Interconnections Between Healthcare Financing and Patient Care Quality: Insights for Improvement

Speaking about such sphere of human activity as healthcare and medicine, it is important to mention that a wide range of problems that may occur in healthcare settings are at the confluence of financial matters and the quality of patient care.

Even though the measures taken by healthcare specialists to improve the quality of life of their patients should be designed with reference to the primary values of the profession and ethical considerations, it sometimes happens that financial problems of healthcare institutions result in decreased quality of patient care or the appearance of special categories of patients who are treated in a different way or discriminated. Importantly, the situation becomes even worse if we consider that satisfaction of the majority of patients is strictly interconnected with the costs of treatment as the latter believe that cheaper healthcare decisions always lead to less significant results for clients.

The problem of patients’ expectations in connection with available financial resources is not urgent in my workplace but, considering the number of potential conflicts between patients and healthcare specialists based on financial matters, this topic needs to be reviewed. As is clear from the professional experience of my colleagues, problems caused by inadequate expectations of patients often lead to financial difficulties for healthcare institutions.

The first aspect of identified problem that may cause a number of conflicts between healthcare specialists and their clients and even become the reason of a significant customer attrition is the expectations of customers related to value for money factor of the proposed interventions and medications. This problem is addressed in the study conducted by Sommers, Goold, McGlynn, Pearson, and Danis (2013) published in Health Affairs.

The researchers aimed at identifying and analyzing the primary problems that arise when patients are provided with an opportunity to participate in the process of intervention planning. More than twenty focus groups were included in the research and the authors have managed to identify four major issues associated with the topic. First, it was patients’ inability to evaluate the effectiveness of interventions. Another problem was related to the lack of experience preventing them from finding a tradeoff alternative that maintains health and is affordable. Also, the barrier connected with their unwillingness to consider limitations faced by insurers was identified.

In the end, the participants were focusing only on their interests even though they understood that the resources were limited. The problem of the quality of care in connection with financial resources of healthcare organizations is also addressed by Skirbekk and Nortvedt (2014) in their study published in Health Care Analysis. From the perspective of the researchers, the perceived inappropriate quality of care related to limited financial resources may be associated with far-reaching ramifications causing stratification and discrimination of patients belonging to more vulnerable segments of the population.

The article presents the research focused on the interconnection of budget restraints with the ability of healthcare professionals to provide elderly patients with appropriate care. The threat of discrimination (the so-called “ageism”) identified by the researchers was connected with the inability of nurses and consulting physicians to consider age peculiarities of patients as a result of budget problems.

The study by Oshima Lee and Emanuel (2013) also considers the problem at the confluence of patient care quality and costs of treatment; having reviewed the sources presenting findings relevant to the topic, the authors conclude that the use of shared decision-making presents a good way to find the balance between the outcomes for patients and appropriate costs; despite that, the lack of data on the topic remains a barrier making it more difficult to use the approach. The audience for all three articles is represented by healthcare professionals who face problems related to patient satisfaction that involve a significant influence of financial factor.

All articles discussing problems that are somehow related to the identified problem contain clues that can be used by healthcare professionals such as nurses to improve patient satisfaction and avoid unnecessary expenses for the healthcare institutions. When it comes to recommendations that can be retrieved from the discussed sources, it is important to state that additional education for nurses may be required in this case.

Having studied the reviewed sources, it is possible to conclude that specialists in nursing have to pay focused attention to the identified characteristics of patients who were allowed to choose between treatment option on their own; to reduce negative perceptions of care reported by patients and prevent unnecessary expenses, nurses may have to practice in providing patient education focused on value for money factor associated with the interventions that are available.

More than that, reduced funding can cause patient discrimination and nurses who feel that this situation is possible for their healthcare settings need to cooperate with physicians and report the problem to the higher management to reduce the risk of discrimination and customer attrition which would be detrimental to financial resources of any healthcare institution. Therefore, nurses have a range of opportunities to prevent the perceived or real decrease in the quality of care having a negative impact on resources available to clients of their organizations.

References

Oshima Lee, E., & Emanuel, E. J. (2013). Shared decision making to improve care and reduce costs. New England Journal of Medicine, 368(1), 6-8.

Skirbekk, H., & Nortvedt, P. (2014). Inadequate treatment for elderly patients: Professional norms and tight budgets could cause “Ageism” in hospitals. Health Care Analysis, 22(2), 192-201.

Sommers, R., Goold, S. D., McGlynn, E. A., Pearson, S. D., & Danis, M. (2013). Focus groups highlight that many patients object to clinicians’ focusing on costs. Health Affairs, 32(2), 338-346.

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StudyCorgi. "Interconnections Between Healthcare Financing and Patient Care Quality: Insights for Improvement." September 30, 2020. https://studycorgi.com/healthcare-financing-and-patient-care-quality/.

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StudyCorgi. 2020. "Interconnections Between Healthcare Financing and Patient Care Quality: Insights for Improvement." September 30, 2020. https://studycorgi.com/healthcare-financing-and-patient-care-quality/.

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