Healthcare Reform

2020 ◽  
pp. 144-166
Author(s):  
Abburi Anil Kumar
Keyword(s):  
Healthcare System ◽  
Point Of View ◽  
Specific Reference ◽  
Patient Centered ◽  
Technical Challenge ◽  
Basic Tenet ◽  
Complex Adaptive ◽  
Rule Breaking ◽  
Technical Solutions ◽  
The U.S

The healthcare system in the U.S. is very fragmented in its structure. It is generally agreed that it needs to be reformed. This chapter addresses this issue from an organizational point of view with specific reference to cancer, a disease termed “The Emperor of All Maladies.” The basic tenet of this chapter is that any healthcare system should be designed so as to maximize the benefit to all the stakeholders involved, while incorporating the newer advances in technologies, but above all, must be patient-centered. Solving a complex adaptive problem requires different approaches compared to solving a simple technical challenge. Especially, when it comes to dealing with cancer—a very intelligent, continually adapting, rule breaking, self-sustaining disease—simple technical solutions are insufficient without an understanding of how to change the system. After discussing the current healthcare system in the U.S., a proposal is made as to how to reform the system.

Person-centered medicine from a complex adaptive systems perspective

2014 ◽  
Vol 2 (1) ◽  
pp. 85 ◽  
Author(s):  
Joachim Sturmberg
Keyword(s):  
Medical Care ◽  
Healthcare System ◽  
Complex Adaptive Systems ◽  
Adaptive Systems ◽  
Health Issues ◽  
Patient Centeredness ◽  
Patient Centered ◽  
Health And Illness ◽  
Complex Adaptive ◽  
Illness And Disease

Miles and Mezzich have proposed person-centered medicine as the way forward to overcome the rapidly escalating crisis of dehuminisation of medical care and the healthcare system at large. The crisis in medical care is caused by a Zeitgeist characterised by 2 themes – conquering disease and profit maximising activities. Overcoming this crisis requires a change of the prevailing worldview and its reductionist thinking about discrete diseases to a worldview that recognises the complexities arising from the interconnections and interdependencies between all facets of a person’s life – his health and illness and disease trajectories. As Kant said: each man has his particular way of being in good health.This paper presents 5 themes that argue for a complexity based framework to achieve a person/patient-centered understanding of health and healthcare: (1) health, illness and disease are complex adaptive states that impact personhood; (2) healthcare must grow health; (3) healing results from personal sense-making and must be fostered; (4) complex adaptive systems thinking allows an exploration and understanding of personal and community health issues and (5) person/patient-centeredness results in an effective and efficient healthcare system.A person/patient-centered focus, the person/patient at the centre of concern, will result in a seamlessly integrated healthcare system. Such a system will show great diversity between communities, each having emerged as a result of best adaptation to local circumstances. Such a system will have substantial benefits – for the person (in terms of staying healthy) / patient (in terms of regaining his health), the community and the economy.

Choice Matters

2018 ◽  
Author(s):  
Gordon Moore ◽  
John A. Quelch ◽  
Emily Boudreau
Keyword(s):  
Public Policy ◽  
Social Media ◽  
Healthcare Provider ◽  
Healthcare System ◽  
Consumer Choice ◽  
Marketing Management ◽  
Appropriate Use ◽  
System P ◽  
The U.S

Choice Matters: How Healthcare Consumers Make Decisions (and Why Clinicians and Managers Should Care) is a timely and thoughtful exploration of the controversial role of consumers in the U.S. healthcare system. In most markets today, consumers have more options and autonomy than ever before. Empowered consumers easily shop around for products and services that better meet their needs, and they widely share their reviews on social media to inform and influence other consumers. Businesses have responded with better experiences and prices to compete for consumers’ business. Though healthcare has lagged behind other industries in this respect, there is a rising tide of interest in consumer choice and empowerment in healthcare markets. However, most healthcare provider organizations, individual doctors, and health insurers are unprepared to consider patients as consumers. The authors draw upon the fields of medicine, marketing, management, psychology, and public policy as they take a substantive, in-depth look at consumer choice and point out its appropriate use, as well as its limitations. This book addresses perplexing issues, such as how healthcare differs from other consumer-driven markets, how consumers make healthcare decisions, and how increased consumer choice in healthcare can not only aid and empower American consumers but also improve the overall healthcare system.

scholarly journals A Kinetic Theory Model of the Dynamics of Liquidity Profiles on Interbank Networks

Symmetry ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 363
Author(s):  
Marina Dolfin ◽  
Leone Leonida ◽  
Eleonora Muzzupappa
Keyword(s):  
Kinetic Theory ◽  
Network Formation ◽  
Transition Probabilities ◽  
Stochastic Game ◽  
Theory Model ◽  
Point Of View ◽  
Network Efficiency ◽  
Modelling Framework ◽  
Wide Range ◽  
Complex Adaptive

This paper adopts the Kinetic Theory for Active Particles (KTAP) approach to model the dynamics of liquidity profiles on a complex adaptive network system that mimic a stylized financial market. Individual incentives of investors to form or delete a link is driven, in our modelling framework, by stochastic game-type interactions modelling the phenomenology related to policy rules implemented under Basel III, and it is exogeneously and dynamically influenced by a measure of overnight interest rate. The strategic network formation dynamics that emerges from the introduced transition probabilities modelling individual incentives of investors to form or delete links, provides a wide range of measures using which networks might be considered “best” from the point of view of the overall welfare of the system. We use the time evolution of the aggregate degree of connectivity to measure the time evolving network efficiency in two different scenarios, suggesting a first analysis of the stability of the arising and evolving network structures.

