scholarly journals Managing the economic challenges in the treatment of heart failure

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ileana L. Piña ◽  
Larry A. Allen ◽  
Nihar R. Desai

Abstract Background Treatment of heart failure is complex and inherently challenging. Patients traverse multiple practice settings as inpatients and outpatients, often resulting in fragmented care. The Center for Medicare and Medicaid Services is implementing payment programs that reward delivery of high-quality, cost-effective care, and one of the newer programs, the Bundled Payment for Care Improvement Advanced program, attempts to improve the coordination of care across practices for a hospitalization episode and post-acute care. The quality and cost of care contribute to its value, but value may be defined in different ways by different entities. Conclusions The rapidly changing world of digital health may contribute to or detract from the quality and cost of care. Health systems, payers, and patients are all grappling with these issues, which were reviewed at a symposium at the Heart Failure Society of America conference in Philadelphia, Pennsylvania on September 14, 2019. This article constitutes the proceedings from that symposium.

PEDIATRICS ◽  
1995 ◽  
Vol 96 (4) ◽  
pp. 850-851
Author(s):  
Howard A. Pearson

Dr Elsa Stone, in her usual organized and lucid fashion, has presented the case for inclusion of pediatric nurse practitioners (PNPs) in private pediatric practices. She bases her conclusions on her nearly 10 years of positive experience with a PNP in her own practice in Connecticut. Dr Stone describes the PNP population and demography, describes the training curriculum of PNPs, and discusses the scope of work of these individuals. She concludes that "there is substantial evidence that PNPs provide quality health care and that collaborative teams of pediatricians and PNPs can provide high-quality, cost-effective care to a broader spectrum of children than can be served by either profession alone." The American Academy of Pediatrics (AAP) has insisted for several years that there is a shortage of pediatricians to meet the expanding needs of the children of the United States. Furthermore, pediatricians—because of system changes—will be expected increasingly to provide a variety of time-intensive services. Dr Stone believes that many of these services can be well provided by PNPs. Within the AAP, there have been some concerns about the role of PNPs. Of particular worry seems to be the possibility that PNPs might decide to practice independently, leading to a lower quality of care for their patients. Less often stated, but clearly an issue, is that PNPs are viewed by some pediatricians as potential competitors. Dr Stone's demographic analysis of what PNPs are currently doing is relevant to these concerns. One third of PNPs work in private pediatric practices or health maintenance organizations.


2013 ◽  
Vol 87 (2) ◽  
pp. S498-S499 ◽  
Author(s):  
J.M. Vainshtein ◽  
J.A. Hayman ◽  
J.M. Moran ◽  
K.A. Griffith ◽  
R. Jagsi ◽  
...  

Author(s):  
Hrushikesh Das ◽  
Sasmita Panigrahi ◽  
Dharitri Swain

Tele-information and communication have led a global revolution in solving the scarcity of health care workers. In the vision of health for all, different global leaders have initiated many public health reforms to address the health care needs of citizens, like e-Sanjeevani in India. COVID-19 created an acute shortage of nurses, as well as the rising cost of care and hospital occupancy which are major hurdles to address basic health needs. Telenursing is a novel field that utilizes innovative technologies to offer safe, effective, and ethical care promptly by providing. Telenursing may provide a means to overcome some of the challenges faced by patients by providing easier access to cost-effective care and equitable distribution of health care providers. Globally, telenursing is an emerging and rapidly expanding area for professionals and offers unlimited opportunities for its members.


1996 ◽  
Vol 16 (2) ◽  
pp. 32-36 ◽  
Author(s):  
S Schickel ◽  
SN Cronin ◽  
A Mize ◽  
C Voelker

The results of this evaluation indicate that specially trained critical care nurses can remove femoral sheaths with an acceptable margin of safety. As a result, these nurses can provide quality, cost-effective care to angioplasty patients. However, before this procedure is included as part of the RN's responsibility, written protocols are needed to identify appropriate patients, proper removal technique, and specific actions to take if complications occur. In addition, plans must be developed for initial education and ongoing competency evaluation to ensure that each nurse involved maintains an adequate knowledge base and skill level.


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