StudentShare
Contact Us
Sign In / Sign Up for FREE
Search
Go to advanced search...
Free

Health Care Economics - Research Paper Example

Cite this document
Summary
This research paper describes the economic value of the health care industry today that is a topic of prime importance that has genuine relationship with the other industrial sectors of the economy. It also focuses on exploration of the implications of the cost of health care fraud…
Download full paper File format: .doc, available for editing
GRAB THE BEST PAPER96.9% of users find it useful
Health Care Economics
Read Text Preview

Extract of sample "Health Care Economics"

Management Topic: Health care Economics The economic value of the health care industry is a topic of prime importance that has genuine relationship with the other industrial sectors of the economy. The industry of health care can be regarded as a pillar to the economic structure of a country on the grounds of circulation of health care generated dollars in the economy and the direct linkages it have with other industrial sectors. Apart from this the features of providing employment and generating revenue through purchases of utility services and other material are the direct contributions of this sector to the economy.(Connie Bodeen, 1998) Research aim and Objectives; Health care frauds are becoming a widespread problem at present time that needs immediate attention of authorities for raising preventive measures. In the year 2008 the reporting of US department of Health and Human service office of inspector general (OIG) reveals the elimination of around 3,000 personnel against accusation of health care related fraud and abuse. Out of these 575 were criminal graded actions and 342 were the civil action abuses. The estimated loss incurred out of the wastage was around $20.4 billion. ((OIG), 2008)The objectives of this research paper is to explore the implications of the cost of health care fraud, abuse and waste, depicting the various aspects of these activities and the measures government has taken in the form of rules and regulations. Health Care Fraud; The definition of Health care fraud in the United States Code is defined as, “knowingly and willfully executing, or attempting to execute, a scheme or artifice to defraud any health care benefit program or to obtain (by means of false or fraudulent pretenses, representations, or promises) any of the money or property owned by, or under the custody or control of, any health care benefit program”(Law, nd). The illustration of law defines it as a white collar crime that induces illegal and harmful practices for the sake of earning profits. The various forms of frauds include unfair schemes, unnecessary hoarding of medicines to raise their price, billing against unoffered services or prescribing unneeded and unnecessary medication that lead a lot of Americans towards over medication and use of drugs that they don’t even need and also the other side.(CULS, nd) The example practices of health care fraud include billing for services that were not provided, intentional duplicate billing, erroneous prescription etc. Health Care Abuse; Health care abuse is the practice incurred for the sake of earnings out of prescriptions / applications that are not needed. The provision of goods and services that do not meet the standard of professional health care industry is health care abuse. The example of health care abuse include charging of unnecessary services or prescription of unwanted treatments etc Difference between Health Care Fraud and Health Care Abuse; the difference in health care fraud and health care abuse pertains with the nature of act. Hence, an act that results into unnecessary treatment / prescription falls under the category of health care abuse but the acts that deliberately aim to charge an extra cost out of cheating is counted in the definition of health care fraud. Waste; It refers to the provision of goods and services that were intended not to swindle or mislead but the payment methods that unintentionally raised the cost due to organizational errors. Rules and Regulations Related to Health Care related Fraud and Abuse; The various laws related to Health Care fraud and abuses are stated below for an overview; each of the below mentioned code followed by their clauses render a different impact on the case based on the execution. False Claims Act (FCA), 31 U.S.C., s. 3729 Florida False Claims Act, F.S. 817.234 Anti-Kickback Statute 42 U.S.C. s. 1320a-7b(b) Physician Self-Referral (“Stark”) Statute, 42 U.S.C. s. 1395nn Deficit Reduction Act of 2005 HIPAA of 1996, Title 18, Section 1347 Fraud Enforcement and Recovery Act of 2009 (FERA). Analysis; The concept of Evidence Based Practice is suggested for Health care control especially for wastage due to unnecessary treatment and methods to evaluate its relevance and contribution to practice. In order to have a clear