Category: Healthcare

Executive summary

The purpose of this dissertation shall be to evaluate the impacts that organizational leadership and organizational management have in international healthcare. The undertaking shall focus on both the leadership and management techniques showcased by various healthcare organizations in regards to a list of documented medical phenomena. Some of the issues under investigation include but will not be limited to: organ trafficking, organ transfer, bioengineering and bioterrorism among others.

Data linking these issues to various management and leadership aspects shall be reviewed from relevant literatures and the ethical conundrums that may present themselves due to the existence of such issues within a given organization discussed. The steps that leaders should take to ensure that their organizations remain ethical and profitable in the competitive arena that is the medical sector shall also be highlighted.

The study will utilize the content analysis method of research to effectively provide answers to the following questions:

1. Identify and analyze current phenomena in the international healthcare theatre?
2. Why would internationals patronize U.S. healthcare facilities?
3. How would internationals’ serviced locally, benefit communities like Pittsburgh, PA?
4. What leadership strategies are needed to successfully lead such processes?
5. How can financial profit be maximized nationally through international healthcare?
6. With sensitive international healthcare agendas, e.g., organ transplants, what ethical conundrums will present?
7. How should these ethical conundrums be processed and addressed as a leader?

Data collected will at the end help in establishing the extent to which leadership and management in international healthcare has been successful in fulfilling its duty all the while providing quality and affordable services.

Introduction

Background of the Study

Health care is arguably one of the chief concerns of governments all over the world. All developed countries are characterized by having elaborate healthcare systems which are in place to ensure that majority of the population has access to medical care when they need it (Center for Bioethics, 2004). Inevitably, ensuring the health of a nation is a very expensive affair and this might be beyond the realms of most developing counties which are mostly burdened by the fundamental task of feeding and sheltering their people.

A question therefore arises as to whether the rich countries have a responsibility to help poor counties achieve better health. However, in the recent past, there has been a rapid emergence of various issues affecting the delivery of healthcare internationally. Healthcare critics argue that the leadership and management systems implemented by various health organizations determine the ethical and non ethical practices experienced in these organizations. To this end, it would be a worthwhile endeavor to delve into the various issues that have been raised and analyze how leaders can facilitate or mitigate their existence on the international scene.

Statement of the Problem

Majority of the population is greatly dissatisfied with the current healthcare system provided and the insurance schemes in particular. While an effective system can be deemed to be one which is efficient, acceptable and at the same time equitable, the current systems have been observed to be lacking in these attributes (Eastaugh, 2003). To this effect, the leadership and management of healthcare organizations have been under great criticism and pressure in regards to their policy on various issues affecting equitable and quality health provision.

Purpose statement

This research will aim at evaluating various issues that affect international healthcare. An overview of the Post Modern Healthcare will be provided and the various challenges being faced by healthcare providers globally given. An evaluation of the international healthcare markets will also be discussed.

Literature review

Post Modern Health care

As of today, most of the health care systems are characterized by being curative in nature. Zerwekh and Claborn (2006) asset that an ideal health care system should focus mainly on prevention, promotion of healthy living and the management of chronic ailments and disabilities. They describes the current population trend as one characterized by a large percentage of people over the age of 45 who are increasingly getting sicker more often than before.

Health care programs should focus on cost effectiveness and resource management to ensure that they meet the medical needs of the whole population. These programs require money for them to be implemented. As a result, consumers are forced to dig back into their pockets and pay for medical insurance covers which are very expensive. These bleak realities have contributed significantly to the high costs charged in healthcare organizations globally.

Similarly, the emergence of information technology has greatly improved the managerial and leadership capabilities of healthcare organizations today. Not only has IT improved the level of organization exhibited by the organizations, but it has also facilitated the speeding up of processes in the healthcare sector. The digitalization and off shoring of medical documents has further enabled patients to get the same quality of healthcare globally as they do in their host nations.

However, Schimpff (2007) states that the proposed $50 billion investment in digitalizing health-care records by American hospitals has raised tension since the completion of this program will inevitably affect the ability to win big contracts of various medical organizations. In addition, technology has also had some adverse effects on the healthcare sector. Bioterrorism (use of diseases to inflict fear among the population) has also been on the rise in various parts of the world leading to the deaths of millions of people.

International healthcare markets

Medical tourism

Reid (2009) gives a detailed analysis of the American healthcare systems. In his analysis, he highlights the various aspects that have led to the increased cost in receiving medical care in the United States. In his book, the Author proposes various recommendations that can be implemented in the ailing American healthcare system to ensure that it offers quality and affordable healthcare to all patients. The author refers to Germany, Canada and Japan as great examples of nations that offer great medical services to all and at a reasonable cost. He proposes that America should adopt some of the policies implemented by these nations in order to ensure that more people come to get medical care from the States.

In addition, Zarocostas (2009) considers how rising costs of health care in rich countries is driving patients to seek treatment in developing nations. The report entitled ‘The Rise in Medical Tourism’ estimates that the global market in medical tourism will increase from $US60 billion in 2006 to $100 billion in 2012” (p. 3). This rise is triggered not only by the expense of health care in developed countries, but also by emerging countries investing heavily into medical tourism. In 2008, 700,000 Americans travelled abroad and spent nearly $35 billion on medical procedures.

Organ markets

The acute shortage of available organs has led to a situation whereby majority of the people who need organ transplants failing or having to wait for long periods of times to get the organs. The United Network for Organ Sharing (UNOS) which maintains a real-time database of the status of people awaiting organs reveals that over 106,612 people are currently on the waiting list for organs in the USA. Bearing in mind that an average of20 people die each day while waiting for an organ, it is evident that the current sources for getting organs are inadequate (Center for Bioethics, 14)

The lack of a legitimate market for organs has resulted in the increased suffering of patients and escalation of hospital bills. Mclaughlin, Prusher and Downie (2004) note that due to the shortage in organs caused by a lack of a market oriented means for acquiring the organs, many patients have to bear with painful medical procedures such as dialysis as they await organs for an indefinite number of years.

Some patients end up dying as they wait and the medical expenses reach an excess of $50,000 per year. This is far more expensive than an organ would cost if there was a legitimate market. As such, a legally regulated market for organs would not only decrease the unnecessary suffering in patients thus improving the quality of their lives; but it would also result in less money being expended to cover the medical costs that people have to incur while they await transplanting.

Profitability

Schimpff (2007) seeks to explore how various institutions in the United Arab Emirate (UAE) have invested heavily in the healthcare sector. In his book, the author reveals how healthcare organizations can invest in other industries to make profits. He highlights how American hospitals make profits at the expense of their patients by overcharging them or providing low quality care.

However, Jones (2009) explores the impact of tightening credit markets and slowing investment on global healthcare projects with ties to U.S. partners. This shows the tremendous improvement and benefits that are bound to emanate in the U.S. healthcare sector. Such initiatives would ensure that the healthcare organizations remain profitable all the while providing quality and affordable services to the population.

Challenges of working in international health care

Multiculturalism

Due to globalization, people from various backgrounds have been forced to integrate in their search for better lives. This has resulted in the presence of communities characterized by a mix in cultures, norms and beliefs. However, individually, people have their perceptions regarding various issues. In regards to the hospitals, health care givers often face challenges regarding to language barriers, patient’s ability to read and write and differed perceptions in regards to medication and treatment procedures. However, Zerwekh and Claborn (2006) assert that all medical practitioners and healthcare providers should implement strategies to ensure that challenges emanating from multiculturalism are adequately addressed.

