MSN Writing Services

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

New Samples

Struggling With Your Assessments? Get Help From Our Tutors

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

    Student Name

    Capella University

    NHS-FPX 6008 Economics and Decision Making in Health Care

    Professor Name

    Date

    Identifying a Local Health Care Economic Issue

    Hospital readmission rates are a perilous healthcare economic issue that has a considerable impact on the elderly population in Texas, United States. This concern is centered around the fact that a higher number of older adults are readmitted to healthcare facilities after their discharge, impacting patients’ health as well as incurring financial implications. Therefore, this assessment explores more about the particular economic concern, its impact on the population and the working groups, and identifies the gap contributing to rising readmission rates. 

    Issue Description and its Impact on Elderly Population 

    Hospital readmission is described as the number of patients returning to the hospital within a specific interval from discharge, usually 30 days, for further treatment. It is an important measure that indicates adverse outcomes which are preventable by improving the quality of care. According to the Centers for Medicare & Medicaid Services (CMS), hospital readmissions are frequent, where 20 percent of Medicare receivers are readmitted within 30 days of discharge (Gupta et al., 2019). Our observations reveal that repeated readmissions can result in poor health outcomes for older adults.

    Each hospital stay transmits the risk of acquiring hospital-related infections, medical errors, and adverse events, which can further complicate their existing health conditions. Furthermore, hospital readmissions can impose a substantial monetary burden on the patients and their families, especially for those without insurance coverage (Lau et al., 2021). Other potential impacts include reduced quality of life and experiences of anxiety, stress, and vulnerability due to recurring health problems and the need for hospitalizations. 

    The Rationale for Choosing Particular Healthcare Economic Issue

    The reasons for choosing the particular healthcare economic issue are my personal and professional experiences related to this matter. One of the reasons is that recurrent admissions within my workplace have led to several monetary penalties under the act of the Hospital Readmissions Reduction Program (HRRP). The focus of the program is to improve healthcare services, enhance communication, and optimize care coordination to prevent avoidable readmissions, eventually improving patient outcomes and quality of care (Centers for Medicare & Medicaid Services, 2023).

    Hospitals showing contrary observations may receive minimal reimbursements and pay additional penalties in this regard, consequently imposing a financial burden on the organizations. Another reason for choosing this problem is a personal connection where I witnessed the struggles and difficulties that my parents and grandparents have encountered due to repeated hospitalizations. The values that I hold as a registered nurse to provide empathetic and compassionate care for the well-being of patients have led me to choose this critical healthcare economic issue, requiring immediate interventions by the stakeholders. 

    Impact of Increasing Hospital Readmission Rates 

    As healthcare workers, the mounting concern of hospital readmission rates has had an overwhelming impact on our work and our organization. As we strive to provide adequate care to returning patients to improve their health and well-being, aggregated workload and resource scarcity are two major challenges that my colleagues and I have confronted. My colleagues and I have had to adapt to more complex patient needs, improve our care coordination process, augment discharge planning, and expand follow-up protocols, all of which demand for additional work and resources. While the organization had to pay penalties for the recurrent admissions, it also handled the detrimental challenge of additional expenses used on the surplus resources.

    A study presents that these additional costs may lead to decreased profitability for the organization, eventually impacting financial viability (Upadhyay et al., 2019). Simultaneously, the increasing hospital readmission rates are particularly challenging for the low socio-economic population within the community. Since the population has limited access to preventive care services and post-discharge support, they are at high risk for acute health issues, increasing the probability of hospitalization and readmission.

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

    Moreover, social factors like insecure housing, lack of proper food, and insignificant income impact their overall well-being, contributing to higher hospitalization rates (Murray et al., 2021). Lastly, frequent readmissions can lead to extensive out-of-pocket costs for medications and other healthcare expenses, which may aggravate the existing financial burden for these diverse and low socioeconomic groups. Therefore, it is crucial to focus on healthcare equity and accessibility while devising interventions to address readmission rates within the community. 

    The Contributing Gap and its Evidence

    The gap significantly increasing the readmission rates exists in the quality of healthcare due to inadequate post-discharge care planning and ineffective care coordination. A systematic review by Hunt‐O’Connor et al. (2021) corroborated a reduced risk of readmission rates for those patients who had received comprehensive post-discharge care. Discharge planning is essential to prevent post-hospital complications and reduce errors, ultimately minimizing the readmission rates. Another important factor is fragmented healthcare. Ineffective care coordination and disintegrated care are associated with higher risks of readmissions in chronically ill patients (Joo, 2023). Elderly patients often experience fragmented care due to the complex nature of their diseases; thus, healthcare professionals must ensure care coordination while dealing with chronic illnesses and older adults. Addressing these gaps is fundamental to improving the transition from hospital to patients’ residences and reducing hospital readmission rates. 

    References

    Centers for Medicare & Medicaid Services. (2023, June). Hospital readmissions reduction program (HRRP). CMS.gov. https://www.cms.gov/medicare/payment/prospective-payment-systems/acute-inpatient-pps/hospital-readmissions-reduction-program-hrrp  

    Gupta, S., Zengul, F. D., Davlyatov, G. K., & Weech-Maldonado, R. (2019). Reduction in hospitals’ readmission rates: Role of hospital-based skilled nursing facilities. Inquiry: A Journal of Medical Care Organization, Provision and Financing56, 0046958018817994. https://doi.org/10.1177/0046958018817994 

    Hunt‐O’Connor, C., Moore, Z., Patton, D., Nugent, L., Avsar, P., & O’Connor, T. (2021). The effect of discharge planning on length of stay and readmission rates of older adults in acute hospitals: A systematic review and meta‐analysis of systematic reviews. Journal of Nursing Management29(8), 2697–2706. https://doi.org/10.1111/jonm.13409

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

    Joo, J. Y. (2023). Fragmented care and chronic illness patient outcomes: A systematic review. Nursing Open10(6), 3460–3473. https://doi.org/10.1002/nop2.1607 

    Lau, H. L., Patel, S. D., & Garg, N. (2021). Causes and predictors of 30-day readmission in elderly patients with delirium. Neurology: Clinical Practice11(3), e251–e260. https://doi.org/10.1212/CPJ.0000000000000976 

    Murray, F., Allen, M., Clark, C. M., Daly, C. J., & Jacobs, D. M. (2021). Socio-demographic and -economic factors associated with 30-day readmission for conditions targeted by the hospital readmissions reduction program: A population-based study. BMC Public Health21, 1922. https://doi.org/10.1186/s12889-021-11987-z 

    Upadhyay, S., Stephenson, A. L., & Smith, D. G. (2019). Readmission rates and their impact on hospital financial performance: A study of Washington hospitals. INQUIRY: The Journal of Health Care Organization, Provision, and Financing56, 004695801986038. https://doi.org/10.1177/0046958019860386