over view of the illustration, this brief needs to be divided into four essential steps. The first step is to define and examine the concept of Evidence Based Practice and the summarise importance in practice by focusing the core issues. The second step is to devise a rationale to understand and comprehend the different reasons and situations that drive health care services towards wastage of goods and services for unnecessary treatments. The third step for achieving the objective is to examine various selected aspect of professional practice supported by research or different sorts of evidence, that could assist in the development of an action plan, which means the evaluation of proposals in the light of cases reported by regulatory bodies and discuss the different research available on the subject, such as, systematic review, quantitative and qualitative research. The four steps are equally important for the development of proposals with rational evaluation of different factors that could facilitate or otherwise can obscure the implication of the referred practice. The concept of evidence practice involves different approaches. According to Sackett et al (1996) the concept of evidence practice includes three elements: clinical expertise, knowledge of research evidence and Understanding of patient preference and choice. Clinical expertise means health care personnel must be answerable or liable for the incurred treatment on patients’ care delivery (LoBiondo-wood Hover 1990). This idea is also supported by the United Kingdom Council for Nurses and Health visitors Code of Professional Conduct (UKCC), which believes that nurses should be obliged for the care of patients and must necessarily, attain information to keep their knowledge and competence up to date. (UKCC 1992). Knowledge of research evidence means that health care personnel must have the ability to select relevant research and updates in clinical expertise to improve patients’ lives (McSherry et al 2002). For example, each individual should be able to utilise guidelines, protocols and other sources of evidence, and be capable of applying those correctly with a thorough understanding of patient’s preference. Understanding of patient preference means that health care personnel should be able to assess and make sure patients have sufficient information regarding their medical state and inclusion of efficient methods to involve the family and caretakers of the patient in decision making concerning their care delivery (DOH 1999). Gray (1997a) however disagrees with the approach developed by Sackett and his contemporaries on the ground of narrow vision of patients’ for decision making and related system organization. He believes that the idea about systematic research seems good, but is not relevant for all cases because of the absence of systematic review in certain areas of research. On the other hand he supports his argument with the statement that decision making from patient’s care delivery should be analyzed through obtaining accurate and authentic evidences. The other option he proposes is to rationally utilize research available for health care control by devising methods to educate the patients to have a clear picture view of their state that could possibly aid them in rational decision making concerning their care delivery (Gray 1997b). The argument is criticized by Sackets and his contemporaries on the fact that it does not offer a solution for patients without mental capacity (Mental Capacity Act 2009). In general, Evidence Based Practice is an approach that requires all healthcare professionals to use information from high quality of research that will certainly bring in a positive difference in health care control by presenting better solutions with less lope holes. (Kenworthy et al 2002). Taylor (2000) thinks that Evidence Based Practice can be classified in several categories following this hierarchy: The evaluation of primary research is referred from the term systematic review (Smyth 2002), randomised trial represents a study that spotlight observations drawn from experimental studies (Silagy Haines 1998), quantitative research is relating to numerical data analysed statistically (Muijs 2004) and qualitative research based on different methods: interview, case studies, ethnographic research and discourse analysis (Bryman Cramer 2001). Nolan and Bradley (2008) believe that the concept of Evidence based practise can bring in significant change in the delivery of health care service. It will help the entities to provide rational care planning for patients’ care delivery, aids professional to get better clinical thinking, and also contributes in choice or improvement of patients’ treatment. Randomised trial represents the best evidence in the choice of medicine and treatment (Matthews 2006). In addition to this, the proposed study will also pave the way to highlight core concerns