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Health System Healthcare Financing And Economics

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Question:

Discuss about the Health Systems Healthcare Financing and Economics.
 
 

Answer:

Introduction

The systematic utilization of cost-efficiency approaches is highly warranted in the context of effectively accomplishing the healthcare requirements of the Australian population (Foteff, et al., 2016). The factorial analysis of the cost of healthcare interventions is highly warranted in the context of surpassing the scope of attaining inaccuracies in the economic assessment. Indeed, resource planning for the public healthcare services and products is highly required with the objective of streamlining revenue cycle management in the Australian healthcare sector. The cost-utility analysis is based on the evaluation of the cost-to-benefit ratio in relation to the medical requirements and other healthcare needs of the target population (Farag, Sherrington, Ferreira, & Howard, 2013). The analysis requires undertaking a systematic survey of the clinical settings as well as community groups for understanding the actual cost of the devices, medications, equipment and procedures in relation to wellness outcomes and disease patterns experienced by the Australian population. The statistical analysis of the pattern of injury, disability and illness requires evidence-based exploration for calculating the requirement of the healthcare interventions and their associated costs for configuring the healthcare planning and economic evaluation. This essay evidentially discusses the concepts of cost-effectiveness and cost-utility analysis in relation to the requirement of healthcare resource allocation for the streamlining of public healthcare services and products in real time scenarios. The essay further explores the potential gaps in the Australian public health system and financial challenges encountered in their effective mitigation. The essay also proposes the health system reform and proactive approaches warranted for accomplishing these gaps to systematically enhance the Australian public health system.

 


Cost-effectiveness and utility analysis for healthcare resource allocation requires feedback from Australian healthcare agencies in relation to the budget allocation and effectiveness of healthcare interventions warranted for the enhancement of wellness outcomes, while reducing the extra cost associated with the medical services and procedures (Baum, DesRoches , Campbell , & Goold , 2011). The healthcare revenue cycle is based on healthcare billing requirements, pre-certification, pre-authorization, underpayments and rejection of medical claims. The thorough evaluation of Australian healthcare revenue cycle is required for the systematic assessment of the cost of various healthcare services as well as insurance policies and conventions governing their administration to the eligible candidates. Additional healthcare reimbursement to physicians and healthcare providers is principally based on the quality of services administered in the healthcare setting (Colpas, 2013). Therefore, the identification of the actual requirement of administration of qualitative healthcare interventions beyond the conventional medical care gives an estimate of the extra cost involved in the effective delivery of additional healthcare interventions in the clinical setting. The assessment of various tools and techniques employed for capturing the healthcare data provides an overview of the appropriateness of these tools in relation to the systematic recording of healthcare needs as well as associated medical interventions warranted for their accomplishment in the medical facility (Giannangelo & Fenton, 2008). The recording of medical services codes in revenue cycle software assists in retrieving the cost incurred in administering the clinical interventions for treating various patient conditions. Analysis of consultation reports gives a true picture of the extent of cost-effective administration of healthcare services to the treated patients. The assessment of patients’ discharge summary from hospital databases provides an overview of the cost incurred in treating the patients during the entire length of their stay in the hospital setting. The systematic analysis of the epidemiological data and technology-intensive healthcare specialties required for evaluating the expense involved in treating various community-based diseases in the Australian sub-continent (Kumar, 2011). Diagnostic interventions like echocardiogram, Holter monitor and screening mammogram are some of the significant approaches utilized for ruling out the onset and progression of cardiovascular as well as cancerous conditions among the patient population. The outcomes of these interventions provide the direction for utilizing therapeutic approaches in the context of treating the diagnosed clinical conditions. The assessment of total cost incurred in undertaking the diagnostic and procedural interventions provides concrete information regarding the cost utilization in healthcare services. However, the assessment of burden of cardiovascular and cancer conditions in the community environment gives direction regarding optimal and cost-effective utilization of diagnostic and procedural services warranted for the enhancement of the wellness outcomes.

 


The Australian public health system is state-based and the healthcare norms follow the conventions stipulated by the Commonwealth of Australia Constitution Act (1900) (Philippon & Philippon, 2008). The Australian public health system utilizes private financing approaches with the objective of equitable administering of healthcare services to the patient population (Collier, 2013). Private funding in public health system increases the pattern of positive competition between the physicians and they tend to administer qualitative healthcare interventions while effectively surpassing unnecessary expenses (Collier, 2013). Localized empowerment of general practitioners in Australia assists them in fostering health and wellness outcomes while accomplishing the requirements of local populations through mutual coordination. The Australian public health system effectively caters the primary healthcare needs of individuals through family practice and advocates the provision of administration of after-hours care to the treated patients (Collier, 2013). The incorporation of private healthcare insurances substantiates the requirement of necessity-based treatment approaches that remain available throughout day and night irrespective of the remote or rural locations of the Australian communities. The greatest shortcoming of the Australian public healthcare system attributes to the fact that it remains less equitable for the underprivileged sections of the society, in comparison to the established groups (Collier, 2013). Patients with lesser financial capacity experience challenges in availing qualitative healthcare interventions at the optimal cost. For example, Indigenous groups in Australia substantially experience the pattern of health inequalities in comparison to the non-aboriginal Australians (Rosenstock, Mukandi, Zwi, & Hill, 2013). This gap in the Australian healthcare system attributes to the financial incapacity of indigenous groups regarding the acquisition of the healthcare services for the enhancement of their quality of life and associated wellness outcomes. Evidence-based research literature documents serious gaps related to the configuration and administration of healthcare services to the Australian patients (Lo, et al., 2017). Patients who receive tertiary healthcare interventions report individualized barriers and treatment challenges that potentially hinder their compliance to the recommended treatment approaches. Some of the major barriers to the administration of tertiary healthcare services in Australia attribute to the deficits in continuity of care, absence of understanding about medical conditions, mood alterations, co-morbid states, irrational medical advices and inappropriate communication between providers and patients (Lo, et al., 2017). The systematic mitigation of these significant gaps needs a major transformation in the Australian healthcare system for effectively administering equitable healthcare services to the patient population. The absence of equitable healthcare delivery system for impoverished Australians requires the systematic configuration of health promotion strategies requiring customization for the empowerment and enhancement of self-determination of indigenous Australians (McPhail-Bell, et al., 2017). However, private healthcare agencies might challenge the attempt for empowering indigenous groups because that could potentially impact their healthcare business, and extra privilege to aboriginal people might also facilitate opposition by the established sections of Australian society. Furthermore, the mitigation of tertiary healthcare challenges requires the configuration of educational approaches and counselling sessions for the treated patients. Private healthcare agencies might oppose this additional investment in tertiary health services because of budgetary issues that could significantly impact the pattern of their profitability.

