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The impact of the Affordable Care Act on healthcare
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One of the biggest challenges in health care today is to reduce the cost. One of the sleep provisions of the Affordable Care Act (ACA) was to encourage greater use of shared decision making in health care. We are all human and there for uniquely different, so one treatment that fits all. For many health situations in which there's not one clearly superior course of treatment, shared decision making can ensure that medical care better aligns with patients' preferences and values. The other part of this is no one person has the answer to everything. One approach is patient education and using written materials, Videos and other interactive electronics presentations that are designed to inform patient and their families about all the health care options out there. The goal of any treatment plan is to have the best possible outcome, with interaction with different members of the team educating people on the benefits and side effects the health care team’s skills and costs. Shared …show more content…
In the United States, 10%–12% of overall health expenditures and 27%– 30% of Medicare’s budget are spent on end-of-life care. These costs are incurred by a disproportionate few; specifically, 30% of Medicare expenditures are attributable to 5% of beneficiaries who die each year. Most of these costs result from either life-sustaining care (eg, mechanical ventilation, resuscitation) or poorly coordinated care (eg, multiple emergency department visits and hospitalizations), which suggests there is potential to reduce or avoid some of these costs and also improve patient care. As the United States baby boomers ages, and life expectancy increases and the rise of chronic illness, it is imperative to develop treatment strategies to lower the costs. Such as Hospice care, advanced directives and palliative care improved the cost, care and quality of end of life care (Holland, Evered, & Center,
...nce that is necessary to provide primary care providers the tools necessary to provide care. Early hospice admission is statistically proven to be more effective in preventing pain at end of life. It is cost effective to do so and has been discussed within the confines of this project. A literature search using CINAHL proved that in different venues the fact that earlier admission does result in pain management was proven.
Gawande’s book is very pertinent to the present day and has by many accounts sparked a national discussion on end-of-life care and how we treat our elderly. With elderly people accounting for a greater proportion of the American populace and as people start living even longer than they do now, end-of-life care will become and remain a major issue faced by doctors, patients, their families, and the healthcare system. Additionally, with our greater focus on improving patient outcomes while getting the most value for our healthcare dollars, end-of-life care is a major area that healthcare systems and hospitals will focus on, as it accounts for a large portion of their budget. As a response to the need to take care of our aging population, hospice care and palliative medicine are some of the newer specialties in the medical field that have been increasing in popularity and more research needs to be focused in these areas to better understand how to improve patient outcomes.
End-of-life care in the United States is often fraught with difficult decisions and borne with great expense. Americans are often uncomfortable discussing death and
outcome for what’s best for the patient. The importance of the teamwork and collaboration to
The Public Health Imperative measures the quality of life of an individual during times of severe chronic illness. This health imperative is characterized by: the potential to prevent suffering caused by the illness, major impact, and high burden. In the recent past is has become evident that care for older people, who have potential to become terminally ill, must be focused on. The types of patients may also lose the capability to make some of their most important decisions which include actions made by health professionals that are related to their end of life situation. Luckily actions were made to identify certain priorities pertaining to the public health and end of life issues. These priorities were established by the National Association of Chronic Disease Directors and the Healthy Aging Program at the Centers for Disease Control and Prevention. These end of life health priorities which address short-term, medium-term and long-term needs are also called advanced care planning. It can be concluded that communication between professionals and among families about the patient can enhance the effectiveness of advanced care planning.
Most healthcare providers will tell you that they feel that they are called to their profession, and most would tell you that they love practicing in their field of study. Healthcare providers are placed in situations frequently that can lead to cognitive dissonance. In healthcare there is a pressure to perform tasks frequently, timely, perfectly, and in a cost effective manner. This can lead to situations that are in conflict with training as well as with personal ethics.
