Identification of a Local Health Care Economic Issue
Katherine Shaw Bethea Hospital is an 80-bed, not-for-profit, independent hospital serving several rural counties. I have personally worked in the Emergency Department at Katherine Shaw Bethea (KSB) for several years. In my work I have seen a rising need to have an urgent care facility that accepts all insurances. Lee County, where KSB is located, has a poverty rate of 20% with an increasing Medicaid population (Lee County, 2018). Unfortunately, the only urgent care in the area, is a private facility that does not accept Medicaid. The patients who need to be seen for non-emergent needs who are unable to get into their primary doctor, or do not have a primary doctor, end up coming to the emergency department, resulting in an influx of non-emergent patients.
What is Urgent Care?
Medical conditions requiring urgent care are conditions not considered an emergency but still require care within 24 hours such as cuts that do not include a lot of bleeding, acute illnesses, eye problems, minor broken bones, and urinary tract infections to name a few. When these patients go to the emergency department (ED) it can cause overcrowding.
Why is Urgent Care Needed?
KSB Hospital is not alone in treating an area with a large population living in poverty, but one difference is that there is not an urgent care facility that accepts Medicaid, which is the insurance most people living in poverty have in Lee County (Lee County, 2018). The main purpose of an ED is to treat emergency and urgent cases, but due to malfunctioning health services in communities, there is a rise in improper use of emergency departments (Sartini et al, 2022). A study done in 2018 showed that Medicaid was the most common payer source for ER visits and that unnecessary ER visits are higher in rural hospitals than urban hospitals (Hess et al, 2018). It can be assumed that there are more urgent care centers in urban areas. As previously stated, the only urgent care facility in Lee County does not accept the primary insurance seen in Lee County.
An influx of patients in the ED results in overcrowding. Overcrowding affects quality of care, increases the risk of patients having adverse outcomes, and increases the risk of errors (Sartini et al, 2022). I have seen firsthand that overcrowding also causes burnout in the physicians, nurses, and other emergency department staff.
Conclusion
An influx of patients in emergency departments causing overcrowding is an issue all over the country. I have seen firsthand how it affects patients and staff in a local, rural hospital. The implementation of an urgent care facility that treats patients of all financial backgrounds is necessary and will have a positive impact on the community.
References
Hess, J., Miller, B., Paiva, W., Stroup, J., & Fong, E. (2018, March 15). Comparison of emergency room utilization for non-emergent purposes before and after the implementation of the affordable care act. OSU Center for Health Sciences Research Profiles. Retrieved from https://scholars.okstate.edu/en/publications/comparison-of-emergency-room-utilization-for-non-emergent-purpose
Lee County Community Health Needs Assessment (CHNA) report. (2018). Retrieved from http://www.leecountyhd.org/files/3916/6128/0584/LEE_CO_CHNA_Report__Oct_2018_web.pdf
Sartini, M., Carbone, A., Demartini, A., Giribone, L., Oliva, M., Spagnolo, A. M., Cremonesi, P., Canale, F., & Cristina, M. L. (2022). Overcrowding in emergency department: Causes, consequences, and Solutions—A narrative review. Healthcare, 10(9), 1625. https://doi-org.library.capella.edu/10.3390/healthcare10091625
Paper details
Develop a 4–7-page business case for the initiative you proposed in Assessment 1 (attached below). Examine feasibility and cost-benefit considerations over a 5-year period, analyze ways to mitigate risks, and complete a cost-benefit analysis.NHS- FP6008 Economics and Decision Making in Health Care.
Assessment Instructions
Develop a business case for the economic initiative you proposed in Assessment 1. Examine the feasibility and cost-benefit considerations of implementing your proposed initiative over the next five years. Analyze ways to mitigate risks and complete a cost-benefit analysis.NHS- FP6008 Economics and Decision Making in Health Care.
Note: Remember that you can submit all, or a portion of, your draft business case to Smarthinking for feedback before you submit the final version for this assessment. If you plan on using this free service, be mindful of the turnaround time of 24–48 hours for receiving feedback.NHS- FP6008 Economics and Decision Making in Health Care.
Requirements
The requirements for your business case, outlined below, correspond to the scoring guide criteria, so be sure to address each main point. Read the performance-level descriptions for each criterion to see how your work will be assessed. In addition, be sure to note the requirements for document format and length and for supporting evidence.NHS- FP6008 Economics and Decision Making in Health Care.
Analyzes the potential economic opportunities and risks associated with a proposed initiative. Draws sound conclusions based on an astute comparison of clearly articulated risks and benefits. Reconciles conflicting data.
How do the potential opportunities benefit your organization or care setting?
How could potential risks pose a threat to the financial security of your organization or care setting?
How do the potential economic opportunities compare to the potential economic risks?
Proposes ethical and culturally sensitive solutions that address the risks associated with an initiative to the future economic security of the organization or care setting. Justifies proposed solutions and articulates underlying assumptions.NHS- FP6008 Economics and Decision Making in Health Care.
Which risks are potentially the most significant for your organization or care setting?
How could you modify your proposed initiative to mitigate those risks?