Black market organ trafficking

Reliance on human organ donations has proven to be unreliable but calls for commercialization so as to increase the demand have been refuted on mostly ethical and moral grounds. Due to the desperation that springs as a result of organ shortages, many wealthy people opt for buying the organs from the black market where priority is given to the highest bidder (Caplan, 2005).

Cleverly & Cameron (2006) report that some of these organs found in the black market are obtained through horrible means such as drugging unwilling victims and performing involuntary nephrectromy on them to obtain the desired organs. Reports of the illegal organ traders not paying the donors as promised are also rife thus highlighting the injustices that exist in an illegitimate and unregulated market.

Ethical considerations

As with most other professions, all healthcare practitioners are bound by rules and regulations that govern how they go about their duties. These rules and regulations are sometimes legally enforceable. Practitioners also face numerous ethical issues in the line of duty. While some of these ethical issues are resolved by following the set ethical standards and guidelines, others rely primarily on the practitioner’s principles and value system to be solved.

These values may sometimes not be in line with the legal obligations of the professional. Legal standards stipulate what is right or wrong according to the laws of the land whereas ethics are standards for professional behavior. Johnstone (2008) articulates that while ethical standards that hinge on personal beliefs and principles may suffice when caring for a loved one in a home setting, they may not be irrefutable when dealing with strangers in the work environment.

Leadership

In light of the above discussion, the international healthcare sector is in need of transformational leaders. At the present, most economies in the world are working towards recovering from the credit crunch that hit almost all countries in the world. It is a reasonable assumption that most organizations were forced to make changes that included cutting on costs or laying off employees so as to remain profitable.

In such times, there is need for a flame of optimism to be fanned in the organization. Bolden et al (2003) state that an optimistic nature is one of the defining behaviors associated with a transformational leader. A person who can enthusiastically talk about the needs of the organization and draw a compelling image of the bright future that all in the organization can look forward to is capable of making a difference in the organization.

Conclusion

This paper set out to investigate what effective leadership and management consists of in international healthcare settings. To this end, the paper has highlighted the issues that affect the global healthcare sector and how best they can be addressed. To this end, the relevance of good managerial and leadership skills have been presented. The information compiled in this proposal has been instrumental in determining and outlining the various issues that I am bound to face in my career. As such, I have learned of the various objectives that have to be prioritized and the challenges that have to be mitigated. Such knowledge will not only help me set my career objectives but will also facilitate my efficiency as a future leader and manager.

References

Bolden, R., Gosling, J., Marturano, A., & Dennison, P. (2003). A Review of Leadership Theory and Competency Frameworks. Web.

Caplan, A. (2005). The Trouble with Organ Trafficking. Web.

Center for Bioethics. (2004). Ethics of Organ Transplantation. Web.

Cleverly, W. O., & Cameron, A. E. (2006). Essentials of Health Care Finance. USA: Jones & Bartlett Publishers.

Eastaugh, S. R. (2003). Health Care Finance and Economics. CA: Jones & Bartlett Publishers.

Jones, R. (2004). Oxford textbook of primary medical care. London: Oxford University Press.

Johnstone, M. (2008). Questioning nursing ethics (ethics & legal). Australian Nursing Journal, 15, 19.

Mclaughlin A., Prusher, I., & Downie, A. (2004). What is a Kidney Worth? Web.

Reid, T. (2010). The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care. NY: Penguin Group.

Schimpff, S. (2007). The Future of Medicine: Megatrends in Health Care That Will Improve Your Quality of Life. CA: Thomas Nelson Inc.

Zerwekh, G. J., & Claborn, C. (2006). Nursing today: transition and trends. NY: Elsevier Health Sciences.

Zarocostas, J. (2009). Rising cost of care in rich countries is driving patients to seek treatment in developing nations. Web.

Research Area of Interest

The research area of interest is to find out the efficacy of antihyperglycemic drugs among patients with diabetes. Since the ability of the body to regulate blood glucose level is subject to the age of individuals, the study sought to find out if the efficacy of a novel antihyperglycemic drug varies across the ages of patients with diabetes. In this view, repeated measures ANOVA seeks to establish if pharmacokinetics and pharmacodynamics of the antihyperglycemic drug vary among the three groups of patients, namely, children between the ages of 6 and 17 years, young adults between the ages of 18 years and 30 years, and adults between the ages of 31 years and 42 years. The study assessed the efficacy of the antihyperglycemic drug using the level of blood glucose level (mg/dL). To obtain reliable findings, the study used 25 patients and measured their levels of blood glucose four times in six months. Before the intervention, two months after intervention, four months after intervention, and six months after the intervention are the four levels of measurements across the period.

Description of Variables

The two variables that are applicable in the analysis of repeated measures ANOVA are the level of glucose in blood across the intervention period of six months and the age of diabetic patients. The level of glucose in blood a dependent variable, which assesses the efficacy of the antihyperglycemic drug for six months. The scale of measurement of the blood glucose level is an interval scale. The blood glucose level is a repeating variable as patients. It measures diabetic patients four times: before the intervention, two months after intervention, four months after intervention, and six months after the intervention. Age of the patients is a categorical variable that gives three levels of measurement for the study, namely, children (between the ages of 6 and 17 years), young adults (between the ages of 18 and 30 years), and adults (between 31 and 42 years. The scale of measurement of the age of patients is nominal, and it is a fixed factor because it comprises the three levels of measurement.

The Assumption of Sphericity

On the SPSS output, one can check if the data violates the assumption of sphericity by looking at the significance value at the table of Mauchly’s Test of Sphericity. The analysis of the hypothetical data gives the above table, which indicates that Mauchly’s value is significant (p = 0.000). When the significance value of Mauchly’s test statistic is less than 0.05, it implies that the data violated the assumption of sphericity. According to Field (2013), violation of the assumption of sphericity invalidates multivariate outcomes in terms of F-statistic and increases the likelihood of the occurrence of type I error. Moreover, since the hypothetical data, three groups, post hoc analysis is appropriate. However, owing to the violation of the assumption of sphericity, the violation complicates multiple comparisons of blood glucose levels among diabetic patients of different ages. Overall, violation of the assumption of sphericity gives erroneous outcomes in multivariate analysis and complicates the interpretation of post hoc analysis.

References

Field, A. (2013). Discovering statistics using IBM SPSS Statistics. London: SAGE Publications.

Myatt, G. (2007). Making sense of data: A practical guide to exploratory data analysis and data mining. London: John Wiley & Sons.

Introduction- thesis statement

In most of the conversations that individuals have, one often does not listen fully to what the speaker addresses. In several instances, the listener often provides partial attention and usually focuses on other issues that may or may not be related t the subject. The listener often assumes to be familiar with the subject being addressed and pounds on the response he would give to the speaker.

Much information is often lost in this ‘partial’ listening process due to a misunderstanding. The speaker is also not motivated by the listener and is often reluctant to provide reliable information.

A therapist who provides less attention to a patient describing his or her condition is likely to make therapeutic measures. Thus, active listening is an important tool that helps therapists to provide the best therapy to their clients.

Active listening

Active listening is a situation in which the listener pays attention and responds to the speaker’s words so that both of them obtain a common understanding of the concept being addressed (Conflict Research Consortium, 1998, para.1).

It involves listening to the speaker and then provides a response on how the listener has perceived the speaker’s statements. The listener paraphrases the statements from the speaker to confirm if they were understood correctly. The listener shares the information with the speaker and should not make a prejudgment (Hoppe, 2007, p.6)

Active listening in a therapeutic setting

In the therapeutic setting, the therapist is required to listen to the victim as the victim narrates or expresses his feelings about a given concept. This will enable the therapist to understand more about a given victim. It has been noted that active listening has several advantages that the listener will enjoy and that makes the conversation fruitful.

