Introduction
Health care system remains an integral component in the society as it contributes in national development. It is within the facet of an effective health care system that a nation can realize its potential in production, technology advancement, trade and other economic sectors. It is clear that a healthy nation is more productive, innovative, and creative than unhealthy one because the former ensures that all citizens have access to quality, affordable, and reliable medical services. In order to achieve this goal, the federal governments has established more health care facilities and nursing homes, hired qualified and trained medical practitioners, and introduced technology. This move aims at reforming the health care system and ensuring that no patient dies from lack of quality medical services.
Over the years, people have had the notion that patients suffering from chronic and terminal illness should stay in nursing homes awaiting their death because they are considered useless and a burden to their families. Based on this aspect, many families have abandoned their patients in nursing homes and ignored the responsibility of taking care and supporting them morally. The act of abandoning the patient in long- term care facilities worsens the patient’s condition and affects the way a patient responds to treatment. On this premises, the government has reformed health care system by introducing patient-centered model in long- term care facilities so that to improve medical services (Brush, 2009). Patient centered model also known as medical home model provide patients with a home like environment, orient medical practitioners to patient’s needs, facilitate coordination of health care system and promote accessibility of medical care services.
In the last few years, long-term care facilities have been under intense pressure to change the traditional approaches, which employ medical care model, and instead employ patient –centered model that is more efficiency and cost effective. The federal government introduced Patient-centered model in 2007 and has continued to gain momentum in the last five years. Patient-centered model and medical care model differ in certain aspects, but they share similar constructs.
Differences
Patient-centered models is a medical approach that aims at providing comprehensive, coordinated, quality and continuous medical services to all patients and improve the outcome of the health care system. This infers that patient-centered model ensure that all patients have access to quality, reliable and affordable medical care services and orient doctors to the needs of the patients. Patient-centered model advocate that doctors rely on team-based perspective and involve medical practitioners with diverse and unique skills and knowledge in their respective profession (Earp, French, & Gilkey, 2008). This move aim at personalizing medical care services so that they meet the needs of the patient. On the other hand, medical model care advocates that a patient has no option of choosing a primary care giver, and instead should accept the one assigned by the hospital management. In other words, a patient has a designated health care provide who has been assigned the responsibility of coordinating, monitoring, and evaluating patient’s medical needs and treatment progress.
Patient-centered model provides comprehensive, coordinated, and continuous medical care services and serves patients of all ages. It is applicable to all people suffering from different illnesses and of different age. On the other hand, medical model care in long-term care facilities provide quality, affordable and reliable medical care services, but to patients suffering from either two or more chronic diseases or at a higher risk of developing chronic and terminal illness (Miller, 2010). It is also applicable to patients suffering from mental illnesses, and because of their medical condition requires intensive and coordinated care.
Patient-centered model employs medical practices, which are physician-based, and are offered by either a doctor or a qualified, trained and registered nurse. On the other hand, medical care model mainly integrate other practices such as community based health organization, counselors, addict service providers and other federal health agencies.
Similarities
Both models have a common goal of maximizing the outcome of medical care services, and ensure that patients have access to quality, affordable and accessible medical services. Patient-centered model provide comprehensive primary care to all patients and has introduced the use of technology so that to attain this goal. In the same breath, medical care model articulate that all patients suffering from terminal and chronic illnesses have right for quality, accessible and affordable medical care services.
Both models employ medical practices, which are offered by qualified, trained, and accredited medical practitioners and health agencies. Patient-centered model is physician based as it involves nurses and doctors, and the same aspect applies in medical care model.
Factors, which prevent adoption of patient-centered model in long -term care settings
Long care facilities are under pressure to adopt patient-centered models, but they are resistant to this idea based on the following factors:
Financial constraints: This is a major challenge facing the health care system. The idea of introducing patient-centered model will have negative impacts on the system because it will mean that the government should hire more medical practitioners, establish more health care facilities with large scale space, introduce technology, reform, and formulate new policies in health care sector. These plans and changes requires that the government provide money and human resources so that to implement the model effectively; an idea that will affect the economy of the country (Miller, 2010). Based on this fact, long-term facilities have argued that adopting patient-centered model will increase their operation cost and affect national economy.
Gaps in legal provisions and health care policies: According to the recent studies, there are no clear guidelines and evidence that supports the idea that patient-centered model will work and improve health care system. This fact is based on the idea that patient-centered model was introduced in 2007, but only a few health care facilities have adopted the model (Earp, French, & Gilkey, 2008). The government is the process of conducting pilot studies to establish whether the model will be effective, cost effective, and reliable as anticipated. Similarly, the federal government has not provided a comprehensive policy and guideline that defines the model effectively, stipulate on how it should function and who should use it. For instance, physicians and nurses who offer medical services to all people should use the model, but this is not the case as other experts are using the model. Based on this fact, long-term care facilities prefer medical care model to patient-centered model because there is substantial evidence to support its effectiveness. Additionally, medical care model has clear and concise legal provisions and guidelines than patient-centered model.
It will compromise health care system and medical services: Patient-centered model is effective, but it has many loopholes, which may compromise the health care system. The model aim at providing comprehensive, continuous, and coordinated primary care to all people, and lower medical costs. However, this goal will not be achieved because there are no clear guidelines that stipulate on whether experts and physician should use the model. Currently, experts use this model, but this will affect efficiency and effectives of health care system. Many experts will engage in unethical practices so that to lower their operation cost and maximize profits.
Advantages of patient-centered model
Provide comprehensive, coordinate, and continuous primary health care to all patients: Patient-centered model is one of the most effective models because it aims at providing quality, accessible and affordable medical services to all patients. Unlike, medical model care that focuses on a given segment of population, patient-centered model serve all population and patients of different age. Therefore, patient-centered model will ensure that all patients receive quality, affordable and accessible medical services thus promoting healthy living.
Promote mutual relationship between the patient, family members and medical practitioner: Patient-centered model provide a platform where patients and patient’s family members can relate well with the doctor, share the patient’s progress and challenges. The model provides a patient with an option of choosing a physician who understands his/her medical needs well thus shortening the recovery period. This is in contract with medical care model where a physician is assigned by the hospital managements thus depriving the patient the right of making that choice. Based on these assertions, it is evident that long-term care facilities should adopt patient-centered model because it is efficient, cost effective, promote mutual relation between patient and physician, and provide comprehensive, coordinated, and continuous medical care to all people.
References
Brush, J. (2009). Improving Quality of Life in Long-Term Care . Perspectives on Gerontology . Retrieved July 3, 2013, from http://div15perspectives.asha.org/content/14/2/37.full
Earp, J. A., French, E. A., & Gilkey, M. B. (2008). Patient advocacy for health care quality: strategies for achieving patient-centered care. Sudbury, Mass.: Jones and Bartlett Pub..
Miller, W. (2010). Defining and Measuring the Patient-Centered Medical Home. National Center for Biotechnology Information. Retrieved July 3, 2013, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2869425/
