Analysis of Gaps in Healthcare
Explain why the chosen topic is a gap in healthcare and analyze the specific population impacted by the issue.
Specifically, you should address the following:
• Describe a specific gap in the delivery of healthcare.
• Briefly describe the history of this gap in access to healthcare. Has this been an issue historically, or is it a modern issue?
• Explain the impact that the socioeconomic background of the population has on their access to healthcare.
• Describe how the healthcare delivered to the population is affected by the gap in access. • Predict any potential implications if this gap in access is not addressed.
Here is a sample article to help you get started.
The aging of the U.S. population, driven by the postwar baby boom generation, is upon us. As is true across the country, in our state of Nebraska baby boomers represent the largest birth cohort, projected to grow the state’s 65-and-older population to nearly 420,000 by 2030. The proportion of older Nebraskans within the state’s overall population is also growing because other demographic changes, such as birth rates and immigration, are not projected to keep pace with the aging of the state’s residents. Consequently, legislators and other policy-makers are becoming increasingly concerned about the fiscal consequences of population aging.
Some of the impacts are already well known. In the United States, baby boomers are becoming eligible for Social Security and Medicare and will produce unprecedented strains on these programs, particularly over the next two decades. Additionally, since Medicare does not meet all health-care expenses, particularly long-term care costs, older Americans will pay higher out-of-pocket costs for these services and will increasingly rely upon Medicaid when they can no longer meet these expenses. In a state like Nebraska with an already large older population, the specter of future Medicaid long-term care costs looms quite large. These expenses totaled $742.5 million in fiscal year 2013 — nearly 40 percent of the state’s total Medicaid spending.
Nonetheless, the continued upward spiraling of Medicaid long-term care costs is not inevitable. Today, the highest Medicaid costs for long-term care derive from care provided by skilled-nursing facilities. The annual cost of nursing-home care in Nebraska averages more than $75,000 per person. However, nursing-home placement, while necessary for some individuals who require skilled nursing assistance 24 hours a day, seven days a week, is not needed by everyone who receives long-term care. The most effective way to save Medicaid costs is to delay or prevent unnecessary nursing-home placement.
Assisted living has long been marketed as a residential alternative to nursing homes, but these settings are limited in their capacity to meet the long-term-care needs of older adults. Assisted-living facilities are not required to provide the professional staffing needed by residents with clinical diagnoses such as dementia; in addition, most do not provide personal-care assistance for activities of daily living such as bathing, dressing, feeding and toileting. Further, the supply of assisted-living facilities in rural states like Nebraska is limited. And assisted living is expensive to families, since most of these facilities do not accept Medicaid.
For these reasons, the most effective way to lower long-term care costs, and to delay or prevent nursing-home placement, is through home and community based services (HCBS). In-home services such as home health and personal care cost roughly half of the $230 average per day for a skilled nursing facility in the United States. Community-based services, such as adult day care, cost one-quarter of the expenses for nursing home care. For many older Nebraskans, HCBS are already available, particularly for those in metropolitan areas who can afford to pay for services out-of-pocket. However, the affordability and the availability of private-sector HCBS providers for low-income and/or rural elders is limited. The best option for lowering long-term-care costs is to expand lower-cost HCBS in the public sector. This includes working in continued partnership with Area Agencies on Aging, which receive federal funding under the Older Americans Act to provide services such as nutrition, transportation and care management.
Although the demand for long-term-care services among older Americans will continue to increase over the next two decades, this does not necessarily require a corresponding increase in costs to states. The key lies in the ability of state policy-makers, working with providers in both the public and private sectors, to delay or prevent unnecessary nursing-home placement through the expansion of more affordable alternatives, specifically HCBS. The greater availability of these options will enable states to meet their long-term care challenges in a way that provides more choices for our seniors and is economically sustainable.
Christopher M. Kelly is an associate professor in the Department of Gerontology at the University of Nebraska at Omaha. Jerome Deichert is director of the Center for Public Affairs Research at the University of Nebraska at Omaha. This commentary is based on a policy brief prepared in December 2013 by the authors for the Nebraska Legislative Planning Committee.
http://www.governing.com/gov-institute/voices/col-aging-population-cost-effective-home-community-based-care.html
http://www.modernhealthcare.com/article/20150528/NEWS/150529893
The question first appeared on Write My Essay
Solution
Analysis of Gaps in Healthcare
Introduction
Most contemporary healthcare systems are characterized by the tremendously rising cost of healthcare and a marked increase in the gap in safety, quality, equity, and access to healthcare. One of the primary victims of non-equitable healthcare provisions is the veterans and the mentally ill. Most of them are not insured of their health and hence lack coverage for their health. This has been the subject of discussion by health policymakers and the various concerned private health sectors. They are continually working on strategies that will ensure high-quality, equitable, and accessible health services are provided to every individual. The primary focus of this article will be how equity and access to health care affect veterans and the mentally ill.