Active listening is interactive and the attention of the listener is fully restricted to the speaker. The concepts that are unclear to the listener can be identified and the required clarifications given (Conflict Research Consortium, 1998, para.4). Besides, active listening encourages the speaker to reveal more information.

The attention that the listener also motivates the speaker who will then open up and reveal more information regarding a given subject (Conflict Research Consortium, 1998, para.4). A therapist will thus learn more from a victim if he gives full attention to the victim.

Active listening in work situations

Active listening is applicable in a work situation. The tasks that are to be performed in a given job require certain procedures to be followed. When an individual is being introduced to these procedures, it is necessary that he actively listens to the instructor in order to get the procedures right.

Failure to pay good attention will result into poor work and loss of employment. Active listening is also appropriate in solving disputes that may occur among the workers. Paying attention to the conflicting parties can enable one to resolve the dispute. The same applies to making a decision in a work environment that contains individuals with different views.

Results of personal active listening, strengths and areas for improvement

Active listening improves my ability to interact with more people. It helps in understanding the diversity that exists in the abilities of different people in expressing themselves. Active listening promotes group development (Rogers & Farson, 2007, p.1). By paying attention to every individual as he speaks, one gets to learn the ability of the individual in self-expression.

I am particularly best at providing equal attention to different individuals. I do not a prejudgment on the subject that an individual is to address even if there are previous relevant experiences of the same. The difficulty is in dealing with those who shy away if the listener provides full attention to them.

Personal communication changes to improve listening skills

Despite my ability to manage different individuals, there are certain weaknesses that may require an adjustment. The listener should be objective in responding to the speaker and should not provide an individual opinion in the response. My interpretations often contain own opinions that influence the speaker’s views.

An active listener should not seek to fulfill his needs from the process (Rogers & Farson, 2007, p.3). Besides, expressing a sympathetic feeling has often barred my clients from providing more information as they are deeply upset.

Conclusion

Active listening is an essential tool obtaining reliable information in a conversation. A therapist should provide full attention to a patient and should not assume the speaker’s words perhaps based on his experiences with other patients.

It should be noted that the more a therapist provides attention while listening to a patient, the more the patient will be willing to provide information regarding his or her conditions. The appropriate therapeutic procedures will then be adopted by the therapist to the advantage of both of them.

References

Conflict Research Consortium, (1998). Active Listening: International Online Training Program on Intractable Conflict. Web.

Hoppe, M. (2007). Active Listening: Improve Your Ability to Listen and Lead. Greensboro: Center for Creative Leadership

Rogers, C. and Farson, R. (2007). Active listening. Gordon Training International. Web.

Introduction

Healthcare systems are bodies mandated to deliver medical services with a view of curbing diseases. The US government has strived to establish more health programs to promote the well-being of the ever-increasing population in the Chicago City. This essay provides an insight into the healthcare systems of the city by analyzing various needs of the people, policies, facility overviews, roles, and structures.

Major Healthcare Needs of Chicago City

The healthcare needs of the Chicago City are determined by analyzing various factors that include accessibility, cost of services, and sources of funding healthcare in both private and public facilities. Healthcare insurance is an aspect that is prioritized in the city.

Accessibility of Health

Authorities at the Chicago City are striving to improve the availability of healthcare services for its residents. This situation is ensured through the provision of quality and comprehensive healthcare, including primary care services (Fossett et al., 1992). The number of uninsured and underinsured people has been increasing regardless of the growth of many insurance firms in the city. Therefore, there is a need to encourage people to enroll in health insurance in an attempt to reduce costs that are incurred in hospitals. This situation will increase accessibility of healthcare to many citizens who dwell in the city (Luo & Wang, 2003).

Costs of Healthcare in Chicago City

Hartman, Martin, Nuccio, and Catlin (2010) reveal that the overall cost of healthcare services in Chicago City has been amplifying in the last rise in the last decade. It is approximated that the expenditure will increase to about 5 trillion dollars by 2021 (Hartman et al., 2010). This situation will account for about 20-percent of the country’s GDP.

Government Progress in Healthcare Services

The government has been implementing health policies and education programs. (Fossett et al., 1992). It has also strived create awareness of the importance of health cover amongst the city residents. Current health programs that are in place include Medicaid, CHIP, Medicare, and High-Risk State Pools among others. The government plans to spend on medical care among its residents through the PPO. The PPO can offer deductibles, pay for care, and negotiate health care costs among others. This situation will ensure minimization of expenses (Hartman et al., 2010).

Funding and Economic Indicators of the Chicago City

An economic indicator provides information on the economic performance of a given entity. It determines the future economic situation of a country or town. Various indicators in the economy include indices, salary and wages reports, consumer pricing indices, leveraging ratios, bankruptcy, gross domestic product, and stock markets among others (Hartman et al., 2010).

Various governmental agencies that seek healthcare funds include the Medicaid and CHIP. The two organizations fund Medicare and High-Risk State Pools (HRSP). Additional funds are also received from employers, associations, and higher learning institutions among others. The government of Chicago ensures that healthcare is supported through efficient management of resources. Partnerships are also established to solicit funds from investors.

Analysis of healthcare policies in both state and locality

The authorities of the Chicago City have implemented public health policies to guide delivery of medical services. An example of such policies includes the Patient Protection Policy Act (ACA) of 2010, which ensures public access to healthcare insurance. The person in charge of all public policies that are related to healthcare services is Jeremy Barewin. He is also the Vice President in charge of Marketing and Community Engagement at the National Multiple Sclerosis Society (Luo & Wang, 2003).

Facility Overview

Relief Care Clinic

The Relief Care Clinic is a convenient type of healthcare facility that is located at the central business district of the Chicago City. The facility has been established to handle minor illnesses. It also serves as a collection point of samples that are used in laboratory analysis. This facility provides minimal services that lie between 15 and 25 of common diagnoses. The Relief Care Clinic is operates for about six hours in a day for five days in a week. It has six nurse practitioners with three assistants. The main service provided in the facility is treatment of both children and adult patients who are infected with common illnesses such as flu, cold, minor injuries, burns and scalds, allergies, physical therapy, and skin rashes among others.

Challenges to Providing Care in the Facility

Size of the Population and Behavior

The Relief Care Clinic operates in a densely populated area that demands better healthcare services. As a result, the management is striving to handle up to 500 patients per day. However, situations that are more complicated are referred to other healthcare facilities.

Challenges of behavior among children and adolescents

The behavior of children and adolescents has various implications for healthcare provision. They require a wide range of services that encompass developmental and behavioral care needs. Furthermore, provisions are supposed to be community-based, in-home, out-of-home, and support services. In most cases, the Relief Care Clinic refers such instances to well-developed healthcare centers and departments that provide behavioral health and developmental disability services to children and adolescents.

Resources Available, Cost, and Funding

An issue of inadequate resources leads to poor quality healthcare delivery. Most of the healthcare managers try to equip their facilities to serve the ever-increasing number of patients in the town efficiently. Funding for the Relief Care Clinic is a bit cumbersome. However, the current sources of funding are well-wishers, donors, personal savings, and the surrounding community members who wish to support the facility. Donors and well-wishers also subsidize some of the resources. This situation has minimized the overall expense made by the patients.

Challenge of Prevalence

Although the clinic has been successfully managing common infections, cases of new diseases that are related to lifestyle and complicated situations that crop up are always handled at referral hospitals.

