DHA 724 Health Care Organization Assignment

DHA 724 Health Care Organization Assignment

Assume the role of the chief executive officer of a health care organization in the country you selected

Identify a problem, issue, or situation in the health care organization that must be addressed.

Develop a problem statement and a purpose statement responding to the problem, issue, or situation.

Imagine that you have been asked to present an innovative model on how health care leaders can address the problem and create value in their services to remain competitive in health on the global platform.

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Indicate how you will work with leaders in the United States to gain competitive advantage for your health care organization.

Address potential challenges to your model and the feasibility of using your model as a pilot program that could be adopted by health services organization to maintain global competitiveness.

How Should Health Care Rationing Be Defined?
Health care rationing may be thought of as one form of health care cost control. As we shall see shortly, defining the notion of rationing is itself controversial. Roughly speaking, health care rationing occurs when individual patients are denied (or must deny themselves) needed or desired health care because a particular health care intervention costs too much and yields too little benefit. For example, in 1984, Congress put in place the DRG mechanism to control hospital costs for the Medicare program. The letters DRG stand for diagnosis-related groupings. This is a diagnostic code that must be attached to a Medicare patient within 24 h of admission to a hospital. That code determines a fixed prospective sum of money attached to that DRG which Medicare will pay the hospital for caring for that patient. If the hospital can meet the health care needs of the patient for less than that sum, the hospital makes a profit. Otherwise, the hospital incurs a loss.

In the early 1980s, patients with a first-time uncomplicated heart attack were routinely kept in the hospital for 10 days. Medical research suggested there was little health gain for these patients after day 4. Consequently, the DRG for such patients paid for only 4 hospital days. That saves Medicare the cost of 6 hospital days for such patients. More than 1.5 million Americans have a heart attack in a year. Giving up those extra hospital days has no practical consequences for the vast majority of those individuals. However, a small number of them will experience a second heart attack during one of those 6 days in their home at considerable distance from a hospital and die. If most of those individuals could have been saved if they were in the hospital, then this is an instance of health care rationing as defined above. That is, the relatively small number of additional life-years that might have been saved was given up in order to save large sums of money for Medicare.

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