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Example research essay topic: Health Care Providers People With Disabilities - 2,323 words

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... means of the following four key elements: Arrangement with selected clinicians to furnish a comprehensive set of health care services to members of the plan for a preset fee in most cases. Explicit standards for the selection of health care clinicians. Formal programs of quality assurance and utilization review. Substantial incentives for members to use clinicians associated with the plan.

Managed care has aimed to provide quality health services while constraining costs. Committee on Children with Disabilities (1998) adds that a potential benefit of managed care may be improved access to primary care with greater likelihood of establishing a medical home from which a broader array of services may successfully be provided. It is also implied that all persons involved in managed care, including pediatricians and families, must address the issues. When plans for managed care are already designed and implemented, planners and policymakers need to closely monitor them for unintended or unanticipated negative effects on children with special health care needs, their families, and appropriate pediatricians. Developmental abnormalities, according to Riley and Halliday (as cited in Tracy & Henderson, 2004), are present in 3. 9 % of babies in Victoria, Australia. Many of those defects involve impairments in neurological function leading to intellectual, physical, social or sensory disabilities.

Other children experience hypoxic, infective, traumatic or toxic injuries to their developing brain that lead to developmental disabilities. The level of income affects unfortunately adult patients as well. For example, a study conducted in England in almost 1 000 people aged 35 and over with hip pain and disability had demonstrated that participants with lower socioeconomic position had experienced a greater severity of hip disease (Eachus, Chan, Pearson, Proper, & Smith, 1999). The poorest sector of the population seems to be in double jeopardy: they not only experience a greater burden of chronic morbidity but also a greater severity of hip disease. The researchers have concluded that inequalities in a tax funded health care system occur not simply because of different persons ability to command health care resources, or because the poorest people experience a higher prevalence of morbidity but also because, for a common chronic disorder, such as disease of the hip, the pain and disability experienced by poorer people is more severe than that of their richer counterparts.

An interesting analysis made by Giles, Cameron, and Crotty (2003) in older Australians provided projections indicating a 70 % increase in the number of older people with profound disability over the next 30 years. The main conditions associated with profound or severe core activity restriction in older Australians are musculoskeletal, nervous system, circulatory and respiratory conditions as well as stroke. If so, in the visible future, there will be many older people requiring assistance due to disability. Accordingly, this will present a marked challenge to families, friends, volunteers and paid service providers. And the planning ratio for residential aged-care services and community aged care services should be changed to take account of the shift to an older population with greater need of support. Of utmost importance is a conclusion of Giles, Cameron, and Crotty (2003) that it may be possible to reduce the projected increase in profound disability late in life.

They mean evidence that treating chronic health impairments (for instance, self-management approaches for diabetes and arthritis) prevents disability. Indeed, any prophylactic ways are doubtless hugely useful and effective in terms of both medical and economic aspects. But, of clear concern are the findings suggesting that the provision of preventive services was not a high priority for physicians caring for individuals living in community care facilities (Lewis et al, 2002). As Tracy and Henderson (2004) have noted, the care of people with developmental disabilities is the province of general practitioners. The authors add, however, that although barriers take place to providing good primary care, the pleasures and satisfaction gained from working in partnership with the people concerned, their families, and health care providers can be most rewarding, and many resources and services are fortunately available to support health providers. Lewis et al. (2002) guess community-based care is the predominant service mode for individuals with developmental disabilities.

However, given the reluctance of some physicians to provide care for these patients due to attitudes related to provision of health promotion services (according to Bond, Kerr, Dunstan, and Thapar as cited in Lewis et al, 2002), lack of formal training in caring for these individuals (noted by National Center for Health Statistics as cited in Lewis et al, 2002), as well as financial disincentives system changes will be required to improve the quality of care provided. When discussing recommendations to improve outcomes for the individual or family, it is worthy to provide, e. g. , a view of Edgman-Levitan and Cleary (as cited in Ireys & Perry, 1999) that an important component in evaluating health care interventions is patient satisfaction. Ireys and Perry (1999) add that most health-oriented researchers, policymakers, and administrators agree that patient satisfaction is an important measure of quality and, hence, of system and health plan performance. Of obvious note is the issue of health promotion for people with disabilities. As Rimmer (1999) points out, until recently, this promotion has been a neglected area of interest on the part of the general health community, however today, at least for the US, researchers, funding agencies, and health care providers and consumers are leading an effort to establish higher-quality health care for the millions of people with disabilities.

