Week 5 – Final Project
Comparative Summary Project
⦁ Prior to beginning this assignment, review the chapters assigned from the textbook each week of the class. Throughout the course, you have delved into the differences among healthcare settings, regulations, accrediting organizations, documentation requirements, reimbursement, coding, and classification systems, and health information management employment opportunities. These weekly activities served as building blocks for the Comparative Summary Project. Your Comparative Summary Project must include a summary of information for the following healthcare settings:
⦁ Hospital-Based Care
⦁ Freestanding Ambulatory Care
⦁ Managed Care
⦁ Dialysis
⦁ Correctional Facilities
⦁ Behavioral Health
⦁ Long-Term Care
⦁ Rehabilitation
⦁ Home Health Care
⦁ Hospice
For each of the above healthcare settings
⦁ Describe the types of care provided.
⦁ Identify the national organization(s) and the healthcare standards for the setting.
⦁ Identify your home state for state-specific information.
⦁ Summarize the state-specific health record (i.e., medical record) documentation guidelines for the healthcare setting, including the statute, regulation, and administrative code reference number.
⦁ Summarize the state-specific health record (i.e., medical record) retention guidelines for the health care setting, including the statute, regulation, and administrative code reference number.
⦁ Summarize the documentation requirements from The Joint Commission, including the standard and section (only for hospital-based care).
⦁ Describe the reimbursement method for the healthcare setting.
⦁ Describe a minimum of two coding or classification systems utilized.
⦁ Summarize at least one commonly reported database associated with the health care setting.
⦁ Identify a minimum of two job opportunities in that setting for registered health information management administrators (RHIA). For each job opportunity selected, include the following (Do not copy and paste):
⦁ Position title
⦁ Salary or salary range
⦁ Educational requirements
⦁ Experience requirements
Comparative Summary Project
Hospital-based care
Hospitals present with the provision of diagnosis and medical therapies to people who are in dire need of extensive or emergency care. It is a facility where patients are taken under the supervision of respective medical experts and looked after thoroughly till the time they are discharged.
Hospitals differ among themselves from the point of their ownership and authority, the medical services they provide, the duration of patient’s stay, and their overall infrastructure and size. They can be run by the government itself or government-aided, non-profit, or private organizations. All these parameters definitely have a role in deciding the patient outcome for the medical treatment being presented and the overall expense spent. In the initial phase, people usually get first-hand care at a general hospital and later get referred to specialty care like cancer or infectious diseases and get specific treatment for the disease (DeCherrie et al., 2019).
Access to the electronic database kept by the State discharge data collection system can be proven valuable to analyze the status of hospital-based healthcare settings within the US. The Joint Commission requires documents stating the admission of the patient within the perimeter of the hospitals and the continuous medical progress report of that individual (jointcommission.org, 2022).
Freestanding Ambulatory Care
As per the New Jersey Department of Health Licenses, it conducts diagnosis and provides cautionary care and medical therapies to patients. However, it differs from hospital facilities in terms of patients coming are getting out the same day after receiving the proper treatment for the cause. Facilities that have licenses for performing surgical procedures are separate and provide ambulatory surgical care in emergency cases. Sometimes these facilities can be adjoined to a hospital premise but operate completely under autonomous administrative authorities. They provide surgical opportunities at a reduced cost to patients than what is provided in hospitals. Further patients who get their surgery done from freestanding ambulatory care centers are at lower risk of getting infected as they are here for the time being and are discharged immediately once the procedures are done. The Accreditation Commission for Health Care and the state government overlook the standards and policies and overall maintain the standard in the treatment provided by Freestanding Ambulatory Care.
Managed Care
A managed care healthcare setting overlooks the expenditure of treatments being provided to patients in all its value and utility. For example, Medicaid managed care services operate to maintain transparency in providing healthcare beneficiaries and other medical services based on the terms and conditions agreed between the state Medicaid service providers and managed care organizations, popularly known as MCOs. These MCOs help in managing the expenditure of Medicaid programs offered by the health departments and evaluate the quality of medical service that is being provided. A betterment in terms of healthcare cost, management, and patient outcome has been seen when managed properly by these MCOs. A special focus on managing complex and rare diseases, and infectious diseases and accordingly managing funds and keeping a thorough check upon the value of the treatments being provided, the satisfaction of the patients, and establishing accountability for maintaining good patient relations is being taken by few of the states in the US.
