The state of the American health care system is among the three top issues that the American public would want policymakers to address. Its importance increases as economic insecurity continues to grow. …
The state of the American health care system is among the three top issues that the American public would want policymakers to address. Its importance increases as economic insecurity continues to grow. The most frequently cited problems are gaps in coverage, the quality of care that patients receive and the high cost of insurance. Over 45 million Americans do not have health insurance because of high coverage cost, availability of employer coverage, individual priorities and health market inefficiencies like access barriers in the individual market. The idea of too-little-too-late health care is usually as a result of lack of insurance and it has life-threatened health consequences. Notably too, is that many people have insurance but it is manifestly inadequate because it either lacks coverage for key services like prescriptions drugs or is accompanied by steep copayments and deductibles. For instance, the number of the underinsured has risen by an alarming rate of 60 percent since 2003. The high cost of health care has adversely affected not only individuals but also the economy. Consumers face burdensome out-of-pocket expenses for healthcare access, which adds another burden to illness. The high health care costs have continued to claim a larger share of the economy, now consisting of the gross domestic product, and still rising at a rate at least twice that of general inflation. There are also grave concerns on the quality of health care delivery and the management of risk in health care. A comprehensive study following about 7000 patients over a period of two years found that the received only 54 percent of the care significantly recommended for their conditions. The Institute of Medicine approximates about 100,000 deaths per year as a result of injuries to patients in hospital care. There are significant inequalities in effectiveness and quality of care delivered across different ethnic and racial groups. Compared to other developed countries like Germany, the United States lags behind in terms of information technologies, organizational design and other systems that can manage risk and improve quality. Patient safety, quality and risk management Protecting the patients and the health care management organization from risk is one of the top goals for all health care providers. Risk management entails reducing the likelihood of errors, particularly those costly in terms damage, disability, discomfort or distressing to a patient. This is achieved through detection, reporting and correction of the actual or potential deficiencies in the process of care that, though minor, could lead to significant and costly mistake. Healthcare quality entails more than just technical and professional performance. Much care can be said to be a series of compromises, tradeoffs and choices, made in the best conditions, by well-informed patients guided by knowledgeable healthcare professionals in safe and relaxed surroundings. Quality of care can be classified into three important categories that provide a useful framework for discussing quality of health care. The first is the basis of work on quality improvement, is Donabedian’s classification of health care into its structure, process and outcome components as targets for quality assessment (Donabedian, 1966, p.166). The second encompasses six dimensions of quality developed by Maxwell in a discussion on the need for an integrated quality improvement based on a systematic assessment. This has the following quality dimensions: Effectiveness Efficiency Appropriateness Acceptability Access Equity The third is also on the work on Donabedian and it considers health care in three main parts: the technical aspects of healthcare, the interpersonal aspects of care, and the amenities or the environment in which health care is ...
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