scholarly journals High Reliability Care: At the Intersection of Policy and Practice

2018 ◽  
Vol 3 (3) ◽  
Keyword(s):  
United States ◽  
Health Care ◽  
Patient Care ◽  
Health Care Policy ◽  
High Reliability ◽  
Local Level ◽  
The United States ◽  
Joint Commission ◽  
Local Health ◽  
Quality And Safety

Health care organizations in the United States struggle to maintain safety and provide quality patient care. In a complex policy environment, the Joint Commission has directed its efforts toward helping health systems achieve high reliability health care. Heath care organizations, facing both accreditation imperatives and political challenges, are mired in the uncertainty of resource availability. The challenges of high reliability in a high stakes industry elude even the most seasoned CEOs and administrators. In particular, it is essential at this time is to pinpoint how public health policy, when coupled with development of high reliability culture, informs implementation of quality and safety at the local level and advances Joint Commission directives related to high reliability care. This theoretically focused paper explores the phenomena of quality and safety from the vantage of two differing lenses, practice and policy. The theoretical analysis of high reliability health care (policy, organizational structure, and actors) contributes to further understanding the challenges facing high reliability patient care implementation throughout hospital systems in the United States. Discussion highlights appropriateness of model fit, whether a top down approach to patient care is realistic, and possible challenges of a centralized policy in an inherently decentralized industry environment. Conclusions reinforce the need for local health care systems and administrators to adopt and adapt the Joint Commission’s high reliability model to their system to correct industry failures.

PERCENTAGE OF UNINSURED CHILDREN HAS INCREASED

PEDIATRICS ◽  
1991 ◽  
Vol 88 (5) ◽  
pp. 1051-1051
Author(s):  
STUDENT
Keyword(s):  
Public Health ◽  
United States ◽  
Health Care ◽  
Low Income ◽  
Health Care Policy ◽  
The United States ◽  
Public Health Insurance ◽  
Care Policy ◽  
Low Income Families ◽  
Uninsured Children

The proportion of children in the United States without private or public health insurance increased from roughly 13 percent to 18 percent between 1977 and 1987, according to a new study by the Agency for Health Care Policy and Research (AHCPR). The growth in the proportion of uninsured children in poor and low-income families over the decade was even more dramatic—it rose from 21 percent to 31 percent.

Medical Expenditures on and by Immigrant Populations in the United States: A Systematic Review

2018 ◽  
Vol 48 (4) ◽  
pp. 601-621 ◽  
Author(s):  
Lila Flavin ◽  
Leah Zallman ◽  
Danny McCormick ◽  
J. Wesley Boyd
Keyword(s):  
United States ◽  
Health Care ◽  
Medical Care ◽  
Health Care Policy ◽  
Age Groups ◽  
Health Care Expenditures ◽  
The United States ◽  
Public And Private ◽  
Health Insurance Markets ◽  
Private And Public

In health care policy debates, discussion centers around the often-misperceived costs of providing medical care to immigrants. This review seeks to compare health care expenditures of U.S. immigrants to those of U.S.-born individuals and evaluate the role which immigrants play in the rising cost of health care. We systematically examined all post-2000, peer-reviewed studies in PubMed related to health care expenditures by immigrants written in English in the United States. The reviewers extracted data independently using a standardized approach. Immigrants’ overall expenditures were one-half to two-thirds those of U.S.-born individuals, across all assessed age groups, regardless of immigration status. Per capita expenditures from private and public insurance sources were lower for immigrants, particularly expenditures for undocumented immigrants. Immigrant individuals made larger out-of-pocket health care payments compared to U.S.-born individuals. Overall, immigrants almost certainly paid more toward medical expenses than they withdrew, providing a low-risk pool that subsidized the public and private health insurance markets. We conclude that insurance and medical care should be made more available to immigrants rather than less so.