Dialysis
People with renal disorders or damage often need dialysis treatment on a regular basis in order to function properly. Dialysis is nothing but an artificial filtration system that clears out our blood and absorbs necessary nutrients from it. In the US, such renal disorders are very common and affect almost 14% of the total population. The proper functioning of the kidney is greatly hampered in renal disorders and the frequency of dialysis to be performed depends thoroughly upon the degree of severity of the disease. In case of something really serious, patients might have to go through this dialysis procedure two or three times a week in order to function properly and ignore unwanted complexities.
Patients undergoing frequent dialysis remain at risk of getting infectious easily. Hence the facilities with dialysis provision abrasively look after the cleanliness and hygiene of the premises. They are also a better-suited option against hospitals where the risk of catching infections is extremely high. Dialysis facilities are dedicated and specialized care centers where the value of the treatment and surgery is maintained and subsequently, the extreme pressure on the shoulders of the hospitals is shared.
Correctional Facilities
The National Commission on Correctional Health Care (NCCHC) published a report in 2002 on the healthcare conditions among prisoners under the jurisdiction of US prisons. Needless to say, it raised an array of questions about the current health status of the incarcerated population and how poorly it is looked after. The scientific investigation equipped with tools of sociology, finance, economics, behavioral science, and technology is used to further dissect the healthcare status among inmates and understand the healthcare outcome in light of the aforementioned parameters. Emerging concerns about the conditions within prisons and the well-being of the inmates have gained momentum in the improvement of health status within correctional facilities over the span of the last few decades. However, this still lacks a well-thought-out and properly financed healthcare setting with basic and advanced diagnostic and medical services and a central regulatory board and research organization to study, make, and maintain policies over the system specially designed for the incarcerated population in society.
A number of obstacles hinder the process like lack of concrete database, unreliable sources to maintain records, and above all lack of policies and regulations implemented by the government for the inmates within the correctional facilities. This is of much concern a country like the US having more than 3000 prisons within its territory has been proven incompetent in maintaining health statuses and records of those living within the perimeters of correctional homes. In order to bring a positive change in the healthcare outcome, a concrete electronic database must be maintained. In this way, the valuable labor within the correctional facilities can be reorganized, maintained, and proved very productive if given proper attentive and palliative care within the premises. It has also been associated with bringing positive behavioral and psychological as well as physical outcomes of treatment amongst patients living here (Armstrong, 2020).
Behavioral Health
This is a special type of facility that is different from other healthcare settings that deal with mostly physical ailments. The US has always been an advocate for behavioral health issues and talked widely about the special type of treatment that is required. Behavioral health settings may exist as an isolated entities specialized in behavioral issues like anger, gambling, excessive retail, obsessing over video games or internet browsing or social networking, getting obsessed over likes, comments, and shares on digital platforms, etc. They also may exist as a part of mental health institutions dealing with mental and behavioral health in general. More than the physical administration of medical treatment, they require contact rehabilitation, an affirmative environment, and social discussion and assimilation as medical services or therapies.
At a higher degree of causality, hospitalization may be required and these behavioral health facilities are affiliated with that. Especially hospitals dedicated to treating intangible aspects of health overall.
Long-Term Care
Long-term care healthcare settings provide a special type of medical design in order to sustain patients with short-term recovery, recurring or chronic health statuses, and permanent disabilities. They equip the patients with a special type of medical care, attention, and treatment to help them get through their routine activities with as little assistance as possible. This can be done within the boundaries of a medical facility or at home with stay-at-home homemaking or nursing assistance. Homemaking and care assistance offer little help to people who need just a little aid to perform their routine activities like older people. Such activities include cooking, cleaning, bathing, getting up or sitting down, walking around, using the toilet, maintaining proper grooming and hygiene etc. They can also include driving services if needed. On the other hand, the nursing service assures proper full-time medical care to those who are unable due to the cause of age or any ailment.
An urgency for long-term care may emerge all of a sudden due to sudden injury and accidents, stroke, trauma, or any major health problems. For people belonging to the senior group, the urgency may arise with age and how ill or weaker they become (Peden, 2017).
