1 Soledad M. Guzman HCM-340 Professor Bradley A Gap in Quality Related to Care Coordination for Individuals with Chronic Illnesses Even though there…

Soledad M. Guzman

HCM-340

Professor Bradley

A Gap in Quality Related to Care Coordination for Individuals with Chronic Illnesses

Even though there have been different measures, development and initiatives from both the public and private healthcare sectors, gaps relating to access to quality, equity, or efficiency of healthcare service provided have been observed over time. This research analyzes a gap in quality related to care coordination for people suffering from chronic illnesses. The gap can be traced back in the year 2001 when the Institute of Medicine concluded that with regard to quality “between the health care we have and the care we could have lies not just a gap, but a chasm” (Institute of Medicine, 2001).  The described is not only over quality. Focusing on individuals with chronic illness; lack of access, financial barriers, workforce shortages, and high costs are among the dimensions of our current healthcare systems which expose the gap between “what is” and “what should be” (Price-Haywood, 2016). The reason for this is because patients with chronic conditions use the medical assistance more frequently, see more specialist, frequent doctors’ visits, need daily multiple medicines, are hospitalized more often and home care needs, consume more healthcare resources than other population, and have long term relationships with the systems.

The gap largely affects the socially disadvantaged and clinical vulnerable population. Under socially disadvantaged population include racial and ethnic minority, immigrants, low income earners, low level of education, and people with low health literacy and those residing in rural areas (McGlynn, E.A., et al., 2003). Additionally, the gap impacts negatively homeless people, non-English speaking patients, uninsured or underinsured, and those with low social support. That is to say, the socioeconomic background of the affected population has a direct effect on the accessibility of the healthcare services. Social economic factors are more related to the level of income, literacy level, social status and class in the community as well as physical living conditions (Essential Hospitals, 2013). Only those with poor economic, educational, as well as living conditions have little access to the healthcare services.

The healthcare delivered to the population is affected by the gap in access in different ways. First, care is often fragmented and poorly coordinated because of the health education and the literacy level of those affected (Price-Haywood, 2016). Consequently, the current and modern information technology and innovation and other technological developments cannot be used. The providers are limited to what the patients can afford and comprehend. Secondly, too few providers are adequately trained in chronic care. The few available can only attend to patients in the urban areas. Those in rural areas have nobody to attend to them. Finally, the quality of services is compromised. The American health care system is based on an episodic, acute care medical model.  It rests on conceptual models which are designed to make sense out of complex events in the world and to help organize people responses and not provide the healthcare services required (McGlynn, E.A., et al., 2003). It typically ignores the interdependent nature of multiple conditions; thus failing.

If this gap in quality related to care coordination for people suffering from chronic diseases is not addressed, it would imply that the less fortune people in the society would nether have neither right nor entitled to quality healthcare services as further as chronic conditions are concerned. Only high income earners, people with healthcare education, individuals with high social class or status in the community and those fully insured will be entitled to access of quality healthcare service for chronic conditions. Most importantly, even those with monetary capacity will have to seek treatment and medication for such conditions outside the country. The current system is ill-equipped to treat chronically ill patients.Besides that, it breaks down quickly when confronted with patients with multiple chronic conditions.

References

Essential hospital, (2013). Facilitators and Barriers to Providing Patient-Centered Chronic            Disease Care to Patient Populations at Risk for Health and Health Care Disparities in          Safety Net Settings. Available at http://www.pcori.org/assets/2014/01/PCORI-            Facilitators-Barriers-Providing-Patient-Centered-Chronic-Disease-Care-120613.pdf

Institute of Medicine(2001). Crossing the quality chasm: A new health system for the 21st            century (Vol. 2001). Washington D.C.: National Academy Press.

McGlynn, E.A., et al. (2003). The quality of health care delivered to adults in the United States.  New England Journal of Medicine 348(26), 2635-2645.

Price-Haywood, E., Amering, S., Luo, Q., &Lefante, J. (2016). Clinical Pharmacist Team-Based Care in a Safety Net Medical Home: Facilitators and Barriers to Chronic Care           Management. Population Health Management. http://dx.doi.org/10.1089/pop.2015.0177

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