NUR 621 Economics and Quality

Economics and Quality

            Health problems such as obesity act as a source of disease burden to the global populations. Nurses and other healthcare providers implement evidence-based, population-centered interventions to prevent, treat, and reduce its impact on the population. Countries make policies that aim at addressing the prioritized population needs. Nurses and nurse leaders utilize their knowledge and skills to influence the adoption of health care policies that enhance safety, quality, and efficiency of care services to those in need. Therefore, this essay examines the health economic impacts of obesity. It explores topics that include significance of obesity in the United States of America, its impact, what I can do as a nurse leader, impact of nurses on health policy and quality measures on reimbursement.

Significance of the Health Care Issue in the United States

            Obesity is a significant health care issue in the United States. The prevalence rate of obesity is high in the USA. According to the Centers for Disease Control and Prevention (CDC), the obesity rate in the USA in 2017-2020 was 41.9%. The prevalence rate has been rising, as seen from the statistics that it was 30.5% in 199-2000. The prevalence rate of severe obesity over the same period rose from 4.7% to 9.2%. Obesity is a crucial predictor of several health problems. They include conditions such as type 2 diabetes mellitus, some types of cancer, heart disease, and stroke(CDC, 2022). These conditions contribute to a high rate of disability, decline functioning, and premature mortalities.

            The health spending on obesity-related problems in the USA is high. According to the CDC, the estimated healthcare spending for obesity in the USA was about $173 billion in 2019. Medical spending by adults with obesity was $1861 higher than that incurred by individuals with healthy weight. Obesity leads to a decline in functioning and productivity among the affected populations. This is attributed to factors such as frequent hospitalizations and missed workdays among those affected by its associated complications. Disparities exist in the rate and burden of obesity in the population. For example, non-Hispanic Black adults have the highest prevalence rate of obesity as compared to other ethnicities(CDC, 2020, 2022). In addition, obesity rate is high among individuals from low socioeconomic status, hence, the concern.

Impact of Health Economics on the Topic

            Health economics affect obesity in the United States. Obesity is a lifestyle disease. In addition, it is preventable through interventions such as health education on lifestyle and behavioral modification. The success of health promotion and disease prevention strategies targeting obesity depends largely on the adequacy of funding from the government and other institutions involved in the promotion of public health. Inadequate financing of health promotion initiatives such as health education and screening campaigns and increased access to healthy diets for those at risk will increase the rates of obesity(Okunogbe et al., 2021). In addition, inadequate financing of healthcare systems to address lifestyle diseases increases the overall burden of obesity and its related problems in the community.

            Healthcare systems operate in an environment characterized by considering competing needs. Often, they must prioritize the allocation of the scarce resources to ensure optimum outcomes. The increasing competing needs in the healthcare industry affects the allocation of the necessary resources for addressing the issue of obesity. For example, the recent high demands from Covid19 led to a shift in resource allocation from disease prevention and health promotion to treating and addressing the challenges brought by the pandemic(Biener et al., 2020). Therefore, the scarcity of resources in health and competing needs and demands affect the adoption of interventions and programs to address obesity in the population.

What I could do as a Nurse Leader

            I can do several things as a nurse leader to create an impact on obesity in my professional setting. One of the things that I can do is implementing guidelines that recognize the need for screening all patients for obesity in the practice site. The screening will enable timely diagnosis, prevention, and treatment of patients that may be suffering from obesity-related complications. The intervention will also provide opportunities to educate the patients about the causes, risk factors, health risks, and prevention of obesity(Sjunnestrand et al., 2019). Health education will promote lifestyle and behavioral change among the patients.

            The other way I can influence obesity in the practice site is lobbying for resource support to be used in community-centered initiatives addressing the problem. This includesadvocating for the organization’s support for community programs that aim at raising awareness about obesity and the need for healthy and lifestyle modification among the population. Community programs will create extensive awareness and impact, thereby, minimizing the rate of obesity. The last way in which I can influence obesity in my practice is by engaging in research to identify population-centered and appropriate interventions to address the problem(Warr et al., 2021). The scholarly roles will enable the use of evidence-based interventions in the practice site to enhance safety, quality, and efficiency outcomes in prevention and management of obesity.

Impact of Quality Measures on Reimbursement

            Quality measures have a significant impact on reimbursement in health. Health organizations focus mainly on achieving the set quality metrics for increased reimbursement. The quality measures provide insight into the safety, quality, and efficiency of care given to those in need. The measures also demonstrate the ability of health organizations to deliver value-based care to their consumers. Hospitals that score high in the different quality metrics tend to receive high reimbursement including bonuses for the services rendered(Yabroff et al., 2019). However, low scores are associated with low reimbursements that penalties, which affect performance and service utilization by the consumers.