The author has also mentioned that the aims of a health promotion program for people with disabilities are to reduce secondary conditions (e. g. , hypertension, obesity, pressure sores), to maintain functional independence, to provide an opportunity for leisure and enjoyment, and to enhance the overall quality of life by reducing environmental barriers to good health. All the listed is definitely essential with regard to improving the lives of such persons and diminishing the social burden related to their existence. Rimmer (1999) supposes that the most widely accepted definition of health as the absence of disease may be one of the strongest reasons for the lack of attention given to people with disabilities in health promotion.

The Public Health Service (as cited in Rimmer, 1999) is fortunately responsible for the emerging paradigm shift from disease and disability prevention to prevention of secondary conditions in people with disabilities. In a recent working document, Healthy People With Disabilities 2010 (as cited in Rimmer, 1999), the definition of health promotion for people with disabilities has been consisted of four parts: (1) the promotion of healthy lifestyles and a healthy environment, (2) the prevention of health complications (medical secondary conditions) and further disabling conditions, (3) the preparation of the person with a disability to understand and monitor his / her own health and health care needs, and (4) the promotion of opportunities for participation in commonly held life activities. As for children with special health care needs, Ireys and Perry (1999) suppose that satisfaction data may be especially important because few other general indices of outcome have been identified to date. These two authors developed a satisfaction instrument specifically for children with special needs and their families. Using this tool, the researchers demonstrated that it is quite applicable to the diverse provider-family arrangements that characterize the service system for the population of interest. The results obtained suggest that parental satisfaction is highly dependent on service delivery structure.

This satisfaction may also be influenced by parental expectations. Most parents desire to raise their children with special health care needs at home (Johnson, Kastner, & the Committee/Section on Children with Disabilities, 2005). However, as these authors add, sometimes individual circumstances and societal factors strain the family's ability to provide for their childs special needs. In this regard, resources available to families can be conceptualized along the following four levels of support. The family is the childs best resource. The second ring represents the family's natural supports and includes extended family members, neighbors, and friends.

The third ring represents informal supports including social networking with other families through various support groups, community organizations, specialty clinics, and, most recently, the Web. The outer ring represents formal supports (financial, legal, and health insurance benefits, respite waiver vouchers, and early intervention and special educational programs) to which families of children with special health care needs are entitled. Bergman and Singer, along with the Committee on Early Childhood, Adoption, and Dependent Care (as cited in Johnson et al. , 2005) have proposed a very interesting and productive idea, namely permanency planning, which is the philosophy and practice of securing for children with special health care needs permanent family placements and ongoing relationships with caring adults. This planning has emphasized the use of supports necessary to enable a child to be raised in a home, has focused on promoting a sense of belonging, and is evaluated according to the ability of the setting to promote ongoing and secure relationships.

According to Roseau (as cited in Johnson et al. , 2005), the permanency planning philosophy can of course be contrasted against placement strategies emphasizing delivery of services, focusing on location, and evaluated in accordance with competence of care providers. An analysis made by Newacheck and Halfon (1998) indicates that children with disabilities experience a substantial added burden of illness. However, with the goal of ameliorating adverse outcomes, additional study is definitely needed to identify preventable causes and consequences of childhood chronic illness and disability. As Rimmer (1999) inferred, health promotion for people with disabilities must become a major focus for the new millennium. He guesses, in this way, preventing secondary health conditions by empowering people with disabilities to take control of their own health will be more cost-effective, and certainly more humane, than watching people with disabilities decline in function from a lack of good health maintenance. It can finally be concluded that health care providers do need to embrace a multi-disciplinary approach to quality to meet the needs of persons with disabilities, and that rethinking the design of service delivery for persons with disability leads to a system that integrates and coordinates medical, social and vocational services (Lawthers et al. , 2003).

