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Policy Power And Politics In Health Care

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Question:

Discuss about the Policy Power And Politics In Health Care.
 
 

Answer:

Introduction:

The human society nowadays has advanced considerably with the older people, often, their needs, their preferences and they themselves are vastly neglected. With their psychosocial needs unheard, their health deteriorates further and their health care needs increase at large. Time withers away the living, hence with increasing age, the onset many health complexities leading to various chronic diseases are facilitated. These chronic conditions that attempt to cripple the ageing members of the society include coronary heart disease, diabetes, kidney disorders, respiratory disorders and what not. To cope with all these age derived health complexities the aged populations require extensive and compassionate health care.

It has to be understood that the health care needs of the ageing individuals are entirely different from that of the younger or middle-aged patients. Hence there is a need for a specific health care policy for the ageing population, which can address the specific needs and requirements of the ageing population with critical Health Care needs.  It has to be understood that the critically ill ageing patient population have sensitive and critical needs and they are mostly in the need for a strategically curated palliative care plan. And in this context, the aged care services aim at overall care for the ageing individuals not just emphasizing on the physical health of the patients but also divulging on restoring and fortifying the psychosocial health of the patients. This assignment will focus on the aged care policies in place in the health care industry and the factors affect the formation and improvisation of the aged care policies taking Australian context as an example.

Relevance to Australian health care system:

Now aged care is a relatively new concept to health care industry and the needs of the ageing populations for health care has been neglected until now, and the world health authorities have only recently stated to take notice of the distinct needs of the ageing populations. Aged care in all demographics has two distinct bifurcations, short term care or long-term care or permanent and respite residential care. It has to be understood that every policy in the context of health care is extremely interdependent of the demographic where it will be implemented. As political context is extremely influential in the case of policy making and implementation, the demographic factor is an important aspect in case of policy structuring. The concept of aged care in case of Australian context is much more considerate and the structuring of policies, in this case, is much more advanced in the context of benefits to the aged population (Falls prevention. 2017).

 

Morality reasoning:

While analysing a policy, it is of much importance that the policy is evaluated in the context of economic, political and socio-cultural aspects. If we consider the moral ground for this policy it has to be understood that the fall prevention policy under the aged care is highly morally relevant for the Australian health care system, as the last report has contested that more than 10% of the aged patients in the health care facilities suffered from fatal consequences after sustaining a fall in the hospital facility (Robertson et al., 2014). It has to be understood that aging comes coupled with a number of other age associated health care complexities, and sustaining a fall in already a critical health care disorders can further complicate the medical conditions of the patients, and can exponentially increase the suffering of the already tortured patients significantly (Britton et al., 2016).

Policy context:

Often the majority of the ageing patient population take the long-term residential ageing care benefit, where the ageing and critically ill patients are under the careful guidance of the health care professionals. In the context of critically ill patients in the palliative unit, one of the major complications that arise with alarming frequency was fall. Occurrences of falls in the aged care unit resulted in major injuries and further complications for the already critically ill aged patients and sometimes led to even fatal consequences. Fall prevention policy under the umbrella term of aged care policies was published in the month of May 2011, in the NSW local health districts, under the provision of aged care for health population and health promotional activities (Britt et al.2013).

The main purpose behind the establishment of this policy was to reduce the significant amount of avoidable risk that the consequences of a critically ill aged patient falling off of the bed will inflict. This policy was also aimed to ensure that the social, psychological and economic impact of the fall on the ageing patient and his family is significantly reduced. The contents of the policy mandate the health care professional to take necessary strategic actions to ensure that all the potential risks to the patient falling can be averted. These actions include screening, assessing and identifying fall risk factors and eradicating those factors by the means of complying with best practice guidelines. There are 9 specific standards that guide the health care professional to ensure that the ageing patient is no risk of falling within the NSW health care facility (Chen et al., 2017).

Public spending on the policy:

Whenever a new policy is developed there are many socioeconomic and environmental determinants playing a pivotal part in the establishment and adequate implementation of the policies. The prevalent social notions regarding ageing and aged care is a major factor in the successful establishment and implementation of the policies. The general social ideology, in this case, is prevalently dominated by the lack of awareness in the mass about the differential healthcare needs of the ageing population and consequences of complications sustaining a fall. The society is never much aware of the impact sustaining a fall can have on the deteriorating health of a critically ill ageing patient, which heavily discourages public spending on shaping the aged care policies and infrastructure for the aged care as well (Hughes, 2017).