This paper will discuss three theories of decision-making that can be adopted in nursing practice, additionally how decision-making theories are able to be implemented and used. Decision-making in nursing is adopted through the critical thinking process that provides each nurse a model to make the best choices, solve problems and to meet goals in clinical practice (Berman & Kozier 2018, pp. 199-200; Levett-Jones & Hoffman 2013, pp. 4-5). Effective decision-making in nursing is a vital component and part of the role of a registered nurse; each year a substantial number of patients die due to medical errors and poor decision-making (Levett-Jones & Hoffman 2013, pp. 4-5; Nibbelink & Brewer 2017, p. 3). Through the use of effective decision making
The care of patients at the end of their live should be as humane and respectful to help them cope with the accompanying prognosis of the end of their lives. The reality of this situation is that all too often, the care a patient receives at the end of their life is quite different and generally not performed well. The healthcare system of the United States does not perform well within the scope of providing the patient with by all means a distress and pain free palliative or hospice care plan. To often patients do not have a specific plan implemented on how they wish to have their end of life care carried out for them. End of life decisions are frequently left to the decision of family member's or physicians who may not know what the patient needs are beforehand or is not acting in the patient's best wishes. This places the unenviable task of choosing care for the patient instead of the patient having a carefully written out plan on how to carry out their final days. A strategy that can improve the rate of care that patients receive and improve the healthcare system in general would be to have the patient create a end of life care plan with their primary care physician one to two years prior to when the physician feels that the patient is near the end of their life. This would put the decision making power on the patient and it would improve the quality of care the patient receives when they are at the end of their life. By developing a specific care plan, the patient would be in control of their wishes on how they would like their care to be handled when the time of death nears. We can identify strengths and weakness with this strategy and implement changes to the strategy to improve the overall system of care with...
2 With that being said, most health care facilities place an emphasis on coordinated and integrated interactions between the clinician and patient. This may include open communication, and shared decision making, ensuring that the patient is an active participant in his or her own care. Research shows that when a patient is treated with dignity and respect, and includes the family and caregivers in the decision making, better outcomes are to be reported.
A health care system exists to address the health care issues of its community. To do so equitably it must recognise, plan for and implement necessary changes to cater for the diverse needs of the community. It is when the community engages in dialogue with the providers of health care that the specific needs are revealed and can then be planned for and implemented. However it is often those who have no voice in the community who have the greatest need of health care. Their lower socio economic status, as well as their lower educational levels, deters them from accessing appropriate health care. Consumer participation is one way to address this lack of representation.
These tools are helpful in framing my practice into interventions that are evidenced based and effective. However, I’ve found that allowing patients and their families to be the guide for the treatment plan gives then much needed control over their lives as a uncertainty and lack of control have become the norm for them. It also keeps me honestly engaged in intentional and active listening to the patient. I am always looking to them for cues on ways to join them on their journey. Listening to my patient from a person-centered perspective cures my need to solve everything for the patient. Many of them have the solutions and we are partners in discovering the road to those solutions. Even when a patient may be full of despair and feeling low, they continually express that they are more than a diagnosis. They are a person who has many influences that may greatly impact their illness experience. As their therapist, my role is to respect their desires and goals, and help them maintain optimal functioning in this
...preference predictions into the shared decision- making process if this reduces the stress and burden on their loved ones and increases the chances that they will receive treatment consistent with their preferences and values. If true, using preference predictions would also promote the goal of respecting patients’ preferences regarding how treatment decisions are made for them."
...ue to numerous medical errors. With the amount of medical errors that currently do occur which is a current health care issue it cost the health care billions of dollar each year to fix the mistakes that were made.
We as health care professionals need to work side by side with the families to provide the best care and decisions that are right by our patients. We have to be mindful of the cause and effect our course of treatment depicts for our patients. No individual wants to live in pain or misery, we all want to be healthy and happy and are willing to go great lengths to achieve this goal. Death is the final stage of life, but as we live and get older we start to prepare for death as to not fear death but accept it. Health care professionals may benefit from the opportunity to acknowledge, normalize and integrate death and dying into the continuum of life, both for themselves as well as their patients. (Sinclair, 2011) With advancements in technology and medicine we are living longer and fuller lives, and given time quality of life will only continue to improve.
Health care has always been an interesting topic all over the world. Voltaire once said, “The art of medicine consists of amusing the patient while nature cures the disease.” It may seem like health care that nothing gets accomplished in different health care systems, but ultimately many trying to cures diseases and improve health care systems.