Health Policy and Planning in Manuka - Coursework Example

Health policy and planning in Manuka Name Subject Instructor Institution Date Executive summary This report elucidates the inspiration from the demand for the health services that has promoted the emergence of the Manuka health region. This prompted the community to be very vocal especially during the last Federal Election. They insisted on improved and broader access to health care services. With the incoming of Prime Minister Gillard to power, health care department have tremendously improved. He promised various election commitments for the region. He was particularly committed to constructing of the highway to connect Sea bridge with Woodside. Other contributions that have been put in place include; the funding for the implementation of fibre optic broadband network in the support of improving the accessibility to the rural communities. Other funding was done in the major capital works that were associated with health facilities in an effort to meet the demands of the communities growing. Sceptics in the community consider this ineffective due to formerly unfulfilled promises by the Gillard’s Government. For the capital works to be efficient, a team of departmental capital works was selected to ensure complete consideration of the local issues in the planning. Those who were selected hold prominent position in Worksville Hospital in the region. Equity enhances access to the facilities provided. Table of Contents Executive summary..............................................................................................................2 Table of Contents 3 1Introduction 4 1.1Significance of the report 4 1.2Sources of information 5 1.3Scope of the report 5 2Geographical size and main centers 5 2.1Area 6 2.1.1District one 6 2.1.2District two 6 3Internal factors 7 3.1Hospital patients’ separations 7 3.2Occupied bed trays 8 3.3Hospital occupancy levels 8 3.4Aged care facilities 9 4External factors 9 4.1Transport 9 4.2Employment 9 4.3 Demography: Population 10 4.3.1 District one population 10 5 Future requirements for 2012 13 5.1Standards 13 5.2Methodology 14 5.3Occupancy rates 14 5.4Hospital Projection 15 5.5Aged care 16 5.6Occupancy rate for a hospital: 18 5.7For the aged care facilities 21 6Conclusion 22 7Recommendations 22 1Introduction Health care service planning is aimed at ensuring that, current and future health services provided are in alignment and, their expansion is based on population needs that change with time and resources as noted by (Harrison, 2010). This report elaborates on the need for proper planning in improvement of the health care facilities, information which is vital in government planning. Mark, Pencheon & Elliott (2000) discerns that, accessibility for the entire population is vital in ensuring equitable distribution of resources regardless of cultural geographical locations and service acceptability. According to (Donati, 2005), accessibility enhances the extent to which professionals in health care conforms to the standards that are pre-set. 1.1Significance of the report This report is aimed at giving a situational analysis of Manuka health region in Queensland, directed to the state minister for health. This report elaborates on the need for proper planning in improvement of the health care facilities, information which is vital in government planning. 1.2Sources of information Information presented herein is obtained from population statistics for the years and from the hospital records. The census is usually done after every five years and as a result, having the five year interval and starting from the year 1996, the last population statistics analyzed is in the year 2026. This information provides information on age and age category. Information on employment statistics based on census report, facilitated information availability on the purchasing power of various people that translates into the ability of accessibility to health facilities. 1.3Scope of the report This report concentrates on situational analysis. The various data available is analyzed to give an impression of hospital patients’ separation, occupied bed, hospital occupancy levels, and community and age care facilities from the two Districts. It includes Worksville, Seabridge and Woodside. Also, analysis on age care was based on data from private nursing homes, hostel places and from community care centers. 2Geographical size and main centers Manuka health region is located on coast in the subtropical section. The distance is about 500km from capital city, Brisvegas, with a highway running through the Western Corner and connecting state capital of Brisvegas and regional Workside town. 2.1Area This area covers 1,200 sq. kilometers. It extends northwards towards Worksville town and southwards towards the Woodside town. To the southern Workside is Sunkist community and to the west is the dense mountain range. This region is composed of two districts. 