However, the government encourages public spending on the aged care concept of healthcare industries as well. Considering the fact that the social ideologies about the health care needs of the ageing population is slowly but steadily changing, the mass is now more aware of the critical and complex health Care needs of our elders in our society and hence the public spending from on the aged care policies have increased as well in Australia. Therefore the public spending on the sector of aged care is improving progressively and it can be home that with the change in the social ideologies the funding will increase further (Savy et al., 2017).  

 

Cost effectiveness:

Another most effective parameter for analyzing a policy and its impact is the cost-effectiveness of the policy that is the justified government spending on the policy under consideration. In this context, it must be mentioned that the government allotted cost for aged care has increased by 44% in the last 5 years in Australia, which is a magnanimous change (Henderson et al., 2016). These positive or progressive changes in the public service sector like health care is undoubtedly commendable, however, the impact of such spending should not negatively impact other relevant sectors that need equal or equivalent attention. However, it must also be mentioned that the need for such policies n health care is paramount as well. Hence it can be safely concluded that the extra expense in the context of the aged care in the demographic that has a significant ageing population is justified.

The political context of the policy:

The power play of social political position is an important fact that facilitates policy-making an implementation in the Healthcare sector but at all other Public Service sectors in different nations. It has to be understood the critical decision making about the establishment and limitation of major Health Care policies are critically dependent on the political agreement and enthusiasm. Similarly, in case of establishment of aged care policies, the political position within the government has the maximum power to decide what policies will be implemented based on the cost-effectiveness and minimum expenditure and the government trust. Unfortunately, in this case, the politicians is much more on pleasing the majority of the citizens with policies and protocols to ensure that establishment of the new policies will be of electoral benefit to the politician. Moreover, the friction within the political context between the leading and opposition parties often pose challenges and hurdles in the path for a publicly beneficial policy to be implemented (Xiao et al., 2014).

It must be understood that the fall prevention policies that is the subject of discussion in this assignment have been a major breakthrough in the Healthcare directives all throughout the world. It must be mentioned that there was a conspicuous lack of compassion and emphasis on the specific needs of the ageing population of the society and through this particular policy, the approach and handling patterns of the Healthcare professionals will also take a better turn towards the unfortunate and critically ill ageing patients. Hence it can hope that the political and societal measures together will bring forth most beneficial policies for the sake of the disadvantaged and neglected sectors of the society (Willis et al., 2016).

Policy scope:

Fall prevention strategy is a national document, and the fall prevention policy is just the beginning for an organised and well-curated health strategy for the ageing population of this society. Along with that, we must also consider the fact that this policy directly affects the health care professionals, their efficiency and dedication to the ageing patients. This policy and its protocols can be the first step in the direction for the development of a high compassionate and safe care plan for the ageing patients that are critically ill. It will be the perfect foundation for the development of many such safety policies that will change the standards of the health care system at large (Althaus et al.,. 2012).

 

Evolution of policy:

As the average age of the global population has increased, the policies related to the health care of the aged individual has undergone modification that has helped to deal with the new challenges that are encountered in the modern day healthcare system.  

The history of the Government Health Care related to the aged individual in Australia can be traced back the year of 1920. However, during the initial stage, the total number of people within the highest category was much lower and hence the government did not have to make any special effort to organize those policies.  From the year 1939, the aged health care service was an important part of all types of Community Health Care Centre and also it was a part of social security. In the year 1991, the government introduced health and Housing policies that were aimed to improve upon the health status of the aged individual (Pajala et al., 2016). Later on in the year 2001, the health and aged care department were introduced that was aimed to improve upon the human services related to the health service of aged individuals. In 2008 the government introduced a Healthcare policy for the indigenous population (Carande-Kulis et al., 2015).

The government of Australia had introduced the policy of pension and health insurance schemes in order to ensure that the aged people are able to look after their health challenges. The investment that is made by the government on the aged healthcare has also been increased in the recent times. The total cost that has been invested in the support of the aged individual has been raised to the amount of 32.25 billion dollars in the year 2015, which was just 15.60 dollar in the year 2010 (Laflamme et al., 2015). The rate at which the pension has been provided has also been increased to the amount of 59.7% that has helped to deal with all the higher cost of the healthcare service for the aged individual (Uusi-Rasi et al., 2015).

