Health Care Delivery System at St Lukes Medical Center - Essay Example

Running Head: Health Care Delivery Systems Health Care Delivery System at St. Luke’s Medical Center: A Review in Perspectives This essay is written with the objective of describing the current health care delivery structure at St. Luke’s Medical Center in Phoenix, Arizona. The health care delivery structure would be compared with that of Phoenix VA Health Care System. In addition, the profile of the impact of licensing and regulatory factors on health care delivery at St. Luke’s would be determined. The changes that are occurring in the economy or with regards to licensing and regulatory factors that need to be considered in the future would likewise be assessed. Further, a discourse on the national trends that are affecting competition and pricing initiatives would be evaluated. Finally, the kind of quality indicators affecting pricing at the local level would be proffered. Introduction The health care in the United States are administered by private health institutions. There are no public hospitals owned by the government. However, the delivery of health care are funded by several public components or programs such as Medicare (covering the elderly and the disabled with previous employment records), the Medicaid (a social welfare program for low income groups), and the Veterans Health Administration program (catering to military veterans of the United States), among others. The health care system of America seeks reform utilizing the present administrations measures focusing on the universal health care plan. In the meantime, health care organizations have their own systems of delivering health care depending on their organizational structure and the profile of patients seeking health care. This essay is written with the objective of describing the current health care delivery structure at St. Luke’s Medical Center in Phoenix, Arizona. The health care delivery structure would be compared with that of Phoenix VA Health Care System. In addition, the profile of the impact of licensing and regulatory factors on health care delivery at St. Luke’s would be determined. The changes that are occurring in the economy or with regards to licensing and regulatory factors that need to be considered in the future would likewise be assessed. Further, a discourse on the national trends that are affecting competition and pricing initiatives would be evaluated. Finally, the kind of quality indicators affecting pricing at the local level would be proffered. Health Care Delivery at St. Luke’s Medical Center St. Luke’s Medical Center is located in E. Van Buren Street, Phoenix, Arizona equipped with 235 beds and providing comprehensive healthcare services. By comprehensive, St. Luke’s deliver services which include emergency services, rehabilitation, cardiovascular care, surgical procedures, diagnostic and therapeutic services, orthopedic, and general medical care. It enlists 28 medical specialties ranging from bariatric surgery to urology (Iasis, 2009, 1). In addition, St. Luke’s accept a wide range of health plans totaling 57 including Medicare, Medicaid and Veterans Administration. It mission statement expressed their commitment to serve their wide range of clientele through the most advanced technology and systems in an emphasized compassionate manner. (St. Lukes, 2009, par. 1). It boasts of reporting critical information to the Centers for Medicare and Medicaid Services (CMS) on activities related to patient care. Patients who underwent recommended treatments and care for cardiovascular problems and surgical procedures reveal how St. Luke’s delivered the expected health services. (St. Lukes: Quality Care, 2009, par. 15) Health Care at Phoenix VA Health Care System Unlike St. Luke’s which provide comprehensive health services to a diverse range of clientele including patients, visitors, physicians, healthcare professionals, students, volunteers, Phoenix VA offers exclusive health services to US military Veterans, Veterans dependents, surviving spouse, child or parent of a deceased Veteran, and uniformed service member of the US military. (USDVA, 2009, par. 2) As a Veteran Health Administration System, it is known to provide services which range from general medical services to critical care, mental health, radiology, physical therapy and surgery, among others. For patients presenting their concerns for the delivery of health care services, Phoenix VA utilizes the Patient Advocacy Program which provides efficient customer service on a timely manner. Impact of Licensing Requirements and Regulatory Factors on Health Care Delivery Authors Pindus & Greiner (1997) averred that regulatory requirements are designed primarily for the protection and safety of the public’s health. As indicated these regulations have the effect of “establishing and maintaining professional identities and enabling different health professions to carve out exclusive domains. These "turf battles" have impeded reform and obscured issues more directly related to protection of the consumer.” (par. 14) In addition, it is eminent that diverse licensing bills and requirements between states created confusion in terms of uniformity in laws, language, regulations between standards of practice and mobility presenting hindrances in integrating the current delivery of health care. At St. Luke’s the sheer enormity of accepted health insurance plans pose dilemmas in tying reimbursement to particular professional groups. Professionals are faced with reimbursement issues undermine the priority of health care practitioners to focus on the delivery of required patient care vis-à-vis the stipulated terms on the patients’ respective health plans. There are issues that emerge regarding licensure requirements on new occupational groups and the flexibility accorded in the scope of practice. Increasing health practitioners’ scope of responsibility with the objective of cutting costs create questions of competency and qualifications to encompass additional tasks at the expense of ensuring efficient and effective delivery of patient care and access to information and health services. The key issues on expanding scope