Introduction
Health policy can be defined as a plan or decision combined with actions to achieve specific healthcare goals by implementing key strategies within the society (WHO, 2016). As per the World Health Organization (WHO), an explicit health policy is known to be associated with several success factors such as development of a vision for the future and establishment of key targets for the short and long-term. Health policies enable organizations, institutes, societies, and groups to define outline, propose new goals, and inculcate different roles across various healthcare sectors (Záliš, et al. 2016). Healthcare policies are known to unite people and help build a consensus for the betterment of the future and the healthcare system
In the past decade, researchers and healthcare policy decision makers have focused on the speciality of emergency medicine and global health policy. Both, healthcare policy and emergency medicine have been developed and implemented as a new concept in the past 30 years. It is important to understand the concepts and recent changes to global health policy pertaining to current trends with respect to disease burden, health economics, health disparities, and the intersecting factors such as emergency, palliative, and chronic care. It is essential to review the overall health status and the impact of a new health policy to reduce the overall economic impact and burden on the healthcare system, in both developed and underdeveloped nations (Morris. 2016). As per the WHO and the United Nations (UN), there has been significant research and decision making to address the unmet needs of healthcare among the under developed nations of the world. Most of the policies and reforms have been designed in an ad-hoc manner which are aimed to resolve a single health issue among a multitude of other health problems (Kim, et al. 2013). The key issue with these reforms are associated with poor assessment plans and low integrative solutions to the spread to these policies. The assessments of healthcare delivery although effective lack efficient study and research due to which they are unable to assess the cost-effectiveness of interventions. This paper provides an overview of healthcare policy and delivery and its association with the nursing profession.
Historical perspectives on concern for Global Health learning in nursing
Nurses have played a key role in the global healthcare system since its inception in the 1860’s. Nurses are known for their services expanding across various sectors of healthcare (Wilson, et al. 2016). The nursing profession has a profound impact on the healthcare system with respect to both policy making and healthcare delivery (Maier & Aieken. 2016). Nursing professionals have had a significant demand since the early 1980s owing to their compassionate and communicative skills. Many researchers have proven that the implementation of nursing within the healthcare system has been associated with improved health outcomes and enhanced patient satisfaction (Hesse, et al. 2014). It is important to inculcate global health learning in the nursing fraternity in order to further improve the healthcare system. Based on current evidence, a team of researchers assessed and reported that it is essential and mandatory to plan and execute a global health experience among nursing students, both at the graduate and undergraduate level (Visovsky, et al. 2106). The global healthcare policy and delivery is based on current evidence based practices and research-based modelling (Majid, et al. 2011).
Importance of health care disparities
Healthcare disparity is a common health issue in the healthcare system and it has been present since the past 3 decades. Some of the most common health disparities include disparities in quality care and access to healthcare services. Quality care disparities is most common among African and the Black population (Chen, et al. 2016). There is moderate disparity in quality care among the Asians in comparison to the White population. Racial and ethnic health disparity is a common and major health issue (Fiscella & Sanders. 2016). In a recent survey, women from the Black and Asian population are known to suffer from quality care and restricted healthcare services (Carter, et al. 2016). Socioeconomic status of an individual, group, community, or society has a significant impact on access to basic healthcare services. In a recent report by the Centers for Disease Control and Prevention (CDC), most of the African and Black communities in the US supper from healthcare disparities owing to low income and the inability to understand healthcare services due to lack of education (Frieden and CDC. 2013). Based on current evidence, some of the other notable healthcare disparities reported across the world include environmental threats, inadequate access to healthcare, individual and behavioural factors, and educational inequalities (Braveman, 2014). Most of the healthcare disparities observed are unintentional and are often a result of a biased and imbalanced society. Most of the disparities are associated with education inequalities, inadequate healthcare services, and poor healthcare framework among the affected populations (Blair, Steiner, & Havranek. 2011). The current policies and healthcare reforms do not target affected populations but regulate and promote health among the developed sectors of society which increases the gap for healthcare services and leads to a healthcare disparity (Woolf & Braveman. 2011 and LaVeist, Gaskin, Richard. 2011).
Healthy people 2020 and other regulatory guidelines
The Healthy People 2020 is a evidence and science-based 20 year objective nationwide with an aim to provide improved healthcare to all Americans. The sole objective is to provide an enhanced patient-centric and high quality healthcare system to all Americans by the next decade, 2020. In the past 30 years, Healthy People has been associated with the establishment of key benchmarks in the healthcare arena which are as follows: (a) Collaboration across communities and sectors for improved health outcomes (b) Empowerment of individuals for informed health decision making and access to healthcare services and (c) Assessment and evaluation of the impaction of preventative activities (Healthy People, 2020). The Healthy People 2020 is governed by certain regulatory policies and have 4 agendas associated with their vision and mission statement. The first agenda is to recognize, assessment, and streamline ecological and organizational factors for health promotion and disease prevention. It takes into account the personal (individual), organizational, social, and policy-level factors while addressing key determinants for better health outcomes. The second agenda supports the use of secure, faster, and feasible information technology for improved health communication across all sectors of the healthcare system. Its primary outlook would be on health literacy among healthcare professionals, nurses, and patients. The third agenda is focused on addressing various health hazards such as natural calamities (storms, hurricane etc.), epidemic, and emergency care (Fielding, Teutsch, & Koh, 2012).
