Catherine Owens

Title

Healthcare Products Pricing and the Impact of Medicare

Supporting Literature

The first step in developing your prospectus is to search the literature related to the general area related to healthcare administration you want to investigate (see social problem below). In your review of recent, empirical literature, what keywords did you search and in what databases?

The keywords and databases searched included Healthcare costs, healthcare prices in the US, Healthcare costs for chronic diseases in the US.

Provide at maximum of 10 brief summaries of recent, scholarly (peer-reviewed) articles and empirical literature. The summaries should include: a) 3 – 5 brief summaries within the last 5 years that justify a current and relevant problem in your discipline or professional field; b) article(s) that support your theoretical/conceptual framework; c) article that supports your Nature of the Study section; d) additional articles that support that your problem is current and relevant to your discipline or professional field for a total of 10 brief summaries.

Include the complete, APA reference entry and (a) an in-text citation; (b) what was studied; (c) what was found; and (d) why this research is important in relation to your study. This evidence provides the justification for your research problem.

HSO Justification Literature

(minimum of 3 sources within last 5 years justifying an HSO operational, administrative or management problem)

Benavidez, G. & Frakt, A. (2019). Price Transparency in Health Care Has Been Disappointing, but It Doesn’t Have to Be. JAMA 322(13):1243–1244. doi:10.1001/jama.2019.14603

a) a)Benavidez & Frakt (2019); b) the authors explained that the problems of pricing healthcare activities are critical since it creates issues when attempting to implement cost-sharing. c) it was discovered that experienced healthcare providers are required to handle their healthcare activities and the ability to create reliable outcomes for all patients. There have been issues in the healthcare industry when the prices do not get explained to clients. d) This is factual because inadequate quality care is not entirely connected to the cost of healthcare. The authors explained that generating information about the quality of healthcare and the impact on the services performed by healthcare providers are intertwined actions that must get addressed to improve the quality of healthcare. Existent rewards programs are imperative in ensuring all healthcare improvement activities receive reliable methods of handling all patient procedures. The authors explained that the existence of rewards programs was a critical activity that healthcare providers were involved with to handle patient improvements. Nursing clinics can use the knowledge for maximum healthcare improvement.

Branning, G. & Vater. M. (2016). “Healthcare Spending: Plenty of Blame to Go Around.” American health & drug benefits vol. 9,8: 445-447. Retrieved 2 July 2021 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5394555/.

a) Branning & Vater (2016); b) the authors explained that the American population spent trillions for healthcare improvement. c) this is factual since the value improvement technique of healthcare environments involved cash payments to ensure all resources get provided for the patients. d) Use of insurance like Medicaid and Medicare were also involved in handling the health improvement of a nursing clinic

Crowley, R., Daniel, H., Gooney, T. G., & Engel, L. S. (2020). Envisioning a Better U.S. Health Care System for All: Coverage and Cost of Care. Supplement: Vision for the U.S. Health Care. https://doi.org/10.7326/M19-2415

a) Crowley et al. (2020); b) the authors explained that the cost of healthcare is constantly increasing due to the technical needs of healthcare systems. It is common to encounter situations when the health systems do not have a proper payment system; c) The research discovered that the process of ensuring the healthcare system gets provided with proper costs is critical and requires the involvement of persons with experience and capability of promoting healthcare improvements; d) all in all, there are diverse social determinants of healthcare that must get addressed to handle cost allocation. Persons experienced in the healthcare environment would be more capable of allowing cost management and improvement for all healthcare departments. The authors explained that healthcare systems are developed using current knowledge that promotes the reliability of health insurance activities. It is easy to solve long-term cost-management requirements that can provide the healthcare environment with high-quality patient improvement.

Almeida, F. (2018). Strategies to Perform A Mixed Methods Study. European Journal Of Education Studies, 5(1), 137-150. https://doi.org/10.5281/zenodo.1406214

a) Almeida, (2018), b) the author offers a detailed appreciation of the mixed method research approach. By breaking down the research design to its element components, it allows for its effective application. c) The research was able to identify that the research method can be applied in approximately ten varying designs with each design having its own limitations and advantages. d) overall, the detailed understanding of the mixed method research is critical as improper application of the design can result in unreliable outcomes. Moreover, with the design having numerous strategies, it is necessary to identify the parameters of the study before its exploitation.

