NHS FPX 6008 Assessment 4 Lobbying for Change

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NHS FPX 6008 Assessment 4 Lobbying for Change

NHS FPX 6008 Assessment 4 Lobbying for Change

Name

Capella university

NHS-FPX 6008 Economics and Decision Making in Health Care

Prof. Name

Date

Lobbying for Change

February 2024

 

Douglas A. Holt

Director, Florida Department of Health -Hillsborough County

Tampa, FL 33675-5135

(813) 307-8000

Dear Douglas,

I am writing to urgently address the concerning issue of escalating rehospitalization rates at Tampa General Hospital (TGH). In Florida, more than 15% of stroke patients were readmitted to the hospital within 30 days between 2010 and 2013. Furthermore, according to the study, 12% of stroke patients were readmitted after 30 days due to vascular anomalies, and 3% of stroke patients experienced a recurrent stroke, impacting patient safety (Gardener et al., 2023). The financial strain caused by high rehospitalization rates is palpable, affecting both patients and healthcare facilities like TGH. Patients endure additional medical expenses, potential income loss, and decreased quality of life, while hospitals face increased resource utilization and financial strain. At TGH, the shortage of various resources, especially post-discharge care facilities, exacerbates the problem. These economic ramifications directly impact the constituents of the Florida Department of Health, fostering dissatisfaction with the healthcare system due to the perceived lack of continuity of care and inefficiencies in managing chronic conditions.

Dear Sir, by addressing this issue, we can achieve significant positive outcomes including smoother transitions between care settings, comprehensive post-discharge support, reduced rehospitalization rates, decreased healthcare expenditures, and optimized resource allocation within the healthcare system. Respectful Official, failure to address high rehospitalization rates will result in detrimental consequences like worsened health outcomes, increased mortality rates among patients, escalated healthcare costs, eroded public trust in the healthcare system, and systemic challenges like overcrowded emergency departments, inefficient resource utilization, and healthcare disparities (Dawson et al., 2021).

NHS FPX 6008 Assessment 4 Lobbying for Change

Hilton et al. (2022) found that lower-income patients discharged after sepsis had an increased risk of readmission, emphasizing the influence of social determinants of health on post-sepsis readmission rates. Lan et al. (2021) conducted a systematic review on heart failure patients, revealing a 30-day readmission rate of 0.19 and highlighting the need to address risk factors to reduce rehospitalization. Ruan et al. (2023) reported high rehospitalization rates (2.6-82.2%) among Chronic Obstructive Pulmonary Disease patients due to exacerbations, proposing strategies such as national guidelines and symptom monitoring for prevention. According to one study, among patients with lower socioeconomic levels, 30-day readmissions accounted for roughly 19.6% of all readmissions, necessitating interventions to prevent this issue among vulnerable populations (Feng et al., 2020).

Kim et al. (2020) found that heart failure patients, especially men with more extended follow-up periods and women with shorter ones, were prone to higher hospital readmissions, emphasizing the need for tailored intervention approaches. At the institutional level, rehospitalization strains the resources of TGH, affects hospital reimbursement rates, and impacts overall financial sustainability. Locally, high rehospitalization rates contribute to healthcare disparities in Hillsborough County, particularly affecting vulnerable populations with limited access to post-discharge support. Statewide, addressing rehospitalization aligns with efforts to improve healthcare quality and reduce costs, contributing to Florida’s overall health outcomes. Nationally, reducing rehospitalization rates is a priority for healthcare reform efforts, aiming to enhance patient care, decrease healthcare spending, and improve population health in America.

NHS FPX 6008 Assessment 4 Lobbying for Change

It is strongly advised to put comprehensive care coordination methods into practice by enlisting multidisciplinary teams to guarantee smooth transitions between care settings and promote continuity of treatment (Masip & Underdahl, 2020). Additionally, using telehealth platforms and electronic health records (EHRs) makes it easier for members of the care team to share information and communicate in real-time. In order to prevent adverse events and lower the risk of readmission, patients should also get strong support throughout care transitions, including medication reconciliation, patient education, and follow-up appointments (Santiago et al., 2020). In addressing rehospitalization, we’ve prioritized equity, autonomy, and cultural competence, ensuring equal access to transitional care. Patient involvement in decision-making respects autonomy, while culturally sensitive strategies acknowledge diverse needs, enhancing effectiveness. By integrating these principles, our interventions are inclusive and patient-centered, fostering better outcomes in rehospitalization efforts. 