Fall has been one of the major causes of injuries and other health challenges among elderly people. It is important in the context to ethically analyze the consequence of the fall that causes severe injuries among aged people. It is the ethical duty of the government to ensure that the policies related to fall prevention among elderly are implemented properly that will help to improve the health condition of the physically disabled. Property implementation of the health care policy related to fall prevention can help to have a better lifestyle of aged people. Due to age-related constraints, most of the individual in the given age category are not able to have a proper lifestyle and carry on the daily activities that can help them to deal with the challenges (Voukelatos et al., 2015). It is the ethical duties of all stakeholders of Health Organization to ensure that proper care of The aged individuals are implemented that can help to reduce the side effect of injuries and other consequences of health challenges that are associated with fall and other unintentional accidents. With the help of fall prevention policies, the ethical dilemmas related to the care of aged people can be overcome that are related in this age category due to the fact that they will get full support from the society in order to overcome the physical constraints. It is also important to ensure that equality is maintained while taking care of the aged individual that will help them to be an active part of the society and also able to motivate them to overcome all the major health challenges (Voukelatos et al., 2015).

Future direction of the policy

According to the report of World Health Organization falls are one of the prominent causes of unintentional injuries among the aged individuals. From the Global report that is published by World Health Organization is clear that nearly 35% all the population of age category about 65 years have been the victim of unintentional fall. The person who is above 70 years have also been the victim of fall and the percentage varies is from 40 to 50% (Deandrea et al., 2013). The injuries that are caused due to unintentional fall can have severe effect depending upon the age sex and other physical attributes of the aged individual. The night time is believed to be the most vulnerable time of the day, owing to the fact that most of the fall occurs during this time of the day. It is believed that the people within the colder climate have also the high trends of being the victim of fall that is the cause of the injury among the aged. The main objectives of the analysis done by the World Health organization are to provide recommendations for future change of the policies.

Few of the major injuries that are suffered by the aged individual from the Fall and other types of accidents include the hip fracture and 95% accident results from this injury (Törnvall et al., 2016). The future policy of the accidents needs to include the primary intervention steps that are needed to recover from the consequence of fall and all types of injuries that occur due to the fall. The primary support system is one of the fundamental requirements that are needed in order to minimize the consequence of the fall and also the injuries that are associated.

 

Recommendations for future change

The report of the World Health organization also suggests that most of the fall also occurs outside from that of home. The policies for fall prevention have thus been made in accordance with the report of the World Health Organization so that it is possible to prevent the injuries that are caused due to the fall. For example, the fall policy that is implemented by the government has protocols that have provided them with extra care during the time of winter. It also aims to ensure that most of the aged people can have their daily working activities inside the house, where the chance of fall is much lower compared to that in the outdoor environment. Hence, the reports that are published by the World Health Organization have significant effects on the fall prevention policy that are implemented by the government of Australia.

It is recommended to make future changes depending upon the loopholes and limitations that exist in the present policies of fall. It is important to deal with the consequence of support system that is needed in order to decrease the chance of the fall among the aged individual (Schoene et al., 2014).  In the current scenario, there has been a great debate to provide the definition of the fall and its cause among the aged individual. Hence, it is important for the future policies to define the importance of the health needs that is needed to provide description of the fall policy. It is also important to identify the actual cause of the fall that can help to change the policies

Addressing the needs of the disadvantaged groups

The fall prevention policy can be of great support to the disadvantaged group within the society that will allow them to have equal rights and opportunity in the community of Australia and also able them to take active participation in all social activities. It is possible to deal with all the challenges of inequality that the aged individuals have to face among the disadvantaged group of the society. The fall prevention policy is thus, an effective policy that can help to remove the physical disabilities. It can be also mentioned in the context that the aged individual among the socially disadvantaged groups is more vulnerable to have the consequence of fall (Robinovitch et al., 2013).

Conclusion

The policies related to the fall prevention among the aged individual can have the result to improve the health condition of the aged individual. Due to the physical disability related to the age, it is common for the older people to face unintentional accidents that will result in the fall and thereby cause physical injuries. These physical injuries are the cause of several fractures and other types of risks that are associated. 

The government of Australia has implemented the policies that have helped to reduce upon the consequence of fall among the aged individuals. The main purpose of this policy is to minimize the effects and adverse consequence of fall that can cause severe level of physical injuries among the aged individual. The effective planning process is needed that will help to improve the present condition of the fall policy that can help to improve upon the health policies related to the aged care and also provide them with the opportunity to participate in all types of social activities. It is also the important make suitable changes within the policy making process that will help to remove upon the drawbacks that exist in the current policy.    

