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History And Health Policy In United State

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Question:

Discuss About The History And Health Policy In United State.

 

Answer:

Introduction

This report is about the financial crash and the increasing number of hospitalization cases of the health care system of the Abruzzo region in Italy and its recovery. For preparing this report we have been provided with a case study that includes the data and information from 2000 to 2010. The hospitalization rates in the Abruzzo region increased from the year 2000 to 2005. The rate was as high as 280 admissions over 1000 peoples. During this period due to the increase of the hospitalization rates the health care debt was also increased making the health care system to crash (Marmot, 2013). The government of Italy and the Abruzzo region decided to introduce cost containment policies that would not affect the quality but increase the efficiency of the health care system for the betterment of the state in terms of reduced expenses and for the betterment of the state population in terms of quality health care services. The state government was not only concerned about the increasing health care debts but they were more concerned about the increasing number of the hospitalization of the residents (Jones, 2014). The name of the policy was decided to be the cost containment policy.

 

Description

In this part of the report we will discuss about the crash of the health care system of the Abruzzo region by going into the depth of the facts and information available to us. The data used in this report was publicly available and provided by the regional informatics system. In Italy during the period 2000-2005 the hospitalization rate increased so much that every 280 out of 1000 people in the Abruzzo region has been hospitalized (Goldhill, 2012). During this period the health care debt increased almost tripled i.e. 274% or by 1586 Euro. The hospitalization rate in Abruzzo was the highest in the entire Italy. But after the implementation of the new health care reform system, the increased rate of the hospitalization decreased by 31.4% and the health care debt decreased by 33.0% (Bodenheimer, 2014).

The implementation of the health care reform system improved various health indicators including the efficiency indicators, however the index of the population health remain unaffected (Kronenfeld, 2013). The case study provided, itself states that the data provided is not enough to claim that if the health care reforms have affected the health of the population. In this case study, the government of Italy is pressurizing the Abruzzo local or state government to keep the hospitalization rate and the expenses of the health care under control. Abruzzo as stated in the case study is not amongst the poorest cities of the Italy neither it has any such history of any financial crashes earlier (Dranove, 2011).

The hospitalization rate of the Abruzzo is not only of the people living in Abruzzo but also the outsiders. The government of Italy and Abruzzo were concerned about the increasing expenses of the health care system and the increase in the hospitalization rate.

 

Data from  

In the case study there is a table given that shows the rate of hospitalization from 2000 to 2010 of the Italy and Abruzzo region. The initial years of this period were normal i.e. the rate of hospitalization in the year 2000 to 2001 was normal. The actual increase started from the year 2001 when the hospitalization rate of Italy and Abruzzo region increased by +2.1% and +3.0%, again in the year 2002 the increase in the hospitalization rate was about +2.2% for Italy and +6.8% for Abruzzo region. In the year 2004 the hospitalization rate increased by +7.4% and +2.5% again. +7.2% and +2.2% was increased in the year 2005 which made the total hospitalization rate to reach an unbelievable high of 280 admissions over 1000 inhabitants (Gusmano, 2014). Till 2005 there were no specific health reforms to control the ever increasing rate of hospitalization and the health care debts but after 2005 there was the introduction of the health care reforms and it not only just decreased the health care debts but also decreased the hospitalization rates (Shaw, 2012). In the year 2006, this was the time when health care reforms were established by the Italy and the Abruzzo government to control the hospitalization rates and debts. The rate of hospitalization and the health care debt of Italy were dropped to 0.0% and it was still increasing at +4.1% in case of Abruzzo. In 2007, the hospitalization rate of Abruzzo dropped by -10.0% and in the same year it was dropped by another -2.6% in case of Italy. In the year 2008, a new commissioner came to the registered office and that year the hospitalization rate of Abruzzo region went down by -20.1% and for Italy it went down by -4.5%. Talking about 2009 there was a great reduction in the hospitalization rate of both the mentioned parties, the reduction in Abruzzo and Italy as whole was around -27.3% and -7.9%. It was the year of 2010 that has seen the greatest reduction in the hospitalization rate and the health care debts rate. In 2010 the Hospitalization rate in Abruzzo was -31.4% and in Italy it was -12.2% (Anonymous, 2010). The reason why there was a substantial decrease in the hospitalization rate and the health care debt rate is because of the implementation of the new health care reform system. In the year 2005, a new pact came into power between the state and the region government, in 2006 new accreditation system and recovery plan was approved. While in the year 2009 and 2010, 3 private and 4 public hospitals were closed to control the increasing health care debts and the hospitalization rates (Anonymous, Contemporary Public Health: Principles, Practice, and Policy, 2014).     

Assessment

In this section of the report we are going to discuss the table 2 and table 3 data. The report is about the increase of the hospitalization rate and the health care debt. Table 2 of the case study shows the summary of the hospitalization rate of Abruzzo and the Italy and also the financial summary of the health care system of both these parties. While table 3, of this case study shows the information of different heads under the health care system of Abruzzo (Anonymous, History and Health Policy in the United States: Putting the Past Back In, 2011).

 The table shows that most of the sectors or the parts of the health care system were improved with little improvements. The total number of hospitalization rate in Italy alone was 12, 671,564 in 2000. This number rose to 12, 955,882 in the year 2005. In 2005, the hospitalization rate in Abruzzo was 3, 75,590, which is 1, 34,020 more from the year 2000 (Rushefsky, 2010). In 2005, the new health care reforms were established and implemented as to control the increasing rates of hospitalization and the health care debts. After implementing the health care reforms to control the increasing rate of hospitalization and the health care debts, the results were quite impressive, however not many things came under control as expected but the results showed a positive hope. The patient safety indicators, caesarean delivery cases and the overall age standardized cancer mortality rate were slightly improved. Another good point of implementing the health care reform was that, the proportions of the patients satisfaction was increased by 46.6% in the period of 2005-2010. The hospitalization rate for uncontrolled diabetes decreased to 18.7% in 2010 from 29.2% in 2005. Following to this the asthmatic patients number of hospitalization also decreased to 7.61% in 2010 from 47.2% in 2005 (Barr, 2009).