of responsibilities are “supervision, delegation and accountability.” (Pindus & Greiner, 1997, par.18) Economic Changes Contemporary changes in the economy necessitate a wider range of reforms in the delivery of health care. From among the most discussed concerns are “models for uniform terminology, standardizing entry to practice requirements across states, licensing of acts or skills rather than specific occupations, and institutional licensure.” (Pindus & Greiner, 1997, par. 113) The uniformity in licensing is a critical issue to minimize confusion between state standards in the delivery of health care. Uniform guidelines should be designed under the primary jurisdiction of occupational and professional licensing boards. This change is relevant to ensure an integrated system required for future applications of electronic business in health care, such as telemedicine, teleconferencing, accessibility and availability of patient information across state boarders, among others. National Trends National trends have the effect of altering economic tools due to a variety of factors. Licensing regulations, for example, designed to screen prospective health care practitioners who not satisfy the prescribed standards. Various studies have noted the use of licensing to regulate the supply of health care practitioners only for the economic benefit of a specified occupational group. (Shimberg, 1982, 1). As averred by Morrison & Carter, (1996, 674), increasing and restricting entry requirements beyond the prescribed minimum competency standards have the effect of increasing the cost of services and eventually, the income of licensed practitioners. Economists view licensure laws as state-enforced service monopolies that decrease competition, increase costs, and decrease access for the consumer, with the most restrictive licensure statutes contributing the most economic harm to the consumer (Finocchio et al., 1995, 135). Further, current trends in regulations affecting health occupations have expanded health care services which were previously exclusive to doctors and professionals. Professionals who delegate responsibilities such as prescribing medications need appropriate supervision and monitoring to ensure that the same high quality of health care services is being delivered. As emphasized, “under current delegation laws and interpretations, a practitioner may delegate tasks or services within his or her scope of practice to someone who would not otherwise be allowed by law to perform them. Practitioners who currently require delegation or supervision are attempting to gain more independent authority to perform services.” (Pindus & Greiner, 1997, par. 124) Quality Indicators According to Pindus & Greiner (1997, par. 57) there are three indicators which are commonly used in measuring the quality of care, to wit: structure, process of care, and outcomes or end results of care. There factors affect pricing strategies at the local level. Structural measures, for example, include factors such as staffing ratios, board certifications for professionals, and hospital accreditation to various health agencies (like JCAHO). Outcomes, on the other hand, determine the end results of interventions used to improve the status of health of the patients. Finally, process of care encompass required diagnostic and therapeutic examinations and approached needed to diagnose the health condition of patients. For private health care institutions, high quality health care is equated to high costs. The more sophisticated the equipment and technology used to diagnose a patient’s health status or condition, the more the patient pays. The higher the educational attainment and expertise of the attending physician contracted by specific patients, the higher the professional fees charged. Pincus & Greiner noted that the cost of health care services are affected and increased by turf battles of professionals (1997, par. 73). They averred that these professionals tend to invest time and money to solicit support from legislative bodies to ensure a wider range in their specific scopes of practice. Professionals in the field of medicine, pharmacy and dentistry spend a considerable amount to defend their scopes of endeavors from threats of invasion. Conclusion The delivery of health care is affected by diverse factors including economic policies and laws and regulations created primarily to safeguard the public’s wellbeing. The discourse proffered a comparison of health care delivery systems between a private health organization and one run by the state. Various factors such as licensing, state regulations, national trends, economic changes, and quality indicators have profound effects on health care delivery systems. The public should therefore be more vigilant in determining how these factors affect the quality and efficiency of health care services they expect from their respective health providers. References Finocchio, L. J., C.M. Dower, T. McMahon, C.M. Gragnola and the Taskforce on Health Care Workforce Regulation. December 1995. Reforming Health Care Workforce Regulation: Policy Considerations for the 21st Century. San Francisco, CA: Pew Health Professions Commission. Iasis Healthcare. (2009). St. Luke’s Medical Center. Retrieved 04 Feb. 2010. Morrison, R.D. & Carter, E.A. (1994). "Licensure, Certification, and Registration," in Encyclopedia of Educational Research, Sixth Edition. New York: Macmillan Publishing Company. Pindus, N.M. & Greiner, A. (1997). The Effects of Health Care Industry Changes on Health Care Workers and Quality of Patient Care: Summary of Literature and Research. Urban Institute. Retrieved 04 Feb. 2010. < http://www.urban.org/publications/407308.html> Shimberg, B. (1982). Occupational Licensing: A Public Perspective. Princeton, NJ: Educational Testing Service. St. Luke’s Medical Center. (2009). Mission and Values. Retrieved 04 Feb. 2010. < http://www.stlukesmedcenter.com/about/mission/> ______________________. (2009). Quality Care. Retrieved 04 Feb. 2010. < http://www.stlukesmedcenter.com/about/quality/> U.S. Department of Veterans Affairs. (2009). New to VA. Retrieved 04 Feb. 2010. < http://www1.va.gov/opa/newtova.asp> Read More