Role and structure of information technology in the health facility

Information technology currently plays a vital role in improving the relationship between various individuals who are part of healthcare sectors. These individuals range from patients, their families, nurses or caregivers doctors, and any other person who is in the health service system.

Role of Information Technology in the Healthcare Facility

Various roles of IT in healthcare facility include communication, effective data management, and improvement of the relationship with patients and staff among others within the healthcare facility.

Structure of IT in the chosen Relief Care Clinic

The prospective IT structure will encompass a centrally placed server computer. This computer will store all the information in the hospital. Various departments will also have different computers, but the information will be delivered from the main source. The centrally placed computer will also ensure that the information from all the departments is stored collectively.

Strategy for IT implementation for Patient Record-Keeping

The prospective strategy will be robust and realistic. At the outset, a committee will be formed to handle the task of ensuring efficient IT systems, evaluation practices, and procedures. It will also encourage teamwork, allocation of enough resources, the storage and filing systems for all the departments will then be improved and stored digitally on the hospital website, and a periodic review will be conducted to ensure that the strategy of IT works efficiently.

IT strategy for Communication and Knowledge Access

A central computer that supplies the entire departments with information will be put in place. A link for communication with other computers in the various departments will then be created to ensure networking so that staff can access information required by the department with ease.

Reliance on Consultants and Vendors

Implementation of the IT strategy requires proper planning. Therefore, the entity management will consult various institutions and experts who can effectively install a feasible IT system. The equipment will also be outsourced from registered information technology vendors to provide proper equipment needed.

Funding Information Technology

Funds have to be obtained from personal sources, friends, well-wishers, and donors to ensure successful implementation of the strategy. In addition, the government will play a vital role in financing the implementation of information technology in the healthcare facility. Funds can also be obtained by acquiring loans from banks and other financial institutions.

A Vision Statement for the Facility

Relief care clinic will offer quality healthcare services to its clients to about 40 percent in the coming one year to be recognized as the leading healthcare service provider for all types of patients in three years’ time with fully equipped bed capacity of 200 for in-patients.

Conclusion

The essay has elaborated various healthcare needs in Chicago city. It also explains the policies that ensure accessibility of healthcare insurance to the city residents. It also focused on a number of challenges that healthcare institutions and patients face amidst the ever-increasing medical costs. As a result, there is a need to establish proper health insurance plans to curtail such problems in the near future.

Reference List

Fossett, J., Perloff, J., Kletke, P., & Peterson, J. (1992). Medicaid and access to child healthcare in Chicago. Journal of Health Politics, Policy, and Law, 17(2), 273-98.

Hartman, M., Martin, A., Nuccio, O., & Catlin, A. (2010). Health spending growth at a historic low in 2008. Health Affairs, 29(1), 147-55.

Luo, W., & Wang, F. (2003). Measures of spatial accessibility to healthcare in a GIS environment: synthesis and a case study in the Chicago region. Environment, Planning B Planning, and Design, 30(1), 865-84.

Executive summary

During the year 2008, the government of Jamaica decided to remove the fees on the health sector for the users, which has increased the rate of demand on the healthcare services by the citizens.

The ministry of health in Jamaica is also trying to restructure the processes within the health sector to improve its services to the citizens, enhance service delivery and increase the accessibility as well as accountability in the management system of the health services.

The use of electronic medical record (EMR) also known as electronic healthcare record (EHR) is a data collection document that records the digital data of medical reports for the patients.

In addition, it shares the information with other healthcare doctors as well as providing personal health reports for patients to present to their doctors when required. This technology of recording the patient’s information is seen as a way of improving the services offered in healthcare facilities.

This has been adopted by countries like United States and others are on the process of implementing it. Jamaica is one of the countries, which has also planned to implement the technology to improve the health services.

Introduction

Jamaica is the largest English-speaking Caribbean Island in its advanced stages to improve the health system, which is reflected by a decreased fertility and mortality rates in the country.

The maternal mortality rate in Jamaica has been high due to high rate of abortion done by girls and due to poor services in the maternal section but government has tried to improve its operations to curb the situation (Planning Institute of Jamaica, 2007).

The National Health Services Act in Jamaica divided the country into four health regions whereby each region is governed by the regional health authority. The regional authority has the mandate of ensuring that public health services are delivered to the citizens within the region.

The delivery of the health services is availed through the network of the secondary or tertiary care facilities and the primary care facilities, which are managed by the regional authorities in the country (Jamaica Ministry of Health, 2005).

The main aim of the research is to discuss the deficiencies in the health system of Jamaica and the benefits the country will achieve in adopting the EMR/EHR in operating its healthcare facilities.

The study tackles the challenges related to handling health information, medical products and technology, service delivery, health workforce, health financing and leadership and governance.

The research looks at the benefits that the country is likely to achieve in implementing the electronic medical record in the health system as well as some of the challenges the country might face in implementing the technology (Planning Institute of Jamaica, 2010).

Health information

The health information system in Jamaica is fragmented that there is no policy on health information system to govern the communication processes within the health system.

The country has always lacked data to carry out the statistical analysis in the health sector that it has always used the 1993 data to estimate the vital statistics in the subsequent years in preparing the health reports (Ministry of health, 2008).

In the year 2005 audit of the vital statistics, it was noted that in the health sector there was lack of communication and coordination between the government and the health agencies, which has made it hard for the government to plan accurately on how to improve the health system.

The government should therefore strengthen its national regulatory bodies governing the sharing of the health information between the public and the private sectors (World Health Organization, 2006).

Medical products and technology

Drug production in Jamaica proves to be limited due to the limited raw material imported for the production of the drugs. The country therefore depends heavily on the imported drugs and this increases the prices especially to the end user.

The government has therefore experienced increased costs in the health sector especially in the pharmaceutical service, which is the most utilized section and regularly accessed by the public due to the removal of the user fee in the health system (Ministers of Health of the Americas, 2007).

Service delivery

The authority in the four regions within the country monitors the delivery of services in Jamaica. The health services are therefore provided through a network between the primary care facilities and the secondary/tertiary care facilities within the region.

The distribution of services is high in urban areas as compared to rural areas where the healthcare facilities are few. The public sector in the country provides 95% of the services to the citizens.

The private sector provides the 5% and its services are rendered by the professionals in the public sector who own the private health facilities (Ross, 2009).

The quality assurance in Jamaica is under the various departments within the ministry of health and this result to a fragmented process. The country has therefore a goal for the year 2015 where it plans to achieve effective operations in the clinical processes within the four regions of operation.

The government needs to improve the delivery of services in the regions as well as develop a policy to guide its implementation (Planning Institute of Jamaica, 2007).

Health workforce

The study shows that the human resource in the health sector is not sufficient to serve the public. It was therefore noted that the distribution of the workforce in the regions is not equal because some regions are poorly served.

The study indicates that the dentists, doctors, midwives and nurses in the public sector are very few that the ratio at which they serve the public is 12.1/10,000 populations approximately.

In additional to this kind of shortage there is also inadequate number of rehabilitation experts in the occupational therapy and in speech (Ministry of health, 2008).

Leadership and governance

In the year 1997, the government channeled most of its energy in reforming the health sector by decentralizing the healthcare services to its four regions within the country and strengthening the ministry of health to be steering the four regions.

In the year 2003 evaluation, it was revealed that the government had not achieved its targets fully in health planning, transparency, service delivery, community involvement and accountability by the management (Ministers of Health of the Americas, 2007).

In the year 2009, the country had achieved some of its targets but still there are some weaknesses in areas of communication, service delivery and quality assurance.