            Quality measures also strengthen adherence to measured and standardized processes in health organizations. The standardization enhances continuous improvement of the existing systems and processes in an organization. As a result, health organizations gain monetary value through increased delivery of value-based care that align or exceed consumer needs. Quality measures also promote efficiency in healthcare for more financial gains. Accordingly, health organizations obtain objective understanding of their most prioritized needs and resources that should be allocated to achieve them(Song et al., 2019). The implication is that organizations achieve optimum outcomes while using their resources efficiently, hence, the direct financial gain alongside reimbursement for rendered services.

Impact on Health Policy

            I can have immense impacts on health policy as a nurse leader. First, nurse leaders have experience with healthcare issues that affect their populations. They have experience with the effect of factors such as social determinants of health and barriers to healthcare that face consumers of healthcare services. As a result, they use their experience to ensure the adoption of healthcare policies that align with the actual needs of their populations. Nurse leaders also have experience with lobbying for resources for different initiatives(Abbasinia et al., 2020). This experience helps them in advocating adequate resource support for the different policies adopted to enhance health outcomes for the different populations.

            Healthcare policies should be ethical and align with legal requirements in a state. Nurse leaders have extensive experience in the implementation of policies and guidelines that align with the set legal and ethical guidelines. They use their experience to ensure the protection of the population right to safe and high-quality care in health policy. They ensure the adopted policies advance common good for the population and safeguard their right to autonomous care. Nurse leaders are also scholars. They have experience in the translation of evidence into practice. This implies that they can influence healthcare policies by ensuring the use of evidence-based strategies in policy assessment, planning, implementation, monitoring, and evaluation(Godsey et al., 2020). The use of evidence-based strategies will enhance optimum outcomes with the adopted policies in health.

Conclusion

            Obesity is a significant issue in the United States. It is adisease burden for the affected populations. Health economics affect obesity in the United States. Quality measures influence reimbursement. Hospitals with high scores on the quality measures receive high reimbursement, commission, and incentives. Nurse leaders can influence obesity. They can implement interventions such as patient screening and health education and community-centered campaign to raise awareness about obesity and its prevention. Nurse leaders can also influence health policy. They ensure the adoption of population-centered policies to optimize population outcomes.

References

Abbasinia, M., Ahmadi, F., & Kazemnejad, A. (2020). Patient advocacy in nursing: A concept analysis. Nursing Ethics, 27(1), 141–151. https://doi.org/10.1177/0969733019832950

Biener, A. I., Cawley, J., & Meyerhoefer, C. (2020). The medical care costs of obesity and severe obesity in youth: An instrumental variables approach. Health Economics, 29(5), 624–639. https://doi.org/10.1002/hec.4007

CDC. (2020, June 26). Products—Data Briefs—Number 360—February 2020. https://www.cdc.gov/nchs/products/databriefs/db360.htm

CDC. (2022, July 20). Obesity is a Common, Serious, and Costly Disease. Centers for Disease Control and Prevention. https://www.cdc.gov/obesity/data/adult.html

Godsey, J. A., Houghton, D. M., & Hayes, T. (2020). Registered nurse perceptions of factors contributing to the inconsistent brand image of the nursing profession. Nursing Outlook, 68(6), 808–821. https://doi.org/10.1016/j.outlook.2020.06.005

Okunogbe, A., Nugent, R., Spencer, G., Ralston, J., & Wilding, J. (2021). Economic impacts of overweight and obesity: Current and future estimates for eight countries. BMJ Global Health, 6(10), e006351. https://doi.org/10.1136/bmjgh-2021-006351

Sjunnestrand, M., Nordin, K., Eli, K., Nowicka, P., & Ek, A. (2019). Planting a seed – child health care nurses’ perceptions of speaking to parents about overweight and obesity: A qualitative study within the STOP project. BMC Public Health, 19(1), 1494. https://doi.org/10.1186/s12889-019-7852-4

Song, Z., Ji, Y., Safran, D. G., & Chernew, M. E. (2019). Health Care Spending, Utilization, and Quality 8 Years into Global Payment. New England Journal of Medicine, 381(3), 252–263. https://doi.org/10.1056/NEJMsa1813621

Warr, W., Aveyard, P., Albury, C., Nicholson, B., Tudor, K., Hobbs, R., Roberts, N., & Ziebland, S. (2021). A systematic review and thematic synthesis of qualitative studies exploring GPs’ and nurses’ perspectives on discussing weight with patients with overweight and obesity in primary care. Obesity Reviews, 22(4), e13151. https://doi.org/10.1111/obr.13151

Yabroff, K. R., Gansler, T., Wender, R. C., Cullen, K. J., & Brawley, O. W. (2019). Minimizing the burden of cancer in the United States: Goals for a high-performing health care system. CA: A Cancer Journal for Clinicians, 69(3), 166–183. https://doi.org/10.3322/caac.21556