The Future Outlook of Health care Access, Delivery & Costs of Chronic Patient Care: A Review of Three Important Population Groups in Association with Three Chronic Conditions and Their Impact on the Recruitment & Retention of Health care Professionals
Part VII: Program Justification
If quality health services are to be made more accessible and affordable, health care planners must envision the future of such services and the potential impact of the dynamics associated with the delivery of competent services on all aspects. By definition, chronic conditions are long-term health complications, usually lasting more than 6 months or for the rest of a patient’s life. These conditions have far-reaching effects on the quality of life of their patients (Kane, Priester & Totten 2005); and strategic planning in their management is of paramount importance. At the core of chronic condition management is medication, long-term care and adjustment in lifestyle (such as embarking on proper diets, engaging in physical exercises and getting into stress management programs) so as to cure or alleviate the severity of the condition.
Millions of people live with either one or a combination of the chronic conditions discussed in this paper (diabetes, heart disease and cancer). Throughout the 20th century and up to now, life expectancy has kept on increasing significantly. Bearing in mind that most chronic conditions are more common in the aging population (mostly in those 65 years and over), it is obvious that their impact in the total population is bound to continue increasing as the percentage of older people increases with time.
The American health care system is the most expensive system in the world. Add in the fact that over 45 percent of American citizens are directly affected by at least one chronic condition; with diabetes, heart disease and cancer being the most prevalent (Larsen & Lubkin 2009). The costs associated with the management of chronic conditions are very high; and therefore the underinsured and uninsured, under prevailing conditions, are unable to furnish the costs of the care they need. Elaborate mechanisms therefore need to be put in place so that they too can gain access to the necessary health services and care they need to improve the quality of their lives.
This program is therefore essential since less than half of the people with chronic conditions actually gain access to the care they need. There is thus a need for health care planners and caregivers to come together and combine efforts in the establishment of efficient frameworks and mechanisms so that the delivery of health care services to these people can be more effective (Larsen & Lubkin 2009). Recruitment and retention of health care professionals is essential for a smooth implementation of such a framework since they are the executives in the field who will execute the delivery of the necessary care to chronically ill patients.
An Evaluation of the Health care Reform
Without proper incentives, caring for patients with diabetes, heart disease, cancer or any other chronic condition can be devastating for both the family and the patient. There has been little coordination between health care professionals serving chronically ill patients at different stages. Many times, patients have been left alone without the necessary care or the information they need to manage their condition (Kane, Priester & Totten 2005). The only hope therefore lies in reforming the system and continually reviewing it to cater for the changing needs of chronically ill patients.
The focus of health care reform now and in the future should be on the creation of a more effective and efficient system that improves the quality of care delivered to chronically ill patients while lowering the cost of delivered care. The areas which need to be constantly reviewed include the following:
Issuing government funds, loan forgiveness and scholarships to bolster recruitment and retention of health care professionals
Retrospective chart reviews to ensure proper treatment protocols are being met
Implementation of universal-based insurance programs and plans
Pamphlets, webinars, and websites to educate patients on the pros and cons of health and lifestyle choices
Increasing access to research data so that chronically ill patients can make educated choices
Investing widely in medical and nursing homes, long-term care facilities and assisted living housing for chronically ill patients.
Government funds, loan forgiveness and scholarships
The costs of health care services have continued to increase despite there being measures taken to contain them. Secondly, access to and the quality of managed care has, in spite of there being regulations and set standards to enhance these attributes, continued to go down (Kane, Priester & Totten 2005). One main reason for these trends is that there has been a shortage of healthcare professionals. The system has thus become reactive as this shortage not only affects the delivery of care to, in this case, our three significant population groups (the baby boomers, the under-insured and the uninsured), but also the education and training of future caregivers since its effect is directly translated into a shortage in the health care professional educator workforce (Committee on Health Insurance Status and Its Consequences 2009). Recruitment and retention therefore becomes core to a sustained health care system in which quality and accessible care is delivered to our target population groups at an affordable price.
