NURS FPX 6008 Assessment 1 Identifying a Local Health Care Economic Issue

NURS FPX 6008 Assessment 1 Identifying a Local Health Care Economic Issue

NURS FPX 6008 Assessment 1 Identifying a Local Health Care Economic Issue

The economy in the United States plays a significant role in determining the diversity of interrelationships between employment, health insurance, costs, and outcomes. Despite the fact that the United States spends more on healthcare, many Americans still cannot afford medical treatment due to a lack of insurance, expensive patient health plans, and distant clinics (Alcaraz et al., 2019). The mission of the Villa Healthcare organization is to reduce suffering by providing quality healthcare to those who cannot afford it, including the elderly, the underserved, the disabled, and the chronically ill. High rates of hospital readmission pose a major economic challenge for villa healthcare. Both patient safety and the surrounding community are suffering as a result of this problem.

Health Care Economic Issue

NURS FPX 6008 Assessment 1 Identifying a Local Health Care Economic Issue

The Villa Healthcare Hospital can be found in Minneapolis, which is the capital city of the state of Minnesota. The Villa Healthcare System consists of a series that includes a variety of medical facilities, including clinics, hospitals, and other medical centers. It is estimated that approximately 800k people are living in the area surrounding the Villa Hospital (Warren, 2020). The majority of the population (7.4%) consists of Whites (both Hispanic and non-Hispanic), while 9% are Black and 7% are Asian American (Warren, 2020). The cultural backgrounds of patients determine how they deal with disease and its treatment. The uncertainty and misinterpretation over cultural differences can destroy the trust and treatment compliance of patients, which are particularly problematic in today’s diverse ethnic environment. The majority of readmissions happen among patients whose medical requirements cannot be fulfilled due to cultural differences. Culture has a significant impact on health. It influences how people think about and talk about health, illness, and death. Also, it influences how they approach disease prevention and health promotion; how they feel and talk about illness and pain; where they go and what treatments they choose; and much more. Villa Healthcare’s high number of hospital readmissions will unavoidably have an adverse impact on the quality of treatment provided to its patients. Increased patient stress from financial burdens and increased death rates are just two examples of the negative health outcomes that are linked to readmission (Beauvais et al., 2022). On the other hand, higher patient satisfaction and better results are connected to lower readmission rates. Inadequate patient education is a significant reason for readmissions.

It has also been discovered that readmitted patients had a greater in-hospital mortality rate. According to the results of previous studies, readmissions cause patients to spend more time in the hospital and resulting in higher costs (Kitzman et al., 2021). Revenue declines as a result of readmissions because of the fines imposed by Medicare and other insurers. Nurses’ workloads, administrative responsibilities, ability to influence scheduling, and morale are all negatively impacted by the high rate of hospital readmissions (Kitzman et al., 2021). 

Multiple interventions have been shown to minimize readmission rates among patients who have been discharged. These interventions include medication reconciliation, assessments of patient requirements, patient education, timely scheduling of outpatient visits, and telephone follow-up. There is a 30% reduction in readmissions for patients who can follow their aftercare instructions without confusion (Sinha et al., 2018).

The Rationale for Choosing the Health Care Economic Issue

NURS FPX 6008 Assessment 1 Identifying a Local Health Care Economic Issue

High rates of hospital readmission are problematic for patients, healthcare providers, and the healthcare system as a whole. Reducing hospital readmissions is an important priority with many potential advantages. Reducing the number of patients who need to be readmitted after being discharged is also beneficial because it lowers healthcare costs. The Medicare and Medicaid Services Centers estimate that the Hospital Readmission Reduction Program (HRRP) will save around $521 million annually (Sinha et al., 2018). HRRP is aimed to reduce hospital readmissions by enhancing care integration and communication. Hospital readmissions cost around $25 billion annually due to things like medical errors and problems, ineffective discharge processes, and a lack of coordinated follow-up treatment (Sinha et al., 2018). Better coordination, involvement, and communication help patients understand their diagnoses and treatment strategies. These methods can help improve patient satisfaction by facilitating the hospital-to-home transition. Hospitals must understand the ethical aspect of patient readmission. My experience as a nurse at Villa Healthcare has shown me how a failure to properly educate patients can result in less reliable and equitable treatment of people of various origins and cultures. When nurses are overworked and stressed, they can’t treat patients equally regardless of their race or culture, which damages patients’ trust in the care they receive. All of these factors highlight the rationale for choosing the economic issue of hospital readmissions.

Effects of Healthcare Economic Issues on the Organization, Colleagues, and Community

NURS FPX 6008 Assessment 1 Identifying a Local Health Care Economic Issue

The elevated levels of hospital readmissions have negatively impacted my career and contributed to my stress levels. Since we regularly have to work overtime, my coworkers and I are inevitably distressed and frequently make more errors. Due to the increasing workload, we were unable to provide quality care for the patients. Patients who are readmitted multiple times develop a dependency on a healthcare system. Because of their inability to self-manage their illness, they are repeatedly readmitted to the hospital. Repeated readmission is a problem for many patients, creating a vicious cycle. Single readmission to hospital costs around $11,200 (Winograd et al., 2020). Everyone at Villa Healthcare is stressed and received insufficient acknowledgment for their efforts.

