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Problem
The population at Risk for Healthcare Disparity
In the USA, the main problem that is experienced by different deprived populations is the lack of insurance that can cover at least a part of health-associated expenses. However, those who have low income cannot afford it, which prevents them from obtaining the required care. A similar situation is faced by immigrants, as some of them enter the country illegally or just fail to find a well-paid job because of a poor level of English (Lee, Oneill, Park, Scully, & Shenassa, 2012).
Risk and Prevalence
Even though the cost of coverage is lower than the cost of healthcare services, it remains too high (Lee, Lim, & Park, 2016). Some have those jobs that do not provide insurance or do not suit Medicaid, others lack those documents that are needed to obtain coverage. In this case, people cannot afford high-quality services and receive no preventive care. In particular, almost 10.5% of the US population under age 65 have no insurance, which is more than 28 million individuals. More than 12.% of adults and 5% of children are uninsured (CDC, 2017).
Proposed Program
There are various healthcare facilities that help those individuals who have no insurance. However, those professionals who work there are often overloaded and underpaid, which affects their ability to get in touch with deprived populations. Seen that they are not willing to communicate and provide care, clients become unwilling to come for a consultation and discourage others. To make people seek medical assistance instead of avoiding it, the leaders of the healthcare system should put efforts to increase the number of people recruited into the primary care field (Healthy People, 2017). In this way, more patients will be able to obtain medical care because there will be no necessity to go to distant locations and wait long hours for a consolation. In addition to that, healthcare professionals should utilize a holistic care theory that allows remaining focused on caring for the patient being grounded and self-aware at all times (Schmidt & Haglund, 2017). Thus, the number of physicians and nurses who are friendly and attentive to patients will increase.
Steps to Implement and Evaluate the Program
To implement the program includes increased recruiting of practitioners. To meet this goal, governmental funding is needed. To obtain it, the researchers should write a letter to their legislative representative, explaining the necessity of this change. The use of telemedicine in underserved areas can both increase the number of professionals at a particular location and reveal the positive influences of this change. Thus, researchers should ask to fund a pilot program based on telemedicine. In addition to that, providers should be trained to self-reflect in order to manage the overwhelming workload and avoid burnout. Evaluation of the program should include the comparison of the number of clients served and their satisfaction with the obtained services.
Epidemiological Data
Endemic versus Epidemic
Endemic: in the USA, the issue of poor access to healthcare is often discussed because of the way this field operates. High costs of medical treatment and associated services make it almost impossible for the uninsured to afford required treatment (Ziller, Lenardson,& Coburn, 2012). While a typical American has an opportunity to obtain coverage at work, immigrants can hardly find a vacancy with such benefits or appropriate wages.
Epidemic: issues with access to health care can be found almost in every country, but those problems faced by the uninsured, including immigrants, are typical for the USA.
Goals and Objectives
The goal of this project is to identify a healthcare issue in a population at risk for healthcare disparity and to develop an initiative that can be used to cope with it. In particular, it is aimed at the improvement of healthcare access for the uninsured, including immigrants. Thus, the objectives of the program include:
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Identification of a public health problem;
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Description of the population at risk;
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Development of a program that resolves the issue;
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Evaluation of the program.
Activities to Support Objectives
Research should be conducted to discuss the problem in more detail and ensure that the developed intervention is appropriate. It should include two surveys: the first one conducted before the implementation and the next one after it. They should gather information about the number of clients who obtained services and their feedback regarding services.
Literature Search
According to the literature review, many people from the USA face an issue with access to healthcare services because they are rather expensive and it is not always easy to obtain insurance. Advantages of coverage are undeniable, but they cannot be obtained by particular populations, as they have low wages that fail to cover associated expenses, do not have a package of benefits at work, or lack vital documents (Chernin et al., 2012). As a result, people cannot visit physicians, which leads to adverse health outcomes. Suffering from various diseases they affect community health negatively. Nevertheless, an increased number of nursing and medical staff at specific facilities is likely to allow more people to obtain the required care.
Ethical Concerns
Surveys should be conducted anonymously to ensure that physicians and clients do not face issues because of the revealed information. Moreover, anonymity makes people more willing to disclose information about their immigrant status, etc.
Plan
Activities and Program
To implement the program, governmental funding should be obtained to start using telemedicine. Using reports, the number of patients before and after the intervention should be compared. Professionals should be educated regarding the implementation of the holistic care theory. Finally, a questionnaire to obtain consumers feedback should be developed and utilized. Additional funding will be needed to use telemedicine and educate professionals. These expenses are likely to be covered by the government.
Role of Advanced Practice Nursing
An advanced practice nurse (APN) who is going to work with a patient according to the proposed project will ensure that all patients receive the required care and are not affected by he/her biased reaction. In this way, clients will not be afraid to come again and will encourage their friends and families to seek assistance instead of focusing on self-treatment. Sharing strategies to avoid work-related issues, APNs will motivate colleagues and students to work in those facilities that serve the uninsured, as these people require the most support and appreciate having a usual care provider.
A tool to Measure Goals, Objectives, and Outcomes
Questionnaires will include open-ended questions that can be discussed through the analysis of qualitative data based on explanations. In addition to that, some answers can include ranges (assessment of some elements from 0 to 5). A comparison of these data gathered initially and after the implementation and the number of clients served will reveal the success of the project. This tool is both reliable and valid, as it is often used to obtain clear and unbiased results when a qualitative analysis is conducted. Moreover, it is appropriate for the study, as each answer reveals the level of variables. This tool turns abstract discussions in numbers, making them more concrete and trustworthy.
References
CDC. (2017). Health insurance coverage. Web.
Chernin, G., Gal-Oz, A., Schwartz, I., Shashar, M., Schwartz, D., & Weinstain, T. (2012). Care of undocumented-uninsured immigrants in a large urban dialysis unit. BMC Nephrology, 13, 112-121.
Healthy People. (2017). Access to healthcare services. Web.
Lee, K., Lim, S., & Park, J. (2016). Expelled uninsured patients in a less-competitive hospital market in Florida, USA. International Journal for Equity in Health, 15, 1-9.
Lee, S., Oneill, A., Park, J., Scully, L., & Shenassa, E. (2012). Health insurance moderates the association between immigrant length of stay and health status. Journal of Immigrant and Minority Health, 14(2), 345-349.
Schmidt, M. & Haglund, C. (2017). Debrief in emergency department to improve compassion fatigue and promote resiliency. Society of Trauma Nurses, 24(5), 317-322.
Ziller, E., Lenardson, J., & Coburn, A. (2012). Health care access and use among the rural uninsured. Journal of Health Care for the Poor and Underserved, 23(3), 1327-1345.
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