for critical evaluation. Furthermore, the accurate statistics of errors will lead to point the core issues with the aid of government. Conclusion; precisely, although the benefits of medications when used properly cannot be under estimated but the control of resources will grant the improvement in all the other sectors directly and indirectly. Evidence based training with the utilization of proposed strategy will support the authorities to raise the potential of professional staff by rendering compact training with plans based on rationale of evidences. A thorough education of policies and procedures along with the training sessions in support of new practices induced via evidence based evaluation will aid the health care authorities to attain an improved level of control on health care delivery. Hitherto, a mutually cooperative exercise will not only aid the socio economic structure but will further improve the system by contracting the space for illegal practices. References; (OIG), U. D. (2008). Annual Performance report. US: Denial R. Levinson. A, S. C. (1998). Evidence Based Practice in Primary Care British Medical Journal . agency, N. P. (2007). Prevention and Control Healthcare Associated Infections NHS . Bourn. (2000). The Management and Control of Hospital Acquired infection in Acute NHS Trust in England National Audit Office. BR, s. L. (1996). Evidence-Based Medicine: How to practice and teach EBM Churchill Livingstone . C, M. (1997). Infection Control Hospital and Community Stanley Thorns . C, T. M. (2000). Evidence-Based Practice for Occupational Therapist Blackwell Science. Clark, K. (2003). Infection Control and Epidemiology: Hand Hygiene for Healthcare Workers APIC. Connie Bodeen, R. S. (1998). The Economic Value of the Health Care Industry:. Economic Development , 98. CULS. (nd). Healthcare fraud. Retrieved Dec 12, 2011, from http://www.law.cornell.edu/wex/healthcare_fraud D, B. A. (2001). A guide for social scientists quantitative data analysis with SPSS release 10 for windows Routledge. D, B. J. (2002). Guideline for hand hygiene in health care settings. Centre for disease control and prevention , 16(51). D, m. (2004). Doing quantitative research in education with SPSS Sage . D, P. (2000). Improving compliance with hand hygiene in hospitals Infection Control and Hospital Epidemiology 21(6): . 381-386. department, I. c. (2009). Infection Control Policy: Hand decontamination R UH . G, L. (2007). Hand Hygiene: A small study of nursing students’ experiences of hand hygiene on clinical placement suggests that students have few positive models Nursing Management 6 -14. Gould D, G. J. (2000). Improving Hand Hygiene in Community Healthcare Settings the impact of research & clinical collaboration . Journal of nursing9(1) , 95-102. Grice J E, R. I. (2008). The effect of posters and displays on the use of alcohol gel British Journal of Infection Control. Health, D. o. (1999). Making a difference: Strengthening Nursing Midwifery and Health Visiting Contribution to Health and Healthcare HMSO . Health, D. o. (2009). Mental Capacity act DoH. J, L. W. (1990). Nursing Research Methods Critical Appraisal and Utilization St Louis Mosby. JAM, G. (1997 (a)). Evidence Based Health Churchill Livingstone . JNS, m. (2006). Texts in Statistical Science: Introduction to Randomized Controlled Clinical Trial 2nd Taylor & Francis. Kenqworthy N, s. G. (2008). Common Foundation Studies in Nursing 4ed Churchill Livingstone. Law, F. (nd). Search 18 U.S.C. § 1347 : US Code - Section 1347: Health care fraud. Retrieved Dec 12, 2011, from http://codes.lp.findlaw.com/uscode/18/I/63/1347 M, D. N. (2003). Manual Infection Control Prodedures. cambridge University Press. M, G. J. (1997 (b)). Evidence-Based Healthcare How to Make Health Policy and Management Decisions Churchill Livingstone. Mcsherry R, S. M. (2002). Evidence-Informed Nursing: A guide for Clinical Nurses Routledge . Medical, J. C. (2005). Infection Control issues in the environment of care Joint Commission Resources. P, A. (2002). Implementing evidence informed- informed bursing research awareness routledge. RL, S. (2002). Systematic Review: What are they and how can they be used? Churchill Livingstone. SMS, S. (2009). A review offhand-washing techniques in primary care and community settings . Journal of Clinical nursing 18 , 786-790. Read More
Cite this document
  • APA
  • MLA
  • CHICAGO
(“Health Care Economics Research Paper Example | Topics and Well Written Essays - 1250 words”, n.d.)
Retrieved de https://studentshare.org/management/1392755-health-care-economics
(Health Care Economics Research Paper Example | Topics and Well Written Essays - 1250 Words)
https://studentshare.org/management/1392755-health-care-economics.
“Health Care Economics Research Paper Example | Topics and Well Written Essays - 1250 Words”, n.d. https://studentshare.org/management/1392755-health-care-economics.
  • Cited: 0 times

