Health Politics, Policy and Planning

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Why is ageing not the main explanation for rising health care costs in Australia?

According to the Australian Bureau of Statistics (2012), the current population of Australia stands at over 23 million people. These figures make Australia the 52^nd most populated country in the world. The average age of the Australian population is about 75 years, showing that Australia is mainly made up of the aged population. However, these figures do not indicate ageing as the main explanation for the rising health care cost in the country.

In Australia, ageing is not a problem, especially because the government has put in place a health planning policy that would ensure proper health care for everyone in the country. For example, the government has developed programs to assist parents in bringing up their children.

The aged Australian citizens are accorded with a good life quality through programs that are aimed at ensuring that they remain healthy at all times. Therefore, the ability of the elderly population to adopt a healthy lifestyle and the policy of the country to promote better quality life (including prevention of diseases) have prolonged life expectancy age in the country (Australian Bureau of Statistics, 2012).

Explain the difference between a regulatory and self-regulatory policy with an example of each

The self-regulatory policy is a kind of policy where a company passes its own regulation of safety standards as well as both legal and ethical standards with its workers or volunteers. Such regulatory policy does not include outsiders in the company’s regulation. Here, the organisation adheres to and enforces its own rules. Some examples of a self-regulatory policy are the United States Environmental Protection Agency’s Audit, the Federal Aviation Administration (FAA), and the American Bar Association (ABA). They formulate model ethical codes related to the legal profession (McKenzie & Smeltzer, 1997).

On the other hand, regulatory policies are rules or principles that target the behaviour of individuals or industry. For example, the Occupational Safety and Health Act (OHSA) outlines the need for regulatory policy. These policies guide the rationale used to achieve certain outcomes; for instance, the Health Insurance Policy (Eager et al., 2001).

Outline the differences between political and economic perspectives on health policy

Political health policy is a perspective health policy that seeks to understand the conditions shaping population health and development of the health services within the area of the political context. This perspective shows that the growth in the health sector is due to effective political ideologies, which later lead to an increased number of health resources. This, in turn, guarantees improved living conditions and better health services. Therefore, political conditions should be considered while dealing with health issues in general. The roles in health politics cover the following aspects: formulation and implementation decisions must be made in consultation with people in grassroots, and medical practitioners act as representatives of households in decision making.

On the other hand, the economic health policy requires the analysis and consideration of the economic growth rate as well as implementing and evaluating health frameworks and other principles dealing with the health care matters (Hupalo & Herden, 1999). The economic factor of the health policy involves making it financially viable for people to access health facilities, in addition to making sure that health resources are available at affordable rates. Thus, the formulation of the policy takes into account the economic status of consumers who benefit from the policy.

Define the following health performance terms: separation, SSR, outflows, ALOS, RSI

Generally, separation concerns removing patients from a hospital’s current records due to either their referring or moving to another hospital or because they are deceased. However, discharge and new admission records are no used. The standard tables record details of the patient, including age, sex, days hospitalised, the place of initial diagnosis, and the procedure and diagnosis performed. Determining the separation rate always factors these details, which is normally compared to the Standard Separation Rate (SSR) for efficiency (Bradshaw, 1972).

ALOS is the average length of stay in a hospital for each episode of care that is used as a cost indicator. It is calculated by taking the total number of the occupied days divided by the number of patients treated in that period, usually a year. Relative Stay Index (RSI), on the other hand, is determined by factoring age, sex, ALOS, diagnosis, the mode of separation and hospital type. It is normally produced on a half-yearly basis. This index is utilised for comparative hospital performance, showing ALOS by a clinical group whether above or below the state average. The adjustments are usually made daily.

Explain why there are never enough health resources to meet demand

Health resources cannot be enough to meet the demand, mainly because people become sick every day and the population that requires health resources is growing daily. Due to the high population of people seeking health services, demand is always higher than supply in the provision of health services. As a result, resources need to meet the health requirements of the constantly growing population. In most cases, the required health resources are very expensive, thus becoming unaffordable to many people. Consequently, there will always be people in need of health services, who cannot access them adequately.

Moreover, health resources are very limited in number. In other words, demand always exceeds supply. Lastly, due to complications that occur in the health care sector frequently, it is very hard for health resources to cover the needs. Indeed, innovation and creativity are required to ensure there are adequate health resources. Shortage of experts in the field of innovation complicates the operation in terms of the resource provision and utilisation of the available resources. Therefore, it would be very difficult to provide enough health resources to satisfy current demand (Bradshaw, 1972).

Describe the three essential components to a needs analysis with examples of each component for aged care

A need analysis performs the following functions:

Shows the gap between what is and ought to be;
Guides service development;
Is an essential starting point in the planning cycle;
Is perceived as difficult and helps if the time is limited;
Helps with a selection of interventions; and
Often, funding is limited, which affects the scope and thoroughness of the needs analysis (Reeves, 1989).

The three essential components of the needs analysis include published information, for example, the size of population and information concerning the health records. Another important component of the needs analysis is the literature covering articles from journals and other literary texts. Lastly, consultation involves seeking more direction from experts and specialists in the local area.

