The evolution of healthcare has promoted diversification of medical services such as through the integration of evidence-based practice. In part, EBP has sought to balance healthcare costs while allowing access to quality treatment and care services for patients. Thus, such an approach has been effective in promoting positive health outcomes among patients. It becomes imperative to appreciate that healthcare systems are subject to the influence of varied factors such as patient diversity, differences in belief systems, hospital capacity to manage cases, among others. Nonetheless, the significance of managing resources while also ensuring high-quality medical services cannot be ignored.
During the late 1980s, the United States experienced a dramatic change in the healthcare sector. Gold (1991) noted that health maintenance organizations (HMOs) were active in changing how healthcare in the country was financed and delivered. Their primary focus was on creating a system that emphasized the significance of quality medical services, but at an affordable rate. According to Morrison and Luft (1990) the emergence pf HMOs saw the develop of fee-for-service medicine which brought about change through making the healthcare sector competitive. Healthcare institutions and insurance companies were looking to present themselves as the best option in terms of offering varied medical services at an affordable cost. Thus, there was emphasis on the quality of healthcare given to patients. HMOs functioned as moderators of the delivery of medical services while ensuring that there was a balancing between health coverage and quality.
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Over the years, healthcare systems have evolved such as through requiring that hospitals advance continuous quality improvement (CQI) initiatives. At a time when the number of providers has increased considerably, hospitals are now facing the pressure to remain competitive not only in terms of rates, but also in the quality of services provided. For that reason, Baillie et al. (2017) noted that the building blocks in hospitals across the country are such as engaged leadership, team-based care, as well as data-driven improvement. These are considered as being vital to promoting certain phenomena such as patient-doctor relationships, easy access to care services, care coordination among healthcare workers (HCWs), and management of the population (Baillie et al., 2017). Thus, through appreciating the effect of managed care, hospitals are now facing the pressure to ensure that patients receive high-quality and reliable care services. However, to build such capacity, they need to invest in staffing, alongside acquisition of resources such as technology.
In order for CQI to become a norm among hospitals, there is a need to appreciate that different populations present with varied health issues. Hence, it is expected that HCWs adopted hybrid care approaches when providing medical services to these populations. In some cases, they will require to coordinate with other professionals in other fields to ensure optimum support guaranteeing positive health outcomes. As a consequence, hospitals need to embrace for even more pressure in the future. With technology becoming a household resource in the healthcare sector, they need to invest in ensuring that staff receive adequate training. The integration of team-based care will be, in part, be premised on interprofessional collaboration. For instance, members of the information technology (IT) department will be expected to collaborate with nurses and physicians to address technology-related issues that are focused on improving healthcare delivery.
To promote public health, the U.S. should remain active in ensuring that healthcare providers do not focus on profitability thereby neglecting their obligation to provide quality care. The concept of managed care should be carried through into future whereby implementing changes such as integrating advanced technology might be costly for hospitals. However, even in such cases, the quality of care should not be sacrificed.
References
Bailie, R., Bailie, J., Larkins, S., & Broughton, E. (2017). Editorial: Continuous Quality Improvement (CQI)-advancing understanding of design, application, impact, and evaluation of CQI approaches. Frontiers in public health , 5 , 306. https://doi.org/10.3389/fpubh.2017.00306
Gold, M. (1991). HMOs and Managed Care. Health Affairs , 10 (4), 189-206. https://doi.org/10.1377/hlthaff.10.4.189
Morrison, E. M., & Luft, H. S. (1990). Health maintenance organization environments in the 1980s and beyond. Health care financing review , 12 (1), 81–90.
