Empowerment of Advanced Practice Nurses: Regulation Reform Needed to Increase Access to Care

1993 ◽  
Vol 21 (2) ◽  
pp. 193-205 ◽  
Author(s):  
Antoinette DeBois Inglis ◽  
Diane K. Kjervik
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Gross National Product ◽  
Advanced Practice Nurses ◽  
The United States ◽  
Infant Mortality Rate ◽  
Advanced Practice ◽  
Major Health ◽  
Practice Nurses ◽  
Care System

As the millennium approaches, the United States is on the verge of major health care reform. While swallowing scarce national resources, our health care system produces unenviable results and major inconsistencies. In 1992, $838.5 billion were spent on health care, biting more than 14 percent out of our gross national product. From 35 to 37 million Americans, or approximately 14 percent of the populationn, are uninsured. Our health care system is inherently inconsistent: We have the highest birthweight-specific survival rate of any country in the world, yet we rank 19th worldwide in infant mortality rate, i.e., state-of-the-art medical technology allows us to save a 500-gram infant, yet the mother of that infant may not have had access to basic, minimal prenatal care.

A Description of How Advanced Practice Nurses Screen for Osteoporosis in Maryland

2016 ◽  
Vol 9 (1) ◽  
pp. 60-68
Author(s):  
Walton Reddish
Keyword(s):  
Nurse Practitioners ◽  
Urban Areas ◽  
Survey Methods ◽  
Advanced Practice Nurses ◽  
The United States ◽  
Advanced Practice ◽  
Major Health Problem ◽  
Major Health ◽  
Doctor Of Nursing Practice ◽  
Practice Nurses

Osteoporosis is a major health problem in the United States, yet the evidence suggests that practitioners often fail to screen for osteoporosis risk and, as a result, underdiagnose and fail to treat the disease. Because little is known about how well advanced practice nurses (APNs) evaluate osteoporotic risk, determining the extent to which they screen may enhance our understanding of the scope of APN diagnostic practice. The purpose of this study was 3-fold: (a) to determine if APNs routinely screen for osteoporotic risks, (b) to ascertain how they screen, and (c) to identify barriers that influence osteoporosis screening. Survey methods were used to poll members of the Nurse Practitioner Association of Maryland (n = 357) who identified themselves as adult, family, geriatric, and women’s health nurse practitioners. The results suggest that master’s-prepared APNs screen for osteoporosis more so than APNs with doctor of nursing practice (DNP) degrees. In addition, adult APN screened more often than family APNs and APNs in urban areas screened more frequently than rural-based APNs. Logistic regression failed to predict which APNs were likely to screen for osteoporosis.

Should Screening Programs Be Perfect?

PEDIATRICS ◽  
1983 ◽  
Vol 71 (2) ◽  
pp. 301-301
Author(s):  
PHILIP R. WYATT
Keyword(s):  
United States ◽  
Health Care ◽  
Early Detection ◽  
New England ◽  
Health Care System ◽  
The United States ◽  
Neonatal Hypothyroidism ◽  
Screening Programs ◽  
Care System

To the Editor.— The report of the New England Regional Screening Program1 on neonatal hypothyroidism is a stunning illustration of the vulnerability of screening programs. It is unfortunate that this experience will probably be used as an argument to minimize the input of screening programs in the health care system in the United States. The report illustrates that, in addition to the 2% of the screened population that eluded the program, 14 infants with hypothyroidism escaped the full benefits of early detection and treatment.

scholarly journals An Opportunity for Pharmacists to Help Improve Coordination and Continuity of Patient Health Care

Pharmacy ◽  
2018 ◽  
Vol 6 (3) ◽  
pp. 78 ◽  
Author(s):  
Jon Schommer ◽  
Lawrence Brown ◽  
Ryan Bortz ◽  
Alina Cernasev ◽  
Basma Gomaa ◽  
...  
Keyword(s):  
United States ◽  
Health Care ◽  
Health Care System ◽  
Medication Use ◽  
The United States ◽  
Patient Health ◽  
Consumer Perspective ◽  
Medication Experience ◽  
Pharmacist Workforce ◽  
Care System

Pharmacist workforce researchers are predicting a potential surplus of pharmacists in the United States that might result in pharmacists being available for engagement in new roles. The objective for this study was to describe consumer opinions regarding medication use, the health care system, and pharmacists to help identify new roles for pharmacists from the consumer perspective. Data were obtained from the 2015 and 2016 National Consumer Surveys on the Medication Experience and Pharmacist Roles. Out of the representative sample of 36,673 respondents living in the United States, 80% (29,426) submitted written comments at the end of the survey. Of these, 2178 were specifically about medicines, pharmacists or health and were relevant and usable for this study. Thematic analysis, content analysis, and computer-based text mining were used for identifying themes and coding comments. The findings showed that 66% of the comments about medication use and 82% about the health care system were negative. Regarding pharmacists, 73% of the comments were positive with many commenting about the value of the pharmacist for overcoming fears and for filling current gaps in their healthcare. We propose that these comments might be signals that pharmacists could help improve coordination and continuity for peoples’ healthcare and could help guide the development of new service offerings.

scholarly journals Satisfaction with health care system: A comparative study between market-based insurance model of the United States and “out-of-pocket” model in developing and low-income countries