Bardha, I., Chen, H., & Karahanna, E. (2020). Connecting Systems, Data, And People: A Multidisciplinary Research Roadmap For Chronic Disease Management. MIS Quarterly, 44(1), 185-200. https://doi.org/10.25300/MISQ/2020/14644

a) (Bardha et al., 2020), b) the authors studied the prevalence of chronic diseases in the US and its contribution to the escalating healthcare costs. c) By comparing the data from the number of beneficiaries of Medicare, private insurance and non-insured, they are able to populate the probable cause of the problem. d) the research plays a critical role as it offers an in depth understanding of the scale of the issue considering the current implications posed by the COVID-19 pandemic.

Cramer, E., Seneviratne, M., Sharifi, H., Ozturk, A., & Hernandez-Boussard, T. (2019). Predicting the Incidence of Pressure Ulcers in the Intensive Care Unit Using Machine Learning. Egems (Generating Evidence & Methods To Improve Patient Outcomes), 7(1). https://doi.org/10.5334/egems.307

a) Cramer et al. (2019), b) the use of machine learning in assessing data on chronic conditions by utilizing pressure ulcers as a base for the algorithm to learn. c) the results of the research demonstrated the exploitation of current hospital data on patients with chronic diseases identifying social and economic factors that contribute to the high cost of their care. d) the information from the study is essential as it allows for possible solutions to be identified by exploiting technology for simplified problem solving execution.

HSO Problem Supporting Sources

(social problem, significance, or variables beyond justified HSO problem)

Borges dos Santos, M.A., dos Santos Dias, L.L., Santos Pinto, C.D.B. et al. (2019). Factors influencing pharmaceutical pricing - a scoping review of academic literature in health science. J of Pharm Policy and Pract 12, 24. https://doi.org/10.1186/s40545-019-0183-0

a) Borges dos Santos et al. (2019); b) the authors stated that pricing procedures in healthcare environments required consideration of the value that such pharmaceutical products would improve; c) access of knowledge of health care environments is imperative in handling all concepts of studying patients; d) nursing clinics can provide patients with better health and high-quality medicine.

Garcia, S. P., Haddix, A., & Barnett, K. (2018). Incremental Health Care Costs Associated With Food Insecurity and Chronic Conditions Among Older Adults. Preventing chronic disease, 15, E108. https://doi.org/10.5888/pcd15.180058

a)Garcia et al. (2018); b) the authors explained that expensive healthcare is detrimental to healthcare since it affects persons with chronic conditions; c) the study identified that the process of providing chronically ill patients with their required resources is critical and must get performed in high quality while ensuring health departments promote complete treatment; d) nursing clinics can act to ensure a proper connection with health management measures.

Framework Literature

(minimum of 1 source that aligns with the research variables)

Naberhuis, J.K., Hunt, V.N., Bell, J.D., Partridge, J.S., Goates, S., & Nuijten, M.J.C. (2017). Health care costs matter a review of nutrition economics – is there a role for nutritional support to reduce the cost of medical health care?. Nutrition and Dietary Supplements. 9:55-62

 https://doi.org/10.2147/NDS.S126232

a) Naberhuis et al. (2017); b) the authors examined the connection between costs of healthcare and the ability to improve on the nutrition of all patients; c) the outcome was that the procedures applied in the economy are critical since it ensures the entire health environment gets provided with interventions known to promote better health environments; d) nursing clinics can thus provide affordable health management in this way.

