Despite serious advancements in medical technology and successful transition to evidence-based practice, healthcare systems in the United States and a variety of other countries continue to face challenges. The present paper analyzes the problem of challenges within health systems by reviewing a number of scholarly articles that pay maximum attention to the particular aspects of the problem.
The preliminary study of the topic has shown that obstacles in healthcare do exist, and for them to be effectively resolved, multiple issues must be addressed on both governmental and local levels. Among those, one may figure out understaffing, turnover, patient security, insufficient funding, operating extensive data, and more. To successfully overcome these and other obstacles, healthcare organizations should closely consider the available service improvement options and pick some that are suited for their units’ needs.
Regarding the mentioned options, particular studies indicate that there are still measures to help clinics stabilize the occurring situation. White et al. (2017) emphasize that resolving financial issues is the clue to improving the quality of care while also the key factor in raising patients’ satisfaction with the services received. The researchers recommend health organizations develop a healthcare ingenuity plan that would consider the incomes of various social groups and provide suitable programs for all categories of clients, including immigrants (White et al., 2017).
Another option is to make health insurance personal and portable, controlled by an individual rather than an employer. This way, one will always know the true cost of health services and can decide which aspects to cover first. Speaking of health services, clinics should do maximum to empower non-physician professionals, making them capable of making decisions. The given option would stimulate higher involvement of nurses and midwives in care delivery.
Background Information
Considering that an increasing number of patients, same as healthcare workers, express their concerns regarding safety in clinical settings, the problem of challenges faced by health systems proves to be relevant and requiring quick intervention. As Blank, Burau, and Kuhlmann (2017) stress out, the percentage of Americans dying each year due to medical errors is presently higher than that of people killed in accidents.
Resolving this situation is a number one task not only for the U.S. government but for the rest of countries too, as the life of people often depends on the quality of services they receive. Postponing the problem solution can, in fact, be the cause of the further increase in death statistics and higher turnover among clinicians. With regards to the given facts, the outlined issue must be addressed by all governments immediately.
As was mentioned earlier, resolving the problems in health systems requires all clinics to choose among options that help improve the quality of care. Creating a single financial pool for Medicaid coverage would allow healthcare units to allocate funds to the most burning needs without addressing additional financial establishments or wasting time on bureaucracy (Curtis & Burns, 2015).
However, not only financial aspects of the matter require reforming; the employee-motivation programs must be introduced to stimulate higher devotion of medical staff to their duties. A motivated employee is more likely to establish a needed patient-provider communication, same as to follow the principles of medical ethics. If this level of care delivery is achieved, the number of challenges faced by clinicians would be significantly diminished.
Landscape
Dissatisfaction in healthcare is a global issue, which is often viewed as a result of either unfavorable socioeconomic conditions or adverse political situations within a state. Due to the given factors, a rising number of patients report their disapproval of the treatment methods used by clinics. Regarding this fact, a lot of studies on challenges in health systems drag attention to patients as the key stakeholders.
As Roy, van der Weijden, and de Vries (2017) admit, clinics’ primary objective is to satisfy the medical needs of their customers and thus, reduce the overall percentage of readmissions. However, patients are not the only group participating in the process of care delivery. Among the populations involved, one may also figure out clinicians (doctors, administrators, nurses, midwives, and other medical workers) and governmental structures.
The clients’ position demonstrates a higher interest in private services rather than receiving care from public settings. According to the research made by Roy et al. (2017), the level of customer satisfaction is higher among those clients who address private clinics: 25% compared to 18.2% of people visiting public hospitals (p. 2). Judging by these figures, one may assume that there is a substantial need to reformlic healthcare and adopting a more efficient and patient-oriented health policy.
The financial accessibility of a private sector creates additional obstacles for public establishments’ operation: while clients openly promote the former, they never stop criticizing the latter for poor performance (Pitt et al., 2016). Patients are currently convinced that such qualities as reliability, communication, responsiveness, and empathy for a client are only inherent in private clinics.
As referred to clinicians, their position is mainly determined by the need to improve services through hiring new employees. With regards to the fact that the constant turnover of nurses is a disturbing problem in U.S. healthcare, expanding staff and employing new professionals is the task to be resolved firsthand by the clinics. Many doctors admit the insufficient quality of provided medical care. However, they primarily link it to the financial situation within the sector.
