Quality Health Care - Report Example

A country’s success is measured through a few major areas and health is counted for a huge bulk of it and when resources of a country is allocated todifferent areas for bringing prosperity to a nation then health is the area which grasps most of the attention of the policy makers. Providing quality health care to a nation makes the nation healthy, rich and prosperous. Both in developing and developed countries health is a major issue and work is continuing on improving it either one way or another. In developed nations the focus is mainly on the quality of the services but the accessibility of the same quality service for every human being is still a challenge. In developing countries the focus is on improving the quality of services along with making it accessible and cost effective for everyone seeking health facilities. Cost of the intervention, quality of it and the accessibility of health services are the three main areas for all the nations to work on and still needs to be sorted out depending on the developmental status of a country these areas are targeted with different amount of importance. Quality and quantity are two important parameters that are considered while providing any facility to the needy and at times it becomes hard to decide which one is more important and which one to be entertained more. IN United States where health has been taken care of the best way and over there one satisfaction is there for the government that they are providing best quality health care but the next thing comes is how accessible it is to everyone and how cost effective it is to be practiced in other countries as well. Similarly in United Kingdom the situation is almost the same but over there the cost effectiveness of the intervention is very satisfying but the question raises whether the quality and accessibility are appreciable or not ? Health is an important area and it needs to be covered completely like it has to be cost effective, accessible to everyone and should be the best quality health care provision. Health care provision for a nation is defined as “health for all” this was a slogan used by WHO to address issues related to health. An intervention to entertain issues related to health has to be cost effective so that the amount of nation that is being utilized can also be utilized for a number of other things as well so, if the funds are getting allocated to health care provision one should at least get the satisfaction that the funds are getting utilized economically and this was the best use of it. Taking an example of a developing county which has “slums” in it have a very poor population residing in them and they are not provided with any health care facilities what these developing nations do is that they make small groups of doctors from the group of community medicine are these groups are sent to these remote areas to provide as much health care as they can. For these doctors who are not provided with any funds or limited funds have very less facilities. For groups like these they need to have enough understanding of the term cost effectiveness like if a person comes with a vague abdominal pain there could be a list of extensive and expensive investigation that could be done but then the population they are dealing with are very non affording and if those funds provided to them are not used carefully the amount of benefit that is needed for that population will not be provided effectively. In these circumstances if these team of doctors can cut down the list of their differentials by a careful history and cautious physical examination then in majority of the cases they will not need to do any investigations to start with and this way a lot of money will be saved and will be used effectively. In United States the health care facilities that are provided are high quality services but they it is still questionable whether it is fulfilling all the three areas including cost, access, and quality so it is only fulfilling one and the rest is not achieved fully. “The American health care system is beset by significant problems. Chief among these are the continuing rapid growth in costs, and denial of access to a large portion of the population. Amidst the problems, however, remains the fact that the U.S. system offers a very high quality of care to those with access. To address the problems in the health care system, yet preserve quality standard, a considerable number of reform proposals have been advanced. The problem of providing universal access without decreasing quality or increasing cost, however, remains challenging” ( Ahmadi, H. R & Asthana, R. 1999). In developing countries there has been so much of research work to come up with a treatment plan which is less costly and which will be more suitable for the poor population but then keeping that view we happen to compromise on accessibility and quality in most of the cases. Cost is important in developing countries but not of so much of importance in developed countries. If we are keeping patient’s population in view we should focus on the medication side of it like different trade names are available for the same generic name which will be with drastic price difference and that will be bringing a huge price difference to the patient. The second thing which has been given a lot of importance is quality a lot of nations agree that it is alright if they could not achieve the targeted quantity of coverage but they believe in achieving the quality of what they have. In most of the cases this is a clear cut understanding that quality is obviously better than quantity but in health care system talking about these two terminologies one gets into a dilemma whether to treat a few people the best way by providing high quality care or to treat majority of the people by providing broader coverage by decreasing the cost and increasing the accessibility but compromising on the quality. Talking about individual disease in some cases this might be possible like if a disease emerges which is contagious and has emerged in 3 patients only but their a fear that it might spread and cover a huge area soon then the intervention needs to be modified like covering these three people fully with best quality care but making health care provision difficult for a number of other some of them might be critically ill and treating them might be matter of death and life for them can be ignored and here one can justify oneself that the action taken is still appropriate. About United States the perception is that the cost of medical care seems to be unmanageable for future. It is becoming expensive day by day which is raising people’s expectation for getting almost every disease cured and a long with that people are ready to spend as much as needed but they want the disease to be cured completely and that lead to frustration and sometimes spending money on a particular medical condition (like terminally ill patient on ventilator care ) does not lead to the favorable outcome and that is again to be agreed upon whether it is worthier to spend such a huge amount on providing a high quality care to this patient but deprive may be more than one from getting fully treated for a number of treatable diseases? By the late 2020s, the Urban Institute predicts that federal expenditures for just three mandatory spending categories—publicly financed health care, Social Security, and interest on the debt—will devour virtually all projected revenues based on current tax