2.1.1District one The first district is located north of Manuka Health Region and the main economic activity practiced is tourism. The major town is Worksville, and is about 5km from the chief highway which runs across the state. There are two hospitals in this area; Worksville Regional hospital and Seabridge Cottage Hospital located near the coastline, at about 20Km to East of the Worksville Regional Hospital. A community health centre is situated within the site of Worksville regional hospital which connects the two districts. Sunkist is situated at about 20km to the south of Seabridge. Ambulance service operates from about 5kilometres west of the Seabridge region and on the major roads that connects the region. The distance between Worksville and Woodside is 104 kilometers. The road connecting Sunkist and Pleasantville is relatively poor and adversely affected by bad weather. The area has a population of approximately 318,525. 2.1.2District two The second district lies to the south of the region. The main economic activity is fishing, agriculture and forestry. This district has one hospital located in Woodsville town; Woodside General Hospital. Pleasantville community health centre is 12kms to the North of Woodsville. Local ambulance service in this District is staffed locally by volunteer and, is situated between the two health facilities. From the recent population projection, this district has a population of 79,704. A map representing Manuka Health Region 3Internal factors 3.1Hospital patients’ separations This is the analysis of Major diagnostic categories by age group and separation as presented by various diseases and disorders, and corresponding diagnostic categories in medical, surgical and obstetric, for the age groups: 0-14, 15-64 and 65years and above. Medical and surgical disorders are diagnosed in the two categories of 0-14 and 65 and above years, while obstetric is diagnosed for the age 15-64; for pregnancy newborns, childbirth and puerperium, with child birth and pregnancy being the highest. Some diagnostic categories are more prevalent to a certain age group than in the other. 3.2Occupied bed trays On occupied bed day’s analysis, the elderly in the capacity of medical diagnosis occupy most of the bed days. This is especially in the diseases and disorders of the circulatory system, and also the respiratory disorders. Surgical category diagnosis reflects that the age group 15-65 has the highest data recorded. The disorders of reproductive system, especially to female’s surgical category record the highest number of cases. It is very clear from the data that susceptibility to certain disease increase with advancement in age. Example is the musculoskeletal system and connective tissue disorders. Comparison of the disorders on hospital OBDs data on basis of sex reveal that female are less vulnerable during tender age than, their male counterparts and at middle age, the reverse is true, and at old age, male record high values of OBDs than female. Mental disorders are more prevalent among the middle aged population rand least among the infants. Overall analysis reflects high cases of OBDs medical category being higher than the surgical cases, with the middle aged population recording the greater number of surgical disorders. 3.3Hospital occupancy levels In hospital occupancy configurations, the analysis is done in the three hospitals in the capacity of medical, surgical, obstetric, neonate and Intensive care. In bed configuration, Worksville records the highest configuration and Woodside has the lowest bed configuration. Out of the recorded 338 configurations, medical category has the highest bed configuration with the intensive care category recording the lowest, which is zero for the Seabridge hospital In hospital separations, Worksville hospital records the highest separations in all categories of medical, surgical, obstetric, Neonate and intensive care. 3.4Aged care facilities The aged care facilities include nursing homes, hostel places and community care services. District one has more facilities than district two. Hostel places are the major facilities from both districts. 4External factors 4.1Transport Most males are involved in transport and storage than females from the two districts, but more men are involved in transport in district one than in district two. There is a major highway running from the Western corner of the region and connects the state capital; Brisvegas, and the Workside town. A major road links Sunkist and Seabridge towns. The road connecting Workville and Woodside through the mountain range between the Sunkist and Pleasantville is poor and impassable during bad weather; most appropriate for 4wd vehicles. The projects underway include highway construction that connects Seabridge and woodhouse. There is also the policy of connecting the rural communities through the implementation of fibre optic broadband network. 4.2Employment The main economic activities carried out in Manuka region are trade, construction, education and health and community services. Women play a significant role as far as employment is concerned. They perform tasks that are equally performed by men, and some are even more competent than men. This is reflected by the high percentages of women involvement. Despite of some economic activities done by both men and women, some of the activities are solely done by men. The mining population have relatively higher income when compared to the rest of the population, with district two having high rate of mining than district one. This translates into overall average income being lower when compared to state average value. Unemployment rate supersedes national average with 7.4% among females and 11.3% males. Data by (Houston & Lisa, 2007) shows that, trends in unemployment rates for the past five years are disturbing; with a greater percentage in people between the ages of 14 and 25, and males are the most affected. Some of the social factors are speculated to be the probable reason for the increased drug and alcohol abuse. 