Catholic Church Advocacy and the Affordable Care Act

2019 ◽  
Author(s):  
Jeanine Kraybill
Keyword(s):  
United States ◽  
Health Care ◽  
Affordable Care Act ◽  
Catholic Church ◽  
Health Care Policy ◽  
Common Ground ◽  
The United States ◽  
Universal Health Care ◽  
The Government ◽  
Universal Health

The American Catholic Church has a long history in health care. At the turn of 19th century, Catholic nuns began developing the United States’ first hospital and health care systems, amassing a high level of professionalization and expertise in the field. The bishops also have a well-established record advocating for healthcare, stemming back to 1919 with the Bishops’ Program for Social Reconstruction, which called for affordable and comprehensive care, particularly for the poor and vulnerable. Moving into the latter part of the 20th century, the bishops continued to push for health care reform. However, in the aftermath of Roe v. Wade (1973), the American bishops insisted that any reform or form of universal health care be consistent with the Church’s teaching against abortion, contraception, and euthanasia. The bishops were also adamant that health care policy respect religious liberty and freedom of conscience. In 1993, these concerns caused the bishops to pull their support for the Clinton Administration’s Health Security Act, since the bill covered abortion as a medical and pregnancy-related service. The debate over health care in the 1990s served as a precursor for the United States Conference of Catholic Bishops’ (USCCB) opposition to the Obama Administration’s Affordable Care Act (ACA) and the Department of Health and Human Services’ (HHS) contraception mandate. The ACA also highlighted a divide within the Church on health care among religious leaders. For example, progressive female religious leadership organizations, such as the Leadership Conference of Women Religious (LCWR) and their affiliate NETWORK (a Catholic social justice lobby), took a different position than the bishops and supported the ACA, believing it had enough protections against federally funded abortion. Though some argue this divide lead to institutional scrutiny of the sisters affiliated with the LCWR and NETWORK, both the bishops and the nuns have held common ground on lobbying the government for affordable, comprehensive, and universal health care.

Redefining the State in Health Care Policy in Italy and the United States

2018 ◽  
Vol 4 (2) ◽  
pp. 234-254 ◽  
Author(s):  
Lorraine Frisina Doetter ◽  
Stefano Neri
Keyword(s):  
United States ◽  
Health Care ◽  
Health Care Policy ◽  
The United States ◽  
The State ◽  
Care Policy

Bridging the Gulf on Health Care Policy Beyond the Affordable Care Act

2022 ◽  
Vol 7 (1) ◽  
pp. 0-0
Keyword(s):  
United States ◽  
Health Care ◽  
Health Care System ◽  
Affordable Care Act ◽  
Health Care Policy ◽  
The United States ◽  
Care Policy ◽  
Democratic System ◽  
The Affordable Care Act ◽  
Sustainable Health

This article presents a brief overview of the Affordable Care Act (ACA) and changes ushered into the health care system by the Act. The overview is followed by arguments for and against the ACA, integrating and situating the divergent arguments within the context of both democratic and conservative standpoints on health care policy. Furthermore, the article explores the possibility of identifying factors responsible for the seeming difficulty in transiting policy from agenda status to adoption in a democratic system of governance. The article concludes with suggestions on ways and strategies that can help in bridging the ostensible gap between divergent positions, with the hope of charting the course to the desired destination of an equitable and sustainable health care policy for the United States.

scholarly journals State Preparedness for Crisis Standards of Care in the United States: Implications for Emergency Management

2020 ◽  
pp. 1-3
Author(s):  
Annie E. Ingram ◽  
Attila J. Hertelendy ◽  
Michael S. Molloy ◽  
Gregory R. Ciottone
Keyword(s):  
United States ◽  
Health Care ◽  
Hurricane Katrina ◽  
Local Level ◽  
The United States ◽  
Health Care Facilities ◽  
Legal Responsibility ◽  
Standards Of Care ◽  
Clear Understanding ◽  
State And Local

Abstract State governments and hospital facilities are often unprepared to handle a complex medical crisis, despite a moral and ethical obligation to be prepared for disaster. The 2019 novel coronavirus disease (COVID-19) has drawn attention to the lack of state guidance on how hospitals should provide care in a crisis. When the resources available are insufficient to treat the current patient load, crisis standards of care (CSC) are implemented to provide care to the population in an ethical manner, while maintaining an ability to handle the surge. This Editorial aims to raise awareness concerning a lack of preparedness that calls for immediate correction at the state and local level. Analysis of state guidelines for implementation of CSC demonstrates a lack of preparedness, as only five states in the US have appropriately completed necessary plans, despite a clear understanding of the danger. States have a legal responsibility to regulate the medical care within their borders. Failure of hospital facilities to properly prepare for disasters is not a new issue; Hurricane Katrina (2005) demonstrated a lack of planning and coordination. Improving disaster health care readiness in the United States requires states to create new policy and legislative directives for the health care facilities within their respective jurisdictions. Hospitals should have clear directives to prepare for disasters as part of a “duty to care” and to ensure that the necessary planning and supplies are available to their employees.

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