Cost and Quality Analysis Essay Paper

Cost and Quality Analysis Essay Paper

In a paper of 500-1,000 words, describe the relationship between health care cost and quality. Address the following:
Select one public agency and one private agency. Differentiate the roles of these agencies and the major initiatives they have undertaken to address cost and quality in health care. Refer to the Topic 4 study materials for sources related to health care agencies.
Analyze current and projected initiatives to improve quality while simultaneously controlling costs in both the private and public spheres. Describe any unintended consequences that have resulted or may result from these efforts.
Synthesize the implications of these efforts for staff nurses and advanced practice nurses. Include evidence-based practice, relative to cost and quality, in your response.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.  Cost and Quality Analysis Essay Paper

Cost and Quality Analysis

Health care is extremely costly, and although the rate of increase in the costs has recently attenuated, per capita spending remains high. However, this does not reflect on the care quality with indications of wasteful spending. In fact, spending patterns are not correlated with patient outcomes with some spending being cost effective while others are not cost effective (Burke & Ryan, 2014). The present paper explores the relationship between health care cost and quality.

Public agency and private agency

The public health care agency has been identified as the National Institutes of Health (NIH), a medical research agency that focuses on enabling Americans to live healthier and longer. Its mission is to seek the fundamental knowledge about the behaviour and nature of living systems and apply the acquired knowledge to reduce disability and health, lengthen life and enhance health. The agency focuses on achieving four main goals. The first goal is to exemplify and promote the highest level of social responsibility, public accountability and scientific integrity in the conduct of science. The second goal is to expand the knowledge base of medical science and associated science to enhance the national well-being and ensure continued high returns from investments in research activities. The third goal is to develop, maintain and renew scientific physical and human resources to ensure the national capability to prevent disease. The fourth goal is to foster innovative research strategies and fundamental creative discoveries, and their application as the basis for protecting and improving health (National Institutes of Health, 2017).  Cost and Quality Analysis Essay Paper

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The private health care agency has been identified as the National Academy of Medicine (NAM), one of the three academies that comprise the National Academies of Sciences, Engineering and Medicine. NAM operates as a private non-profit institution under the 1863 Congressional charter of the National Academy of Sciences. NAM is outside the control of the government and is concerned with offering objective advice on matters of health, technology and science. The agency’s mission is to improve the health for all Americans by accelerating health equity, advancing science, and providing trusted, authoritative and independence advice to ensure a healthier future. NAM acts as an independent and evidence-based scientific advisor that has harnessed the expertise and talents who undertake meticulous processes to balance and avoid bias. Its foundational goal is to be a reliable source for credible policy and scientific advice on human health. It is committed to catalyzing action and achieving impact by identifying and generating momentum around critical health issues, and build evidence-based solutions (National Academy of Medicine, 2020).

The two agencies (NIH and NAM) recognize that the value of public health investments can only be optimized if evidence is generated and synthesized then directed towards the efficiency and effectives of medical services provided to the public/communities. To be more precise, they engage researchers to investigate the strategies for improving the value and quality of health services (Schmidt & Brown, 2019).

Initiatives to improve quality and control costs

There have been a range of efforts and initiatives to improve quality while simultaneously controlling costs in both the private and public spheres. The first example of these initiatives is Allina Health’s pharmacist-led medication therapy management targeted at reducing the total cost of care by leveraging analytics system. The initiative reduced medication-related adverse events, reduced total cost of care per patient by $2,085 over six months, reduced hospital admissions per 1,000 members by 12%, reduced emergency department visits per 1,000 members by 10%, and reduced average medication count. The second example is Mission Health’s initiative to optimize sepsis care to improve early recognition and outcomes. The initiative reduced patient mortality from septic shock and severe sepsis by 1%, reduced mortality by 9% when evidence-based protocols were used, 4% reduction in emergency department length of stay for patients with septic shock and severe sepsis, and 4% reduction in intensive care unit length of stay. The third example is Memorial Hospital’s systematic data-driven approach to lower length of stay and improve care coordination. The initiative resulting in $2 million cost savings from decreased length of stay and utilization of medication and supplies, and improved care coordination and physician engagement (Health Catalyst, 2019). In the three discussed initiatives, it is clear that efforts involved the use of evidence-based practice and were targeted at improving health care quality while controlling costs.

Implications for nurses

Nurses play a significant role in initiatives and efforts to improve quality and control costs. Firstly, the staffing and organization of nurses determines whether these initiatives can be implemented. Nurses apply the initiatives by developing an understanding of the associated protocols, collecting data on the initiatives, and presenting feedback. Secondly, nurses are actively involved in process improvements by making suggestions on what can be changed in the initiatives to improve their outcomes. They rely on their experiences and knowledge to make the improvement suggestions. The two roles ensure that nurses knowledge can be tapped, and they become increasingly visible as leaders (Raingruber, 2017).

References

Burke, L., & Ryan, A. (2014). The Complex Relationship between Cost and Quality in US Health Care. Virtual Mentor, 16(2), 124-130. https://doi.org/10.1001/virtualmentor.2014.16.2.pfor1-1402

Health Catalyst (2019). The Top Six Examples of Quality Improvement in Healthcare. https://www.healthcatalyst.com/insights/top-examples-quality-improvement-healthcare

National Academy of Medicine (2020). About the National Academy of Medicine. https://nam.edu/about-the-nam/

National Institutes of Health (2017). What we do: mission and goals. https://www.nih.gov/about-nih/what-we-do/mission-goals

Raingruber, B. (2017). Contemporary Health Promotion in Nursing Practice (2nd ed.). Jones & Bartlett Learning, LLC.

Schmidt, N., & Brown, J. (2019). Evidence-Based Practice for Nurses: Appraisal and Application of Research (4th ed.). Jones & Bartlett Learning, LLC.  Cost and Quality Analysis Essay Paper

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