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Nature of Study Literature Methods and Analysis

(minimum of 1 source for the methodology and type of analysis)

According to Bardha et al. (2020), the chronic diseases are currently the most costly healthcare services provided in the sector. According to data from the CDC, over 90% of the country’s annual healthcare expenditure is on the chronic and mentally ill. Accounting for over $3.5 trillion in 2018, it is expected to continue rising as the population ages increasing their vulnerability. By assessing the information on the main cause of rising cost of healthcare, strategies such as prevention and effective disease management can be employed thereby reducing overall cost of healthcare (Bardha et al., 2020). It relies on understanding the factors such as affected population and other political and economic factors that will be collected from the data,

Nature of Study Literature Dataset

(minimum of 1 source for the dataset)

The literature dataset will mainly address age, gender, socioeconomic class and government interventions, exploiting the statistical and details pertaining to the problem offers a more diverse approach to the problem. By understanding the key stakeholders affected by the rise in healthcare costs necessary action can be implemented..

Rubric Standard | Justified > Is evidence presented that this problem is significant to the discipline and/or professional field?

Problem

What was the social problem and the healthcare administration problem that prompted you to search the literature to find out more? Write in complete sentences using a scholarly tone.

The situation or issue that prompted me to search the literature is The situation or issue that prompted me to search the literature is the social issue of increasing costs of treating chronic cancer and diabetes. Such issues have been progressing due to an increase in financial requirements and the increase in handling health improvements for such problems. The majority of persons affected are dependents and patients’ relatives.

Based on all of the above justification and supporting information (literature, social problem, healthcare administration problem), in one sentence, what is your operational/ research problem ?

The specific research problem that will be addressed through this study is The specific research problem that will be addressed through this study increase in mortality rates when persons in the healthcare environment do not affect the treatment procedure.

Now that you have read and summarized some of the recent literature, what meaningful gap in the literature that aligns with your HSO research problem your study will address? (What is still not known?)

Although researchers have investigated this issue, there is very little or no literature on the ability to prevent avoidable deaths entirely using an affordable treatment process.

Rubric Standard | Meaningful > Has a meaningful problem and gap in the research literature been identified?

Rubric Standard | Original > Does this doctoral study have potential to make an original contribution?

Purpose

To address your stated research problem, what is the purpose of your study? Will you compare, explore, examine, etc.? Complete the purpose sentence below and be sure to clarify your dependent and independent variables of interest.

The purpose of this quantitative study is to improve knowledge on how transforming prices of medical operations can improve overall healthcare impact. The method applied to study the topic is by comparing different peer-reviewed articles containing information concerning medicine pricing and how it affects patient outcomes. The dependent variable in this study is patient outcomes and ability to access hospital care, while the independent variable is the pricing of medication and hospital procedures

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Framework (Conceptual or Theoretical)

What theory(ies) and/or concept(s) support (frame) your study and who are the original authors? Provide an in-text citation with your response, and the complete APA reference entry with summary in the Supporting Literature section.

The theories and/or concepts that ground this study include social cognitive theory and health belief model that have an impact on the ability to influence patients and healthcare providers to realize the importance of all medical procedures.

Smith, Y., Garcia-Torres, R., Coughlin, S. S., Ling, J., Marin, T., Su, S., & Young, L. (2020). Effectiveness of Social Cognitive Theory-Based Interventions for Glycemic Control in Adults With Type 2 Diabetes Mellitus: Protocol for a Systematic Review and Meta-Analysis. JMIR research protocols, 9(9), e17148. https://doi.org/10.2196/17148.

Smith et al. (2020) stated that the social cognitive theory effectively offers self-management and the patient's capability to adhere to treatment. The study analyzed how patients can understand their physical needs and collaborate with medical improvement measures. Knowing treatment processes is the best option to handle health improvement.

Social cognitive theory ensures patients accept diverse treatment prices and procedures to increase their quality of life.

Masoudiyekta, L., Rezaei-Bayatiyani, H., Dashtbozorgi, B., Gheibizadeh, M., Malehi, A. S., & Moradi, M. (2018). Effect of Education Based on Health Belief Model on the Behavior of Breast Cancer Screening in Women. Asia-Pacific journal of oncology nursing, 5(1), 114–120. https://doi.org/10.4103/apjon.apjon_36_17

Masoudiyekta et al. (2018) stated that the health belief model offers effective management of behaviors of different persons once they are directed to engage in treatment measures. It is possible to use behavioral adaptations to handle diverse activities in healthcare environments.

A health belief model and healthcare pricing connection are evident since decision-makers in healthcare industries can assess patients to determine suitable treatment and affordability.

