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Major Problems Facing Hospitals Today

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Submitted By ebenger
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HIM 4083 Health Organization Trends
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Exam 2
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Essay Questions – Turn in by midnight Tuesday, February 25, 2014 via www.turnitin.com

Each question should be answered with 2-4 paragraphs for maximum credit. Answer the question (which may be your opinion) and then substantiate your answer.

1. Discuss the major problems facing hospitals today. Offer some possible solutions to each of these problems.

Some of the major problems that face hospitals today include; cost increases, bed surpluses, and the overemphasis of specialized care vs. primary care. Cost increases for hospitals are caused by several different factors. According to a report by the American Hospital Association, labor cost accounts for more than half of hospitals’ total expenses. This number grew by between 5 to 8% a year from 2002 to 2009. Another issue effecting hospitals is the growth in patients covered by Medicare and Medicaid. These patients represent 60% of all admissions. These programs do not pay the full cost of care. The AHA claims the amount each program pays has decreased significantly year after year. Patients unable to pay for care amount to about 6% of hospitals’ cost. To me a universal health care system would definitely assist in this problem. If everyone paid a portion for the same health care, then costs would not rise so high.
Bed surpluses are detrimental to healthcare for several reasons. First, money is invested to create the capacity for beds in health facilities. That money is basically wasted if the beds are not utilized. Second, the beds cost so much to operate and if they are empty they are not bringing income. The surplus of beds can also lead to unnecessary hospital admissions. One answer to this problem is the use of swing beds. Surplus beds could be utilized by those people who are needing longer term care, but do not need constant medical attention. Such as the elderly who qualify for nursing home care.
The overemphasis of specialized care vs. primary care is a problem in hospitals for several reasons. Specialized care is generally more expensive than primary care. Usually, when patient needs care it is usually because they have had a problem that has worsened, because it was not being managed well to begin with. This can be prevented by regular primary care that involves; better preventative care and better management of chronic conditions. This can reduce the need for more specialized care like emergency room visits and hospital admissions. This problem is addressed in the Affordable Care Act.

2. Discuss some of the problems facing the long term care industry today. What are some possible solutions for these problems?

Some of the problems facing the long term care industry today include; cost, workforce shortages, and a lack of integrated care.
The demand for long term care exceeds the supply of workers who are qualified to provide this service. There is a very high turnover rate for paraprofessionals such as CNAs and home health aides. These jobs are known for high injury rates, low wages, and little to no advancement. A few possible solutions to this problem could be offering higher wages, practicing safer lifting techniques including the utilization of electric lifts, and better on the job training that includes safety skills, and creating opportunities for workers to advance their careers, such as offering tuition assistance.
The lack of integrated care in is a healthcare wide deficit. If health care providers had more opportunity to discuss the care of patients with fellow care givers, integrated care could be a huge asset. This problem is being addressed by the creation of electronic health records and exchanges. I have personally seen an elderly patient that was prescribed and using three different eye drop medications that all treated the same condition. These three medications had been prescribed by different doctors around the same time. If they had access to the same electronic health record they would have seen that the patient had already been prescribed medication and been able to address that.
Cost is one possibly the number one problem facing the long term care industry today. According to a report by the Academy of Health; the largest source of public funds comes from Medicaid which accounts for 45 percent of all long-term care spending. Budget shortfalls resulting from the weak economy leads to the increase of co-payments, cutting benefits, and restricting eligibility. One measure to help correct this problem is the use of prospective payments. Providers are given a fixed payment for a given service. More utilization of home health could be another way to lessen costs of long term care as it is less expensive.

3. Discuss how society has viewed mental health throughout the years. Include how you feel it should be included in our healthcare coverage today.

Historically, in most societies, mental illness was viewed as a form of religious punishment or possession by demons. Many mentally ill patients were institutionalized in extreme unhygienic and degrading conditions. As early as 1840, people recognized the need for changes in the treatment of mental illness. Dorthea Dix finally persuaded the U.S. government to build 32 state psychiatric hospitals after a 40 year period of lobbying. Families welcomed this respite from the struggle of caring for such patients at home. Many of these hospitals were understaffed and underfunded which resulted in poor living conditions for the patients.
In the 1950’s outpatient treatment was introduced and became successful because of the development of antipsychotic drugs. The belief that patients would have a better life in their communities and the development of these drugs led to the diminished use of many inpatient facilities. According to www.uniteforsight.org the number of institutionalized mentally ill patients fell from 560,000 in the 1950s to 130,000 by 1980. By 2000, the number of state psychiatric hospital beds per 100,000 people was 22, down from 339 in 1955. Varying laws and acts have been passed to assist in increasing knowledge about mental illness and treatments for it. The National Mental Health Act passed by Harry Truman in 1946, created the National Institute of Mental Health and allocated government funds towards research for mental illness causes and treatments. Congress passed the Mental Retardation Facilities and Community Health Centers Construction Act, which provided federal funding for the development of community based mental health services.
Personally, with mental illness being so prominent I think a good way to deal with it would be to test people, especially young adults, early so they are able to receive treatment and learn to cope without having to go through a debilitating period before diagnosis. Also, mental illness is an illness just like any physical problem and should be covered by insurance companies the same.

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