Resource allocation in the healthcare sector continues to pose a challenge to the industry, as the stakeholders try to assign the scarce resources equitably and justly across all the important healthcare activities. Resource allocation refers to the assignment of the available resources to different activities (Buck & Dixon, 2013). Despite the enormous efforts by the various stakeholders to adjust resources in accordance with the activities, the issue continues to plague the healthcare industry. Misappropriation of the resources, in addition to the scarcity, has majorly contributed to inefficiency in the delivery of care services.
Access to quality healthcare services is impeded by inefficient allocation of resources. Also, resource allocation is one of the major sources of ethical dilemma in healthcare, especially when a care giver has to make a choice over who deserves the services. Guindo et al. (2012) attributes the challenges in resource allocation to the high differentiation between the providers of the services and the departments that allocate the resources. This paper will discuss the management of healthcare resources in my area of practicum, focusing on the systems and processes used in this setting. Additionally, the paper will analyze how the allocation of resources is determined, and the changes I would make in the resource allocation process at the facility.
Management of Resource Allocation
The government is the overall provider of funds for availing healthcare resources in the care facilities. After the funds reach the individual healthcare facilities, the managing boards take up the responsibility of allocating the resources. In some facilities, the decision lies with the management, while in others, it lies with the individual departments in the facility. Each healthcare facility subscribes to a different resource allocation method, which is largely determined by the utilization activities. Also, the forces of the external market have a significant impact on the allocation of resources in healthcare (Buck & Dixon, 2013).
Jakovljevic (2013) observed that allocation of resources in the healthcare facilities is guided by two broad categories of decision-making; macro-allocation and micro-allocation. Micro-allocation focuses on decisions that are intended to improve the individual wellbeing of specific patients (Guindo et al., 2012). For example, decisions regarding who should receive a heart for transplant. Also, micro-allocation may involve helping a patient make a decision on the kind of treatment to receive, especially when such decisions are constrained by time factor. For example, during second stage arrest, the mother or surrogate should make an informed decision on the best cause of action to take in order to save the child and the mother.
On the other hand, macro-allocation involves decisions that determine the amount of healthcare resources that should be availed for certain healthcare services (Jakovljevic, 2013). For example, how the government decides how much resources should be assigned for healthcare spending. The resources assigned via macro-allocation decision-making affects the overall healthcare industry, unlike micro-allocation, which only affects individual patients. In practicum, both the macro-allocation and micro-allocation decision-making processes are used.
Resource allocation at this care facility considers the payers of the services, such as Medicaid and Medicare, privately funded insurance covers, and even those without insurance. Macro-allocation is used by the government in assigning the funds and other resources to the facility. The resources are allocated using this approach based on the services offered to its patients and the average number of patients that it attends to every month. Micro-allocation is mostly done on a more personal level, and has a direct impact on the patients.
The managing board decides how much each department should receive, while the heads of the departments manage the allocation of such resources to the patients, in conjunction with the supplies department. However, some allocations of resources require the involvement of the managing board, the department heads, and even the nurses. An instance when the input of the staff and the board might be required in resource allocation is when one department requires more resources.
Systems and Processes in Place
Healthcare funding is achieved through general taxation of the citizens. The taxes are then allocated to the various needs of the country such as healthcare using a determinant system on previous spending and expected expenses. The tenets of the care facility are to provide quality and safe care services equitably and justly to the community it serves. However, these principles are challenged by the availability of resources. Since the facility receives insured and non-insured emergency and non-emergency it is difficult to decide who gets the services, especially in the face of high demand of some services. However, to resolve this common dilemma, the care facility adopts a system and processes that ease the decision-making process on resource allocation.
The Crossman’s system is majorly employed in this healthcare facility in the allocation of resources. This model was devised in the 1970’s and it was named after the minister who devised it (Hulshof, Boucherie, Hans & Hurink, 2013). The main tenet of Crossman’s system of resource allocation is equity, whereby resources are allocated based on the target population. Resources are allocated on the basis of who needs the resources more. For example, the emergency department receives an influx of patients often, hence requiring more resources compared to other units. Consequently, the emergency department, at any time of resource allocation, receives more resources that the rest, although with a preset limit.
The allocation utilizes a data analytical tool, which indicates previous spending, and the expected expenses of the facility. The predictive analysis is based on the previous experiences of the hospital, and is mostly constant with minimal significant changes. In addition to the predictive analysis, the hospital also sets a spending limit for the various departments, which cannot be breached without the involvement of the board of management.
Determination of Resource Allocation and Distribution
The resource allocation systems and processes at the facility significantly contribute to how the resources are allocated, and consequently, distributed. In addition to the system and processes, other factors that determine resource allocation include the prevailing condition of the external market and the internal operations of the facility. The external market is a major determinant of how the resources are allocated, as it has an impact on the cost of such resources, including labor. For example, during the economic downturn, medical services became unbearably inaccessible due to high costs.
Similarly, the internal operations determine how the resources are allocated and distributed. The internal operations are bound to frequent changes as fits the managing board, and the business model of the care facility. Some of the internal operations that determine the distribution and allocation of resources include leadership and leadership roles, and the number of patients that the hospital can accommodate. Different leaders adopt different styles of leadership, which consequently impacts how the resources are spent and/or distributed.
Also, the number of patients seeking varied healthcare services varies, and has the potential to affect the distribution of resources. For example, the pediatrics unit may receive an influx of patients due to some external facilitating factors for a period of time. However, as the external facilitating forces are addressed, the department may not require a lot of resources.
Changes to Initiate in the Resource Allocation Process
Despite the systems and processes adopted by the care facility regarding resource allocation and distribution, the inefficiency still rages on, calling for better strategies in resource allocation by the executives. One change that I would institute in regards to resource allocation would be to lift the limit on spending by the various departments, while increasing oversight on how the resources are utilized.
Steven (2012) observed that the lack of a limit on the spending may encourage wastage by the staff. However, the limits may also lead to inefficient delivery of care, and increased cases of ethical dilemmas related to resource allocation. To increase efficiency in utilization of the resources while reducing wastage, I would lift the limit on how much a department receives in terms of resources, but increase oversight on how the resources are utilized.
Conclusion
In conclusion, resource allocation remains an elusive aspect in the healthcare industry due to scarcity. Different healthcare facilities utilize varying systems and processes in assigning resources to their departments. This paper analyzed resource allocation from the perspective of my practicum, focusing on the processes and systems. In addition, the paper analyzed the factors that determine the distribution of resources and the changes I would institute in practicum to enhance the process of resource allocation. The analysis was significant in understanding the process of resource allocation in healthcare.
References
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Hulshof, P. J., Boucherie, R. J., Hans, E. W., & Hurink, J. L. (2013). Tactical resource
allocation and elective patient admission planning in care processes. Health Care
Management Science, 16(2), 152-166.
Jakovljevic, M. B. (2013). Resource allocation strategies in Southeastern European health
policy. The European Journal of Health Economics, 14(2), 153-159.
Steven T. (2012). Ethics of resource allocation and rationing medical care in a time of fiscal
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