The number or percentage of repeated admissions in the year 2005 was 9.2% and it gradually decreased to 5.9% by the year 2010. It is not that only improvement has been done by the new health care reforms, there are some parts of the health that has not even slightly improved even after the implementation of the new health care system. Some of these parts are the mean length of the stay of a patient at a hospital has been increased to 6.82% in 2010 from 6.05% in 2005, that means it has been increased by an overall of +12.7%. Although the caesarean delivery cases are satisfied but there is an overall increase of +1.1% i.e. in the year 2005 it was 43.1% and in the year 2010 it rose to 43.6%. The infection rate in the year 2005 was 5.45%, which decreased to 2.72% in the year 2010, the overall decrease in the infection from Medicare rate was around -50.1%.

If we talk about the satisfaction of the people with the new health care system then it won’t be wrong to say that the new health care reform worked in the favor of the general public and they seems to be quite satisfied with the new health care reform system. In the year 2005, the number of satisfied patient was 23.2%, which increased to 34.8% in the year 2010. It was 2005, when the new health care reform policies were implemented to control the rising rate of the hospitalization and the ever increasing health care debts. The overall satisfied patients marked an increase of +46.6%.

Most of the above mentioned or stated data is available in the table 3 of the case study. The table 3 of the case study has a number of heads under which all this data has been presented. There is a head called “Population health status”, under which the life expectancy rate, cancer mortality rate has been given. In the year 2005, the male and female life expectancy rate was 78.1% and 84.2% which increase to 79.1% and 84.8%, which means an overall increase of +1.3% and in female case +0.7% (Mason, 2011).

 

Effects of the Health Care Reforms 

In this part of the report we are going to discuss about the effects that has been come out as a result of the health care reforms of 2005. In the whole case study, no where it has been shown that the patients have been affected by the health reforms. However in the initial years from 2000, the increase in the hospitalization rate and the increase of the health care debt became the matter of concern for the government of the Italy and they started pressurizing the Abruzzo state government to look into the matter and introduce some new health reforms in order to lower the hospitalization rate and the health care debts.

It was not the general public, who was getting affected by the increasing health care debt but it was the government that is why they had to introduce the new health care reform. In the period between, 2000 to 2005 the health care debt almost got tripled i.e. 274% increase. The efficiency of the health care system of Abruzzo increased after implementing the new policies. However there were still some parts under the health care system that didn’t improved much even after implementing the new health care policies.

After the implementation of the health reform policy there is noticeable decrease in the hospitalization rate and has decreased the health care debts to perceptible point. The hospitalization rate of the residents of Abruzzo is decreased by 30.5% and the overall hospitals admissions in the region have been decreased by 36.0%. This reduction in the number of hospitalization rate and the health care debts is worth noting because a major part of the population is aged and the number of diabetes and dangerous diseases has been increased in the same period (Mailer, 2015).

Recommendation

Abruzzo is a small region of Italy; the state government is concerned about the ever increasing hospitalization rates and the health care debts. In order to control this increase in the hospitalization and health care debts the government has introduced a new health care reform policies that’s main aim is to cut down the costs and provide efficient and qualitative health services to the residents of the whole Italy.

 

Conclusion

In this part of the report, a detailed and a concise conclusion has been presented to give this report a final ending. The case study nowhere states that’s the residents or the non residents of the Abruzzo region has any negative affect of the new health care reforms. However there is one very conspicuous thing about this case and that is the implementation of the new health policies reduced the hospitalization rate and the health care debts, however in this same period the number of dangerous diseases and diabetes increased, and also a very high level earthquake hit Italy and left it with a lots of destruction. If all this happened in the same period of the new health reforms then why there is no increase in the overall hospitalization rate, maybe because we are not provided with the full data. Hence it won’t be wrong to say the new health reform policy helped the Abruzzo and state government to slightly improve their situations.

 

References

Anonymous. (2014). Contemporary Public Health: Principles, Practice, and Policy. Sydney: K.K Printing and Press.

Anonymous. (2011). History and Health Policy in the United States: Putting the Past Back In.

Anonymous. (2010). Policy Challenges in Modern Health Care. Eastern Mediterranean Health Journal , 31.

Barr, D. A. (2009). Health Policy . Clinical Ethics , 2.

Bodenheimer, T. (2014). Understanding Health Policy. Vancouver: Naigra Publishers.

Dranove, D. (2011). Code Red: An Economist Explains How to Revive the Healthcare System . Bulletin of the World Health Organization .

Goldhill, D. (2012). Catastrophic Care: Why Everything We Think We Know about Health Care Is . Marriam Printing Press.

Gusmano, C. M. (2014). Healthy Voices, Unhealthy Silence: Advocacy and Health Policy for the Poor. Milbank Quarterly .

Jones, S. (2014). Health Care Deliveries. APH of Health , 5.

Kronenfeld, J. J. (2013). Health Care Policy: Issues and Trends. Epidemiology , 10.

Mailer, J. E. (2015). Setting Limits Fairly. London.

Marmot, M. (2013). The Health Gap: The Challenge of an Unequal World. Druid Journals , 10.

Mason, D. J. (2011). Policy and Politics in Nursing and Health Care. Journal of Clinical Epidemiology , 7.

Rushefsky, K. P. (2010). Politics, Power and Policy Making: Case of Health Care Reform. Cape Town.

Shaw, G. M. (2012). The Healthcare Debate. Durban.

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