How do these theories and/or concepts relate to your research problem, purpose, and the nature of your study?

The logical connections between the framework presented and the nature of my study include an effective explanation of the impact of high medical prices on the ability to improve healthcare.

Rubric Standard | Grounded > Is the problem framed to enable the researcher to either build upon or counter the previously published findings on the topic?

Research Question(s) and Hypotheses

List the question(s) that you plan to use to address the research problem. Your questions must align with your study purpose and include the dependent and independent variables and how they will be examined.

The following research questions shall offer comprehensive method of analyzing the topics. The dependent variable for research question 1 is limited treatment for patients that cannot afford healthcare. The first independent variable is receiving substandard healthcare and taking inappropriate medication. The second independent variable is increase in number of deaths per year due to lack of affordability of required medical procedures. The dependent variable for research question 2 in this study is patient outcomes and ability to access hospital care while there are two independent variables. The independent variables are impact of healthcare pricing requirements by healthcare organizations and the daily healthcare procedures applied by hospital managers for the improvement of their patients’ conditions.

Improvement of health outcomes for patients is a critical procedure that requires involvement of different people all conversant with the procedures. Since Medicare is the main hospital service in the USA that offers care, it is the duty of all healthcare providers to instruct their patients to register for Medicare to avoid issues of healthcare pricing and high expenses required for improved care. Assessment of healthcare organizations and the impact they have on patients is a profound activity that involves persons with different levels of experience. It is possible to connect with different knowledge improvement areas for the full benefit of patients. Healthcare prices affect full treatment of patients due to the need to eliminate the external physical requirements that patients need. Medicare involves its trustees to determine types of illnesses covered and duration of time patients spend at hospitals (Conover, 2018). Improvement of accuracy during medical procedures is a critical process that requires understanding of the pricing procedure and the capability of remaining objective during health managements sessions.

RQ 1 – What is the impact of high cost of healthcare for patients that require health improvement at all times?

H₀1- There is no impact of high cost of healthcare on patients’ treatment.

H₀2- There is a connection between high healthcare costs and patients’ treatment requirements.

RQ 2- What is the connection between healthcare organizations that allow patients to afford medical care insurance and the ability of patients to afford the premiums?

H₀1- There is no impact of healthcare insurance and patients’ capability of affording premiums.

H₀1- There is an impact of healthcare insurance on patients’ ability to afford premiums.

Nature of the Study

What systematic approach (methodology and research design) do you plan to use to address your research question(s)?

To address the research questions in this Mixed Method study, the specific research design will include collecting, assessing, and integrating previously compiled data on the social problem to develop or identify an effective solution. The research design was selected due to the already identified parameters of the research. Additionally, several statistical and correlational factors are to be considered in the study, thus, for effective appreciation of the data, the mixed methods research design was preferred.

Reference entry for the work on which this research design is based:

Almeida, F. (2018). Strategies to Perform A Mixed Methods Study. European Journal Of Education Studies, 5(1), 137-150. https://doi.org/10.5281/zenodo.1406214

According to the author, the mixed method approach to research incorporates the facets attributed to qualitative and quantitative research designs. The outcome of the research design is a broader and more comprehensive understanding of the issue compared to having a single approach to the research problem. In other words, the mixed method will analyze the problem as well as develop comprehensive aspects of the study that require in depth understanding. Based on the strategies proposed by Almeida (2018), the mixed methods approach has the advantage of overcoming the limitations of qualitative and quantitative methodologies allowing rich data to be collected. Thus, each of the research questions will be broken don into its core components then addressed individually thereby offering the needed comprehension of the problems.

What is the possible secondary data source(s)?

For my planned research design, I will need government data, publications from renowned organizations, previous research articles addressing either of the research questions and industry reports.

What specific data points from these sources do you plan to use to answer your research question(s)?

With the patients being the main members of the statistical population, the sources will provide data values on income, age, social class, and number of individuals in the same group. The data will be coupled with data from the healthcare sector which will focus on cost of chronic condition care and the factors attributing to its variance.