CHECK THESE SAMPLES OF Health Care Economics

Economics and Health Care

This research paper examines a question of applying principles of economic to health care.... Economics is a social science that seeks to explain how society allocates its scarce resources to satisfy the demand for goods, Howewer, health care is different from conventional goods and services… Many scholars have debated whether the concepts and principles developed in economics can be used to explain how decisions are made in health care....
4 Pages (1000 words) Research Paper

The Role of the Public Sector in Health Care

In the United States health care is an issue that consumes much of their political discussion because as a people they have not come to the decision that health care is a responsibility of government to its people.... In Canada it has been publically determined that the health of… The Canadian system is based on the universal health care system, providing care for anyone who needs care and is a citizen or resident of the state.... There are many reasons for having a public health care system....
18 Pages (4500 words) Essay

Supply in health care services-physician services

?Health Care Economics.... The projection of future physician supply and demand informs stakeholders, as well as policy makers on the health care… Studies have demonstrated that both pecuniary and non-pecuniary factors impact on physicians' labor supply decisions.... The projection of future physician supply and demand informs stakeholders, as well as policy makers on the health care workforce implication of anticipated changes within the health care environment....
1 Pages (250 words) Essay

Governments Role in Health Care Market - Health Care Economics

Primary needs of people compulsorily include food security and health care.... In recent times, health care concerns are increasing due to ever increasing complexity of ambiance people live in.... Keeping in view these concerns United States government has been in the phase of transition which has health care services as one of the major moot points.... Investments in the development of effective medicine, attempts to promulgate health care schemes and finding cost effective all inclusive health care facilities are apparently important for the government....
9 Pages (2250 words) Research Paper

True Cost of Health Care

The essay "True Cost of health care" states that health refers to the state of complete well-being (physically, mentally and socially) of an individual without merely the absence of disease.... For all these variables to remain constant, much health care cost has to be incurred.... ulture affects the quality of health care, which is a paramount measure.... he factor of research, technology, and innovation has greatly affected the overhead cost of health care....
1 Pages (250 words) Essay

Health Care Economics in US, UK and China

The paper "Health Care Economics in the US, UK and China" will examine the comparative analysis of  UK, US and China medical systems paying attention to GDP, the proportion allocated to health and effects of existing health economics on life expectancy, morbidity, and mortality.... hellip; There have been efforts in the past decades to promote universal health care coverage by designing a health care system that provides financial protection to all citizens....
9 Pages (2250 words) Literature review

Prominent economist

In essence, his research in Health Care Economics revealed startling results, with close relation to insurance, its market value, and marginal share costs (Pauly, 2001).... Kenneth Arrow and the changing economics of health care.... With the summed up achievements, it is no doubt that Kenneth remains an icon and a hero in the economics fraternity.... Journal of health Politics, Policy and Law, 26, 829–834....
1 Pages (250 words) Essay

CSR Gerontological Society

ith regards to Health Care Economics, the shareholder model advocates for corporate survival through legally maximizing profits which could be at the expense of reducing employee health care benefits if need be.... The increasing burden of health care expenses on US businesses has become a source of competitive disadvantage in the wake of globalization.... According to Condit (2007) in 2005 General Motors spent $1,525 on health care for every vehicle built in the US while its major competitor Toyota spent $97 per vehicle in Japan....
5 Pages (1250 words) Term Paper
sponsored ads
We use cookies to create the best experience for you. Keep on browsing if you are OK with that, or find out how to manage cookies.
Contact Us