The government is therefore trying to involve the society in the health planning as well as the delivery of services since there are greater opportunities the government is likely to gain.

The involvement of the church in educating the public about some of the diseases like HIV or any other chronic disease will help in improving the lifestyles of the citizens (World Health Organization, 2006).

Health financing

Research shows that the human resource expenditure in the year 2004/2005 increased to 82.6% of the total expenditure of the regional health authorities as compared to the previous expenditure, which was 79.3%.

The health financing programs by the government of Jamaica has not been successful due to poor performance in the economic sector, which is greatly affected by the fiscal constraints ((World Health Organization, 2001).

As much as the government has tried to settle the public debts, it has still not managed to maintain or expand the resources allocated to the health sector. In the analysis the expenditure incurred by the government in the health sector in the years 1992 to 2006 fluctuated by $70 per capital, which is equal to 2.3% GDP.

Research shows that due to the abolition of the user fee in the healthcare system the government is likely to incur an increased expenditure, which is estimated as US$44 million though at a constant rate.

The government is therefore expected to meet 52% of the expenditures as the remaining amount is collected from the revenues from the granting of casino licenses.

The study shows that the government is still unable to meet the expenses in the health sector as planned in the year 2015 target (United Nations, 2006).

Electronic medical records

The government of Jamaica is likely to implement the use of modern technology devices in its health system as planned in the year 2030 strategic plan. The electronic medical records have proved to be beneficial to the patients, healthcare providers as well as the government of the country that uses the EMR.

As compared to the paper records electronic medical records proves to be having many benefits such as security, privacy, easy accessibility of the files, financial benefits, accuracy in the clinical processes and administration as well as management benefits (Hayden, Maccurtain, Richards, Roche & Sahm, 2009).

Privacy and security

The health insurance portability and accountability act in the federal law requires that privacy should be maintained in the health sector. The information of the patients should not be revealed to any other person except the doctor or any other healthcare provider who will be attending the patient.

The technology of recording digital data in the health sector will enhance privacy due to different levels of accessing the information by the governmental agencies as well as the individuals (Curioso & Kurth, 2008).

The storage of digital data is durable and easy to trace for analysis as compared to the paper records where information can be erased or altered easily. The government of Jamaica is therefore likely to benefit by accessing the health information for the statistical analysis.

This is because it has been encountering challenges in tracing the required data during the analysis of the health matters for it to plan effectively. The citizens of Jamaica will also be guaranteed security of their medical reports as well as accuracy in the data presented for the administering of drugs.

This will also reduce the mortality cases related to maternal care since information will be clear in the files for the doctors to be able to assist (Ministry of health, 2009).

Improved clinical services for quality assurance

The implementation of electronic medical records improves the quality of the services offered to the patients.

The digital data help nurses to be more efficient in offering their services to the patients since the information presented to them by the doctors is clear compared to paper records where the nurse might fail to understand or read the information given correctly.

In most cases, this results to guess work where the nurses give different instructions from the doctor’s prescriptions (Planning Institute of Jamaica, 2010).

The use of electronic medical records will also reduce cases of redundant lab tests. In the paper work, doctors may fail to interpret the results submitted by the lab technicians due to illegibility of the writings and doctors end up giving wrong prescriptions to the patients.

The digital records help doctors to have an overview of the previous medication administered to the patients to understand the necessary changes to be made on the prescription of the drugs.

The use of digital data will also help the doctors to diagnose the disease through the list of symptoms provided in the document of the patient (Ministry of health, 2009).

The government of Jamaica will therefore achieve its goal in the year 2030 vision of quality assurance if it implements the use of this technology in the healthcare system.

The healthcare providers in the four regions will therefore avail services of high quality to the patients in terms of prescription of the drugs, dosage issued, medical lab tests and the interpretation of the lab tests.

This will help in reducing the costs of overused drugs as well as the mortality rate in the country (Ross, 2009).

Information integration

Through the implementation of the electronic medical recording, the sharing of information becomes easy since it is transferred electronically within the shortest time possible.

Doctors will therefore share the relevant information about the patients, which will facilitate quick service (Hanauer, Laffel, Laffel & Wentzell, 2009). This sharing of information will save patients the energy of travelling long distances for instance if one needs to see a specialist who is far.

The doctor attending him/her can send the required results to the specialists for the prescription of the drugs.

This will help the Jamaican government to reduce the costs in the health sector since the users do not incur the expenditures of medication (Hayden et al., 2009).

The patient internet portal, which can be devised through the implementation of the electronic medical records, will help the patients to learn the updated information about the healthcare services.

The citizens will therefore know the plans of the government in improving the health system and some of the contributions the government expects from them.

Through this process of sharing information, the government will achieve its target in involving the citizens in its planning (Curioso & Kurth, 2008).

Research purposes

The implementation of the electronic medical records will facilitate easy way of carrying out research. The information can be shared easily between the ministry of health and the relevant agencies to carry out the research.

This can be beneficial to the government since through research information about the possible ways of controlling some diseases can be devised as well as provide information to the government for easy planning on the future of the health system (Corson, 2009).

Reduction of the financial costs

As much as the implementation process of the electronic medical records may seem to be costly, the country is likely to benefit more after its implementation by cutting down the costs related to health.

Digital data records saves time in tracing the information for the patients, which enables doctors to attend many patients as compared to the traditional way of recording the information.

The healthcare facilities are likely to save the amount of money used in purchasing the papers and reduce the space of storage since the hard drives will occupy less space (Ministry of health, 2009).

The Jamaican government will reduce the cost of expenditure in its health system. Through the studies, analysis shows that the government incurs expenses in the pharmaceutical section and this can be cut down through the implementation of the EMR.

This is possible because the billing of drugs is easy in electronic data and this will help doctors to provide lists of generic drugs to the patients.

The knowledge on different drugs helps to save money hence reducing the heath costs incurred by the government (Ministry of health, 2008).

Estimated costs with and without the implementation of the technology in Jamaica

The government of Jamaica has been spending low as compared to other countries in the Caribbean. The government removed the medical expenses on the users of the facilities in the year 2008 for its citizens to access the facilities easily and conveniently.

This will improve the health system to achieve the 2015 goals in the health sector. In its strategic planning of the year 2009 to achieve the 2030 vision the government aims at improving its health services as well as cutting down the expenses related to healthcare (Planning Institute of Jamaica, 2010).

Study shows that the health system and services budget for the year 2006/2007 biennium was $995,860, which reduced to $911,000 in the 2008-2009 budgets.

During the strategic planning for the year 2030 vision the country plans to lower the costs for the country to be able to expand its services to the public.

Research shows that the implementation of the electronic medical records will therefore reduce the costs by 10% in the first year after its implementation, 20% in the second year and 35% in the third year (World Health Organization, 2008).

Research shows that the estimated value of implementing an EMR per physician is approximately $33,000 and the licensing ranges from $1,000-$25,000 while the full licensing is approximately $10,000.

The implementation fee of the EMR is usually billed per hour where one hour is approximately $75-$150 while the time of implementation is 35 hours approximately.

The network hardware costs and configurations depend on the type of the server as well as the workstations (Ministers of Health of the Americas, 2007).

Conclusion

Through the adoption of the electronic medical records by the government of Jamaica in running its health system, the country is likely to achieve more benefits at earlier stage than the projected vision of the year 2030.

The government will be able to manage risks in the health system like reducing non-clinical time and increasing time for doctors to attend the patients as well as improve the quality of services in healthcare facilities.

The government will attain administrative and management benefits related to accountability and transparency, which has been a problem in the health system of Jamaica for a long period.

