You will write a 20-page research-based paper in current APA format that focuses on an applied topic of your choosing related to healthcare economics and decision-making in the healthcare industry or a healthcare facility. The paper must include at least 15 references in addition to the course textbook and the Bible. All sources must be less than 10 years old. You will complete an Annotated Bibliography, Outline, Draft, and Final paper in order to complete this project
Informed Decision Making and Its Economic
Impact on Healthcare Choices
The healthcare economy is a multi-billion-dollar industry that is supposed to effectively take care of all aspects of healthcare for the worldly population. The United States is at the top of that food chain in most revenue spent for its citizens regarding healthcare. The rising costs of healthcare for services they utilize yearly have many taken their healthcare spending into their own hands. The age of technology and the advancements of smartphones has provided most patients a mini computer in the palms of their hands. Patients can navigate the internet and search for additional information regarding diagnosis, treatment options, and medications before ever leaving the physician office. The power of the informed patient has changed the spectrum of provider to patient relationships, continuation of care, and the finances of healthcare industry. The goal of this paper is to investigate how patients are becoming more informed of their healthcare diagnosis, management of services and what they are spending out to effectively keep costs down. Lastly, this paper seeks to explore the impact informed patients and their decision making will have on future revenue of the healthcare industry.
Informed consent has provided the pathway for patients to be more aware in the healthcare processes of their plan of care, be involved in the decision making, and how to effectively make an informed decision based off the information given. What is informed consent? It is best defined as a patient’s agreeance to any type of procedure, testing, or treatment based on them being aware or knowledgeable of any potential risk, harms, and benefits of their choice. Merriam Webster defines informed decision as “a decision based on facts or information” (n.d.). The patient can make an informed choice based on how it aligns with their healthcare needs, religious preferences, and lifestyle choices.
The are many different methods that can be utilized to create a dialogue for a patient to make an informed decision. The first one starts with a discussion in the office that has the doctor discuss all potential health care treatment plans. The physician will give the patient their interpretation on what the best avenue of care would be but also speak on alternatives. The second portion of this dialogue is a critical component for an informed decision to occur is the educational material that is given to the patient. “Patient decision aids come in a variety of formats, from simple one-page sheets designed to prompt discussion within consultations to more detailed information supplied via DVDs, computer programs or interactive websites” (Coulter, 2018). This can be developed by the facility or personally put together by the physician himself. It allows the patient to go home, read or view the material, formulate any additional questions, and come back to the physician to make shared decision on care. Shared decision making is the collaboration of the patient making an informed decision with the physician who recommending services. “The incorporation of shared decision-making tools and elicitation of patient values and preferences into the traditional but obsolete surgery consent process is informed choice” (Weinstein, Clay, Morgan, 2007, p. 726). “Identifying the medical problem and laying out the reasonable options are primarily the responsibility of the physician”. “Patients have the primary responsibility for identifying and conveying their goals and concerns relevant to the decision they are facing” (Fowler, Levin, & Sepucha, 2011, p 699). This statement is true when deliberating and agreeing on every form of treatment plan with a physician no matter how small or huge.
Consumers drive the market and that would make patients the driving force in healthcare.
The Internet’s self-service culture and people’s expectations for increased information and control over every aspect of their lives are also driving consumer driven care. In a world in which people book and track their travel online, buy everything from books to furniture online, and can access the accumulated knowledge of the world with a single click, they expect that they should be able to get healthcare information and manage their own health via Internet, smartphone, and tablet technologies (Elsevier Clinical Solutions, 2015, p. 4).
“Evidence suggests that consumers tend to choose better performing health plans and providers and are responsive to initiatives that provide quality information” (Kolstad & Chernew, 2009, p. 28S). Patients as consumers are doing more research on suggestions for their health care needs beyond the physician office visit. It allows them to come with a formed opinion of what the they think the physician should tell them but also the first thing they do after a diagnosis is to Google it to get a better clarification of what could possibly be potential outcomes.
