Evaluation of Integrated Delivery Systems

1573 words (6 pages) Nursing Essay

2nd Oct 2020 Nursing Essay Reference this

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Integrated Delivery Systems

  • Briefly describe the following healthcare settings:
    • Hospitals

Hospitals provide diagnostic and therapeutic services to people who need more than several hours of care, although most hospitals are also active in outpatient (walk-in) facilities (Gapenski, 2012). Hospitals must be authorized by the government and undergo inspections to comply with government laws to guarantee a minimum level of security and quality which are accredited by the Joint Commission and is voluntary (Gapenski, 2012). Although the cost of achieving and maintaining norms can be significant, accreditation offers eligibility for Medicare program involvement, and so most hospitals seek accreditation (Gapenski, 2012). Hospitals vary in function, duration, size, and ownership of the patient (Gapenski, 2012). These variables influence the type and amount of the demands for resources, services and management and often determine the sort and amount of reimbursement (Gapenski, 2012). Hospitals are either categorized as general or specialty care centres (Gapenski, 2012). General acute care hospitals are short-stay facilities and account for most clinics, providing general medical and surgical services and chosen acute specialty services (Gapenski, 2012). Specialty hospitals, such as psychiatric facilities, children's facilities, women's facilities, rehabilitation facilities, and cancer facilities, restrict patient entry to particular age, gender, disease, or circumstances (Gapenski, 2012).

Hospitals differ in size and are categorized as private non-profit, owned by investors, and governmental by property, which are fitted for the treatment and diagnosis of illnesses (Gapenski, 2012). Those with general acute care tend to be bigger than those with specialties (Gapenski, 2012). Small hospitals are generally situated in rural regions, with fewer than 100 beds (Gapenski, 2012). Most of the biggest hospitals, including tertiary facilities (an extremely specialized and technical nature, providing services to patients with exceptionally serious, complicated or unusual issues), are academic health centers or teaching hospitals (Gapenski, 2012).

  • Ambulatory care

Ambulatory care is widely described as outpatient care (Gapenski, 2012). Ambulatory care relates to any medical procedure in an ambulatory environment that allows the patient to be handled and sent back within the same day (Gapenski, 2012). Without admission to hospital, minimally invasive surgeries and operations can be conducted (Gapenski, 2012). Colonoscopies, carpal tunnel surgery, and other laparoscopic surgeries are examples of processes that can be finished through outpatient care (Gapenski, 2012).

  • Home health care

Home health care is the services given in the home of the patient (Haggerty, n.d.). Not only is home health care more convenient for patients, it is also less costly than being handled in a hospital or a skilled nursing establishment (Haggerty, n.d.). While home health care is very useful to patients, a doctor must create a referral for home health services and it must be approved by the insurance (Haggerty, n.d.). Services such as nursing and physical, occupational, speech and respiratory therapy are provided (Haggerty, n.d.). Usually they are short-term services and are covered by Medicare as long as the person is home-bound (Haggerty, n.d.). Many home health care facilities seek accreditation by the Community Health Accreditation Program (CHAP), the Health Care Accreditation Commission (ACHC), and the Joint Commission (JCAHO) (Haggerty, n.d.).

  • Long-term care

Long-term care involves providing healthcare services to people who lack some degree of functional capacity, as well as some private services and usually covers an extended period of time and includes both hospital and outpatient services, often focusing on mental health, rehabilitation, and home care for nursingĀ  (Gapenski, 2012). Long-term care deals with levels of daily activities such as eating, bathing, and locomotion and become too physically or mentally disabled to perform the necessary tasks or when their family members are unable to provide the necessary services to assist them (Gapenski, 2012). Long-term care is a hybrid of social and health care facilities; nursing homes are a significant source of such care but there are many new services are being developed to meet the needs of society in a less institutional environment, such as day care for adults, life care centers, and hospice programs (Gapenski, 2012).

Home health care can be an alternative to nursing home care for many patients, provided for an extended period of time, but it is not as readily available in many rural areas as nursing home care (Gapenski, 2012). In addition, third-party payers, particularly Medicare, have sent mixed signals about their readiness to pay for home health care properly (Gapenski, 2012). In reality, as a consequence of a fresh, less generous Medicare payment scheme, many home healthcare companies have been compelled to close in latest years (Gapenski, 2012).

  • Integrated delivery systems

An integrated delivery system (IDS), sometimes referred to as an integrated delivery system for healthcare, addresses healthcare problems related to information technology (Wilson, 2019). It is basically a system that implements health care service integration and makes full use of the value of health information technology (Wilson, 2019). IDSs align incentives and resources better than most distribution schemes for healthcare, resulting in enhanced quality of medical care while controlling expenses (Wilson, 2019).

In latest years, this word has focused more on incorporating a health system with various clinics and associated facilities (often referred to as an integrated distribution network) to coordinate care (Wilson, 2019). It also defines improvements in communications and systems within a single hospital, however (Wilson, 2019). The goal of integrated delivery systems is to provide its member population with all the necessary facilities at the lowest price (Gapenski, 2012).

  • What benefits are attributed to integrated delivery systems?

The hypothesized advantages of integrated delivery systems include the following:

  • Patients are kept in the corporate network of services (patient capture) (Gapenski, 2012).
  • Providers have access to managerial and functional specialists (e.g., reimbursement and marketing professionals) (Gapenski, 2012).
  • Information systems that track all aspects of patient care, as well as insurance and other information, can be created more readily and the expenses of developing them are shared. Typically, many of these population-based attempts are not provided by stand-alone providers (Gapenski, 2012).
  • Incentives can be created that encourage all providers in the system to work together for the common good of the scheme, which has the ability to enhance quality and control expenses (Gapenski, 2012).
  • What are the challenges/drawbacks to implementing integrated delivery systems?

Although the Integrated Delivery System has excellent advantages, there are also many difficulties. Healthcare system managers have discovered it harder to handle big, varied businesses than they initially intended (Gapenski, 2012). This problem was particularly true when physician practices were obtained by hospitals or health systems (Gapenski, 2012). In many cases, the predicted financial and patient care gains have not been realized and some of the integrated delivery systems created in the 1990s have broken up (Gapenski, 2012). However, healthcare reform legislation has created additional incentives that are expected to foster the creation of a new type of integrated de-livery system, the accountable care organization (Gapenski, 2012).

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