The government will reduce its expenditure in the healthcare especially in the pharmaceutical section where there is an increased number of users hence increased expenses.

The Jamaican government should therefore utilize the opportunity of implementing the technology to be effective in planning due to the availability of the information and improve the quality of the services rendered to the public as well as improve the lifestyle of the public.

Through improved lifestyle and reduced costs in the health sector, the government of Jamaica will improve its economy as well as standards of living.

References

Corson, J. (2009). Jamaica health for all: Health service equity and efficiency. Final draft, 10(1).

Curioso, W. & Kurth, A. (2008). Access use and perceptions regarding internet, cell phones and PDAs as a means for health promotion for people living with HIV in Peru. BMC Med. Inform. Decis. Mak, 12(7): 24.

Hanauer, D., Laffel, L., Laffel, N. & Wentzell, K. (2009). Computerized automated reminder diabetes system (CARDS): E-mail and SMS cell phone text messaging reminders to support diabetes management. Diabetes Technology, 11(2): 99-106.

Hayden, J., Maccurtain, A., Richards, H., Roche, C. & Sahm, L. (2009, September 3). Electronic reminders to improve medication adherence: Are they acceptable to the patient? Pharm World Sci, p.15.

Jamaica Ministry of Health. (2005). National strategic plan 2006-2010. Kingston. Web.

Ministry of health. (2009). Ministry of health, Jamaica strategic plan 2030 vision: Time to care time to act. Epidemiology unit, 1(1).

Ministry of health. (2008). National policy for the promotion of health lifestyle in Jamaica. Health promotion and protection branch, 1(1).

Ministers of Health of the Americas. (2007). Health Agenda for the Americas 2008-2017. Web.

Planning Institute of Jamaica. (2010). Vision 2030 Jamaica: National development plan. Web.

Planning Institute of Jamaica. (2007). Jamaica 2015: Framework and action plan for improving effectiveness, collaboration and accountability in the delivery of social policy. Cabinet office and PIOJ, 12(5): 34-67.

Ross, A. (2009). Rating maternal and neonatal health programs in developing countries. Carolina: University of North Carolina.

United Nations. (2006). Development assistance framework (UNDAF) for the government of Jamaica (2007-2011). Kingston: The United Nations Country Team (UNCT).

World Health Organization. (2008). Medium-term strategic plan 2008-2013. Web.

World Health Organization. (2006). Eleventh general programme of work 2006-2015. Web.

World Health Organization. (2001). Advancing safe motherhood through human rights. Web.

Medicare Payment Methods for Outpatient and Physician Services: Differences

Two basic differences that Medicare can be distinguished by among the previous insurance programs, the payment methods for outpatient and physician services deserve being considered closer. According to the definitions provided, the key methods used in Medicare for outpatient services used to be on hospital’s costs, as Outpatient hospital services payment system (2007) explains. However, with Medicare, the outpatient services payment strategy was shifted towards setting payment for individual services (Guterman, Davis, Stremikis & Drake, 2010), which presupposes that hospitals receive outlier adjustments for extraordinary cases as additional payments.

Physician services, on the other hand, were intended to be based on the principle of reimbursement, according to the Medicare system (Scarrow, 2002). The given payment principle is much more flexible than the previous one, seeing how it splits the finances for the healthcare services into two basic categories (Lesser, Fineberg & Cassel, 2010), i.e., the hospital insurance and the medical insurance (Hospital outpatient prospective payment system, 2012). While the former is financed by payroll taxes, the funds for the latter are supplied from the monthly premiums for the most (25%) part.

Defining the key difference between the two aforementioned principles of payment, one must specify the fact that the source of the payment is different in each case. While the outpatient services are based on the use of hospital costs, the physician services payment is carried out by withdrawing funds from payroll taxes (Wilensky, 2009). The amount of payment for each of the types of services, therefore, is also different.

Bundled Payments and Global Payments: Difference

Among the key innovations that the Obamacare reform offers the U.S. citizens, the concepts of bundled payments and global payments should be listed. According to the existing definition, a bundled payment is the type of payment that is traditionally given to the provider of healthcare services to facilitate multiple healthcare services to the people with a particular health issue. Doctors, in their turn, choose the means to use the funds supplied for the needs of the patients. Also known as condition-related services, they are traditionally used for specific episodes of treatment, i.e., the cases that have a beginning and an ending; however, according to the rules of the Obamacare reform, the given payment system also includes payment for managing chronic conditions and their exacerbations (Affordable Care Act: How Obama’s signature legislation could be changed, 2013, November 20).

Global payments, in their turn, are traditionally defined as a series of fixed payments that are provided for a fixed amount of time, yet are not supposed to be used for addressing a particular disease and can be utilized for the needs of any patient. In the given case, it is not the amount of time that serves as the defining feature of the initiative, but the severity of the patient’s disease (Humer, 2013, November 11).

When it comes to comparing the two types of payment, one must mention that the bundled payment presupposes that every episode of the patient’s treatment must be paid separately, while in global payment system, the total case is covered, disregarding the number of times that the patient had to visit his or her doctor, or the number of treatment interventions that had to be undertaken.

Patient Reform Initiatives in the Patient Protection and Affordable Care Act

The Patient Protection and Affordable Care Act, also known as Obamacare, presupposes that the healthcare provider should be enhanced by increasing the number of uninsured citizens. There are largely three key changes that the given reform has made in U.S. healthcare. To start with, Obamacare presupposes that bundled payments initiative should be introduced into the healthcare system, as several sources explain (Gottlieb, 2012, December 22; Jaspen, 2013, January 2). The concept of the bundled payment, in its turn, includes supplying doctors with money that are supposed to be used for treating severe conditions, such as cancer, heart diseases, etc. While the given initiative does allow for more opportunities in terms of the choice of treatment, it still makes a patient more dependable on the doctor.

The second initiative that should be singled out of the ACA is the so-called Pay for Performance, which can be described as an attempt to introduce the principle of reimbursement into the healthcare system (Nox, 2013, November 20). While driving with good intentions, the given change to the healthcare system presupposes that specific standards for different kinds of healthcare services should be introduced. Finally, the initiative known as the elimination of co-payments should be listed among the most significant changes made to the U.S. healthcare service system (Becker, 2013, August 7). The given initiative will supposedly increase liability rates among the patients using the co-payment system. However, the given system may be considered limiting for several patients, who use the support of sponsors. Therefore, while having a few upsides to it, the Obamacare system requires better scrutiny and, perhaps, several amendments.

Reference List

Affordable Care Act: How Obama’s signature legislation could be changed (2013). The Wall Street Journal. Web.

Becker, A. L. (2013). The Obamacare premiums are in. But what about deductibles and copays?The CT Mirror. Web.

Gottlieb, S. (2012). The problem with Obamacare’s bundled payments initiative. AEIdeas. Web.

Guterman, S., Davis, K., Stremikis, K., & Drake, H. (2010). Innovation in Medicare and Medicaid will be central to health reform’s success. Health Affairs, 29(6), 1188-93. Web.

Hospital outpatient prospective payment system (2012). Web.

Humer, C. (2013). Initial Obamacare enrollment estimates far short of targets: reports. Reuters. Web.

Jaspen, B. (2013). Though Obamacare pays less, providers flock to ‘bundled’ Medicare payments.Forbes. Web.

Lesser, C., Fineberg, H., & Cassel, C. (2010). Physician payment reform: Principles that should shape it. Health Affairs, 29(5), 948-952. Retrieved from ProQuest.

Nox, K. (2013). What Obamacare’s pay-jor-performance programs mean for health care quality.The Healthcare Foundation of America. Web.