How have other organizations and experts in the field dealt with similar risks?
How do ethics and equality factor into your proposed solutions?
Are your solutions unfairly burdening or disadvantaging any specific groups?
How will this proposal affect community health care delivery outcomes?
What makes this a great opportunity for economic growth?
What potential issues should be considered?
Analyzes the economic costs and benefits of a proposed initiative over a five-year period. Impartially examines potential negative implications or consequences of the initiative and provides clear, justifiable recommendations for using analysis findings in deciding on the feasibility of the initiative.NHS- FP6008 Economics and Decision Making in Health Care.
Use the Cost-Benefit Analysis Template [XLSX] for your calculations. Add the worksheet to your business case as an appendix.
Does your analysis warn against specific aspects of your proposed initiative?
How would you recommend that your findings be incorporated into decisions about the feasibility of your proposed initiative?
Proposes ethical and culturally equitable ways of keeping costs under control, while maximizing the benefits of an initiative. Clearly articulates trade-offs underlying fully justified and effective strategies to control or reduce costs, mitigate risk, and maximize benefits.NHS- FP6008 Economics and Decision Making in Health Care.
What costs are you most likely to be able to control or reduce?
How would you go about ensuring this?
How could controlling or reducing these costs affect the benefits of your proposed initiative?
What strategies could you employ to maintain or maximize these benefits, while controlling or reducing costs?NHS- FP6008 Economics and Decision Making in Health Care.
How do you plan to ensure that any cost controls or benefit reductions are ethical and equitable?
Justifies the relevance and significance of the quantitative and qualitative economic, financial, and scholarly evidence used to support a business case. Presents a persuasive argument strengthened by explicit evaluation criteria and a perceptive interpretation and synthesis of the evidence.
This criterion applies to any evidence you cited throughout your business case. Your evidence should be persuasive and relevant to your findings, proposals, and recommendations. Consider one or more of the following questions when citing support evidence:NHS- FP6008 Economics and Decision Making in Health Care.
How is the evidence relevant to your organization or care setting?
How is the evidence relevant to your proposed economic initiative?
How does the evidence illustrate a solution that has been successful in the past?
How does the evidence illustrate that an initiative or solution is likely to be a net benefit to the organization or care setting?
Writes concisely and directly. Conveys precise and unequivocal meaning through clear and consistent use of active voice.
Proofread your document before you submit it to minimize errors that could distract readers and make it more difficult for them to focus on the substance of your business case.
Exhibits strict and nearly flawless adherence to APA 7th edition formatting of in-text citations and references.NHS- FP6008 Economics and Decision Making in Health Care.
Example Assessment: You may use the following to give you an idea of what a Proficient or higher rating on the scoring guide would look like:
ADDITIONAL REQUIREMENTS
Your assessment should also meet the following requirements:
Format: Format your business case using APA current style. Use the APA Style Paper Template [DOCX]. An APA Style Paper Tutorial [DOCX] is also provided to help you in writing and formatting your business case. Be sure to include:
A title page and references page. An abstract is not required.
A running head on all pages.NHS- FP6008 Economics and Decision Making in Health Care.
Appropriate section headings.
Length: Your business case should be 4–7 pages in length, not including the title page and references page.
Supporting evidence: Cite 4–5 authoritative and scholarly resources to support your business case. Be sure that your sources include specific economic data.
Note: Faculty may use the Writing Feedback Tool when grading this assessment. The Writing Feedback Tool is designed to provide you with guidance and resources to develop your writing based on five core skills. You will find writing feedback in the Scoring Guide for the assessment, after your work has been evaluated.NHS- FP6008 Economics and Decision Making in Health Care.
Portfolio Prompt: You may choose to save your business case to your ePortfolio.
Competencies Measured
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment scoring guide criteria:
Competency 1: Analyze the effects of financial and economic factors (such as cost-benefit, supply and demand, return on investment, and risks) in a health care system on patient care, services offered, and organizational structures and operation.
Analyze the potential economic opportunities and risks associated with a proposed initiative.NHS- FP6008 Economics and Decision Making in Health Care.
Analyze the economic costs and benefits of a proposed initiative over a five-year period.
Competency 2: Develop ethical and culturally equitable solutions to economic problems within a health care organization in an effort to improve the quality of care and services offered.
Propose ethical and culturally equitable ways of keeping costs under control, while maximizing the benefits of an initiative.
Competency 3: Justify the qualitative and quantitative information used to guide economic decision making to stakeholders and colleagues.NHS- FP6008 Economics and Decision Making in Health Care.
Justify the relevance and significance of the quantitative and qualitative economic, financial, and scholarly evidence used to support a business case.
Competency 4: Develop ethical and culturally equitable economic strategies to address dynamic environmental forces and ensure the future security of an organization’s resources and its ability to provide quality care.
Propose ethical and culturally sensitive solutions that address the risks associated with an initiative to the future economic security of the organization or care setting.
Competency 5: Produce clear, coherent, and professional written work, in accordance with Capella writing standards.
Write concisely and directly using active voice.
Apply APA formatting to in-text citations and references.NHS- FP6008 Economics and Decision Making in Health Care.