 

References:

Althaus, C., Bridgman, P., & Davis, G. (2012). The Australian policy handbook. Allen & Unwin

Britt, H., Miller, G. C., Henderson, J., Bayram, C., Valenti, L., Harrison, C., ... & O'Halloran, J. (2013). General Practice Activity in Australia 2012-13: BEACH: Bettering the Evaluation and Care of Health (No. 33). Sydney University Press.

Britton, K. F., Durey, A., O'grady, M. J., & Slack?Smith, L. M. (2016). Does residential aged care need dental professionals? A qualitative study on dental professionals' perceptions in Australia. Gerodontology, 33(4), 554-561.

Carande-Kulis, V., Stevens, J. A., Florence, C. S., Beattie, B. L., & Arias, I. (2015). A cost–benefit analysis of three older adult fall prevention interventions. Journal of safety research, 52, 65-70.

Chen, Y. H., Jones, C., & Osborne, D. (2017). Exploratory study of Australian aged care staff knowledge and attitudes of later life sexuality. Australasian Journal on Ageing.

Deandrea, S., Bravi, F., Turati, F., Lucenteforte, E., La Vecchia, C., & Negri, E. (2013). Risk factors for falls in older people in nursing homes and hospitals. A systematic review and meta-analysis. Archives of gerontology and geriatrics, 56(3), 407-415.

Falls prevention. (2017). Health.nsw.gov.au. Retrieved 15 June 2017, from https://www.health.nsw.gov.au/falls

Henderson, J., Willis, E., Xiao, L., & Blackman, I. (2016). Missed care in residential aged care in Australia: An exploratory study. Collegian.

Hughes, M. (2017). Towards the Inquiry into Aged Care and Beyond: The Promise and Challenge of a New Era in LGBTI Ageing. Ageing and Sexualities: Interdisciplinary Perspectives, 183.

Laflamme, L., Monárrez-Espino, J., Johnell, K., Elling, B., & Möller, J. (2015). Type, number or both? A population-based matched case-control study on the risk of fall injuries among older people and number of medications beyond fall-inducing drugs. PloS one, 10(3), e0123390.

Pajala, S., Kolehmainen, L., Koivula, R., Råback, M., & Lounamaa, A. (2016). 502 Prevention of accidental falls among older people in Finland–National IkinÄ-program. Injury Prevention, 22(Suppl 2), A181-A181.

Robertson, H., Nicholas, N., Rosenfeld, T., Georgiou, A., Johnson, J., & Travaglia, J. (2014, August). A virtual aged care system: when health informatics and spatial science intersect. In HIC (pp. 137-142).

Robinovitch, S. N., Feldman, F., Yang, Y., Schonnop, R., Leung, P. M., Sarraf, T., ... & Loughin, M. (2013). Video capture of the circumstances of falls in elderly people residing in long-term care: an observational study. The Lancet, 381(9860), 47-54.

Savy, P., Warburton, J., Hodgkin, S., & Hodgkin, J. W. S. (2017). Challenges to the provision of community aged care services across rural Australia: perceptions of service managers. Rural and Remote Health, 17(4059).

Schoene, D., Valenzuela, T., Lord, S. R., & de Bruin, E. D. (2014). The effect of interactive cognitive-motor training in reducing fall risk in older people: a systematic review. BMC geriatrics, 14(1), 107.

Törnvall, E., Marcusson, J., & Wressle, E. (2016). Health-related quality of life in relation to mobility and fall risk in 85-year-old people: a population study in Sweden. Ageing and Society, 1-16.

Uusi-Rasi, K., Patil, R., Karinkanta, S., Kannus, P., Tokola, K., Lamberg-Allardt, C., & Sievänen, H. (2015). Exercise and vitamin D in fall prevention among older women: a randomized clinical trial. JAMA internal medicine, 175(5), 703-711.

Voukelatos, A., Merom, D., Sherrington, C., Rissel, C., Cumming, R. G., & Lord, S. R. (2015). The impact of a home-based walking programme on falls in older people: the Easy Steps randomised controlled trial. Age and ageing, 44(3), 377-383.

Willis, E., Reynolds, L., & Keleher, H. (Eds.). (2016). Understanding the Australian health care system. Elsevier Health Sciences.

Xiao, L. D., Wang, J., He, G. P., De Bellis, A., Verbeeck, J., & Kyriazopoulos, H. (2014). Family caregiver challenges in dementia care in Australia and China: a critical perspective. BMC geriatrics, 14(1), 6.

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