4.3 Demography: Population From the population projection data, the total population increases gradually. 4.3.1 District one population The adults form the highest percentage, followed by the aged and thereafter the children. The Adult population also records the highest growth rate in district one. The children are the minority and also record the lowest growth rate. The values on growth rate indicate high infant mortality rate, or else family planning methods intensely applied in this district. This is because of the low growth rate Table1. Population of district 1 District One   Age 2006 2026 Growth rate (%) 0-14 39,744 63,664 13% 15-65 116,643 226,147 18% 65 and over 16,416 28,714 15% Total 172,803 318,525 16% Table1. Population of district 2 District Two       Age 2006 2026 Growth rate (%) 0-14 8,978 77,541 11% 15-65 28,398 272,451 13% 65 and over 3,962 48,237 49% Total 41,338 398,229 16% From the projection of district two, most of the population is composed of the adults. The old people are second, and finally is the children, whose growth rate is also small. The aged have the highest growth rate in district two. In comparison of the two districts, district one record a higher population than district two. Furthermore, district two has a very high growth rate for the older population and a smaller growth rate for the younger population, but district one records the highest population growth rate amongst the adults and a low population for the adults. This depict that the mortality rate for district one is very high and life expectancy in district two is higher than in district one. Generally, the growth rate differs depending on the geographical location. District two shows a very high growth rate for the aged population while in district one, the adult population have the highest growth rate. The fact that the growth rate is increasing in all cases; it is a clear indication of a positive development. Despite of the differences in the growth rates for the different age groups, the overall rate of growth from the two districts is the same; 16%. Table 3 Comparing with the overall population growth rate, Age 2021 2026 Growth rate (%) 0-14 69,037 77,541 12.31803236 15-65 232,627 272,451 17.11925099 65 and over 38,070 48,237 26.70606777 Total 339,734 398,229 17.21788223 Age 2006 2026 Growth rate (%) 0-14 48,722 77,541 59.14987 15-65 145,041 272,451 87.84413 65 and over 20,378 48,237 136.7112 Total 214,141 398,229 85.96579 The projections above show significance in those age 65 years and above. They will be more than double136%, and they will be 26% compared to the present 9.5%. The overall growth rate is 85.96579%. This is an increase from 17.217%. The adult population will increase by a higher percentage than the children. The expected value will be 136.7112% of the present value, which is 17.199%. Table 4 population growth rate at interval of five years Total Population Age 2006 2011 2016 2021 2026 Growth rate (%) 0-4 14,983 16,829 18,903 21,231 23,846 12.3206 05-09 16,745 18,808 21,125 23,728 26,650 12.3201 10-14 16,994 19,087 21,438 24,078 27,045 12.3161 15-19 14,023 16,415 19,211 22,493 26,344 17.0577 20-24 12,945 15,148 17,732 20,762 24,318 17.0182 25-29 13,924 16,294 19,073 22,332 26,155 17.021 30-34 16,536 19,351 22,651 26,521 31,061 17.0235 35-39 18,469 21,613 25,299 29,622 34,693 17.0231 40-44 17,673 20,681 24,208 28,345 33,197 17.0203 45-49 16,410 19,203 22,478 26,319 30,825 17.0201 50-54 13,061 15,284 17,891 20,948 24,534 17.0201 55-59 11,370 13,305 15,574 18,236 21,357 17.0185 60-64 10,630 12,439 14,561 17,049 19,967 17.0179 65-69 6,684 8,128 10,006 12,486 15,821 21.6038 70-74 5,931 7,213 8,879 11,081 14,040 21.6152 75+ 7,763 9,441 11,621 14,503 18,376 21.6154 Total 214,141 249,239 290,650 339,734 398,229 16.3901 Generally, from the tables above, the population of the aged shows a significant increase. Despite of the old population forming the smallest percentage, their growth rate is even and very high. The overall growth rate 16.3901% is higher than the overall growth rate for the children 12.301%. This shows that the population for Manuka region is mostly composed of adults and the aged. 5 Future requirements for 2012 5.1Standards This is a crucial component in planning to enhance equity in delivery of services and, quality services are ensured. They include; the planning for efficiency in the occupancy levels, ensuring of the correct and enough aged care facilities, hospital beds number and enhance the appropriate health care facilities as noted by (Collyer & Kevin, 2001). The current service activity measures include public bed numbered, the occupied bed days, the occupancy levels and average time of stay in major diagnostic group and diagnostic related group 5.2Methodology Methodology contains general process description of concepts and theories related to a particular discipline in question. It clearly indicates step by step process in evaluation of a task. In this study, in order to achieve a better planning, various methods were used to predict on the values of hospitals, occupancy rates, community and aged care. Interviews and questionnaires were used to collect data that were used in the analysis. In the projection of hospital demand for the current practices facilitates prediction for future planning. In calculations, there is an assumption of steady state that is employed as noted by (Donati, 2005). The clinical practices are taken to be the same. We also assume constant insurance health. 