History
Statistics have indicated that among over 1.7 million veterans who are not insured, 13% of them are under the age of 60 years. The number has also been reported to have increased by about 300,000 between the years 2000 and 2005. This registers a great disappointment since the country asks for people who are patriotic enough to fight for their country, only to come home and have limited access to healthcare, one of the most basic requirements of humanity. Most of these people also have limited or no access to veteran hospitals (Oliver, 2016). The programs that were set forth to offer service to these every citizen such as Medicaid is not open to these special people. Some communities where these veterans reside are also not equipped with the facilities required to serve the veterans. Some with genuine reasons for having VA health benefits are ignored.
Since time immemorial, from the colonial times, the US government has been providing medical assistance to citizens who have sustained injuries or acquired particular illnesses that are related to their military career. For the consolidation and harmonization of the procedure into a single and manageable program, they came up with the Department of Veteran Affairs, whose headquarters was based in Washington D.C. in the 1970s; the veteran population was both growing and aging. The growing population made the available services inaccessible to the available high population. The hospitals also lacked the primary care facilities that could be used for the service of these patriots. The outpatient service was also offered on the basis that one had first to be admitted for an inpatient care episode. The efficient services provided were also focused on acute conditions. All these were under the management of the VHA
The Veterans Health Administration (VHA) is the largest healthcare-integrated system, which was specifically put in place to honorably the veterans of the U.S armed forces. It is financed from taxation. The quality of VHA was considered weak as early as the 1970s. This was regarding the reaction of various relevant stakeholders (The Centre for Public Integrity, 2008). Services such as angiography are hardly provided by the VHA and the data obtained from the reports of 1993-1996, indicated that the mortality rate that could be preventable by coronary artery bypass grafting was considerably high. The postoperative surgical outcome of these individuals is also weak. The antipsychotic pharmacotherapy offered to the mentally ill is dissimilar to that issued for privately insured patients with schizophrenia. This is an indication of disparity of the quality and accessibility of healthcare offered to these individuals.
Socioeconomic background
Most veterans are ex-military personnel or those who have acquired some illness conditions or sustained severe injuries as they serve in the military field. This is a special group of patriots who offer their lives and sacrifice their commitments, to ensure that their country is at peace. Most of them, after acquiring these conditions are rendered helpless. They have to rely on some other external aid, mostly health-wise, to ensure that they at least live a regular human life. Some of them acquire severe conditions such as schizophrenia, which needs a constant supply of medication that may be expensive. The best way the government could come in was to set up a body that could handle their grievances. It is notable that the government has at times boycotted their obligation to care for these people as they consider them to be a liability.
How health care delivered to the population is affected by this gap
Currently, healthcare delivery to the other average population is facing some challenges. Since veterans are given a higher priority by their immediate family members, these members hardly visit health facilities for financial reasons. They spend it all to the veterans. This leads to their current acute conditions graduating to chronic diseases, a situation that is detrimental. There are also increased deaths since most health conditions go unsolved (military.com, 2016). There is pressure on the available resources in the public sectors. Public areas offer affordable health care and therefore, most veterans flock there in preference to the private hospitals. The health workers in the public sector, therefore, receive a significant workload.
Potential implications of not addressing this gap
Boycotting the health needs of the veterans has caused financial tension to the people close to them such as their spouses and relatives. They spend a lot to ensure that the health of their people is maintained at an almost standard level. Some are also forced to drop their other outstanding commitments such as academics and jobs so that they can take care of these people since some of them are in delicate conditions that need utmost attention and monitoring. There is also an increased rate of dependence among people hence leading to poor living standards. Once these people are abandoned by the government, they depend on others for any form of support for the sake of their health condition.
Conclusion
Research evidence shows that there has been a great gap in the provision of healthcare services, particularly that about the health of veterans. Despite the steps made by the government, the government needs to put more measures regarding investments to ensure that there is an equitable provision of health services. This will also help in closing this gap that exists in health care system. Veterans need to be accorded more special treatment about health, owing to their great sacrifice as an act of patriotism.
References
The Centre for Public Integrity. (2008, December 10). Retrieved September 22, 2017, from The Centre for Public Integrity Web Site: http://www.military-healthcare-overview.html
Oliver, A. (2016). NCBI. Retrieved September 22, 2017, from NCBI Website: http://www.ncbi.nlm.nih.gov