Moral issues in Global Healthcare
Although there have been many healthcare reforms and policy modifications for the betterment of the general public with respect to low cost and ease of access to healthcare, many researchers have reported a significant health disparity and moral issues (Necek, 2012). It is important to understand the key role of moral issues within the healthcare system and its association to healthcare burden and health economics (Scheunemann, & White. 2011). The two major moral issues in the global healthcare is the high cost and inadequate access to basic healthcare services. Religion, culture, caste, ethnicity, attitudes, beliefs, and race are known to be key factors that add to the major moral issues in global healthcare (Institute of Medicine, 2012). In a recent report by a researchers in the US, gaps in access, quality, and affordability are key factors that contribute to healthcare disparity around the globe (Riley, 2012). In the same report a significant moral issue pertaining to specific racial and ethnic groups were identified, wherein African Americans and Black communities suffered from access to basic healthcare services. Some of the key areas included HIV/AIDS, diabetes, cardiovascular disease, asthma, and analgesia (Riley, 2012). Thus, it is essential to address key moral issues pertaining in order to provide ease of access and affordable healthcare services.
Healthcare productivity and Economic costs
Individual health status plays a key role in determining health productivity and overall economic costs. Some of the key factors that contribute to healthcare productivity and economy include hospital associated infections, inpatient falls, readmission related to improper post-admission education, patient injuries, post-surgery pain, medical errors, patient-related medication errors, and physician or nurse associated inefficient care and management (Mitchell, R. J., & Bates, P. 2011). The workforce environment, wages, salary, benefits, security, and welfare of healthcare providers and nursing staff are key determinants to healthcare productivity (Crettenden, et al. 2014). Infectious diseases and epidemics are considered as key determinants in healthcare economy. Epidemics such as Zika virus infection, hepatitis, small pox, measles, cholera, typhus, yellow fever, Ebola, and Chikungunya have contributed to the global healthcare productivity and economy (Quinn, & Kumar. 2014). Lifestyle diseases such as obesity, cardiovascular disease, stroke, hypertension, and diabetes have also contributed to healthcare productivity loss and a burden to the global economy (Arredondo & Aviles, 2015). Thus, it is important to address various contributing factors to the healthcare productivity and global economy.
Availability of healthcare providers (ARNPs, RNs, and physicians)
Based on current evidence, there is insufficient supply of healthcare providers and medical professionals to cope with the growing patient population. Since the implementation of the Affordable Care Act, there is an increase in influx of patients in the US which has put significant burden on the physician population (Jacobson, & Jazowski, 2011). Physicians also face certain compliance and regulatory issues which further adds to the burden on the availability in primary care facilities (Cascardo. 2016). As per the Institute of Medicine (IOM) Committee on the Governance and Financing of Graduate Medical Education there is an increase of physician shortage in the healthcare system which needs to be resolved at the earliest to improve overall health outcomes (Salsberg, 2015). In a recent report by the Canadian Institutes of Health Research, there is a significant shortage of physician and primary HCPs in Canada owing to poor healthcare policies applied to physicians (Islam, 2014). In order to combat the low influx of physician and primary care providers, researchers and competent HCPs state that registered nurses and family nurse practitioners (FNPs) could replace physicians in crisis of shortage. FNPs are qualified, trained, and experienced in various clinical settings to meet basic primary care needs of patients. Although FNPs cannot replace physicians completely, it is stated that the inclusion of FNPs would reduce the overall burden on primary care physicians and HCPs (Lacny, et al. 2016). In a recent cross-sectional Survey in the US, a team of researchers confirmed that family nurse practitioners are competent and quality to provide basic primary care services to patients including diagnosis and prescribing medications (Poghosyan & Liu. 2016). The same researchers also stated that the inclusion of FNPs was associated with improved health outcome and patient satisfaction (Poghosyan & Liu. 2016).
Conclusion
Health policies enable organizations, institutes, societies, and groups to define outline, propose new goals, and inculcate different roles across various healthcare sectors. Healthcare policies help build a consensus for the betterment of the future and the healthcare system. Nurses have played a key role in the global healthcare system and are known for their services expanding across various sectors of healthcare. It is important to address various healthcare issues such as health disparities, moral issues, healthcare productivity, healthcare economy, availability of healthcare services and providers. Nurses play a broad and critical role in the healthcare system and often considered as the backbone of global healthcare delivery.
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