5.3Occupancy rates This is the number of beds occupied in comparison with the beds available, and calculation is done at a specified interval. The rate of occupancy is crucial in future planning of the hospital. A higher occupancy rate ensures proper utilization of resources. Nonetheless, the occupancy rate that is too high results to difficulty in management of the beds. In projection of future demand, these methods will require knowledge in beds per 100,000 populations for the different age groups and for the different bed types; medical, surgical and obstetric. The population is divided pediatrics, adult and aged. Number of beds occupied divided by the available beds, multiply by 100 give the percentage occupancy. 5.4Hospital Projection In projection of the hospital demand, the current services and health care standards need to be known. The current 100000 population for the various age groups should be known. The current annual occupied bed days in 100000 0f the population is 6164 for medical and 21.3 for surgical. The population projection for the children is 77541, therefore, number of annual medical beds that are required is No of annual surgical beds will thus be In calculation of surgical beds required annually are calculated the same way to give out the values that are used in planning. Table 5 Table of annual beds 0-14 15-64 65+ Medical Surgical   Medical Surgical Obstetric   Medical Surgical total 4,780 1,260   91707 28234 27463   20805 4331 178,580 Therefore the total number of annual beds required in 2012 is 178,580; the medical section will require the highest number of bed while the surgical will require the lowest number of beds. 5.5Aged care The aged care facilities are vital during the planning process for the future as asserted by (Harrison, 2010). Low level aged care facilities translate into beds in hospitals acting in the capacity of beds from nursing homes. This is expensive and limits the ability of hospitals offering acute services. Australia uses some policies in numbering the high care places or nursing home beds, low care places or hostel bed types and community care packages. These standards are expressed as: number of places for every 1000 population who are 70 years and over, standards facilitates the calculation of the number of beds that are required. From the data from tables, if the population that is 70 and over years is 20,000, then the standard rates are 20 high cares are for those 70 and over years. 15 for the low care places In calculation, The high care is For low care, the result is In our case, the population with 70 years and above is 249, 239. Using the policies below 35 High cares per 1,000 populations 50 Low care 1,000 populations 60 Community Care Table 6 The total number of places required Table 7a separations Number of places Total population (70+) 249, 239 High care Low care Community care When considering the separations, we have Table 7b Separations   Medical Surgical Obstetric Neonate Intensive Care Total Worksville Regional Hospital 9,202 3,640 2,022 317 21 15,202 Seabridge Cottage Hospital 3,067 1,213 674 106 - 5,060 Woodside General Hospital 2,968 1,176 657 103 8 4,911 Total 15,237 6,030 3,353 525 29 25,174 More intensive care units are recommended, especially for the Seabridge cottage hospital. In future, the ministry of health should check on the equitable distribution of facilities in all districts. Worksville Regional hospital has the largest number of health care institutions. Table 8 Indicates occupied beds Occupied Bed Days   Medical Surgical Obstetric Neonate Intensive Care Nursing Home Type Patients Total Worksville Regional Hospital 35,522 9,583 6,694 2,124 2,144 3,208 59,275 Seabridge Cottage Hospital 12,198 3,552 2,231 708 - 2,138 20,828 Woodside General Hospital 11,469 3,092 2,173 690 704 1,378 19,506 Total 59,189 16,227 11,099 3,522 2,848 6,724 99,609 Hospital occupancy level the number of beds occupied in comparison to beds available. They are calculated over a certain time period, and are expressed in terms of number of the beds that are occupied to the number or beds available. Aged care facilities are crucial in planning services. Decline in Aged care facilities translates into hospitals being used in capacity of nursing homes. This is quite expensive and limits the hospitals in administration of acute services. Planning for the future of hospital services is critical to ensure appropriate services are available for future planning is therefore critical in organization of the community resources and also facilitate planning for the staff requirement. 