This system should focus on issues of access, processes of care, coordination, and client outcomes. The performance of key aspects of the system can be measured and thus improved. A redesigned and integrated system has the potential to lead to substantial and real improvements in the quality of life for persons with disability. References American Academy of Pediatrics. (2002). The medical home. Pediatrics, 110, 184186.

Committee on Children with Disabilities. (1998). Managed care and children with special health care needs: A subject review. Pediatrics, 102, 657660. Committee on Children with Disabilities. (1999). Care coordination: Integrating health and related systems of care for children with special health care needs. Pediatrics, 104, 978981.

Cooley, W. C. , & McAllister, J. W. (2004). Building medical homes: Improvement strategies in primary care for children with special health care needs. Pediatrics, 113, 14991506.

Council on Children with Disabilities. (2005). Care coordination in the medical home: Integrating health and related systems of care for children with special health care needs. Pediatrics, 116, 12381244. Eachus, J. , Chan, P. , Pearson, N. , Proper, C. , & Smith, G.

D. (1999). An additional dimension to health inequalities: disease severity and socioeconomic position. Journal of Epidemiology & Community Health, 53, 603611. Giles, L. C. , Cameron, I. D. , & Crotty, M. (2003).

Disability in older Australians: projections for 20062031. Medical Journal of Australia, 179, 130133. Honberg, L. , McPherson, M. , Strickland, B. , Gage, J. C. , & Newacheck, P. W. (2005). Assuring adequate health insurance: Results of the National Survey of Children with Special Health Care Needs.

Pediatrics, 115, 12331239. Ireys, H. T. , & Perry, J. J. (1999). Development and evaluation of a satisfaction scale for parents of children with special health care needs.

Pediatrics, 104, 11821191. Johnson, C. P. , Kastner, T. A. , & the Committee/Section on Children with Disabilities. (2005). Helping families raise children with special health care needs at home. Pediatrics, 115, 507511.

Kogan, M. D. , Newacheck, P. W. , Honberg, L. , & Strickland, B. (2005). Association between under insurance and access to care among children with special health care needs in the United States. Pediatrics, 116, 11621169. Kahn, G.

L. , Hammond, L. , & Turner, A. (2006). A cascade of disparities: Health and health care access for people with intellectual disabilities. Mental Retardation and Developmental Disabilities Research Reviews, 12, 7082. Lawthers, A. G. , Pransky, G. S. , Peterson, L.

E. , & Himmelstein, J. H. (2003). Rethinking quality in the context of persons with disability. International Journal for Quality in Health Care, 15, 287299. Lewis, M. A. , Lewis, C.

E. , Leake, B. , King, B. H. , & Lindemann, R. (2002). The quality of health care for adults with developmental disabilities. Public Health Reports, 117, 174184. Newacheck, P. W. , & Halfon, N. (1998).

Prevalence and impact of disabling chronic conditions in childhood. American Journal of Public Health, 88, 610617. Rimmer, J. H. (1999). Health promotion for people with disabilities: the emerging paradigm shift from disability prevention to prevention of secondary conditions. Physical Therapy, 79, 495502.

Strickland, B. , McPherson, M. , Weissman, G. , van Dyck, P. , Huang, Z. J. , & Newacheck, P. (2004). Access to the medical home: Results of the National Survey of Children with Special Health Care Needs. Pediatrics, 113, 1485 1492. The handicapped family: Editorial. (1975). Lancet, 7931, 400401.

Tracy, J. , & Henderson, D. (2004). Children and adolescents with developmental disabilities. The GPs role. Australian Family Physician, 33, 591597. Valman, H. B. (1981).

ABC of 1 to 7. The handicapped child. British Medical Journal, 283, 11661169. Wise, P. H. , Wampler, N. S. , Chain, W. , & Romero, D. (2002).

Chronic illness among poor children enrolled in the Temporary Assistance for Needy Families program. American Journal of Public Health, 92, 14581461.


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Research essay sample on Health Care Providers People With Disabilities

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