reply 1 Examining US Health Care Delivery Systems I have direct knowledge of the dramatic changes taking place in the American healthcare system as a committed healthcare professional employed in a county hospital in Los Angeles. Let us examine some of the major changes that have influenced the way healthcare is delivered. The Affordable Care Act (ACA) is being implemented as follows: Aiming to reduce costs, improve quality, and increase healthcare coverage, the Affordable Care Act (ACA) was unveiled in 2010. The extent and influence of this historic law on the lives of people have been enormously transformational. The Affordable Care Act's implementation of policies like Medicaid expansion and the creation of health insurance markets has greatly increased accessibility and affordability for many of our patients in Los Angeles, where a varied range of populations depend on our hospital for medical treatment (Seabert et al., 2022). Changeover to Electronic Health Records (EHRs): With the widespread use of EHRs, a significant change has happened. EHRs have become into essential tools in our busy hospital, where every second counts. They have transformed the way that healthcare is delivered by promoting better provider-to-provider communication, boosting patient safety, and facilitating data-driven decision-making. HealthIT.gov (n.d.) states that electronic health records (EHRs) provide easy access to patient data, improve care coordination, and guarantee that every patient gets individual attention. Population health management and preventive care are prioritized. Population health management and preventative treatment have become more important here in Los Angeles. I am a healthcare worker who is dedicated to fostering community wellness. I have personally seen the benefits of addressing socioeconomic determinants of health, early intervention, and health promotion. We're working to improve the general well-being of our varied community by emphasizing preventative efforts like screenings and immunizations and tackling underlying socioeconomic determinants like housing and nutrition (Seabert et al., 2022). Now let's examine the unique training requirements and duties for various positions in the healthcare workforce: What LPNs, CNAs, and RNs Should Know About Education and Duties: Under the guidance of registered nurses (RNs) or doctors, licensed practical nurses (LPNs) complete extensive one-year training programs and provide basic nursing care. Assisting patients with everyday life tasks and administering medications is only one of the many ways that LPNs at our hospital contribute to providing compassionate care. Certified Nursing Assistants (CNAs): After completing abbreviated training courses, CNAs mostly assist patients with self-care duties, including cleaning, clothing, and eating. Their dedication and attention to detail significantly improve our patients' comfort and general well-being. RNs: The core members of our healthcare team, RNs, are highly educated and capable individuals. Nurse supervisors manage other nursing staff, organize patient care, provide medicines, and educate patients and their families. According to the U.S. Bureau of Labor Statistics (2022), their leadership and proficiency are crucial in guaranteeing that every patient obtains all-encompassing and considerate treatment. Moving on to the specializations of physicians: Differences between Cardiologists' and PCPs' Education and Training: PCPs: I understand that PCPs go through extensive training since I have a strong interest in primary care. These committed individuals concentrate on providing thorough and ongoing care for patients of all ages throughout their career, from medical school to residency. Primary Care Providers (PCPs) are essential in treating chronic illnesses, encouraging preventative care, and developing strong doctor-patient relationships in Los Angeles, where access to primary care is critical. cardiologist Cardiologists, who specialize in the diagnosis and treatment of heart and vascular problems, complete an internal medicine residency and medical school before pursuing further fellowship training in the field. Cardiologists offer specialized treatment, often using cutting-edge procedures and therapies, in our varied community, where cardiovascular health is a priority (American College of Cardiology, n.d.). The medical system's structure is greatly influenced by public health professionals: Functions of Specialists in Public Health: Public health professionals here in Los Angeles are leading the charge in addressing socioeconomic determinants of health, boosting population health, and avoiding illnesses. Their devoted efforts enhance the health of our community by carrying out disease monitoring and putting health education initiatives into place (American Public Health Association, n.d.). Notably, the American healthcare system still faces substantial obstacles in spite of its growth. Key Issues with the American Health Care System: Exorbitant Medical Expenses: In Los Angeles, where inequalities in healthcare are apparent, exorbitant medical expenses make it difficult for a great number of people to get treatment. Unequal Access to Care: Inequalities in our healthcare system persist, harming disadvantaged populations' health outcomes due to differences in socioeconomic position, race, and ethnicity. Fragmented Healthcare Delivery: In our busy metropolis, inefficiencies and gaps in care coordination from fragmented healthcare delivery often impede our attempts to provide all patients with seamless, all-inclusive treatment (Davis et al., 2020). Interventions in public health are essential to addressing these issues successfully. Public Health's Main Problem-Solving Role: Public health initiatives here in Los Angeles aggressively promote policies that favor universal healthcare coverage, equitable access to treatment, and integrated healthcare delivery methods. Through prioritizing preventive treatment and augmenting health promotion