: Columbia University Press.

Smith, V., Gifford, K., Ellis, E., Wiles, A.,… [END OF PREVIEW] . . . READ MORE

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