Outpatient hospital services payment system (2007). Web.

Scarrow, A. M. (2002). Physician reimbursement under Medicare. Neurosurgical Focus 12(4), 1–3. Web.

Wilensky, G. (2009). Reforming Medicare’s physician payment system. New EnglandJournal of Medicine, 360(7), 653-655. Web.

Reasons why the Crude Death Rate is higher in Germany than in the UAE

The crude death rate of a country refers to the ratio of people who die to those who remain alive in a specified country within a one-year period. Usually, the expression of this ratio is in terms of a number of deaths for every one thousand people in the population. The crude death rate in the UAE in 2010 was 1.34, while the crude death in Germany in the same year was 10.5 (WHO, 2010). On the other hand, the median age in UAE as of 2010 was 20.2 years, while the median age in German in the same year was 45.3 years (WHO, 2010). The reason for the disparity in the crude death rates is that age is a very strong source of bias in demographics (Jekel, 2007). This difference in age accounts for the disparity between the crude death rates of the two countries. Therefore, while the crude death rate is an accurate measure of the number of people dying in a particular country, it may be misleading if it does not take into account the age of the population in question.

Using Crude Death Rates to Compare Countries

The crude death rate is a true rating. It reports a vital statistic about a country regarding the mortality rate of the citizens. Comparison of the crude death rates of the two countries is possible provided several issues remain clear. First, the comparison process must account for the bias introduced by age. Age has a significant biasing effect on the crude death rate of a country (Jekel, 2007). Countries with a higher median age report a higher crude death rate. Secondly, the crude death rate is useful if the countries under comparison have similar demographic characteristics. Countries within the same region tend to have similar demographic characteristics. The crude death rate is an important way of comparing the mortality rate in the two countries. The third way of using the crude death rate as a means of comparing the demographic characteristics of countries is by using the crude death rate of a country at an earlier point as a base value for comparison with the value from another country. This approach enables researchers to investigate the impact of factors influencing demographic changes. For instance, how does a simultaneous disease outbreak in different countries affect the crude death rate in a particular year in each of the countries?

Measuring the Burden of Disease, and its Comparison to Infant Mortality

The burden of disease, in simple terms, refers to the cost caused by ill health on a variety of factors. There are several ways of measuring disease burden. World Health Organization (WHO) uses Disability Adjusted Life Years (DALY) to measure the burden of disease (WHO, 2010). This measure expresses the number of years that a person is in ill health, rendering them unable to have normal functioning. A similar measure of disease burden is Quality-Adjusted Life Years (QALY) (WHO, 2010). Infant mortality refers to the number of children under one-year-old that die within a specified year. This measure usually compares well with the overall health standards of the country. The relationship between the burden of disease and infant mortality is that each of these metrics can give an indication of the quality of life in a country (Akhtar, 2008). The computation of the burden of disease is more complex than the computation of infant mortality. The burden of disease requires a means of identifying the number of days people within a region spend on sick offs. This data is more difficult to collect as opposed to mortality data simply because of the finality of death. Disease burden is a lifetime measure while infant mortality covers a single year at a time.

Difference between WHO and World Banks Health System Frameworks

The Health system framework developed by the World Health Organization (WHO) has three main components. These components are, “actors, institutions, and components,” which interact to produce health benefits for communities, and ensure that wealth increases in the community (Shakarishvili, 2009, p. 4). World Bank, on the other hand, looks at health system frameworks in terms of their functional elements, which are, health service inputs, service provision, health financing, and stewardship (Shakarishvili, 2009). The definition from WHO describes what a health system framework ought to include. The definition from the World Bank, on the other hand, uses a systems approach and defines health systems frameworks in terms of the system components.

The definition from the World Bank seems more comprehensive and desirable for describing health systems. It gives a much clearer definition of what constitutes a health system. The definition from WHO requires further clarification hence it is more difficult to use it as the basis of developing a conceptual framework for understanding health system frameworks. Perhaps the reason why the model developed by the World Banks is more attractive for use a health system framework is that the World Bank does not specialize in health issues. Therefore its framework is more summative and comprehensive because it focuses on the big picture rather than too many specifics. WHO on the other hand, has a framework that has many specifics, which end up limiting the potential application of the framework.

Classification of Health Systems and the Main types of Health Systems

It is possible to classify health systems into three main categories. The first category is the descriptive health system frameworks (Shakarishvili, 2009). These frameworks simply explain how the health system looks and how it works. They do not address questions relating to how the components of the system interact. These frameworks simply concentrate on key relationships. Secondly, there are analytical models (Shakarishvili, 2009). These models move beyond simply describing how the health system works. They describe relationships and seek to find out how different parts of the health system interact. This way, they provide a stronger basis for the development of conceptual frameworks and the application of health system frameworks in different environments. The third type of health system frameworks is the deterministic and predictive models (Shakarishvili, 2009). These types of models go further than creating an understanding of what the health system framework is like. They also exceed the limits beyond describing how individual parts of the health system interact with other parts of the health system. The models here seek to uncover success and limiting factors. Deterministic and predictive models seek to provide answers related to the reasons why some models work better. As a result, these models provide practitioners and planners with the capacity to determine which model will apply best given a certain set of conditions. These models are very useful for predicting future scenarios thereby helping in the provision of healthcare. Deterministic and predictive models are invaluable for policymakers and macro-economic experts.

References

Akhtar, S. (2008). Epidemiologic Measures of Association. Karachi: Division of Epidemiology and Biostatistics, Aga Khan University.

Jekel, J. F. (2007). Epidemiology, Biostatistics, and Preventive Medicine. New York, NY: Elsevier Health Sciences.

Shakarishvili, G. (2009). Building on Health Systems Frameworks for Developing a Common Approach to Health Systems Strengthening. World Bank, the Global Fund and the GAVI Alliance (pp. 1-16). Washington DC: World Bank.

WHO. (2010). Advanced Search. Web.

Introduction

The healthcare organizations are currently striving towards providing adequate health care at the most cost-effective prices. For organizations to meet their general productivity goals, labour and other costs must be managed effectively. The operations in the health care sector can be dived into function and organizational related services. In most of the healthcare organizations, operations aren’t optimized. This results in poor services as patients have to wait before being treated. Resources such as physicians, surgical rooms and technical equipment are also not available at the required time due to poor scheduling. Missing files and information also results in postponement and cancellation of procedures and surgery. The process of treating patients may take a long time and this brings a lot of discomfort to patients and increases costs. These problems can be solved through the use of Operations Management (OM). OM can be used to improve healthcare services such as Improving supply chains, Introducing flexibility in the medical sector, managing resources effectively and managing information. The production and consumption of medical goods and services can be classified into:

1. Activities– they include: physical examinations, patient’s visits to hospitals, Surgeries and therapies
2. Inputs-these encompass: nurses, technicians, doctors, administrators, drugs, medical tools, hospitals, catering, clinics and other equipments
3. Products-they include: quality of care, number of cases adjusted for severity and the length of treatment
4. Welfare-it entails the evaluation of the overall welfare the patients
5. Consequences– it entails the health status of the patients adjusted to social, economic and environmental factors

General Productivity Measures for the Department

The following productivity measures can be used in the department:

Output productivity: for productivity to be measured, the output of the products and services must be determined. The aggregate information on the volume, value of services and goods must be factored. This can be determined using a cost weighted output index which is constructed using unit costs and the different outputs. This method measures the percentage change in the output and uses the unit costs to weight the output changes (Antonia et al., 2011). This index can be determined using formula 1

Where X_jt represents the output volume j, in a time t and C_jt is the unit cost for the output j in a time t. In equation 1, the activities received by a patient are quantified but it does not take into account the complete treatment. This method does not measure changes in quality as the output is only expressed in terms of activities. It is, therefore, necessary to adjust the output so as to include quality of the service being offered. The quality data can be expressed in terms of survival rate. This rate is based on the in-hospital mortality and the deaths occurring within 30 days. These adjustment yields equation 2.

