Assess The Value Of Healthcare Professionals And Decision

The United States has a unique system of healthcare delivery, it is complex and massive. Twenty-five years ago; American citizens had guaranteed insurance, meaning the patient could see any physician and the insurance companies and patients would share the cost. But today, 187.4 million Americans have private health insurance coverage (Medicaid, 2014). The subsystems of American health care delivery are Managed care, military, vulnerable populations and integrated delivery

Patients with long-term, chronic illnesses like Mr. Davis’s, care can be very costly, especially when the patient is unable to maintain routine medical care or visits and medications. Without routine medical care and maintenance medications, patients like Mr. Davis tend to have more frequent emergency room visits and hospitalizations; increasing costs for state and local government as well as tax payers. Though Mr. Davis is able to receive care during an emergency room visit, the providers are not fully aware of his health history and are only able to provide a temporary fix of his symptoms and not address his health care needs.

The current health care sector is too costly and too fragmented with a lot of variation in care even with established evidence based guidelines. Providers lack the tools, support and information they need to offer the coordinated health management that can reduce cost and improve outcomes. Primary Care Physicians are constrained in their abilities to perform any proactive care that involves avoiding Hospital or ER visits, and influencing healthy lifestyles.

When contemplating health care policy changes, several economic issues in health care must be considered. These include the financial issues affecting the health sector and have an impact on health policies. Policy makers face unending challenges due to the health sector revenues that are always rising. Another challenge is decreased funding and failure of the health insurance services.

This is true for insured, uninsured, and under-insured Americans. These problems are exacerbated by a lack of coordination of care for patients with chronic diseases. The underlying

In a world of increasing competition for health resources economic evaluations are essential to provide evidence to decision makers that allows them to make appropriate decisions regarding the best use of those resources (Cohen and Reynolds, 2008; Williams et al., 2008). Critical appraisal is the means by which the validity of this research is assessed and is essential for true evidence based practice, and decision-making (Burls, 2009; Ciliska, Thomas and Buffett, 2008).

Healthcare is often driven by consumers and insurance companies; there is strong pushes for insurance companies to start paying better through Patient Care Medical Homes (PCMH) or Accountable Care Organizations (ACO) rather than paying at a per-visit basis (Hamlin, 2015). With PCMH or ACOs payment is made on a continuum of care, encouraging the provider to be involved in all aspects affecting health of the patient (Derksen, & Whelan,

Changing factors such as aging populations and new technologies becoming available are increasing expectations from people throughout the world, and decision makers must make rational choices to maximise benefits to population health whilst working with limited resources. Yothasamut et al (2009) summarise this by observing that "health care resources in every setting are always constrained, while unlimited demand is observed". The 'best' choices in the context of economics are the ones which maximise utility (individual satisfaction through consumption of goods) and welfare, the sum utility experienced by all individuals in society. Decision makers often have to seek satisfactory rather than optimal solutions, also known as working with 'bounded rationality' (Simon 1957 in Williams et al 2008), as it is important to pursue both efficiency and equity in the funding of health care. Therefore, it may be unsuitable to fund the most cost effective option if it sacrifices the equal distribution of benefits. Research in health economics can take a normative or positive approach and this reflects the balance needed between cost control and equity when making economic decisions. Positive economic research and analysis is concerned with 'how things are' and seeks to explain economic phenomena, whilst normative economic research and analysis is concerned with 'how things ought to be' and relies on value

Economists use certain concepts to help better understand health care services and the determining factor in health care funding.

Whereas evaluation of intervention effectiveness looks at how well the intervention improved health outcomes, economic evaluation looks at how cost factors relate to the intervention (CDC, n.d., page 4). In essence, economic evaluation is a way to identify, measure, value, and compare the costs and results of intervention programs and health policies (CDC, n.d., page 6). There are numerous purposes of economic evaluations. These include but are not limited to: generating burden of disease estimates (i.e., cost-of-illness analysis); comparing “willingness to pay” for the intervention to the intervention expense (i.e., cost-benefit analysis); comparing intervention costs to intervention outcomes (i.e., cost-of-effectiveness analysis); providing recommendations about the design or implementation strategy of a health intervention; and informing decision-making processes and policy development (CDC, n.d., page 4-7; Slade, 2016).

Health and human services policymakers expressed the need to move from single –disease solutions to population health interventions. The need is due to a growing public health concern- almost 1 in 3 Americans is diagnosed with multiple chronic conditions and more than 65% of health care spending is for care given to this group. (Kangovi peer research October 2017).

The healthcare system plays a key role in the economic stability of our country, as every year trillions are spent in attempt to combat disease and health issues that plaque humanity. As it makes up a significant amount of the expenditures in the economy, so the costs associated with health care of those in pain from illness and injury, including lost productivity, increased need of assistance in living and also the cost of death in some cases, is important to the economic stability and over all standard of living in our country. The key to economic prosperity is balancing the need for care with the costs of illness to keep as many people healthy and well without breaking the bank of collective society. The costs of healthcare have been increasingly problematic in recent years with so many issues surrounding the current system. With the “total health care spending in the United States expected to reach $4.8 trillion in 2021, up from $2.6 trillion in 2010 and $75 billion in 1970, meaning that health care spending will account for nearly 20 percent of gross domestic product (GDP), or one-fifth of the U.S. economy, by 2021” (Aetna). With this in mind it is apparent that as we look at the trillion-dollar industry of the medical community it seems that it needs to be a major focus of our nation as a whole and with the many issues come many creative solutions. First let us analyze the reasons behind the current cost and the major problems facing this industry and than discus what

The current research programs in the Centre for Health Economic at Monash University took my interest as the university is providing a wide range of research areas in the field of Health Economics. Furthermore, the researches are mainly centred on economic evaluation, health outcomes and performance in the health care system which help me to get a comprehensive knowledge and understanding of micro econometrics and other statistical methods, while focusing on Health Economics. In addition to my postgraduate experience, during my volunteer work at King Edward Memorial Hospital and Multiple Sclerosis Society of Western Australia, I have acquired experience in designing questionnaires in relation to ongoing health programs and analysed the surveys’ data focusing on pre-and post-health outcomes. All these academic and extracurricular activities enhance my interest in Health Economics and therefore I am willing to go for further studies to have a sound knowledge of in this specific field.

A health services perspective was adopted for this analysis as is recommended by previous guidelines (40). Adopting a societal perspective can be challenging, and there is debate and difficulties around what to include as part of this as well of ways of costing all elements of treatment and care, especially from a patient and carers perspective.

Healthcare sector is a major considerate area worldwide. The government of all over the world spends a huge