Introduction
The prevalence of Affordable Care Act (ACA) has reduced the healthcare cost and has extended the eligibility of Medicaid for 32 million Americans. The effect of Medicaid on the healthcare of elderly remains hindered due to the lack of access to care, whereas its effect on the healthcare outcomes have remained optimum and children (Fairman et al., 2011). The combined objective of Medicaid in accordance with the Affordable Care Act incorporates the provision of healthcare services to the low-income parents, children, pregnant women and disabled individuals and hence, the healthcare services for the nondisabled adults are not addressed by their combined objective of healthcare. In this manner, the access to care due to the financial constraints of elderly has been addressed at the state and federal level in order to increase the extent of healthcare services to the elderly (Sommers et al., 2012).
The access to care is not dependent on the financial constraints but its effective availability requires the access to healthcare practitioners and sophisticated and hygienic clinical environment to incorporate the healthcare services (Fitzpatrick, 2010). The access to care is also observed to be hindered among the elderly who do not have children or family members to address their healthcare needs and assist them accessing the healthcare services. It eventually indicates the lack of access to care among elderly in urban and rural areas (Fairman et al., 2011). The current paper enlightens the concern of hindered access to care for elderly and aims to discuss the scholarly articles in order to draw practical ideas for practice in this case.
Discussion
The study conducted by Sommers et al. (2012) indicated that the financial services provided by Medicaid and ACA have reduced the mortality 19.6% per 100,000 adults which eventually indicates the effectiveness of these healthcare initiatives. The decrease in the mortality rate is highly observed among the older adults due to the prevalence of insured and cost effective healthcare services. However, the reduction in mortality rate is observed to highly imperative to the hindering rate of delayed care due to the prevalence of financial assistance. In this manner, the decrease in mortality rate is observed due to reduced financial constraints for the adults.
The access to care incorporates the provision of healthcare services to the individuals who are not able to access the healthcare services on their own. The prevalence of chronic and long-term morbidity rate is found to be high among the elderly which requires the on-going treatment, consultation and care, which is irrespective of the cost advantage provided with the Medicaid and ACA. The demand for the primary care has been increased due to the low cost of healthcare due to which it is not possible for the available clinicians and physicians to engage in the treatment and care provision activities and hence, their role has become limited to consultation (Fairman, 2011).
This situation has threatened the wellbeing of the elderly because their treatment plans are needed to be maintained, enhanced and improved in accordance with their healthcare status. Similarly, their mobility issues refrain them from engaging in the on-going healthcare practices in order to address their healthcare issues. In this manner, it has shifted the dimension of nursing practice to the provision of holistic care to the patient in order to address the accessibility issues faced by the elderly. The nursing practitioners have been encountered with the public stance in order to ensure the access to care in an effective manner (Fairman et al., 2011).
It is estimated that the growing aging population will increase the demand for long-term care facilities and nursing personnel in order to meet their healthcare objectives. Similarly, the increased access to insured healthcare services by means of the financial assistance has increased the prevalence of minority and ethnic groups in accessing the healthcare services due to which it has become necessary to provide the adequate means of care to address the need of the diverse population. However, the issue related to the access to care remains consistent, even increased, due to the objectified inclination towards the diverse population, which also incorporates the care in rural areas (Fitzpatrick, 2010).
The shortage of primary care professionals has made the access to care stagnant due to the lack of availability of healthcare experts to provide healthcare services. In this way, the prevalence increased of financial assistance has provided the general public with the adequate access to approach the healthcare services, which has increased the demand of healthcare services and hence, it has failed in ensuring the availability of healthcare services to the individuals. It is suggested by the scholars that registered nurses and nurse practitioners can contribute in enhancing the access to care on the basis of their academic skills, trainings and professional experience (Fairman et al., 2011).
The dimension of access to care can be increased by mobilizing the nursing practitioners in order to provide care to elderly patients by means of observing, monitoring and improving their care plans in order to achieve their healthcare objectives. The access to care entails the objective of ensuring that adequate access to care is provided to the individuals and if the individuals cannot approach the healthcare facilities then the access to care should be maintained be providing them with the adequate alternatives. In this manner, the nursing practitioners and registered nurses can play a prominent role in enhancing the access to care to elderly patients (Sommers et al., 2012).
The possibility of effective access to care to immobilized and elderly patients can be addressed by the effective integration of the nursing practitioners with the primary care staff. It will help in providing the adequate direction to the nursing staff in accordance with the patients’ healthcare needs will ensure the provision of healthcare services. It is also considered as the cost efficient means of addressing the access to care due to the prior knowledge, experience and skills of the nursing staff in providing care. It is high time that the clinical and healthcare experts focus on addressing the increasing demand of healthcare services rather than maintaining monopoly in providing primary care via consultant physicians and clinical experts (Fairman et al., 2011).
Conclusion
The prevalence of Medicaid and ACA has enhanced the individual’s ability to address their healthcare needs, which has increased the demand of clinical staff in order to provide the healthcare services. In this manner, the prevalence of cost efficiency in the healthcare services has increased the accessibility concerns due to the lack of available clinical staff. Similarly, the access to care also remains hindered for the elderly patients, who face immobility issues due to chronic diseases and old age, and require the on-going observation and care (Sommers et al., 2012). Therefore, the certain ideas for practices are determined to address the issues related to the access to care in which it is considered essential that the nursing staff should be provided with the adequate training in order to address some expects of primary care. The nursing staff can also be assigned to visit the immobile elderly patients in order to check on the effectiveness of the care plans and incorporate necessary changes in their care plans in order to ensure their objectivity towards the positive healthcare outcomes. The integration between nurses and physicians is also suggested so that the monitoring and enhancements in the care plans can be incorporated by the nursing staff and adequate healthcare services can be provided to the patients in a timely manner (Fitzpatrick, 2010).
References
Fairman, J. A., Rowe, J. W., Hassmiller, S., & Shalala, D. E. (2011). Broadening the scope of nursing practice. New England Journal of Medicine,364(3), 193-196.
Fitzpatrick, J. J. (2010). The future of nursing: Leading change, advancing health. Nursing Education Perspectives, 31(6), 347-348.
Sommers, B. D., Baicker, K., & Epstein, A. M. (2012). Mortality and access to care among adults after state Medicaid expansions. New England Journal of Medicine, 367(11), 1025-1034.