Primarily, these three components allow identification of the trends and ideas about what works for the health issue of interest. They also generate efficient ideas for implementation. Using locally generated ideas helps in gaining commitment and support for what may be applied. It also gives local providers the opportunity to evaluate what they are doing and investigate better ways of their performance. All this information is brought together for discussion purposes at a public forum (Green & Kreuter, 1991).

Explain the difference between felt and normative needs and give an example where each would be used in planning to prevent tailgating

Felt needs to express people’s wishes that they mention while filling out surveys, attending public meetings and submissions. An example of such needs can be outlined as a situation when a person prefers certain forms of solution for an exam or petitioning for a dental service. In addition, they may involve sampling of representativeness of a problem, as well as an inadequate measure of needs of an individual (Bradshaw, 1972).

On the other hand, normative needs are based on the value and are described by an expert opinion. These may include different views, which can change depending on time (Bradshaw, 1972). All these needs are conditional, changeable, and political. In addition, they are covered by a good needs analysis as follows:

Target state minus actual state = need;
Ideal minus actual = goal discrepancy;
Normal minus actual = social discrepancy;
Minimal minus actual = essential discrepancy;
Desired minus actual = want;
I am expected minus actual = expected discrepancy.

Therefore, subtraction of an actual from each item shown above leads to another result depending on the perspective taken and the level of rationality.

Explain the differences between goals, objectives and strategies as used for health services as explained in the lectures. Write a goal and three objectives with respect to prostate cancer

According to Reeves and Coile (1989), goals are expressions of the desired conditions of health status and health systems expressed as quantifiable, timeless aspirations. Generally, goals provide the basis for planning by focusing directly on a health issue of concern. However, they are unconstrained by the present planning horizon (Reeves & Coile, 1989).

From a different perspective, objectives are the specific and quantifiable goals of a health service provider. They should be realistic, attainable, and measurable. In addition, objectives should provide direction and the steps to be followed in achieving the stated goals. Moreover, objectives are to be prepared before strategies and materials are developed. Finally, they must be stated as an observable behaviour or performance (Bartol & Martin, 2010).

Lastly, strategies are the logical order of the actions and programmes that will be implemented to achieve the objectives listed. Strategies help identify some tasks to achieve the desired goals and objectives. Some strategies address one or more objectives (Reeves & Coile, 1989).

The three objectives of prostate cancer awareness include the following. First, the essence of awareness is to increase referrals to agencies that offer assistance on prostate cancer screening and treatment. Secondly, it helps improve knowledge about prostate cancer in the community. Lastly, it enhances rates of participation in prostate cancer healing and treatment (Reeves & Coile, 1989).

Explain the differences between process, impact, and outcome evaluation. Explain why outcome measures are important and provide three examples with respect to suicide attempters

The three levels of evaluation are process, impact, and outcome. The first one includes measures like: first, focus group information and literature review information are made available; program penetration and recall rates are determined; resources developed by relevant stakeholders and agreed upon; and lastly, consumer and provider satisfaction surveys with venue, time of sessions, approach adopted, and level of compliance with recommendations are confirmed (Bryson, 1999).

The second level of evaluation is called impact. Here, the achievement of predetermined objectives, the success of projects or programmes in terms of efficiency, and appropriateness are determined. They are set in advance and must be task-specific and on-going in order to permit comparison. Lastly, they are often used for accountability or setting standards of practice (McKenzie & Smeltzer, 1997).

The third and last process is called the outcome evaluation. Here, change in health is due to health service and intervention programme at individuals, groups, or the whole population. Outcome measures include health status, which is an assessment tool of mortality (SMRs) and morbidity; quality of life; disability; and survival rates from surgery and intervention (Bryson, 1999).

References

Australian Bureau of Statistics. (2012). Australian Bureau of Statistics. Web.

Bartol, K. & Martin, D. (2010). Management: A Pacific Rim Focus. Roseville, CA: McGraw-Hill.

Bradshaw, J. (1972). The concept of social need. New Society, 19: 199-205.

Bryson, J. M. (1999). Strategic Planning for Public and Non-Profit Organisations. San Francisco, CA: Jossey Bass Publishers.

Eager, K. Garret, P. & Lin, V. (2001). Health Planning: Australian Perspectives. Crow’s Nest, Australia: Allen and Unwin.

Green, L.W. & Kreuter, M.W. (1991). Health Promotion Planning: An Educational and Environmental Approach. Mountain View, CA: Mayfield Publishing.

Hupalo, P. & Herden, K. (1999). Healthy policy and inequality. Department of Health and Aged Care Occasional Papers: New Series No. 5. Web.

McKenzie, J.F. and Smeltzer, J.L. (1997). Planning, Implementing and Evaluating Health Promotion Programs: A Primer. Boston, MA: Allyn and Bacon.

Reeves, P.N. & Coile, R.C. (1989). Introduction to Health Planning. Arlington, VA: Information Resources Press.

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