What limitations, challenges, and/or barriers might you need to address while conducting this study (e.g., access to participants, access to data, requirements for storing data, separation of roles or other ethical considerations, instrumentation fees, etc.)?

The core limitations that will require addressing before conducting the study includes access to valid data, separation of roles and the funds needed to access the instrumentation. The study will mandate the access of various online libraries at a premium cost,; additionally the data provided may not directly address the issue thereby resulting in limited access to valid data. Finally, with limited funds, it would mandate the development of a small team which may bring about ethical considerations when addressing separation of roles.

Rubric Standard | Feasible > Can a systematic method of inquiry be used to address the problem; and does the approach have the potential to address the problem while considering potential risks and burdens placed on research participants?

Significance

How will your study address the meaningful, discipline-specific issue that you identified and therefore contribute to your field, discipline, professional practice, etc. contributing to positive social change?

This study is significant in that it will address a growing issue within the American population, the rise in healthcare costs for chronic diseases. The study is addressing the problem as the country’s population continues to age further increasing the demand for chronic disease care. By appreciating the factors contributing to the rise in healthcare costs, effective and applicable solutions can be developed easing he issue.

Rubric Standard | Impact > Does this doctoral study have potential to affect positive social change?

Rubric Standard | Objective > Is the topic approached in an objective manner?

Partner Site Masking Self-Check

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☐ Check here to confirm that you will mask the identity of the organization in the final capstone that you publish in ProQuest.

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Research Problem, Purpose, and Framework

Provide one sentence for each. These must align with all rows.

Research Question(s), Method, & Design

List one or more RQs, as needed; select method; identify design. Use a separate form for additional RQs.

Data Collection Tools & Data Sources

List the instrument(s) and people, artifacts, or records that will provide the data for each RQ.

Data Points

List the variables, specific interview questions, scales, etc. that will be used for each RQ.

Data Analysis

Briefly describe the statistical or qualitative analysis that will address each RQ.

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Method: Quantitative

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Rubric Standard | Aligned > Do the various aspects of the prospectus align overall?

Search Log Example

Database

Search Terms

Results

Notes

Research Problem, Purpose, and Framework

Provide one sentence for each. These must align with all rows.

Research Question(s), Method, & Design

List one or more RQs, as needed; select method; identify design. Use a separate form for additional RQs.

Data Collection Tools & Data Sources

List the instrument(s) and people, artifacts, or records that will provide the data for each RQ.

Data Points

List the variables, specific interview questions, scales, etc. that will be used for each RQ.

Data Analysis

Briefly describe the statistical or qualitative analysis that will address each RQ.

Problem: The specific research problem that will be addressed through this study is that hospitals are struggling to retain nurse leaders as a result of increasing levels with nursing burnout due to increasing occupational stressors.

Purpose: The purpose of this quantitative study is to examine the relationship amongst the dependent variable of nurse leader employment retention and the independent variables of nurse leader burnout, occupational stress and self-efficacy.

Framework: The theories and/or concepts that ground this study include Bandura’s (1997) theory of self-efficacy, focusing specifically on one’s perception of how well one can achieve something that appears beyond their reach.

RQ1 – Is there a correlation between higher self-efficacy scores for nurse leaders and lower scores for burnout, occupational stress and intent to leave?

Method: Quantitative

Design: Correlational

The American Organization for Nursing database where the secondary data exist for the Maslach Burnout Inventory Human Services Survey (MBI-HSS) and Leader Efficacy Questionnaire (LEQ).

-Self-efficacy ratings

-Nurse leader burnout rate

-Occupational stress

-Intent to leave

Pearson’s Correlation

RQ2 - Are self-efficacy scores for nurse leaders associated with scores for burnout, occupational stress and intent to leave, after controlling for age, gender, and race / ethnicity?

Method: Quantitative

Design: Correlational

The American Organization for Nursing database where the secondary data exist for the Maslach Burnout Inventory Human Services Survey (MBI-HSS) and Leader Efficacy Questionnaire (LEQ).

-Self-efficacy ratings,

-Nurse leader burnout rate

-Occupational stress

-Intent to leave

-Age, gender and race

Multivariate regression

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