Rehabilitation
Rehabilitation is a unique healthcare setting that helps a person with a holistic approach in all his or her physical, emotional, psychological, behavioral, and social levels. It opposes the reductionist’s way of treatment which is believed to target only one or few causatives in question with the aim of attaining a seeming recovery. The definition of rehabilitation as mentioned by WHO, a rehabilitation center is an amalgamated platform that provides collaborative medical assistance to those who experience some kind of disability in order to help them function properly in daily life as well as keep a healthy social interaction within the community. According to the framework drawn by ICF, the surrounding environment of an individual plays a gigantic role in determining the physical outcome of the treatment. The environment is metered in a physical, social, or cultural context. All of this together decides and modulates the outcome of a treatment that the patient is undergoing. So, the setting of a rehabilitation center is given a lot of importance and must be carefully taken into account while establishing such medical facilities.
The rehabilitation healthcare systems across the globe, although primarily based on similar principles, sometimes differ greatly in their approaches. It provides a very individual-centric treatment which means the method and tools of medical intervention to be used are designed on the blueprint of a person’s individuality and surroundings with the purpose of bringing about a holistic change. Medical assistance is also kept handy for urgent admission in hospitals. Proper care and proper follow-up checks are duly needed to design thorough patient outcomes.
Home health care
Home-based healthcare systems aim to bring medical treatment to your doorstep on an urgent basis due to sudden or chronic ailments or injuries. It is more cost-effective than long-term hospitalization and of many conveniences for the patients. It also comes with less risk of getting an infection, where patients can recover just as well within the comfort of their own home. For example, due to any surgical wound amputations or chronic illness, people require assistance to get through their daily life and recover gradually.
An effective home-based health service should provide wound and injury healing services, caregiving and homemaking services, administration of oral and intravenous medications and nutritional therapies, continuous looking after the health condition, and keeping records. This comes with the aim of speedy recovery with value-added services within the comfort of the home. Survives also boast about their percentage of effective recovery and patient satisfaction. In the US home-based care can be easily availed with a valid prescription from a doctor or medical professionals and is covered under Medicaid insurance (Stone & Bryant, 2019).
Hospice
Rehabilitation-based palliative care is a worldview that incorporates restoration, enablement, self-administration, and taking care of oneself into the all-encompassing model of palliative care. It is an interdisciplinary methodology wherein all individuals from the group, including medical attendants, specialists, and psychosocial and wellbeing experts, work cooperatively with the patient, their family members, and carers to help them accomplish optimistic patient outcomes. Rehabilitation-based palliative care expects to streamline individuals’ ability to empower them to live as freely and completely as could really be expected of them, with decision and independence, inside the impediments of propelling sickness. It is a methodology that enables individuals to adjust to their new condition of being with pride and offers a functioning assistance framework to help them adapt pleasantly to the misfortunes that come about.
Hospice care gives progressing caring consideration to individuals all through the last periods of hopeless sickness so they might live as completely and easily as could be expected. It is a model of care that offers clinical help as well as enthusiastic and surprisingly otherworldly help for patients and their families inside a strong climate that gives nonstop consideration and care (Abbott, Johnson & Wynia, 2020).
References
Abbott, J., Johnson, D., & Wynia, M. (2020). Ensuring adequate palliative and hospice care during COVID-19 surges. Jama, 324(14), 1393-1394.
Armstrong, S. (2020). The prison service is still failing inmates’ healthcare needs. BMJ, 368.
DeCherrie, L. V., Wajnberg, A., Soones, T., Escobar, C., Catalan, E., Lubetsky, S., … & Siu, A. (2019). Hospital at home‐plus: a platform of facility‐based care. Journal of the American Geriatrics Society, 67(3), 596-602.
Jointcommission.org (2022) Standard, Retrieved from: https://www.jointcommission.org/standards/ [Retrieved on:10th February, 2022]
Peden, A. H. (2017). Comparative Health Information Management. Cengage Learning.
Stone, R. I., & Bryant, N. S. (2019). The future of the home care workforce: training and supporting aides as members of home‐based care teams. Journal of the American Geriatrics Society, 67(S2), S444-S448.
