Summary:

This module provided an in-depth analysis of non-hospital entities (ambulatory care, long-term care, and behavioral health services), with a focus on how the move away from hospital-based care has affected the healthcare organization and the community that it serves. This Module reviewed the major elements of ambulatory (outpatient) care. Ambulatory care encompasses a diverse and growing sector of the health care delivery system. Physician services are the chief component; however, hospital outpatient and emergency departments, community health centers, departments of health, and voluntary agencies also contribute important services, particularly for the uninsured and vulnerable populations. Ambulatory surgery is a continuously expanding component of ambulatory care, as new technology enables more procedures to be performed safely and economically outside the hospital.

The number of Americans requiring long-term care services is increasing. Advances in medical care have made a longer life span not only possible but more probable, even in the presence of ongoing chronic disease and disability. This module provided an overview of the diverse array of long-term care services presently provided in institutional, community, and home-based settings. Particular attention was given to the long-term care needs of older adults because they are the fastest growing proportion of the population in the United States today and are the major consumers of long-term care services.

Lastly, this module described the clinical characteristics of people who receive behavioral health services. Historic trends and forces affecting the distribution and kinds of care were examined and compared with epidemiological data regarding the prevalence of psychiatric disorders to hypothesize whether national needs for mental health care were being met. Evolution in the science and technology available for the treatment of psychiatric disorders was reviewed briefly. Opportunities for improvement and evidence of the impact of managed care on effective mental health service delivery were examined.

Demographic shifts will shape the future. An increasing number of debates and discussions are surfacing around the social, economic, and health implications of demographic and social change. All of these concerns present new challenges for public policy, government, business, and the health care industry. Several critical issues and trends deserve attention-the aging baby boomers, the increasing ethnic and radical diversity, the growing disparity between the richest and the poorest households, and the future burden of disease.

Assignment:

1. Given the increasing longevity of Americans and the costs of providing long-term care, anticipation of the costs should be a major element of every family’s financial planning. Current information suggests however, that very few families or individuals give this consideration. What factors might impede this advance planning? What measures might be effective in raising awareness among Americans about this important matter?
2. Identify the major factors that have resulted in the shift in utilization from inpatient hospitalization to ambulatory care services. What are the implications of this shift for hospitals, consumers, and the health care delivery system as a whole?
3. The recipients of mental health services in the US represent only a small percentage of those in need of services. Discuss the factors that impede access to mental illness treatment.

Please submit one APA formatted paper between 1000 – 1500 words, not including the title and reference page. The assignment should have a minimum of four scholarly sources, in addition to the textbook.

Answer for question

1. Given the increasing longevity of Americans and the costs of providing long-term care, anticipation of the costs should be a major element of every family’s financial planning. Current information suggests however, that very few families or individuals give this consideration. What factors might impede this advance planning? What measures might be effective in raising awareness among Americans about this important matter?

In the United States, policy makers, health professionals, and patient advocacy groups have promoted the process of advance care planning, that is, planning for future medical care in the event that a person is unable to make his or her own decisions at the end of life. Advance care planning allows persons with chronic and ultimately fatal illnesses to convey preferences to guide decisions when they cannot speak for themselves. However, many people do not engage in advance care planning discussions, which results in documents such as a living will. A common reason for this is that they do not perceive advance care planning as sufficiently urgent.

But advance care planning has a plausible value for at least 1 group of persons. Unlike persons suffering from other chronic diseases of adulthood, patients with dementia experience a period during which they can participate in decisions followed by several years when they cannot make decisions, requiring others, often family members, to make decisions for them. These decisions include difficult end-of-life choices, but for several years before death they will also include day-to-day decisions about their care and daily living.

One way to achieve patient-centered care and maintain patient autonomy for patients with dementia is to elicit their health care values and preferences before they lose their ability to state those preferences. In the early stage of dementia, the patient has a plausible window of time to talk with family about what goals and values should inform a range of future decisions. Without these discussions, families are left struggling to make decisions about nursing home placement and end-of-life care without the guidance of the patients’ preferences. The prevalence of this problem is likely to increase by the year 2050 when the number of persons with dementia in the United States is estimated to reach 11 to 16 million.

Although, advance care planning is appealing for dementia patients and their family members, little is known about the strategies that can facilitate advance care planning discussions or about the reasons why people do not have these discussions. Understanding these strategies and reasons is crucial to fostering

Factors that might impede the advance planning:

1. People are more concerned at living the moment and spending moe to fulfill their excessive needs.
2. No control and judgement between needs and wants.
3. Lack of training for teaching the importance of saving at an early stage of life.
4. Lack of concern for others. People are becoming more self-seeking.
5. Over avaibility of leisure activities and expensive hobbies.

Possible measures:

1. Training by the family at an early stage of life for saving money.
2. Camps and catchy advertisements of the importance of financial planning.
3. Awareness by making them realise what difference can be made by this planning.
4. Showcasing long term benefits and ease of life at a later period in life in exchange of a minor saving.
5. Promoting hobbies that improve social life and habits of people so that in a long term they become more responsible.

Answers for question

2. Identify the major factors that have resulted in the shift in utilization from inpatient hospitalization to ambulatory care services. What are the implications of this shift for hospitals, consumers, and the health care delivery system as a whole?

A few of the major factors driving an increased emphasis on ambulatory care facilities in the healthcare system are cost, ambulatory care units can be built in locations that are significantly less expensive to operate than hospitals. Technology advancement enables outpatient facilities to deliver coordinate treatment regimens. Patient expectations- ambulatory facilities can provide the convenience of easy access and a shorter visit length that patients want, another factor is competition, hospitals can now compete with other healthcare organizations by adding ambulatory services which is less costly than making capital investment in hospitals. The ambulatory services are beneficial for the hospitals, physicians and consumers becarthe severity of injury or risk of death can be recuced to the maximum extent. This maximum improves both the patient and healthcare relationships .

Answer for question

3. The recipients of mental health services in the US represent only a small percentage of those in need of services. Discuss the factors that impede access to mental illness treatment.

Main factors which impede the access to mental illness treatment are

1. limited availability of medication and health professionals.
2. Limited affordability_as psychological illness treatment are not covered by insurance policies which make it unaffordable.
3. Lack of education
4. Stigma- as patients may attempt to distance themselves from the labels that mark them for social exclusion which often prevents patients from seeking and adhering to treatment.