Posted: June 9th, 2015

Who is at greatest risk of receiving poor health care?

Who is at greatest risk of receiving poor health care?

Introduction

Many adults American do not receive the recommended health care in most cases. There are many reasons that make this happen. However, the quality of healthcare differs with socio-demographic subgroups. Other factors such as the type of health care also required affect the quality of health care that individuals receive (Asch et al., 2006). Several reforms have been embraced in the USA health care system with an aim to improve the quality. There have been some improvements in the system. However, more is needed as it is evident that the health care is far much from the recommended health care. Although Americans classified among the leading in health care provision, healthcare quality in some specific areas such as chronic diseases, mental disorders and end of life issues remain a problem in the country. The US spends a considerable amount of money on health care. However, the public still complain and demand more satisfying services in the health care industry (Knickman & Kovner, 2008). The article being analyzed try’s to analyze different health care received by different groups in the society so as to know who is at greater risk of receiving poor health care (Asch et al., 2006).

The key situations/problems

Health care quality to different socio-demographic sub-groups

Gender

The quality of care received by any group in the society is difficult to conclude the groups that receive best care as there are various characteristics that influence the care provided. Comparing the men and the women health care, the women have overall better score on the quality healthcare as compared to men. However, the score on specific areas of health care is different as they appear to have a higher score on chronic and the preventive care. However, the women’s score for the acute care is lower than that of men. There are various reasons why women tend to have a better score on the preventive and chronic care and lower in acute. The fact that women routinely seek healthcare services early in their life is the main contributor to the difference in the quality of care in the three areas (Asch et al., 2006).

Age

Recommended health care in the US decline with the age, the young people 35 years and below had a higher score on the preventive cares as compared with the old. However considering the follow-up care the older, 65 years and above have a higher score. It is suggested that the difference in the preventive health care between the old and the young might have been affected by the fact that older people go for often screening involving various physicians thus difficult to track their systems. However, difference that was identified in the follow-up care would be as a result of the commitment that the older patients and the physicians to deal with the already identified problems (Asch et al., 2006).

Race

According to Asch, et al. (2006), the blacks scored higher than whites in concerning the health care receive. This was contrary to most of the studies that have been conducted previously. For example a study by Saha, Arbelaez and Cooper (2003), showed that the blacks and the Hispanic receive poor health care as compared to the whites. The reason for the poor health care among these groups was largely contributed by poor physician patients’ relationship among other factors. However, the main difference between the two studies is brought about by the difference of the characteristics that were considered in the studies. Most of the studies that showed the whites to be receiving better healthcare than the blacks included some expensive procedures and not routine health care. In terms of routine healthcare, the blacks receive better healthcare than the whites (Asch, et al. 2006). For example, a study by Council on Ethical and Judicial Affairs (1990) showed the backs receive poor health care quality as compared to whites in terms of specific therapies and surgeries. Some of the healthcare services included in the study included kidney transplant, cardiac surgery, and obstetrics among others. However, the study did not consider other common services and concluded that the difference is brought about by the difference in income and levels of education between the two races.

Insurance and Healthcare Quality

It is important to note that, health insurance has very little to do with the health care quality that individuals receive. However, health insurance makes it easy for individuals to access health care systems (Asch et al., 2006). This notion is supported by Starfield and Shi (2004), who argues that the insurance only reduce the gap between the rich and the poor to access of the health care. However, although insurance helps individuals access health care services at lower cost, it does very little to improve the quality of care that the individuals receive.

Healthcare in America is below Expectation

The overall health care in America is below expectation for all the subgroups in America. They receive about 54.9 of the recommended health care. There is no specific group that receives overall quality health care in all the three areas-acute, chronic, and preventive health care. Of the whole population, women are recorded to have a higher percentage of health care than men (Asch et al., 2006). This study is supported by Schuster, McGlynn and Brook (2005) study, which acknowledged that Americans do not receive recommended health care. The gap in health care quality is in all types of care that are provided such as acute care, preventive, and chronic care. Of all the cares, the acute care has the highest percentage of quality while the preventive care quality being the least. According to Mangione-Smith et al. (2007), children are not exceptional of the health care deficit. Children receive about 46.5 % of the recommended health care in the United States. This is far much below the expectations, and something needs to be done to better the situation. A considerable number of adults in America are not satisfied with the care that they receive, and they would wish the system be changed.

The future trends discussed in this article

Quality Improvement Programs

Health care quality improvement programs are among the future trends that are likely to take place in the USA healthcare industry. The fact that the quality of health care is still below the expectation, various health care programs will be necessary to improve the quality and make it reach or near the expectation. Quality improvement programs may include training of the health care providers for them to better offer their services. Continuing education and training programs will be embraced in the health care sector so as to improve the kind of care that individuals receive (Knickman & Kovner, 2008).

Narrowed gap of the health care quality among the races

In future, there is going to be equal access to quality health care between the blacks and the whites despite the cost. The article acknowledges that the gap between the whites and Blacks health care quality for expensive services such as organ transplants has reduced and is going to reduce. Once this happens, there is likely going to be equality in the quality of health care quality for the blacks and the whites. Moreover, as the article shows some of the reasons that might be making the whites to have lower score on the health care quality as compared to the black, educative actions will be taken which will help better the quality of health care received in the society (Asch, et al., 2006).