Two key factors to consider while envisaging a future outlook of health care in the access, delivery and costs of caring for patients with chronic conditions are the methods which can be employed to increase the level of recruitment of health care professionals into this area, and the methods of retaining those professionals that have already been recruited. Health care professionals need incentives to remain in service. These could include funding them to study, initiating favorable loan repayment schemes or writing off the loans altogether.
In a report produced by the Texas Department of State Health Services (2006), the award of competitive salaries, professional growth and professional support as some of the most important issues in the recruitment and retention of healthcare providers. Offering the above incentives can therefore improve recruitment and retention rates, improving both access and quality to health services especially in rural areas and poorer neighborhoods where the under-insured and uninsured are more likely to be found.
Retrospective chart reviews to ensure proper treatment protocols are being met
Proper treatment protocols can be met by first establishing them and then putting on checks to ensure they are adhered to. If the quality of care delivered to chronically ill patients in our targeted population groups is to be increased, the planning of health care delivery will need to be more elaborate so that care can even be more comprehensive and synchronized (Larsen & Lubkin 2009) from one care situation to the next. Coordination on multiple levels of care will reduce re-hospitalizations resulting from interruption of care regimes; for example when a patient is in transition from a hospital setting into a rehabilitation center. The impact this has on recruitment and retention is that more healthcare professionals at advanced training levels will need to be sourced to implement the planning and coordination of healthcare delivery.
Pamphlets, webinars, and websites to educate patients on the pros and cons of health and lifestyle choices
Chronic conditions are best managed if they are continually monitored; and the necessary choices regarding health and lifestyle are made. However, due to lack of sufficient information, many chronically ill patients consult very infrequently with healthcare professionals and do not make the necessary re-adjustments in their lifestyles so as to reduce the effect and adversity of their condition. Producing and distributing pamphlets, organizing webiners and creating websites will dispatch vital information to patients and lead them on a path where they make the right choices to promote their well-being. Of course, such efforts should be coordinated and executed by adequately qualified healthcare professionals.
Universal-based insurance programs and plans and access to research data to make educated choices
In the same report by the Texas Department of State Health Services (2006), healthcare facilities and professionals cited quality of life as a key inhibitor to the delivery of care. The under-insured and uninsured are more likely to be poorer citizens (Committee on Health Insurance Status and Its Consequences 2009). This means that to improve the quality of care, universal-based insurance programs which qualify the poorer in the society to the same quality of care as their more affluent counterparts must be put in place. Access to research data should also be enhanced as a means of empowering chronically ill patients make informed decisions regarding their health.
Investing widely in medical and nursing homes, long-term care facilities and assisted living housing for chronically ill patients.
As mentioned earlier, most families are usually overwhelmed attempting to provide sufficient care to patients with chronic conditions. In any case, only a few families would have members qualified or at least with information on the required care. For this reason, an envisaged healthcare system which delivers quality care should provide for medical and nursing homes as well as long-term care facilities where chronically ill patients are taken good care of by qualified personnel (Larsen & Lubkin 2009). Despite this appearing as an expensive venture since more healthcare professionals would need to be recruited to staff these facilities, it would be cheaper in the long run since it would eliminate the costs associated with unnecessary readmissions and specialized care arising from wrong decisions and lack of timing in the engagement of necessary interventions (Kane, Priester & Totten 2005).
References
Committee on Health Insurance Status and Its Consequences, Institute of Medicine (2009)
America’s uninsured crisis: consequences for health and health care. Washington, DC: National Academies Press.
Larsen, P. D., & Lubkin, I. M. (2009). Chronic illness: Impact and Intervention (7th Ed.).
Tall Pine Drive Sudbury, MA: Jones & Bartlett Learning.
Kane, R. L., Priester, R. & Totten, A. M. (2005). Meeting the Challenge of Chronic Illness.
Baltimore, MA: JHU Press.
Texas Department of State Health Services (2006). Recruitment and Retention of HealthCare
Providers in Underserved Communities in Texas. Available: http://www.dshs.state.tx.us/chs/hprc/hb916rep.pdf [August 18, 2010]