scholarly journals Illuminating an Invisible Epidemic: A Systemic Review of the Clinical and Economic Benefits of Early Diagnosis and Treatment in Inflammatory Disease and Related Syndromes

2019 ◽  
Vol 8 (4) ◽  
pp. 493 ◽  
Author(s):  
Wylezinski ◽  
Gray ◽  
Polk ◽  
Harmata ◽  
Spurlock
Keyword(s):  
Healthcare System ◽  
Inflammatory Diseases ◽  
The United States ◽  
Economic Benefits ◽  
Systemic Review ◽  
Best Interest ◽  
Delayed Treatment ◽  
Inflammatory Conditions ◽  
Slow Development ◽  
The U.S

Healthcare expenditures in the United States are growing at an alarming level with the Centers for Medicare and Medicaid Services (CMS) projecting that they will reach $5.7 trillion per year by 2026. Inflammatory diseases and related syndromes are growing in prevalence among Western societies. This growing population that affects close to 60 million people in the U.S. places a significant burden on the healthcare system. Characterized by relatively slow development, these diseases and syndromes prove challenging to diagnose, leading to delayed treatment against the backdrop of inevitable disability progression. Patients require healthcare attention but are initially hidden from clinician’s view by the seemingly generalized, non-specific symptoms. It is imperative to identify and manage these underlying conditions to slow disease progression and reduce the likelihood that costly comorbidities will develop. Enhanced diagnostic criteria coupled with additional technological innovation to identify inflammatory conditions earlier is necessary and in the best interest of all healthcare stakeholders. The current total cost to the U.S. healthcare system is at least $90B dollars annually. Through unique analysis of financial cost drivers, this review identifies opportunities to improve clinical outcomes and help control these disease-related costs by 20% or more.

scholarly journals PCN52 IMPACT OF LOWER COST BIOSIMILAR OPTIONS ON PATIENTS IN THE U.S. HEALTHCARE SYSTEM

2020 ◽  
Vol 23 ◽  
pp. S32
Author(s):  
A. Shelbaya ◽  
J. Yang ◽  
J. Brown ◽  
J. Adler ◽  
A. Mahmood
Keyword(s):  
Healthcare System ◽  
Lower Cost ◽  
The U.S

scholarly journals Linking the Unitary Paradigm to Policy through a Synthesis of Caring Science and Integrative Nursing

2017 ◽  
Vol 30 (3) ◽  
pp. 262-268 ◽  
Author(s):  
Mary S. Koithan ◽  
Mary Jo Kreitzer ◽  
Jean Watson
Keyword(s):  
Patient Care ◽  
Healthcare System ◽  
Care Delivery ◽  
Healthcare Policy ◽  
Patient Centered ◽  
Nursing Knowledge ◽  
Call To Action ◽  
Caring Science ◽  
Patient Care Delivery

The principles of integrative nursing and caring science align with the unitary paradigm in a way that can inform and shape nursing knowledge, patient care delivery across populations and settings, and new healthcare policy. The proposed policies may transform the healthcare system in a way that supports nursing praxis and honors the discipline’s unitary paradigm. This call to action provides a distinct and hopeful vision of a healthcare system that is accessible, equitable, safe, patient-centered, and affordable. In these challenging times, it is the unitary paradigm and nursing wisdom that offer a clear path forward.

scholarly journals Improving the External Validity of Clinical Trials: The Case of Multiple Chronic Conditions

2013 ◽  
Vol 3 (2) ◽  
pp. 30-35 ◽  
Author(s):  
Fortin Martin ◽  
Smith M. Susan
Keyword(s):  
Clinical Trials ◽  
External Validity ◽  
Chronic Conditions ◽  
Evidence Base ◽  
Specific Reference ◽  
Multiple Chronic Conditions ◽  
Patient Centered ◽  
Department Of Health ◽  
Patient Groups ◽  
Intervention Trials

The U.S. Department of Health and Human Services vision and strategic framework on multiple chronic conditions (MCCs) incorporates recommendations designed to facilitate research that will improve our knowledge about interventions and systems that will benefit individuals with MCCs (or multimorbidity). The evidence base supporting the management of patients with MCCs will be built through intervention trials specifically designed to address multimorbidity and identification of MCCs in participants across the clinical trial range. This article specifically focuses on issues relating to external validity with specific reference to trials involving patients with MCCs. The exclusion of such patients from clinical trials has been well documented. Randomized control trials (RCTs) are considered the “gold standard” of evidence, but may have drawbacks in relation to external validity, particularly in relation to multimorbidity. It may, therefore, be necessary to consider a broader range of research methods that can provide converging evidence on intervention effects to address MCCs. Approaches can also be taken to increase the usefulness of RCTs in general for providing evidence to inform multimorbidity management. Additional improvements to RCTs would include better reporting of inclusion and exclusion criteria and participant characteristics in relation to MCCs. New trials should be considered in terms of how they will add to the existing evidence base and should inform how interventions may work in different settings and patient groups. Research on treatments and interventions for patients with MCCs is badly needed. It is important that this research includes patient-centered measures and that generalizability issues be explicitly addressed.

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