NUR 514 Explain how health care policy affects health care organizations, patient care, and cost-effective quality care

NUR 514 Explain how health care policy affects health care organizations, patient care, and cost-effective quality care

NUR 514 Explain how health care policy affects health care organizations, patient care, and cost-effective quality care

Health care policy greatly affects health care organizations which in turn can affect patient care and cost-effective quality care. Everyone is always saying healthcare is a basic human right. Then why isn’t it really? For many years I worked in an ER a hospital in a community with a primarily under or uninsured population. Many of our patients who had a chronic illness would come in with severe exacerbation of a chronic disease which might have been easily controlled outpatient. The patient or their family member would explain they couldn’t afford a medication, or the specialist was too expensive, or they had been waiting months to see a specialist. There needs to be a bigger focus on giving that human right to everyone, with a emphasis on preventative and primary care. Additionally, if someone needs a specialist, they should not have to wait months due to needing insurance approval. As bedside nurses, we can truly see and experience how this affects our patients and see why it is so important to get involved to advocate for our patients in healthcare reform. “Now more than ever, it is imperative that nurses, especially nurse entrepreneurs, be able to function competently in the political arena during these very volatile times in health care as critical decisions concerning nursing’s scope of practice are being pondered by legislative and judicial systems (DeNisco & Barker, 2019).” I believe ways to get involved as a nurse leader can be through professional nursing organizations to work together to affect change. Additionally, working with your hospitals social worker to work with these underinsured patients to help them get to the proper care and follow up they need and deserve.

DeNisco, S. M., & Barker, A. M. (2019). Advanced practice nursing: Essential knowledge for the profession (4th ed.). Burlington, MA: Jones & Bartlett Learning. ISBN-13: 9781284072570

Health insurance has become a necessity to treat, prevent, and cure diseases and the cost of having insurance is increasing rapidly along with the economic changes in the United States. According to DeNisco (2019), the WHO defines health as a state of complete physical, mental, and social well-being not just the absence of disease or infirmity. Based on this definition, healthcare policies favor insurance policies in how to provide services to their members. For example, preventive care is covered by insurance, or in some cases, those services are free such as immunizations and yearly physicals.

In the clinic I work, preventative care is optional, and not every individual says yes to it during their doctor’s visit. As a nurse leader that has patients under her care, it is my duty to advocate for my patients by educating them on the importance of preventive care.

Cancer is the second leading cause of death in the United States, with more than 1.5 million people diagnosed with cancer annually (DeNisco, 2019). There are many blood tests that doctors can order for patients that have high-risk factors for cancer. Sometimes insurances need to approve treatment based on actual sickness or symptoms. Doctors are not permitted to just add them routinely because insurance will not cover the cost of the test. A colonoscopy is performed every 5 years after the age of 50 or if the patient does not have any risk factors for colon cancer every 10 years.

Under market justice, the production of health care is determined by how much consumers are willing and able to

NUR 514 Explain how health care policy affects health care organizations, patient care, and cost-effective quality care
NUR 514 Explain how health care policy affects health care organizations, patient care, and cost-effective quality care

purchase health care at prevailing market prices (DeNisco, 2019). The number of Individuals that do not have access to health insurance is rising because they lost a job that provided insurance or it is too expensive to pay for it. Advocating for patients is one of the most important things nurses can do for their patients. Sharing information regarding free health care services and educating individuals on healthy habits and disease management is a priority. Disease treatment and management are two of the main important things nurses should advocate for their patients. Also, nurses can educate patients to take prescribed medication daily and have doctor’s visits to treat diseases to get those conditions under control. Getting preventative care and following a plan of care can help the patient achieve high-quality care and in the long term can become cost-effective for the patient and the insurance.

Reference

DeNisco, S. M. (2019). Advanced practice nursing (4th ed.). Jones & Bartlett Learning.

 

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I agree. Because according to the Centers of Disease (CDC), seven out of 10 deaths in the United States are due to a chronic disease such as cancer and Type 2 diabetes. And many of these conditions are preventable. Studies have shown that evidence-based preventive care services can improve health by identifying the risk factors for poor health outcomes sooner and addressing them before they become complicated and potentially debilitating. This active approach to care also helps lower costs for health care systems and for patients.

Preventive care services includes having regular check-ups, vaccinations against diseases, counseling on important health topics such as smoking cessation, having cancer screenings such as mammograms, and routine screenings such as those for blood pressure and cholesterol levels while incorporating diet and exercise to an individuals routine.

Preventive care improves entire communities by helping people live longer healthier lives. Children who are healthy have more days in attendance at school and have an easier time participating and learning. Healthy adults spend more time working and are more productive in the workplace. Seniors who stay healthy are able to maintain their autonomy for longer periods in life and enjoy a greater sense of well-being. Racial and ethnic groups also stand to benefit from preventive care, as they exhibit higher rates of chronic disease.

https://www.cdc.gov/chronicdisease/index.htm

 

Thank you for responding to my post. I agree with your statement “Preventive care improves entire communities by helping people live longer healthier lives”. As nurses that care for patients, it is our duty to always educate our patients regarding their health prevention and healthy lifestyle choices. Educating the elderly population is also important because education helps them control their chronic conditions and for the young population is important to promote prevention. In a community, there are several age groups and ideas that sometimes are not accurate or involve unhealthy habits and a nurse can clear up any misunderstandings or beliefs that are not true. For example, families pass down eating habits where high fat and low fiber are what make most of their meals. Education can help them to make modifications to their diet instead of having deprivations in their diet. Small changes are easier to do than huge modifications and individuals welcome these small changes easier. The same concept goes for healthcare habits, small medical decisions can actually help the individual to eventually take bigger decisions in their own care.

 

Thank you for your post. I agree with you that preventative care is crucial for decreasing the instance of chronic disease in our country. It is interesting from a patient centered approach increasing accessibility to primary care seems to be one contribution to the solution of chronic disease management that is universally accepted. We must accept that not everyone would utilize the resources if they were available but many would. I believe the barrier to increasing availability to health care and diminishing health disparities is economics. The health care system in the United States has the one of the highest costs among developed nations. We as a nation in 2021 spent 4.1 trillion dollars on health care (National Health Expenditure Accounts, 2021). I believe this is one of the major barriers to health care. If it were profitable there would be many more community clinics available.

 

Reference:

 

National Health Expenditure Accounts, (2021). U.S. Centers for Medicare & Medicaid Services. Retrieved from: https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NationalHealthAccountsHistorical