Automation of health care system

Automation of the health care system is another future trend mentioned in the article. Embracing new technology is aimed to increase the quality of health care service that the US citizens receive. However, there is a challenge as the introduction of the new technology will make the health care more expensive (Asch, et al., 2006). According to Knickman and Kovner (2008), about half of the US spending is largely associated with the new technology that has been embraced so far. Although technology has helped, the country improve health care in some areas such as fighting cancer, more need to be done to ensure that the quality of overall healthcare is acceptable.

The major implications for healthcare

Improved health care and high-cost

The major implication that is going to have in health care in future is that, the emerging trends are likely going to improve the quality of the care that is received. For example, if the quality improvement programs are implemented successfully, the health care providers will become more knowledgeable on how to improve healthcare. This will have a positive impact on both the patients and the society at large. However, there is likely to be an increased cost for health care services as more complex technology get introduced in the health care system. Although it is difficult to satisfy all the citizens, the system will be rated higher than it is now, and there will be reduced complaints about the quality of overall health care provision. Moreover, the healthcare system is likely going to experience various changes and reforms in the process of improving the quality of healthcare (Knickman & Kovner, 2008).

Equality in the quality of health care thus improved life quality

There is going to be equality of health care received by individuals in the society despite the race. This will help solve some inequality problems that have been facing the US health care system. Furthermore, there will be less criticism of the system that will help the patients feel free to interact and be treated by any physician. By receiving the same health care quality, there is likely going to be the most improved quality of life which will be reflected in the improvement of life expectancy of Americans (Knickman & Kovner, 2008).

My thoughts and opinions of the article

I would say that the article is relevant and is related to the title. The way that the ideas have been laid out is good and helps to foster better understanding of the topic. I would support the idea that health care in the United States is far below the expectation. The organization of the article is reasonable, and the language used in the article is easy to understand for everyone irrespective of the field of study

The information used in the article can be relied upon as it is collected from a wider population of the United States. The procedure used to select the participants of this study helps to avoid opinions from individuals who have not recently utilized the health care services thus making the data more relevant and reliable. The article also gives an insight of how different subgroups in the society receive a different quality of different types of care. This is a comprehensive article; however, it is difficult to conclude whose overall health care quality is satisfactory. Although some subgroups like the women registered a high score in preventive care, their score for acute care was relatively low. It is difficult to make a conclusion that a given subgroup is at higher risk of poor health care than the other for all the care areas.

The article considered all the characteristics that can influence the quality of health care received. For example, the education and the income levels were among the factors that were considered. The consideration of these factors helps in reducing the bias on the result. There is also a provision of an explanation of each outcome of the research. For example, the researcher indicated that the main reason why the black recorded higher score than the whites is because the previous studies involved the use of expensive medical care characteristic. The comparison and the linking of the previous study with the current study make the article to be easily understood and to display more concrete evidence of the results.

Summarize of the statistical data

The data in the article was collected from both males and females aged between 18 years and above 65. The ethnic groups from which the data was collected were the whites, black, Hispanic and others. The statistical data showed that Americans adults receive 54.9 % of the recommended health care quality which means that 41.1% need to be improved. Women scored 57.8and 57.9 score on preventive care and chronic care respectively while men scored 50.1 for preventive and 54.5 for chronic. However, women scored 51.9 on acute care while the men scored 58.4% for the same. Individuals who are below 31 years recorded 55.2% for acute care and 58.6 for preventive care while those 31 and above recorded 52.3 for acute care 57.3 chronic car and 54.8 preventive care. However, the young people score for chronic care is quite low 50.9 as compared to those above 31 years old. The blacks recorded higher care in all the three areas than the whites. However, the Hispanic scored higher in acute care and preventive care. Education level did not much influence the score of health care quality. For example, those did not complete high school scored 50.6 for acute care, 55.7 for chronic care and 54.5 for preventive care. On the other hand, the college and the graduate scored54.0, 56.6, and 55.8 for acute, chronic and preventive care respectively.

Conclusion

Poor healthcare in the US remains a concern for many. The quality of health care that is received by adults is not as it is expected. Different groups of people record different score on the different care areas. It can be said that, women, the young and the whites received a higher score on more than one health care area. However, there is no specific subgroup that can be considered to be safest as each group had some weaknesses in some areas of care. For example, the women scored better in chronic and preventive but lower in acute. The young people scored high in preventive and acute but low in the chronic area.

References

Asch, S. M.et al (2006). Who is at greatest risk for receiving poor-quality health care? New England Journal of Medicine, 354(11), 1147-1156.

Council on Ethical and Judicial Affairs (1990). White Disparities in Health Care. JAMA263(12) pp 2344-2346

Knickman, J.R., & Kovner A. R. (2008). Jonas and Kovner’s Health Care Delivery in the United States. NY: Springer Publishing Company.

Mangione-Smith, R., et al. (2007). The quality of ambulatory care delivered to children in the United States. New England Journal of Medicine, 357(15), 1515-1523.

Saha, S., Arbelaez, J. J., & Cooper, L. A. (2003). Patient-physician relationships and racial disparities in the quality of health care. American journal of public health, 93(10), 1713-1719.

Schuster, M. A., McGlynn, E. A., & Brook, R. H. (2005). How good is the quality of health care in the United States?. Milbank Quarterly, 83(4), 843-895.

Starfield, B., & Shi, L. (2004). The medical home, access to care, and insurance: a review of evidence. Pediatrics, 113(Supplement 4), 1493-1498.