rates (Eugene, 1998) may be not now but in future. If United states is followed for providing health care by other developing countries they will fail to achieve what they need to because it will hard for a poor nation to achieve the quality united states has and more than that their cost effectiveness and accessibility which are two very important areas are going to get compromised. As the distinguished health economist Uwe Reinhardt puts it, the cost of "kind acts" that extend health services to low-income Americans may simply have exceeded our willingness to pay ( Uwe, 1997). It is kind act to provide quality care but at times making this care available for everyone whether low income, average income, or high income is also a very considerable and a kind act. So to be 100% sure whtehr to go for quality only or accessibility and cost effectiveness are to be considered as well becomes a dilemma. Talking about US and UK is different but talking about the huge number of developing nations it is an unsolvable matter which one to go for ?and if for all the three then how to make it work together effectively? Accessibility is a very important area and issues regarding making health care accessible to everyone are an ethical matter as well. When we talk about such an important issues we talk about a huge group in general but to make it understandable we take an example of an urban health care center where a best quality care is being provided to everyone that is able to make it to the center but near by in rural area where due to transportation an times constraints health care provision for basic disease conditions is not able to be delivered. Here we can not justify our self that we are providing best care to these people but since the areas are touching each other the disease transition amongst the areas is going to continue which will not be providing an eradication of the problem though a good amount is being spent on it. Whenever any health facility is talked about the next thought comes is whether it is accessible to everyone or not unless health for all slogan is followed targets can not be achieved fully. Accessibility could be restricted due to a number of factors like financial factors, being in remote areas, lack of awareness, social, cultural, and may be personal issues but they al need to be looked into. Patients are examined with slight modification in terms of their exposure and gender availability in most of the areas taking patient’s cultural and personal issues into consideration. Similarly in terms of cost medications used should be used a cheaper brand, laboratory investigation can be replaced with a thorough examination and a careful history. Everyone requires health care at some point during his or her lifetime, and the law increasingly regulates the cost and quality of, and access to, such health care.( Cerminara, 2008) If patients are residing in remote areas some of the funds may be utilized in constructing a small health care center rather than extensive work and expensive medication. All the efforts should be mobilized in order to make sure that everyone has accessibility to health acre whether supreme quality or optimal quality. Health is of utmost importance to every nation whether developed or developing but we mostly talk about US because the world is following their medical practice so that has to be modified in order to bring a change. Having a very well balanced having all the three components of health care provision which includes cost, quality and accessibility are very rare and difficult to implement for every nation so there has to be a thought about the follower as well not just their own nation while developing health policies. “Americans deserve leadership for real health care reform that provides access to high-quality medical care and ends spiraling costs. But the road to reform does not lead through Washington and a hugely expensive, bureaucratic, government-controlled system. We have all tangled with the existing bureaucracy enough to know that such an approach would diminish, not improve, quality. Our challenge is to protect and improve the care that doctors, nurses, and hospitals deliver, while increasing the availability and affordability of health insurance for Americans.” (McCain, 2008). Even United States is aiming at improving the availability of health care provision while keeping the quality of it up. America faces grave challenges in healthcare. Today, about 45 million Americans are left uninsured and 25 million more don’t have enough insurance to keep their medical bills from putting them at risk of bankruptcy. (Arnst, C, 2008). The need has been felt for the last one decade that health care is an important area for every nation and it has to be provided in a more acceptable, economical and accessible way. “Managed care has led to decreased costs for employers and other payers, mostly through reducing hospital admissions or length of stay. Managed care organizations use staff with lesser levels of training (e.g. social workers instead of psychiatrists) and are more likely to offer group outpatient programs and manualized treatment than their fee-for-service counterparts. Despite these differences, there is no clear evidence that health outcomes are worse for patients in managed care. There is an urgent need for researchers to turn their attention to issues such as cost, quality, access, satisfaction, and functional outcomes associated with managed mental health care”(Durham, M. L. 1998). There have been efforts to make this very important provision available in an effective way to everyone. Studies have been done for disease condition individually in some cases it might be reasonable to give more importance to one aspect and ignore the rest but in most of the cases all the three have to be given equal importance in order to have a balanced system. It is an issue that has turned into a dilemma and it needs to be settled with a lot of research work and awareness. References 1. R. H. Ahmadi and R. Asthana, "Cost, Quality, and Access in the Health Care System" (January 1, 1999). Decisions, Operations, and Technology Management. Paper RA18. http://repositories.cdlib.org/anderson/dotm/RA18 2. C. Eugene Steuerle, Edward M. Gramlich, Hugh Heclo and Demetra Smith Nightingale, The Government We Deserve: Responsive Democracy and Changing Expectations (Washington, DC: The Urban Institute Press, 1998).  3. Uwe E. Reinhardt, "Employer-Based Health Insurance: R.I.P." in S.H. Altman, U.E. Reinhardt, editors, The Future U.S. Health Care System: Who Will Care For the Poor and Uninsured? (Ann Arbor, MI: Health Administration Press, 1997).  4. Cerminara, Kathy L.,Introduction: Health Care in the 21st Century: Cost, Quality, and Access in the New Millennium(November 20, 2008). Nova Law Review, Vol. 26, p. 397, 2001-2002; NSU Shepard Broad Law Center Research Paper No. 08-016. Available at SSRN: http://ssrn.com/abstract=1304652 5. McCain, J( 2008). Access to Quality and Affordable Health Care for Every American. Volume 359: 1537-1541. 6. Arnst, C. (2008). Road to Reform: Efforts Must Address Cost, Quality, Access. U.S. HEALTHCARE SYSTEM. Available at http://bx.businessweek.com/us-healthcare-system/road-to-reform-efforts-must-address-cost-quality-access/4663521419724893264-bc02c54db2c8ee08d27902c851fefc0e/ 7. (Durham, M. L. (1998). MENTAL HEALTH AND MANAGED CARE. Annual Review of Public Health Vol. 19: 493-505 (Volume publication date May 1998) (doi:10.1146/annurev.publhealth.19.1.493) Read More