In their opinion, should the governmental structures rearrange the financing of healthcare and raise wages, the occurrence of turnover would be reduced significantly (Roy et al., 2017). Medical workers are ready to implement changes, yet they stress out that fair distribution of duties is impossible without staff replenishment. Thus, unless medical students are motivated to enter clinical settings and devote themselves to a chosen profession, the excessive workload will remain on the list of challenges faced by the majority of health systems.
Governments arrive as another side involved in designing healthcare policies and delivering those to the masses. Initially, all decisions regarding health policies, funding of particular spheres of medicine, and opening clinics are made by the governmental machinery. The U.S. government expresses direct concerns regarding the situation in the country’s public healthcare. The recent decisions have shown that legislators not simply express their awareness of the issue but attempt to provide effective solutions to the matter.
The Affordable Care Act, signed in 2015, is thought to be the first step in solving challenges that the American health system faces, particularly in making services more accessible (Obama, 2016). However, policy implementation requires active assistance from both federal financial establishments and health insurers. Without their direct participation, Medicaid expansion will not see any additional progress.
As to the factors contributing to the problem aggravation, those could be divided into two categories: political and organizational. To the organization, one may refer the power gaps, poor human resource management, insufficient skills, lack of medications, and some others (Roy et al., 2017). The power gaps are usually tracked in the way local and central health authorities coordinate their actions: the delivery of drugs may sometimes take too long due to occurring misunderstandings or misconceptions between the two.
This problem often arrives as the cause of medication undersupply and patients’ utter resentment. Poor resource management usually occurs when the total number of specialists does not allow doctors or nurses to be appointed to rural clinics or sent to other regions. Also, due to the issue of staff shortage, clinics are forced to comply with the problems of employees’ insufficient skills and nurses abandoning their duties.
Political factors are mostly attributed to clinicians entering political groups, the changes in financial policy and local authorities are interfering in the working process. There are multiple occasions when doctors’ promotions were linked to their political weight or surrounding rather than professional achievements. The given tendency is often viewed as the source of discontent in a clinical setting, which can even affect the performance of the entire staff (Roy et al., 2017). A similar effect occurs when local authorities interfere in the clinic’s operation. When a well-adjusted working scheme is being disturbed, there is a risk of medical workers underpaying attention to the clients’ needs, making errors in health records, neglecting security protocols, and so on. If these risks are associated with the lives of people, they are not acceptable by any means.
Options
Among the options to recommend, a single-payer program, healthcare ingenuity plan, renewed health insurance, and empowering non-physicians must be the first to address by the clinics for the level of customers’ satisfaction to rise. Their relevance is determined by the need for better funding, making medications and services more affordable to all categories of patients, and resolving the problem of turnover in healthcare. Each of the options can be applied to solving one or several issues discussed in this research. Yet, their practicability utterly depends on one’s readiness to implement changes and establish proper communication with subordinates.
A single-payer option is supposed to use public financing to guarantee privately delivered healthcare to everyone, including low-income groups and immigrants. The key advantage of this program is that when combined with the U.S. federal poverty level (FPL) initiative, it will make primary care affordable to all social layers (White et al., 2017). The program would substantially reduce out-of-pocket payments making the prices for treatment much more transparent (Snowdon, Bassi, Scarffe, & Smith, 2015). However, as White et al. (2017) indicate, the program introduction would require raising a state payroll tax, which could affect prices for other goods and services. The given fact might be considered as the major drawback.
A healthcare ingenuity plan would consider the incomes of various categories of patients and recommend treatment options accordingly. The plan is suited to operate huge data that cover the client’s disease history, received treatment, and more (Kruse, Goswamy, Raval, & Marawi, 2016). Patients requiring long-term care would experience the benefits of an individually developed plan that involves saving on drugs in the long run. Yet, the initiative would again require raising a state sales tax causing the increase in products’ price (White et al., 2017).
Making health insurance personal provides an individual with a wider choice of options: the insurer would consider exactly the needs of a person, not those of his/her employer. The most beneficial aspect of the matter is that the level of wages would be increased due to employers no longer paying coverage. However, the major shortcoming relates to the fact that many patients would simply ignore the insurance, which could impact both the state treasury and local budgets.
Aside from making health insurance personal, it is also required to increase competition among insurers, which is one more option to add to the list of applied measures. There is presently a strongly pronounced monopoly tracked in the medical coverage sphere. As Snowdon et al. (2015) point out, two organizations located in New York (Empire Blue Cross and GHI) control over 47% of the entire market.
Connecticut and New Jersey demonstrate the situation, which is much similar to that in the mentioned state. Giving patients a richer choice of insurers would allow one to purchase services for lower prices and, again, pick only those options that correspond to his/her current needs. Yet still, if these organizations will not be able to hold their market position, the situation will return to its initial phase with two players holding the sector.