Where a = the survival rate. Equation 2 need adjustments as those patients who were not treated would have a zero quality-adjusted life. This index is adjusted so as to factor in the average health effect on the treatment condition for survival. This is calculated using equation 3.

Where,is the sum of life years accrued to patients who survive the treatment,is the life accrued to patients who have not to be treated(Antonia et al., 2011).

Another model that can be used to account for productivity entails measuring costs, activities, cases, consequences and welfare (Kam, 2011). Here the cost function is expressed as C(w, q) where, w is the input price vector and q is the quantity. The activities are measured using the Laspeyres quantity index given in equation 4.

Where a represents the number of activities i occurring during the period t andis the average cost in period 0 (Kam, 2011).

References

Antonia, H., Matilde, M., Agnes, N., Guldem ,O., Mary,O., Erica, S., & Lucy, S. (2011). Measuring the productivity of the Healthcare sector: Theory and Implementation. Web.

Kam, Y. (2011). Measuring efficiency and Cost-Effectiveness in the Health Care Sector. Web.

Introduction

The paper discusses the historical background of healthcare financing and the roles of the government in allocating resources.

Background

Most developed countries have health sector plans that target public health financing and administration. Some countries have compulsory private healthcare spending and administration like Germany and Japan. Various approaches have been employed while justifying health safety nets for the general population.

In the U.S, by 1965, the U.S congress had already enacted medicare and Medicaid that aimed at poor and elderly Americans. By 1992, the government had spent 14% and 19% on medicare by 2000. The U.S combines both private financing and government spending (Carlstrom, 1994).

Currently, 60% of Americans receive employment-based health coverage which seems to have dropped from 64% in 2006 (Henry, A. 2007). The major reason for declining employer-sponsored health benefits is the double cost due to inflation and earnings (Kaiser Family Foundation, Health Research & Educational Trust, 2007). Apart from the U.S and European countries, developing countries are adversely affected since they do not have the institutional, legal, policy and resource capacities for healthcare. The level of unpreparedness by developing economies excludes vulnerable groups as older, disabled, youth who are mainly from the informal sector of their economies. Both health spending from the government or the private sector ignores them completely. The role of the government comes in to redistribute resources carefully to balance the economic and social welfare of various groups for sustainable development. It has to balance economic forces against welfare forces in a manner that does not kill entrepreneurship from the private sector while not compromising values of vulnerable groups.

Justification for healthcare

Scholars have intimated that healthcare maintains an individual’s normal functioning. The basic rule is that healthcare plans can be affordable if they are limited. At the same time, utilitarians argue that guaranteeing health care services increases the security of the greatest number of people who in turn become more productive in the society at large (Carlstrom,1994).

The roles of the government

Osborne has identified new roles that the government has to play in the healthcare system. He notes, governments provide information to encourage behaviour change to be able to improve health outcomes (Osborne & Gaebler, 1993). If the consumers got enough information about price and quality health services, they would be more empowered to shift their costs or enhance their bargaining power hence reduce the value of the services (Hertzlinger, 1997). Enough information about markets enhances public choices and decision making.

Furthermore, the government develops and enforces policies or regulations that influence public and private sector activities. In most cases, it initiates a healthcare reform policy and law. Health financing requires income redistribution through holding it constant, increasing spending for some groups and reducing costs for uninsured groups (Henry, A. 2007). The government legislates and prohibits insurance companies from discriminating against a person’s current health-related factors. It also provides guidance on capital expenditures on existing facilities and purchase of Medicaid (Carlstrom, C 1994). It enlarges the insurance pool by enhancing the capacities of the private sector. It issues tax incentives for employer-provided healthcare. Finally, the government issues mandates for public and private healthcare providers and administers Medicaid, medicare and veterans affairs (Osborne, D. & Gaebler, T. 1993).

Conclusion

The paper has demonstrated that the government’s traditional roles are necessary even in the laissez-faire economies as opposed to Keynesianism.

Reference List

Henry, A. (2007). Why Has Healthcare Reform Failed? LA: Los Angeles Times.

Hertzlinger, R.(1997). Market Driven Healthcare: Who Wins, Who Loses in Transfomation of America’s Largets Service. Addison: Wesley Pub.

Kaiser Family Foundation, Health Reaserch & Educational Trust. (2007). Employer Health Benefits: 2007 Annual Survey. Washington: Kaiser Family Foundation, Osborne & Gaebler. (1993). Reinventing Government. New York: Plume.

The UAE is working to position itself as a destination for medical tourism. It is trying to follow the example of India, Singapore, Malaysia and Thailand. The UAE already has very good health standards (Deloitte 14). The country has the lowest infant mortality rate, the lowest adult mortality rate, and one of the lowest maternal mortality rates in the world (Deloitte 5).

The government of the UAE is at the forefront of efforts to make the UAE a natural destination for medical tourists. There is a clear effort to avail the highest level of healthcare to attract people from all countries seeking affordable healthcare. This also includes the development of highly specialized medical services in the country to attract people with special needs (Deloitte 6).

The demand for healthcare in UAE comes from the increasing number of immigrants working in the UAE, an ageing population, and an increase in lifestyle diseases such as hypertension, obesity and cardiac ailments associated with the affluent lifestyle of many UAE residents. The government is supporting the home care services program to reduce the number of people spending time in the hospital (Deloitte 15).

The dilemma that comes from the view that human life is priceless has several dimensions. First, it is clear to many people that birth and death are not choices people make. Each individual comes to life without a decision on their part. Similarly, death is a compulsory end to all human life. Despite the best efforts, the longevity of life is not assured even with the best care (Chapin 67). In this sense, all human beings come to this world based on chance. This bestows intrinsic value to human life.

In this debate, the actual question is whether or not an individual can raise the resources required to meet his personal needs. The economic value of a person depends on the ability to access resources to meet personal needs. It is insincere to make those who can meet their needs to feel guilty about not supporting those who cannot meet their needs on the basis of the intrinsic value of life. The value and quality of life are separate issues. One is an issue of intrinsic worth, while the other is a factor of economic worth.

To resolve this dilemma, there are two options. The first option is to institute social support systems to take care of those who are disadvantaged in society to enable them to access basic services necessary for their human dignity. In this sense, every human being deserves respect and recognition in the society. However, this is not a free pass for people who do not want to exert themselves. Support should go to those who truly need it to maintain their dignity as human beings. This group includes the aged, the orphans, and those with physical conditions that hamper their participation in day to day endeavours. The second option is to treat everyone equally. It is possible to let everyone fend for themselves because everyone was born equally. There is sufficient proof that anyone can change their life by making the correct decisions and taking advantage of the opportunities that they come across. In conclusion, human life is priceless in an inherent sense, but not in an economic sense. Some people add equity to their lives by the benefits they accord society. At a certain point, some people become more valuable than others because of this.

Works Cited

Chapin, Rosemary. Social Policy for Effective Practice: A Strengths Approach. New York: Francis & Taylor, 2010. Print.

Deloitte. 2011 Survey of the UAE Healthcare Sector Opportunities and Challenges for Private Providers. Survey Report. London: Deloitte, 2011. Print.