“In an evolving market, healthcare organizations need to go beyond providing appropriate care with optimal outcomes. Instead, they must engage patients and provide superior services to earn customer loyalty” (Deao & Johnson, n.d.). Expectations for physicians are in higher regard now based on several ways’ patients feel that they should handle the visit. Quality measures have been implemented and engaged by the Federal government to facilitate that providers are rated and meet the expectations of their patients. It is the age of technological savvy patients who want to feel more involved. Surveys are distributed through emails, phone calls, and in offices to gauge the patient satisfaction at every turn. Patients leave their opinions on physicians and in turn use these to seek the next provider when in need. Some patients are basing their rating of providers solely on the fact if they can provide written information in conjunction with the verbal information expressed during the office visit.
The golden age of patient and provider relationships relied on the provider being the source of where all decisions were based upon and the patient basically went along with what was suggested. The millennial age has created a change in the dynamics of this relationship. “Empowering patients to be effective advocates for their health requires that they have adequate information and understanding about their health conditions” (Lewis & Pignone, 2009, p.136). Focusing on the care of the patient and making sure that they are knowledgeable or have someone with that is allows for a smoother transition through the processes of their treatment plan. Recognizing the imperative to center on the patient, a learning health care system is one in which patients and their families are key drivers of the design and operation of the learning process” (Smith, Saunders, Stuckhardt, et al, 2013, p. 1).
Decision aids improve decision-making by increasing knowledge of the options, benefits and risks, creating more realistic expectations, lowering decisional conflict, reducing uncertainty about what to choose, enhancing active participation in decision-making, decreasing the proportion of people who are undecided, improving agreement between values and choices (Weinstein, Clay, Morgan, 2007, p. 727).
The utilization of the outside support team plays a factor in the swaying of opinions and so including the family, caretakers, or whomever the patient uses for these types decisions is imperative in the directive for continuation of care. It is an ethical and legal obligation to provide all these factors when encouraging a patient to participate in their health care plan. “Healthcare is no longer immune from customer decision making”. “As the marketplace becomes more segmented and individualized, non-acute and chronic care patients will reward organizations that offer better value, and more personalized and convenient services at lower prices” (Deao & Johnson, n.d.). These patients will shape the way healthcare revenue going forward.
Once a patient has been presented with all the information and possible outcomes of a medical diagnosis then the decision can be quick or takes weeks to decide. There are so many different factors that play into making the correct decision with your physician on how your healthcare plan is effectively completed. The primary concern is the understanding of the medical diagnosis and severity of it. The diagnosis carries the weight of how the plan is formulated and the best treatment options are given. Every diagnosis carries a different weight, a different method of treatment, and then this is compounded by the individual patient. Every patient cannot be treated the exact same way as the next one. There are other medical issues that must be considered, medications taken, pre and post treatment discussions, and the overall quality of life the patient will want to think about to make an informed choice. The mental and emotional state of the patient must be considered also and that is why the incorporation of family and friends in the initial discussion can help the patient have all the factors. “A cancer diagnosis can lead to a state of crisis for an individual and his or her family because most people are not immediately equipped to understand their diagnosis or how to identify options for moving forward” (Levit, Balogh, et. al, 2013, p. 98). An elective surgery, like freezing warts off your hand, does not carry the same weight of critical information need than the cancer diagnosis would take in deciding. “Healthcare consumers will judge value, satisfaction and quality differently depending on which type of care services they require” (Deao & Johnson, n.d.). Treatment options will rely on health insurance coverage allowance and out of pocket expenses that will be needed by the patient. These each are at very different ends of the spectrum on pricing and out of pocket expenses for the patient. This will play a significant factor on what a patient may do next. Second opinion options can delay treatment but change treatment options. Some patients utilize these when the gravity of the medical diagnosis is unclear or there is more than one treatment option available and the physician is suggesting one that the patient may not completely align with.
Patients are researching more and making decisions based on the knowledge of plans, provider ratings, and the costs of services being deemed necessary. They are finding themselves stuck in the midd...