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Unit 5 Discussion Board - Essay Example

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Answer: The Social Security Act of 1935, which marked the real beginning of cooperative federalism, established the principle of federal aid to the states for public health and welfare assistance. It also provided grants to the states for maternal and child health and crippled…
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Unit 5 Discussion Board
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Unit 5 Activity: The U.S. healthcare system is monitored, evaluated, assessed, and regulated. How familiar are you with some of the key concepts associated with regulation and assessment?
-Measuring what one purports to measure = Validity
Because validity is concerned with whether or not researchers are measuring what they claim to be measuring.
-Measuring consistently = Reliability
Because reliability is concerned with whether a measurement instrument measure the same way over time.
-Relates the volume and severity of existing illnesses = Comorbidity
Because comorbidity relates the volume and severity of existing illnesses
-Include information on the most appropriate treatment; the timing of treatment; and sequencing of treatment= Clinical Pathways
Clinical pathways sequence work to maximize the efficiency of the work flow; as such, they often include information about treatment appropriateness and timing.
-A means of providing organized medical knowledge to assist decisions about healthcare= Clinical Guidelines.
Clinical or practice guidelines are systematically developed statements to assist decisions about appropriate healthcare for specific condition.
You are continuing your training as a healthcare consultant. Your trainer, Dr. Wu, has scheduled a brief examination on the regulation and assessment of the U.S. Healthcare system.
Question 1: What is the significance of the Social Security Act of 1935 in regards to the U.S. healthcare system?
Answer: The Social Security Act of 1935, which marked the real beginning of cooperative federalism, established the principle of federal aid to the states for public health and welfare assistance. It also provided grants to the states for maternal and child health and crippled children’s programs. Most important, it established the Old Age, Survivors, and Disability Insurance programs that were to provide both the philosophical and fiscal basis for Medicare.
Question 2: What are the primary dimensions of policy making in healthcare in the U.S.? Answer: Public policy students have identified five dimensions of the policy process in U.S, healthcare: (1) the relationship of government to the Private sector; (2) the distribution of authority within the federal system; (3) pluralistic ideology as the basis of politics; (4) the relationship between policy formulation and administrative implementation; and (5) incrementalism as a strategy of reform.
Question 3: What are the cardinal principles of medical ethics?
Answer: There are several components that comprise medical ethics of which three are considered cardinal: (1) autonomy (the concern with privacy; individual liberty, freedom of choice, and self-control); beneficence (for example, doing no harm, promoting the welfare of others, and doing good); and (3) justice (for example, equality of opportunity, equity, and access, as well as equity of benefits).
Question 4: What attributes are desirable in clinical practice guidelines?
Answer: The following attributes are desirable in clinical practice guidelines: (1) the purpose should be clearly expressed; (2) the content should be frequently reviewed and updated; (3) they should be flexible enough to account for the nuances of clinical medicine; (4) they should be easy to follow; (5) they should be applicable across geography and settings; and (6) they should be demonstrably linked to positive patient outcomes
Are issues of ethical concern regulated and assessed adequately in the U.S.
healthcare system? Why or why not?:
In the USA ethical and human rights concerns are coming to the forefront
In a review of 585 hospitals in Great Britain in 1983, Donovon highlighting lack of pain assessments as healthcare professionals had not even enquired about patients’ pain. (Dr. Schofield. P., 2003). Pain relief today is viewed as a fundamental human right; in a landmark case in the United States, the court ruled $15 million in favour of the relatives of a man with prostrate cancer, who reportedly died in pain.
The medical professional should understand these sensitivities while managing pain in a multi-ethnic populace. The definition and reactions to pain are often affected by cultural background of patients (Needham.J, 2004). While nurses may not be deliberately opting to providing lowered care to any group, understanding ethnic biological differences to the pain stimulus is important.
Also ethnic origins and human rights are an essential part of medical ethics. Several studies have reported the ethnic differences in pain perception. Robert Edwards et al in a multicultural, comparative study found that African Americans had lower pain tolerance and reported greater pain disability when compared to the white population. The study suggested this could be due to the enhanced sensitivity to noxious stimuli for this group. Similarly Woodrow et al reported greater pain tolerance by the white population.
Similarly there are behavioural differences between ethnic groups when expressing pain. University of Michigan’s Programme for Multicultural Health has made a few observations.
Arabs express pain more freely in the presence of family members.
Many Japanese-Americans hold the belief that self-control manages pain better. This leaves them stoic and resistant to pain medication. (Univ. of Michigan, 2006)
The reasons may be attributed (the study says) to poor socio-economic conditions and the climate that is thought to exacerbate these conditions. The important conclusion in the study was that although the pain scores between Asians and Europeans were similar, Asians needed lesser analgesia. It may be due to better attitude towards pain among Asians. There was also a variation in the manner in which Asians expressed psychological distress due to pain. While Asians did have a psychological injury, they remain under-represented in psychological wards, as their primary care physicians are unable to discern this because of language barriers. Asians are found to express psychological pain through, “somatic-metaphors,” which is different from White Americans. Consequently their condition goes undiagnosed with standard tools used for assessments. It was also found that within the group Sikhs were found to be mentally resilient to pain compared to Hindus or Muslims.
Therefore human rights and ethical concerns such as pain relief are at the forefront of US Medical Ethics; hence resulting in the affirmative that the US medical system does rely on Ethical Concerns whilst treating patients.
Needham.J. 2004. Issues relating to effective pain management in young people. Professional Nurse papers. 19: (7) March 01.
Dr. Schofield. P. (2003). Pain assessment: How far have we come in listening to our patients? Professional Nurse Papers. 18(5) January 01 Read More
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