In my healthcare journey, encountering a patient with chronic conditions facing frequent readmissions due to treatment non-adherence underscored the importance of care coordination and patient education in preventing avoidable hospital stays. This experience prompted me to integrate risk analysis into resource planning, identifying the need for improved medication management and patient support services. Additionally, organizational insights highlighted the value of technology and collaboration in optimizing resource allocation and mitigating financial risks associated with rehospitalization. My approach prioritizes patient-centered care and sustainability through proactive planning and effective interventions. As a result, I ask that you address this critical healthcare economic issue right now. In addition to ensuring that proper healthcare is provided at discharge time, addressing this issue will support the well-being of the community by preventing frequent rehospitalization rates

Your Sincerely,

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References

Dawson, N. L., Hull, B. P., Vijapura, P., Dumitrascu, A. G., Ball, C. T., Thiemann, K. M., Maniaci, M. J., & Burton, M. C. (2021). Home telemonitoring to reduce readmission of high-risk patients: A modified intention-to-treat randomized clinical trial. Journal of General Internal Medicine36https://doi.org/10.1007/s11606-020-06589-1

Feng, T. R., Hoyler, M. M., Ma, X., Rong, L. Q., & White, R. S. (2020). Insurance status and socioeconomic markers affect readmission rates after cardiac valve surgery. Journal of Cardiothoracic and Vascular Anesthesia34(3), 668–678. https://doi.org/10.1053/j.jvca.2019.08.002

Gardener, H., Romano, J. G., Derias, T., Gutierrez, C., Asdaghi, N., Johnson, K., Gordon Perue, G., Marulanda, E., Brown, S. C., Foster, D., & Rundek, T. (2023). Early hospital readmission following stroke: The Florida stroke registry. Frontiers in Stroke2https://doi.org/10.3389/fstro.2023.1238442 

Hilton, R. S., Hauschildt, K., Shah, M., Kowalkowski, M., & Taylor, S. (2022). The assessment of social determinants of health in postsepsis mortality and readmission: A scoping review. Critical Care Explorations4(8), e0722. https://doi.org/10.1097/cce.0000000000000722 

Kim, A. H., Parpia, C., Freitas, C., Austin, P. C., Ross, H. J., Wijeysundera, H. C., Tu, K., Mak, S., Farkouh, M. E., Sun, L. Y., Schull, M. J., Mason, R., Lee, D. S., & Rochon, P. A. (2020). Readmission rates following heart failure: A scoping review of sex and gender-based considerations. BMC Cardiovascular Disorders20(1). https://doi.org/10.1186/s12872-020-01422-3

NHS FPX 6008 Assessment 4 Lobbying for Change

Lan, T., Liao, Y.-H., Zhang, J., Yang, Z.-P., Xu, G.-S., Zhu, L., & Fan, D.-M. (2021). Mortality and readmission rates after heart failure: A systematic review and meta-analysis. Therapeutics and Clinical Risk Management17, 1307–1320. https://doi.org/10.2147/tcrm.s340587

Masip, J. R., & Underdahl, L. (2020). Preventing hospital readmissions: A transitions of care coordination framework. Management in Healthcare4(3), 265–273. https://www.ingentaconnect.com/content/hsp/mih/2020/00000004/00000003/art00009

Pugh, J., Penney, L. S., Noël, P. H., Neller, S., Mader, M., Finley, E. P., Lanham, H. J., & Leykum, L. (2021). Evidence-based processes to prevent readmissions: More is better, a ten-site observational study. BMC Health Services Research21(1). https://doi.org/10.1186/s12913-021-06193-x

Ruan, H., Zhang, H., Wang, J., Zhao, H., Han, W., & Li, J. (2023). Readmission rate for acute exacerbation of chronic obstructive pulmonary disease: A systematic review and meta-analysis. Respiratory Medicine206, 107090. https://doi.org/10.1016/j.rmed.2022.107090  

Santiago, M., Magro, F., Correia, L., Portela, F., Ministro, P., Lago, P., Trindade, E., & Dias, C. C. (2020). Rehospitalization rates, costs, and risk factors for inflammatory bowel disease: A 16-year nationwide study. Therapeutic Advances in Gastroenterology13, 175628482092383-175628482092383. https://doi.org/10.1177/1756284820923836 

 

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