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Structure Process & Outcome Discussion

Structure Process & Outcome Discussion

Structure Process & Outcome Discussion

1.Please describe what is meant by “structure, process and outcome’ in assessing the quality of medical care. Give some examples of each dimension. How are the three dimensions related.

270 words for the discussion

Please reply to each of the following posts:

70 words each reply

A-While their is no single answer for how health insurance can be kept more affordable, I do have some thoughts and suggestions on the subject. I think that companies first need to make give their employees the option to even have health insurance as many do not. If more companies invested more into their employees, they would get better quality people that would stay longer and work better. I work for a well known restaurant food chain, and while they do offer the chance to receive health insurance after a year of employment, you have to maintain a certain amount of hours or you loose your insurance. It is also not that great of insurance to start with neither.


I also feel that there needs to be more control of hospitals, doctors, etc..on how much they charge insurance companies for services. When I gave birth to my third son many years ago, I had at the time insurance through my employer. When I was being discharged from the hospital I happen to just glance over the itemized bill that they had given me for my stay. I noticed that they charged and billed my insurance $300.00 for giving me three regular Tylenol from the delivery. I could not believe that they would even be allowed to charge that amount for something that I could buy myself at a Walgreens for less than $6.00 a bottle.


Another thought I have regarding costs and being more affordable would be to come up with a better plan for promoting more wellness programs and preventive measures than waiting for the after affect to hit. It has to start from birth and continue as we get older. Education is a must on our health and what is good and not so good on every aspect. Promote more items on healthy foods and vitamins along with exercises. Educating those about the importance of getting a yearly check up so that if their is something that comes up, doctors have the chance to fix it early.

B-The relationship between clinicians and patients, where doctors knew best and patients were expected to take a passive role and expected to comply has drastically changed. Patients are much more involved in their healthcare needs and often collaborate with their doctors to decide what treatment option is best for them. If patients don’t agree with the treatment option their physician has selected for them they are not obligated to proceed with the treatment. Similarly if a patient wishes to seek a second opinion, they are within their rights to do so and seek another physician. Definitions of the quality of medical care are no longer left solely to clinicians who decide for themselves what constitutes “good care”.

Avedis Donabedian, a physician and founder of the study of quality in health care and medical outcomes research, suggests that the number, kinds, and skill of the providers, as well as the adequacy of their physical resources and the manner in which they perform procedures should influence the quality of those outcomes.For many years, “the Joint Commission on Accreditation of Hospitals made judgements, such as physical facilities and equipment, ratios of professional staff to patients, and the qualifications of various personnel. Later, it added process components to its structural standards and, most recently, has shifted its evaluation process to focus on care outcome” (Sultz & Young, pg 477). This shift in focus to quality of care outcomes is important because it motivates and promotes teamwork, having transparency in quality monitoring and reporting, and better overall quality service to patients.

C- In the United States, there are 47 million people who are uninsured or underinsured. The affordable care act is one of the recent ways the government has tried to decrease the number of people that are uninsured or underinsured by making insurance policy is more available to the general public. The Patient Protection and Affordable Care Act of 2010 represents a historic, pragmatic approach to closing gaps in insurance coverage with a mix of employer, private and public plans. The ACA attempts to shift the focus from diagnosis and treatment to preventing illness and maintaining health. It changes the emphases from individual, episodic care to continuous, comprehensive care and chronic disease management. One way to do this is to eliminate incentives for more services and substitute incentives for appropriate levels of care. A serious commitment to resolving community and public health issues will also be required. Health care providers must take part in the changes. They need to accept the change from purely fee-for-service medicine to being compensated for wellness and prevention time and efforts to become as effective promoting population health as for individual patients.

The costs of health care can be kept affordable with the help of some insurance part of the health care system for both individuals and society. The country’s health care system must account for every citizen’s health. The national health insurance can help to keep the health care cost affordable through collecting premiums as a tax from everyone. This premium can cover the expenses for those people that would need it. Society itself carries an obligation to allow every person access to affordable healthcare. For those to fall into a lower income population clinics and local health centers are the best way for these groups to access healthcare. On the other hand, increased numbers of local voluntary health outreaches would improve access to many Americans in need.

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