Running head: DIABETES PROGRAM 1
Analysis of Challenges and Diabetes Program
Micro-level barrier
The chief financial obstacle for diabetics is the issue of having sufficient funds that can be utilized in accessing quality and adequate care. Low-income families have suffered the problem of not receiving the proper and appropriate insurance coverage as doctors have begun following privately insured patients in more affluent areas (Haas, & Burke, 2014).
People with diabetes that live in neighborhoods isolated by poverty are less likely to have jobs, less likely to have proper transportation and also adequate access to healthy nutritional foods. This issue combined with the low presence of health care providers that can initiate home care programs has led to individuals in such areas receiving poor healthcare (Haas, & Burke, 2014). Diabetic patients of lower socioeconomic standing are less likely to acquire specialist care such as home health care services or utilize these management services. This is because these patients have worse complication risk profiles which include glycemic control.
Such individuals will not also be provided with patient education associated with management of diabetes as home healthcare services in such regions may not have the necessary facilities for the provision of quality services. All relevant stakeholders must initiate strategies that will focus on subsiding on the expenses involved in home health care (Harris, 2015). The government and also other health care officials must create an integrated system which does not discriminate any individual from gaining access to care.
Macro-level barrier
Due to the worsening economy, high rates of unemployment and also escalation of health care costs especially for diabetic patients, these conditions have created and worsened financial impediments for most Americans. Since health insurance is provided by employers, loss of employment is accompanied by the loss of their health insurance and also their inability to afford these home health care facilities (Dunning, 2013).
With diabetic patients that remain employed, there has been an increase in healthcare expenses that have led to higher cost sharing of costs between employer and the worker. This has led to larger deductibles and copayments for diabetes home health care services (Harris, 2015). People with diabetes with health insurance may not be able to access healthcare costs due to the financial burden imposed by these additional fees as they are considered underinsured with economic barriers to healthcare.
Insurance barriers with healthcare for diabetic individuals includes impairment of access to preventive services, issues of failure to efficiently diagnose chronic disease and also inadequate control of chronic conditions. There has been an increased case of mortality among diabetic patients since these individuals cannot afford the necessary care plans that will facilitate management of their disease (Haas, & Burke, 2014).
The solution to this problem is that home health care needs policies and regulations that are concerned with healthcare and which will be vital for the maintenance of the dynamic nature of healthcare. All Americans must have adequate access to health coverage, and this must be of high quality and affordable (Hammaker, Knadig, & Tomlinson, 2016). Home healthcare systems should focus on universal healthcare which could be adequately guaranteed through replacement of employer-paid health care insurance.
Physician’s attitude
A physician’s attitude towards caring for people with diabetes is another barrier. Primary care provides usually consider diabetes more challenging to treat than any other chronic illness since diabetes needs more monitoring and medication adjustment in obtaining useful treatment goals (Harris, 2015). Some home health care practitioners also state that guidelines for reaching the proper treatment goals are not usually evident. Here, some patients also do not have a sense of urgency or comprehending about the treatment of their illness and therefore, are less likely to follow the recommendations from the healthcare provider. There is also the issue of lack of adequate administrative support for the increased time and efforts necessary to treat these patients.
Education of diabetes must be emphasized in home healthcare facilities to prevent occurrences of misunderstandings from the patients regarding their treatment. Practitioners involved in home healthcare services need to be skilled and trained in the importance of patient-centered care (Dunning, 2013). This will be associated to highlighting the importance of acquiring preventive n treatment services on diabetes.
Regulatory, legal, ethical, and accreditation requirements and issues for the service(s) offered in your proposed program.
Issues in regulatory practices involved in home care are that some patients and caregivers when they receive written information concerning the proper guidelines for medications as some do not adhere to these regulations. Some home care facilities do not follow patient care coordination requirements which require licensed clinicians highly accountable for the delivery of care (Pozgar, 2014).
Home healthcare agencies have faced the issue of fraud as some facilities do not comply with the regulations and billing requirements created by the regulatory bodies. This has been amplified by the lack of proper enforcement of reprimands against such issues in home health care.
Providers and doctors entering into compensation agreement for home healthcare services must ensure that all payments are fair of market value and commercially reasonable. This will assist in avoiding running foul practices against the kickback statutes (Hammaker, Knadig, & Tomlinson, 2016). Agencies must also ensure that beneficiaries that receive their services are confined to their homes and need these services.
The legal issue here is that some nurses may not follow the proper licensure, state and federal laws. The physician may also not be duly certified to treat the patient which may lead to cases of poor treatment decisions, lack of expertise in advanced medical technology and even their inability to follow state and federal laws concerning home care (Dunning, 2013).This will lead to the facility facing numerous malpractice issues, wrongful death lawsuits, and other litigation problems.
One of the ethical issues that home care practitioners encounter is that they may find that their beliefs may not be similar to those of the patient especially in dilemmas involving euthanasia of a terminally ill diabetes patient. Here, the clinicians may not respect the decisions of the patients regarding their mode of care even if the decision from the clinician is not made in the best interest of the patient (Hammaker, Knadig, & Tomlinson, 2016).
A patient may have elected to have a do not resuscitate order, and the nurse may disrespect this law. In such a situation, the medical practitioner must focus all their attention of promotion of the highest quality is regardless of their opinions and views. This is essential since it involves beneficence and the medical professional must perform all care activities while considering the requests of the patient regarding their care.
Concerning accreditation requirement, some home health care institutions have focused on describing the organizational processes to examine the process of care experienced by patients. However, some agencies have failed in explaining the complex health care that the patient utilizes in the pursuit of treatment (Harris, 2015). This has led to failures in defining the entire purpose of the home care program which has also been associated with difficulties in adequately standardizing the costs of delivery of care.
References
Dunning, T. (2013). Care of people with diabetes: a manual of nursing practice. John Wiley & Sons.
Haas, L. B., & Burke, S. D. (Eds.). (2014). Diabetes Management in Long-Term Settings: A Clinician's Guide to Optimal Care for the Elderly. American Diabetes Association.
Hammaker, D. K., Knadig, T. M., & Tomlinson, S. J. (2016). Health Care Ethics and the Law. Jones & Bartlett Publishers.
Harris, M. D. (2015). Handbook of home health care administration. Jones & Bartlett Publishers.
Pozgar, G. D. (2014). Legal and ethical issues for health professionals. Jones & Bartlett Publishers.