The need for long-term care is on the rise with statistics indicating that two out of every three Americans over 65 years need long-term care for up to 3 years (Weathers, O'Caoimh, Cornally, Fitzgerald, Kearns, Coffey & Molloy, 2016) . A majority of Americans aged 40 years and above have not started planning for payment for long-term care when they attain the ages of above 65 years. Some of the factors impeding the planning in advance for long-term care include lack of sensitization on the need for earlier planning for long-term care. Today a majority of Americans are not aware or refuse to accept the fact that there is the need for planning for long-term care and its associated cost. There is a lack of knowledge on the coverage by Medicaid and Medicare on long-term care services leading to the poor future planning of long-term care.
Effective Measures in Raising Awareness on Advance Planning of Long-Term Care?
Raising awareness on the significance of long-term care pre-planning needs to be a public health issue. The public health department can develop awareness campaigns on the value of advanced planning of long-term care to explain to Americans on issues like the best age to start long-term care planning. Research has established that it is best to begin long-term care planning 20-25 years early for insurance premiums will be lower (Weathers et al., 2016) . The campaigns can also educate Americans on the best benefit periods and the long-term care elimination periods as well as the benefit amounts having taken into consideration the inflation rider.
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Why the Popularity of Ambulatory Care Services?
The expense for healthcare is high, and comparing inpatient and outpatient services, inpatient hospitalization costs more than twice the amount of outpatient or ambulatory care services. The high cost of inpatient hospitalization is one of the factors that have led to an increase in outpatient centers (Martin-Misener, Harbman, Donald, Reid, Kilpatrick, Carter, & DiCenso, 2015) . Ambulatory care centers provide care for patients under the Medicaid and Medicare health schemes; hence are convenient to many patients who are not in a critical condition to warrant inpatient hospitalization. The ambulatory care centers also offer surgical procedures that are reimbursed for by private insurance companies. Ambulatory care centers provide a wide range of healthcare services at a relatively lower cost due to their operational efficiencies.
Impact of the Shift to Hospitals, Consumers, and the Health Care Delivery System
Hospitals have shifted their focus to providing high-quality ambulatory care and provide inpatient care for patients who are very critical in nature. Hospitals have also improved in the use of technology and health information sharing to ensure patients healthcare cost is reimbursed by the Medicaid and Medicare health schemes and other private health insurance providers (Martin-Misener et alo., 2015) . Consumers have become concerned about their health care spending, thus prefer the use of ambulatory care centers as compared to the high cost of inpatient care services. The healthcare provision system, in its entirety, has seen an increase in the number of ambulatory care centers as compared to inpatient care centers.
Factors that Impede Access to Mental Illness Treatment
Access to mental health has been either unavailable or under-utilized. Some of the reasons behind underutilization or reduced access to mental health treatment include limited availability of mental health professionals to handle an increasing number of mental health illnesses. Stigma among mental health patients is another impediment as most do not seek mental health care services in fear of stigmatization (Knaak, Mantler, & Szeto, 2017) . Finally, there is little understanding of mental disorders, hence hindering access to mental health care management.
Reference(s)
Knaak, S., Mantler, E., & Szeto, A. (2017, March). Mental illness-related stigma in healthcare: Barriers to access and care and evidence-based solutions. In Healthcare management forum (Vol. 30, No. 2, pp. 111-116). Sage, CA: Los Angeles, CA: SAGE Publications.
Martin-Misener, R., Harbman, P., Donald, F., Reid, K., Kilpatrick, K., Carter, N., ... & DiCenso, A. (2015). Cost-effectiveness of nurse practitioners in primary and specialized ambulatory care: a systematic review. BMJ Open , 5 (6), e007167.
Weathers, E., O'Caoimh, R., Cornally, N., Fitzgerald, C., Kearns, T., Coffey, A., ... & Molloy, D. W. (2016). Advance care planning: A systematic review of randomized controlled trials conducted with older adults. Maturitas , 91 , 101-109.