initiatives, our goal is to save healthcare expenses and enhance health outcomes for every person (Gostin et al., 2021). In order to support public health, the ACA includes a number of provisions: A look at the public health-related provisions of the Affordable Care Act The ACA has cleared the path for notable advancements in public health, including the extension of Medicaid coverage and the creation of essential health services criteria. The Kaiser Family Foundation (2021) reports that these measures have boosted preventive care initiatives and expanded accessibility to essential health services, hence improving the overall well-being of the Los Angeles population. In the end, my job as a Los Angeles healthcare professional has brought to light how important it is to both adapt to these revolutionary changes and overcome long-standing challenges to ensure that everyone in our diverse communities has equitable access to high-quality care. Thank you all! reply2 Describe three major changes that have taken place in the development of the U.S. health care system. One of the most recent and most commonly known changes to the development of the U.S. health care system is the health care reform law the Affordable Care Act, colloquially known as Obamacare which was enacted in March of 2010 (U.S. Department of Health and Human Services, n.d.). The ACA came after many other failed attempts at creating health care reform (Seabert et al., 2022). Another major change was the transition from fee-for-service (FFS) to value-based-care (VBC) within Medicare. The change from FFS to VBC was geared to provide better care for individuals at lower costs (Centers for Medicare and Medicaid Services, n.d.). There are many more changes that have occurred to healthcare, but a more recent change that grew in popularity during the initial stages of the Covid pandemic, was the implementation of telehealth not just for primary care appointments, but also for therapy appointments. Describe the education and responsibility differences between an LPN, a CNA, and an RN. Both LPNs and CAN work under the direction of RNs. LPNs are Licensed Practical Nurses, also known as Licensed Vocational Nurses (LVN) in California and Texas. The educational program usually takes around one year and can receive either a diploma or certificate and then pass the National Council Licensure Examination for Practical nurses (NCLEX-PN) (Whittle, 2023). CNAs however only require a six-to-eight-week training program. While a lot of duties of LPNs and CNAs overlap, LPNs can perform more complicated tasks such as drawing blood, and change catheters as well as IVs (Whittle, 2023). At minimum a Registered Nurse (RN) needs is to attend an accredited nursing program and obtain an associate degree in nursing (AND or ASN) or they can pursue a four-year degree and acquire a Bachelor of Science in nursing (BSN) (Reiland, 2023). RNs must pass the NCLEX-RN, and once they do can perform a plethora of tasks depending on the specialty area, they choose to work in. Explain the differences in education and training between a primary care physician (PCP) and a cardiologist. Both primary care physicians (PCP) and cardiologists first have to complete medical school and then complete a residency program. Cardiology is a subspecialty of Internal Medicine therefore before becoming a cardiologist a physician must complete three years of an internal medicine residency followed by a cardiology fellowship. PCPs can do their residency in internal medicine, family medicine, or pediatrics. Some PCPs may choose to do extra schooling by choosing fellowship after their residency. After residency physicians must pass USMLE step 3 or COMLEX-USA Level 3 and may choose to take their boards in their chosen specialty (AAFP, n.d.). Describe the role public health professionals play in the U.S. health care system and its delivery. Public health professionals play a vital role in the U.S. health care system. Public health professionals can help prevent health concerns while also helping identify causes of disease. Thus, helping guide changes in the delivery of healthcare by also influencing policy change. Describe three major problems facing the U.S. health care system when compared to other developed nations. One of the major problems facing the U.S. health care system when compared to other nations is the lack of healthcare coverage for the U.S. population. That being said the percentage of those without health care coverage reached an all-time low of 7.7 percent in 2023 thanks to the 6.3 million people who gained coverage since 2020 thanks to the ACA (U.S. Department of Health and Human Services, 2023). The U.S. has worse health outcomes than other comparable countries and since the onset of the Covid-19 pandemic the gap in mortality rates has widened even more (Telesford et al., 2023). Another major problem is that measures quality of care show that the U.S. health system provides lower-quality care (Telesford et al., 2023). Lower quality of care could be a significant contributor to the increase in mortality rates. Hypothesize the role public health should play in addressing these three major problems. Public health can help to address these concerns but in order to do they need to be well funded. By implementing community led efforts outbreaks can be detected and suppressed sooner. This would help those populations that do not have health care access. Collaboration with other disciplines can help with early detection, and rapid responses to help prevent future pandemics. Identify three elements of the Affordable Care Act that pertain to public health. The ACA has many elements that pertain to public health, but some of them are preventative healthcare systems, prevention and public health fund (PPHF) as well as the national prevention strategy (Jordan & Duckett, n.d.). The ACA’s goal is to increase access to care while also helping improve immunizations and regular disease screenings.
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