More importantly what can be done to mitigate it I will apply the Conflict Theory and utilize secondary quantitative data to identify annual trends as well as qualitative data and conduct ethnography of emergency department workers History of Healthcare Reform in The United States 1900 1960 Societal reform was in action in Europe and the United States during the first twenty years of the 1900 s Europe had already begun passing the first welfare acts marking the beginning of subsidized healthcare Industrial sickness insurance could be purchased through employers however the presence of these types of funds contributed to why the idea of government backed health insurance did not take traction in the U S like it was in the U K and other parts of Europe As Americans became accustomed to this type of payment structure it set the stage for third party health insurers to take hold As the Great Depression struck American people could no longer afford medical services and it was during this time that hospitals and groups of physicians began offering their own insurance the pioneers of this are what we know today as Blue Cross Blue Shield and Kaiser Permanente History of Healthcare Reform in The United States 1960 1990 With the aging population of America and increasing opposition to socialized medicine the Medicare program which is a social government backed insurance providing coverage to those 65 years and older or those with other special criteria such as disabilities was established in 1965 Six years later in 1971
Medicaid was implemented another social government backed insurance this time providing coverage to the poor with children Also at this time a stipulation was put onto employers to offer subsidized health insurance to their employees History of Healthcare Reform in The United States 1990 2017 Present Day Healthcare has continued to be a hot topic in the political arena with increasing public pressure for change Many politicians have proposed different ideas only to have fractions of their policies implemented as they were met with opposition Not until 2011 was the Affordable Care Act or Obamacare signed into law with most major effects taking place in 2014 which cut the uninsured population of Americans in half By 2017 the law has gained major support by society RESULTS Measures of potentially avoidable ED visits ED visits with a primary diagnosis of mental health alcohol or substance abuse ED visits with a primary diagnosis of dental conditions ED visits for asthma Orange County CA Based Health System Data Performance Year 2017 2017 Q1 2017 Q2 2017 Q3 2017 Q4 Diagnosis related to mental health alcohol substance abuse 525 ED visits 449 ED visits 503 ED visits 856 ED visits Diagnosis related to dental conditions 165 ED visits 252 ED visits 160 ED visits 194 ED visits Diagnosis related to asthma 688 ED visits 491 ED visits 446 ED visits 557 ED visits Potential preventative care solutions Patient and family engagement Patient safety Care coordination Population public health Efficient use of healthcare resources Clinical Process Effectiveness DISCUSSION Because some ED visits are potentially avoidable and could have been prevented or addressed outside of a hospital they may be indicative of need for further patient education poor care management lack of a primary care provider access to care in a specific demographic area lack of resources or poor choices at risk behaviors on the part of patients themselves
Potentially avoidable emergency department visits include conditions that are preventable or treatable with appropriate preventative primary care An estimated 22 of ED visits at the health system I studied could be addressed in provider offices public health clinics or urgent care centers saving an average of 6 5 million annually CONCLUSION Results are indicative that if patients received normal preventative care by a primary care provider aligned with quality care measures unnecessary costly emergency department visits could have been drastically reduced avoiding public and private insurer reimbursement as well as unpaid patient debt that burden health care organizations The largest barrier for many people may be their lack of insurance due to financial resources and a fully integrated public health offering subsequently causing them to hold off on seeking medical attention and causing a minor condition to become acute REFERENCES Dr Beena Kazi Pediatric Emergency Medicine CHOC Children's Hospital Daniel Vargas RN ED MemorialCare Orange Coast Medical Center Nash David B Fabius Raymond J Skoufalos Alexis Clarke Janice L 2016 Population Health Creating a Culture of Wellness 2nd ed Burlington MA Jones Bartlett Learning ENDNOTES
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