 


The healthcare reform that I would implement in the Australian healthcare settings attributes to the promotion of behavioural healthcare for the impoverished sections of the society (Willging, et al., 2012). The administration of behavioural approaches will significantly enhance the pattern of trust and confidence of the impoverished patients on the recommended treatment interventions. It will also improve the alliance of the indigenous groups with the treating physicians and assist in the promotion of the therapeutic relationship for the effective enhancement of wellness outcomes. Improved compliance and better therapeutic outcomes will motivate healthcare professionals for taking additional healthcare measures for the impoverished Australians. Eventually, they might convince the private health agencies for undertaking additional financial measures with the objective of streamlining the healthcare system while providing cost effective and equitable healthcare interventions to all sections of the Australian society.

 

Conclusion

Cost-effective and equitable administration of healthcare services to all sections of society should be the preliminary objective of any healthcare system. Australian public health system caters to the healthcare needs of people in rural and urban locations; however, the prohibitive cost of medical services due to the involvement of the private health sector challenges their administration to the economically weaker sections of the society. The Australian public health system requires a major transformation in terms of association of governmental agencies as well as social care organisations in the public health sector for the systematic administration of healthcare interventions to the impoverished individuals. Behavioural counselling and motivation strategies warranted for treating economically weaker sections of the society will require additional financial investment in the initial phase by the healthcare agencies. However, the enhancement of quality of life of impoverished people following the administration of additional healthcare interventions will gradually reduce this extra investment and streamline the Australian public health system for the longer term.

 

References

Baum, N. M., DesRoches , C., Campbell , E. G., & Goold , S. D. (2011). Resource allocation in public health practice: a national survey of local public health officials. Journal of Public Health Management and Practice, 17(3), 265-274. doi:10.1097/PHH.0b013e318207599c

Collier, R. (2013). Looking to Australia for help on health care. CMAJ, 185(6), E251-E252. doi:10.1503/cmaj.109-4421

Colpas, P. (2013). How automation helps steer the revenue cycle process. Health Management Technology, 8-11. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/23855249

Farag, I., Sherrington, C., Ferreira, M., & Howard, K. (2013). A systematic review of the unit costs of allied health and community services used by older people in Australia. BMC Health Services Research. doi:10.1186/1472-6963-13-69

Foteff, C., Kennedy, S., Milton, A. H., Deger, M., Payk, F., & Sanderson , G. (2016). Cost-Utility Analysis of Cochlear Implantation in Australian Adults. Otology and Neurotology, 454-461. doi:10.1097/MAO.0000000000000999

Giannangelo , K., & Fenton , S. (2008). HR's effect on the revenue cycle management Coding function. Journal of Healthcare Information Management, 26-30. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/19267004

Kumar, R. K. (2011). Technology and healthcare costs. Annals of Pediatric Cardiology, 4(1), 84-86. doi:10.4103/0974-2069.79634

Lo, C., Teede, H., Fulcher, G., Gallagher, M., Kerr, P. G., Ranasinha, S., . . . Zoungas, S. (2017). Gaps and barriers in health-care provision for co-morbid diabetes and chronic kidney disease: a cross-sectional study. BMC Nephrology. doi:10.1186/s12882-017-0493-x

McPhail-Bell , K., Appo, N., Haymes, A., Bond, C., Brough, M., & Fredericks , B. (2017). Deadly Choices empowering Indigenous Australians through social networking sites. Health Promotion International. doi:10.1093/heapro/dax014

Philippon, D. J., & Philippon, J. (2008). Health System Organization and Governance in Canada and Australia: A Comparison of Historical Developments, Recent Policy Changes and Future Implications. Healthcare Policy/Politiques de Sante, 4(1), e168-e186. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2645208/

Rosenstock, A., Mukandi, B., Zwi, A. B., & Hill, P. S. (2013). Closing the Gaps: competing estimates of Indigenous Australian life expectancy in the scientific literature. Australian and New Zealand Journal of Public Health, 356-364. doi:10.1111/1753-6405.12084

Willging, C. E., Goodkind, J., Lamphere, L., Saul, G., Fluder, S., & Seanez, P. (2012). The Impact of State Behavioral Health Reform on Native American Individuals, Families, and Communities. Qualitative Health Research, 22(7), 880-896. doi:10.1177/1049732312440329

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