Identification of the Problem
- Number of patients continues to grow;
- Number of medical specialists is in decline;
- Bad healthcare infrastructure;
- Narrow medical networks in all healthcare spheres;
- Long waiting times;
- Lack of insurance coverage.
What Can Be Improved
- Higher medical training of nurse practitioners, physician assistants, and pharmacists;
- New coordinated care models (“patient-centered medical homes”) (Modern Medicine Network, 2014, para. 13);
- Dissemination of “shared medical appointments” (Modern Medicine Network, 2014, para. 20);
- Dissemination of telehealth initiative;
- Possibility to make an appointment in after-hours;
- Popularization and financial facilitation of primary care training;
- Reduction of paperwork tasks.
What Processes Does This Affect
- Federal legislation;
- State economic process;
- Social service;
- Healthcare organization;
- Scientific research;
- Infrastructure development.
What Is the Current Situation
- As of 2014, 26,000 new doctors a year (Modern Medicine Network, 2014, para. 2);
- As of 2014, 9 million of persons with newly gained health insurance (Modern Medicine Network, 2014, para. 5);
- As of 2015, the percentage of the uninsured is 9.1% (U.S. Department of Health and Human Services, 2015, p. 2);
- As of 2015, 10.5% of persons under age 65, 12.8% of persons aged 18–64, and 4.5% of children under age 18 are uninsured (U.S. Department of Health and Human Services, 2015, p. 6);
- As of 2015, 4.5% of persons failed to obtain needed medical care due to high cost (Centers for Disease Control and Prevention, 2016, para. 1);
- As of 2015, 87.8% of persons have a usual place to go for medical care (Centers for Disease Control and Prevention, 2016, para. 1).
Ethical Principles
- Gender, age, race, level of income and education influence the insurance coverage;
- The uninsured receive poor-quality healthcare;
- The problem of fair healthcare resources allocation among the insured;
- Existing principles of distributive justice complicate the problem of allocation;
- Discord in the national community with regards to fair healthcare access principles;
- People do not have the opportunity to influence the allocation decisions that affect them (Trotochaud, 2006).
Communication Process
- Occurs in healthcare continuum (Augmentative Communication News, 2009);
- Arsenal of communication tools (synchronous and asynchronous) to expand access to healthcare;
- Influences consumer satisfaction;
- If effective, reduces waiting time;
- Clinicians take communication training courses;
- The shared medical appointment allows for time-saving.
Strategies That Contribute to Resolution of the Problem
- Increase or decrease of the healthcare services use;
- Evaluation of policies that affect healthcare services use;
- Adoption of new healthcare access principles;
- Reduction of social characteristics influence;
- Minimization of the costs of healthcare services use;
- Implementation of new communicative tools.
Stakeholders Involved in the Process
- Federal government;
- Healthcare organizations and services;
- Social services;
- Influential individuals;
- State doctors and vendors;
- Healthcare service consumers.
Challenges and Opportunities That Arise in the Process of Resolution
- Discord in governmental and private healthcare services;
- Greater costs for insurance coverage provision;
- Social attitude to healthcare minorities;
- Discord in the scientific community with regards to healthcare access principles;
- Development of healthcare infrastructure;
- New working places for primary care specialists;
- Strengthening of healthcare networks.
Evaluation Plan That Can Be Tracked Over Time
- Purpose: assessment of the fair distribution of healthcare services
- Questions:
- How many people receive healthcare?
- What kind of healthcare do the uninsured people receive?
- What ethical principles affect the distribution of healthcare? Are they fair?
- What communicative tools does the healthcare industry use?
- How many newly trained medical professionals are there?
- How many retired medical professionals are there?
- Did the healthcare infrastructure improve?
- Statistical reports will count as a key criterion in the evaluation
Indicators That Can Be Tracked Over Time
- Number of the insured;
- Number of the uninsured;
- Number of medical specialists in all healthcare spheres;
- The efficiency of newly introduced communicative tools;
- The efficiency of newly introduced meth.
References
Augmentative Communication News. (2009). Communication access across the healthcare continuum. Web.
Centers for Disease Control and Prevention. (2016). Access to Health Care. Web.
Modern Medicine Network. (2014). 7 ways to improve access. Web.
Trotochaud, K. (2006). Ethical issues and access to healthcare. Journal of Infusion Nursing, 29(3), 165-171.
U.S. Department of Health and Human Services. (2015). Early release of selected estimates based on data from the 2015 National Health Interview Survey. Web.