Finally, empowering non-physicians creates more room for nurses and midwives to establish the required level of customer communication and avoid conflicts with supervisors. Personal decision-making positively impacts time management, allowing doctors and head nurses to plan working schedules more thoroughly (Snowdon et al., 2015). Yet, the opportunity to make care-related decisions could be the cause of multiple errors tracked in nurses’ work, which leaves a number of questions about the applicability of the given option.
As to the criteria used to assess the response measures, the attention was drawn to such factors as the transparency of implementation, applicability, opportunity to enhance primary care, improving patient-provider relationships, and so on. Options were chosen as not simply a short-lived solution but rather as a long-term conception aimed at continuous improvement of the quality of healthcare and reduction of costs. The primary focus was made on enhancing the U.S. health system. Nonetheless, the options apply to other states, too, if the governments of those countries make advances in the direction of changes and create a suited legislative base.
Recommendations
The first recommendation relates to making medical services more accessible. The Agency for Healthcare Research and Quality is expected to design guidelines based on the best global practices to improve usability and functionality of health information technologies (Kruse et al., 2016). The relevance of these measures is explained by the fact that modern healthcare is impossible to operate without IT technologies.
All patients’ records and leading practices are now stored on the cloud servers so that every medical worker could get immediate access to the required data. It is, therefore, of huge significance to educate patients on how to remotely share the information and receive feedback. The given form of customer-provider relationships would not only reduce treatment costs but could help resolve the nurse understaffing problem as well.
Another recommended option is to arrange training and certification of medical staff to teach them to provide care at home. The U.S. Department of Housing and Urban Development must collaborate with other governmental and public organizations to facilitate health-related home modifications for people of senior age and those with disabilities (Kruse et al., 2016). This is an important step to take since mortality statistics directly depend on one’s ability or inability to receive care. With the program being launched, the level of patients’ loyalty would go higher.
Lastly, clinical establishments should collaborate with the U.S. Food and Drug Administration, software developers, and device manufacturers to design a new medical database for both customers and health providers that would assist with making prescriptions. Medications would be prescribed considering the available disease history, previous recommendations, current state of health, and other factors influencing doctors’ decisions (Kruse et al., 2016).
Special attention will be paid to patients receiving care at home and those requiring the regular intake of a drug: their profiles will be stored in a separate section to provide faster and more accurate results. The database needs to be widely promoted using the internet, media, and other sources of data transfer for clients to actively join the initiative. With the platform launched, the problem of constant readmissions and long patient queues would be finally resolved.
Summarizing all of the findings, the issue of challenges in health systems needs to be addressed now for the public medical sphere to not be abandoned. The viewed scholarly studies show that there are suitable options to deal with the task. If both clinics and state bodies adhere to the given recommendations, the hard situation in the health sector will still be possible to regulate.
References
Blank, R., Burau, V., & Kuhlmann, E. (2017). Comparative health policy (5th ed.). London, UK: Palgrave.
Curtis, L. A., & Burns, A. (2015). Unit costs of health and social care 2015. Kent, UK: Personal Social Services Research Unit.
Kruse, C. S., Goswamy, R., Raval, Y. J., & Marawi, S. (2016). Challenges and opportunities of big data in health care: A systematic review. JMIR Medical Informatics, 4(4), 1-11.
Obama, B. (2016). The United States health care reform: Progress to date and next steps. Jama, 316(5), 525-532.
Pitt, C., Vassall, A., Teerawattananon, Y., Griffiths, U. K., Guinness, L., Walker, D., & Hanson, K. (2016). Foreword: Health economic evaluations in low- and middle-income countries: Methodological issues and challenges for priority setting. Health Economics, 25(1), 1-12.
Roy A., van der Weijden T., & de Vries N. (2017). Challenges of satisfaction of key stakeholders of the district health system of Bangladesh and ways to improve: A qualitative study. Health Systems and Policy Research, 4(2), 1-12.
Snowdon, A. W., Bassi, H., Scarffe, A. D., & Smith, A. D. (2015). Reverse innovation: An opportunity for strengthening health systems. Globalization and Health, 11(2), 1-7.
White, C., Eibner, C., Liu, J. L., Price, C. C., Leibowitz, N., Morley, G., & Meyer, J. (2017). A comprehensive assessment of four options for financing health care delivery in Oregon. Rand Health Quarterly, 7(1), 1-16.