5.6Occupancy rate for a hospital: Taking example of the data from the table 5 above, the corresponding occupancy levels are as indicated in table 9 below. Table 9 Indicating occupancy rate for a hospital Occupancy levels with current bed configuration Medical Surgical Obstetric Neonate Intensive Care Total Worksville Regional Hospital 90.50% 54.70% 50.90% 58.20% 97.90% 73.20% Seabridge Cottage Hospital 97.90% 98.50% 76.40% 97.00% 0.00% 95.10% Woodside General Hospital 99.70% 98.00% 74.40% 94.50% 96.40% 95.40% Total 93.70% 66.40% 58.50% 68.90% 97.50% 80.70% Calculating the number of beds required with occupancy rate specified above, Occupied Bed Days   Medical Surgical Obstetric Neonate Intensive Care Nursing Home Type Patients Total Worksville Regional Hospital 39,251 17,520 13,152 3,650 2,190 3,276 79,038 Seabridge Cottage Hospital 12,460 3,606 2,921 730 - 2,249 21,965 Woodside General Hospital 11,503 3,155 2,921 730 730 1,444 20,484 Total 63,214 24,281 18,994 5,110 2,920 6,969 121,487  The total number of beds required in 100,000 of the population is 121, 487 The number of beds required is considered to be 100% when compared to the occupied bed days. Having the value for the occupied bed days and the rate of occupancy, then the total number of beds required is gotten. Rate of population growth is expressed as: 5.7For the aged care facilities Aged care facilities Expected aged care facilities District One District Two district one district two   Sunkist Nursing Home Pleasantville Community Centre Nursing Home 150 - 197 0 Hostel places 180 - 236 0 Community Care Packages 70 50 111 71   Private Nursing Home Private Nursing Home Nursing Home 210 120 286 150 Hostel places 250 150 358 189  Total     1187 410 For future; 2012, the aged care facilities are required to in Pleasantville community centre for nursing homes and hostel places. 6Conclusion Planning for future hospital services is vital in ensuring availability of the services to the community. It takes into consideration the resources that are available within the community. Employment is a major factor when consideration the health of a region. Planning for the future is thus enhanced through careful planning. Age group is a significant determinant when the health of a particular area is considered. The disorders differ depending on age and to some extent, sex. From both the hospital separation data and OBDS, very many cases related to reproduction are recorded for the female population. This is especially during pregnancies and child birth. As a result of this separation, the OBDs data in turn reflects high number of the female reproductive disorders. Age plays a major role as far as population is considered. Generally, susceptibility increase or sometimes decrease with age. Some disorders are more prevalent to the younger population; others are more susceptible during the middle age and some at old age. When the data on hospital configuration is considered, Worksville Regional hospital records the highest number of cases and consequently, it has the lowest occupancy levels with current bed configuration. Seabridge cottage hospital handles no Intensive care. 7Recommendations It is recommended that, the roads should be all weather, especially those that connect to the health care facilities in the southern. The road connecting the two districts through the mountain range that is between Sunkist and Pleasantville is relatively poor. The government should allocate funds during budget planning for infrastructure development. This will facilitate in time accessibility of the population to the health facilities. Many residents within the Manuka area have lost confidence in their government. The government should ensure it fulfills its promises to the people. The community care facilities in the southern region are poorly established and organizational and government should organize for the improvement of the facilities. This will tremendously reduce the conversion of hospitals into nursing homes. The configuration in various fields reflects underdevelopment of the district two. Though the population is smaller, health care facilities are minimal; hence the ministry of health should look into it. Many reproductive complications presented in this report indicate that females are the most adversely affected. I propose that the ministry should try and construct special hospitals for women like maternity. Special programmes should be implemented on guidance and counseling to reduce instances of mental health, which is more prevalent amongst the adults. References Block, J. (2006). Healthcare outcomes management: Strategies for planning and evaluation. Sudbury, MA: Jones and Bartlett. Collyer, F & Kevin, W. (2001). Corporate control of healthcare in Australia. [Canberra]: Australia Institute. Donati, S. (2005). Evaluation of the 2001 Nursing in general practice initiative: Final report. Adelaide: Healthcare Management Advisors. Gapenski, C. (2008). Healthcare finance: An introduction to accounting and financial management. Chicago: Health Administration. 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