2020 ◽  
Vol 6 (1) ◽  
pp. 41
Author(s):  
Ram Lakhan ◽  
Sean Y. Gillette ◽  
Sean Lee ◽  
Manoj Sharma
Keyword(s):  
United States ◽  
Health Care ◽  
Health Care System ◽  
Undergraduate Students ◽  
Low Income ◽  
Access To Health Care ◽  
The United States ◽  
Low Income Countries ◽  
Healthcare Needs ◽  
Care System

Background and purpose: Access to healthcare services is an essential component for ensuring the quality of life. Globally, there is inequity and disparities regarding access to health care. To meet the global healthcare needs, different models of healthcare have been adopted around the world. However, all healthcare models have some strengths and weaknesses. The purpose of this study was to examine the satisfaction among a group of undergraduate students from different countries with their health care models namely, insurance-based model in the United States and “out-of-pocket” model prevalent in low-income countries.Methods and materials: The study utilized a cross-sectional research design. Undergraduate students, representing different nationalities from a private Southeastern College, were administered a researcher-designed 14-item self-reported electronic questionnaire. Independent t-test and χ2 statistics were used to examine the differences between two health care systems and the qualitative responses were analyzed thematically.Results: Satisfaction towards health care system between the United States and low-income countries was found significantly different (p < .05). However, students in both settings experienced an inability toward affording quality healthcare due to economic factors and disparities.Conclusions: There is dissatisfaction with health care both in the United States and low-income developing countries among a sample of undergraduate students representing these countries. Efforts to ensure low-cost affordable health care should be a global goal.

scholarly journals Rural Michigan Farmers’ Health Concerns and Experiences: A Focus Group Study

2021 ◽  
Vol 12 ◽  
pp. 215013272110535
Author(s):  
Nathan Wright ◽  
Marylee Scherdt ◽  
Michelle L. Aebersold ◽  
Marjorie C. McCullagh ◽  
Barbara R. Medvec ◽  
...  
Keyword(s):  
Health Care ◽  
Focus Groups ◽  
Health Care System ◽  
Health Care Services ◽  
Well Being ◽  
The United States ◽  
Full Time ◽  
Rural Residents ◽  
Care Services ◽  
Care System

Objectives: Rural residents comprise approximately 15% of the United States population. They face challenges in accessing and using a health care system that is not structured to meet their unique needs. It is important to understand rural residents’ perceptions of health and experiences interacting with the health care system to identify gaps in care. Methods: Our team conducted focus groups with members of the Michigan Farm Bureau during their 2019 Annual Meeting. Topics explored included resources to manage health, barriers to virtual health care services, and desired changes to localized healthcare delivery. Surveys were used to capture demographic and internet access information. Conclusion: Analysis included data from 2 focus groups (n = 14). Participants represented a wide age range and a variety of Michigan counties. The majority were full-time farm owners with most—93% (n = 13)—reporting they had access to the internet in their homes and 86% (n = 12) reporting that their cellphones had internet capabilities. Participants identified challenges and opportunities in 4 categories: formal health care; health and well-being supports; health insurance experiences; and virtual health care. Conclusion: The findings from this study provide a useful framework for developing interventions to address the specific needs of rural farming residents. Despite the expressed challenges in access and use of health care services and resources, participants remained hopeful that innovative approaches, such as virtual health platforms, can address existing gaps in care. The study findings should inform the design and evaluation of interventions to address rural health disparities.

Book Reviews: Coddington et al. - The Crisis in Health Care: Costs, Choices, and StrategiesDean C. Coddington, David J. Keen, Keith D. Moore, and Richard L. Clarke San Francisco: Jossey-Bass, 1991, 303 pp. US$30.95 cloth. ISBN 1-55542-273-X. Jossey-Bass Publishers, 350 Sansome St., San Francisco, CA 94104, USA.

1992 ◽  
Vol 11 (2) ◽  
pp. 274-275
Author(s):  
Andrea L. Bonnicksen
Keyword(s):  
Health Care ◽  
San Francisco ◽  
Health Care System ◽  
The United States ◽  
Economic Research ◽  
Present System ◽  
Cost Shifting ◽  
Hospital Administrators ◽  
The Impact ◽  
Care System

PrécisThe authors assume that costs can no longer be contained in the United States health care system and that the present system cannot be sustained beyond the near future. Three of the authors are affiliated with an applied economic research and consulting firm, and the fourth is president of the Healthcare Financial Management Association. They are trained in business and city planning. The bibliography lists articles from such journals as Hospitals, Business & Health, Business Insurance, and Medical Economics.The book is directed to members of hospital governing boards and other hospital administrators, but it will be of interest to students of health policy. Part I highlights tensions between what the authors call the worlds of doctors and hospital administrators struggling to survive, on the one hand, and health care planners worried about spiraling costs on the other. Part II contains five chapters that suggest reasons for growing costs and that criticize cost shifting as a remedy.In Part III the authors evaluate alternative health care systems by presenting four future scenarios: incremental change, universal access, consumer choice model, and single payer system. In these chapters they also approach the fundamental purpose of the book—to “help physicians, hospitals, and health plans take the next steps to position themselves for the future.” While not highly analytical, the book is a readable and thoughtful supplement to more abstract critiques of the impact of today's health care system on distributive justice.

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