NURS FPX 6008 Assessment 1 Identifying a Local Health Care Economic Issue

Furthermore, the Villa Healthcare hospital readmissions could lead to further increased costs, lower wages, higher tax rates, and a deprived economy overall. In addition to this issue, there is the concern of lengthy wait durations for individuals who require immediate medical assistance. Waiting times ultimately lowers community service quality. A decline in health outcomes has the potential to harm the hospital’s profitability and reputation in the community. It would be necessary for patients to return to Villa Healthcare in the event of a wrong diagnosis or inadequate patient education. In addition, the organization suffers greatly from the high rate of readmission in the low-income community. Also, cultural differences can make it hard for nurses to comprehend the requirements of patients from various ethnic groups (Joo & Liu, 2019). That is why they are unable to educate the patients about their treatment, medication, and self-management. Hospital readmissions negatively impact medical care, work, organization, and patient community. 

The Gap That Is Contributing to the Need to Address the Economic Issue

NURS FPX 6008 Assessment 1 Identifying a Local Health Care Economic Issue

Five gaps contribute to the need to address the economic issue of hospital readmissions in Villa Healthcare.

NURS FPX 6008 Assessment 1 Identifying a Local Health Care Economic Issue

• Disengagement and Non-Compliance: These factors are associated with a patient’s lack of interest or compliance with their treatment plan. The most common reasons for avoidable readmissions are lack of participation and non-compliance.
• Health Complications: Some medical issues have a more frequent chance of developing complications that might necessitate a return to the hospital. The majority of individuals with serious diseases like congestive heart disease or individuals who undergo surgeries like amputation end up back in the hospital within 1 month, according to studies (Sivaharan et al., 2021).
• Inadequate Care Transition: Patients are not prepared for their care transition from hospital to home or another care setting during either the discharge or post-discharge procedures. There is a significant gap in the transition that contributes to the problem of hospital readmissions, and that is the lack of follow-up consultations, home health care, and comprehensive care instructions (Sivaharan et al., 2021).
• Discharge Instructions Misinterpretations; Due to misunderstandings of their post-hospitalization care instructions, some patients end up being readmitted. They may be underestimating the importance of their therapy or the seriousness of their medication. Sometimes, they don’t understand the directions, or they acquire information that contradicts itself.
• Demographic Factors; Recent studies have shown that males, the aged, and individuals from lower socioeconomic backgrounds have a higher risk to require hospital readmission (Minejima & Beringer, 2020). Furthermore, Medicaid and Medicare patients had significantly higher readmission rates than those with private health insurance. 

Conclusion 

In conclusion, the high readmission rate at Villa Healthcare is linked to a serious healthcare economic issue. This issue is chosen because of the detrimental impact it has on the organization’s effectiveness and the surrounding patient community. It also negatively impacts healthcare workers, the organization, and patients. Gaps in addressing the healthcare economic issue may include disengagement of patients, health complications, inadequate care transition, demographic factors, etc. 

References

Alcaraz, K. I., Wiedt, T. L., Daniels, E. C., Yabroff, K. R., Guerra, C. E., & Wender, R. C. (2019). Understanding and addressing social determinants to advance cancer health equity in the United States: A blueprint for practice, research, and policy. CA: A Cancer Journal for Clinicians, 70(1), 31–46.

https://doi.org/10.3322/caac.21586 

Beauvais, B., Whitaker, Z., Kim, F., & Anderson, B. (2022). Is the hospital value-based purchasing program associated with reduced hospital readmissions? Journal of Multidisciplinary Healthcare, Volume 15, 1089–1099.

https://doi.org/10.2147/jmdh.s358733 

Joo, J. Y., & Liu, M. F. (2019). Nurses’ barriers to care of ethnic minorities: A qualitative systematic review. Western Journal of Nursing Research, 42(9), 019394591988339.

https://doi.org/10.1177/0193945919883395 

Kitzman, D. W., Whellan, D. J., Duncan, P., Pastva, A. M., Mentz, R. J., Reeves, G. R., Nelson, M. B., Chen, H., Upadhya, B., Reed, S. D., Espeland, M. A., Hewston, L., & O’Connor, C. M. (2021). Physical rehabilitation for older patients hospitalized for heart failure. New England Journal of Medicine, 385(3), 203–216.

https://doi.org/10.1056/nejmoa2026141 

Minejima, E., & Wong-Beringer, A. (2020). Impact of socioeconomic status and race on sepsis epidemiology and outcomes. The Journal of Applied Laboratory Medicine.

https://doi.org/10.1093/jalm/jfaa151 

Sinha, S., Dillon, J., Dargar, S. K., Archambault, A., Martin, P., Frankel, B. A., Lee, J. I., Carmel, A. S., & Safford, M. (2018). What to expect that you’re not expecting: A pilot video education intervention to improve patient self-efficacy surrounding discharge medication barriers. Health Informatics Journal, 25(4), 1595–1605.

https://doi.org/10.1177/1460458218796644 

Sivaharan, A., Boylan, L., Witham, M. D., & Nandhra, S. (2021). Sarcopenia in patients undergoing lower limb bypass surgery is associated with higher mortality and major amputation rates. Annals of Vascular Surgery, 75, 227–236.

https://doi.org/10.1016/j.avsg.2021.02.022 

Wahl, E., Makris, U. E., & Suter, L. G. (2022). Taxonomy of quality of care indicators. Rheumatic Disease Clinics of North America, 48(3), 601–615.

https://doi.org/10.1016/j.rdc.2022.03.004 

Warren, R. (2020). Reverse migration to Mexico led to US undocumented population decline: 2010 to 2018. Journal on Migration and Human Security, 8(1), 32–41.

https://doi.org/10.1177/2331502420906125 

Winograd, D., Staggers, K. A., Sebastian, S., Takashima, M., Yoshor, D., & Samson, S. L. (2020). An effective and practical fluid restriction protocol to decrease the risk of hyponatremia and readmissions after transsphenoidal surgery. Neurosurgery.

https://doi.org/10.1093/neuros/nyz555 

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