Analyze one or more barriers in the U.S. healthcare delivery system related to cost, quality, and/or access that are evident in your selected case study.

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Analyze one or more barriers in the U.S. healthcare delivery system related to cost, quality, and/or access that are evident in your selected case study.

A person’s health may be greatly impacted by his or her access to timely, appropriate care. Yet, in the United States, there are marked differences among the quality of services that are available and each individual’s use of those services. The cost of healthcare, for instance, can greatly influence a person’s decision to visit the doctor or fill a prescription. What other factors impact healthcare-related decisions? In this Discussion, you will read three case studies that illustrate dilemmas related to cost, quality, and access to healthcare, and consider the potential influence these can have on a person’s health, financial standing, and quality of life.

To prepare for this Discussion:

Read the Week 2 Discussion Case Studies.
Select one case study on which to focus for this Discussion.
Review the information presented in the Resources, including Chapter 12 in the Shi and Singh (2015) course text and the two resources you selected.
Reflect on your selected case study and consider the following questions:
Which barriers in the U.S. healthcare delivery system related to cost, quality, and/or access are evident in the case study?
How could these barriers be addressed?
How does the use of insurance influence concerns or decisions related to cost, quality, and/or access to care for the person in this case study?
Post by Day 4 a substantive and cohesive response to the following:

Analyze one or more barriers in the U.S. healthcare delivery system related to cost, quality, and/or access that are evident in your selected case study.
Describe a potential solution for each barrier you have identified.
Explain how health insurance may influence concerns or decisions related to cost, quality, and/or access to care for the person in your selected case study.
Reminder: Be sure to cite your supporting documentation appropriately in correct APA format.

Readings
Shi, L., & Singh, D. A. (2015). Delivering health care in America: A systems approach (6th ed.). Burlington, MA: Jones & Bartlett.
Chapter 12, “Cost, Quality, and Access” (pp. 464–500)
Document: Week 2 Discussion Case Studies (PDF)
Select at least two resources from the following list (not Optional) to research topics for your Discussion posting and responses.

Centers for Medicare and Medicaid Services. (n.d.). Linking quality to payment. Retrieved from http://www.medicare.gov/hospitalcompare/linking-quality-to-payment.html?AspxAutoDetectCookieSupport=1
Gold, J. (2014). FAQ on ACOs: Accountable Care Organizations, explained. Kaiser Health News. Retrieved from http://kaiserhealthnews.org/news/aco-accountable-care-organization-faq/
Levi, J., Segal, L. M., Fuchs Miller, A., & Lang, A. (2013). A healthier America 2013: Strategies to move from sick care to health care in the next four years. Retrieved from http://www.kresge.org/sites/default/files/Trust-for-Americas-Health.pdf
U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion, Healthy People 2020. (2015). Foundation health measures. Retrieved from http://www.healthypeople.gov/2020/about/tracking.aspx
Optio

 

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COMPUTE THE AMOUNT OF SOCIAL SECURITY TAX TO BE WITHHELD FROM EACH EMPLOYEE’S GROSS EARNINGS. ASSUME A 6.2 PERCENT SOCIAL SECURITY RATE ON THE FIRST $122,700 EARNED BY THE EMPLOYEE DURING THE YEAR.

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COMPUTE THE AMOUNT OF SOCIAL SECURITY TAX TO BE WITHHELD FROM EACH EMPLOYEE’S GROSS EARNINGS. ASSUME A 6.2 PERCENT SOCIAL SECURITY RATE ON THE FIRST $122,700 EARNED BY THE EMPLOYEE DURING THE YEAR.

Alexander Wilson operates Metroplex Courier and Delivery Service. He has four employees who are paid on an hourly basis. During the workweek beginning December 15 and ending December 21, 2019, his employees worked the number of hours shown below. Information about their hourly rates, marital status, and withholding allowances also appears below, along with their cumulative earnings for the year prior to the December 15-21 payroll period. INSTRUCTIONS 1. Enter the basic payroll information for each employee in a payroll register. Record the employee’s name, number of withholding allowances, marital status, total and overtime hours, and regular hourly rate. Consider any hours worked beyond 40 in the week as overtime hours. 2. Compute the regular, overtime, and gross earnings for each employee. Enter the figures in the payroll register. 3. Compute the amount of social security tax to be withheld from each employee’s gross earnings. Assume a 6.2 percent social security rate on the first $122,700 earned by the employee during the year. Enter the figures in the payroll register. 4. Compute the amount of Medicare tax to be withheld from each employee’s gross earnings. Assume a 1.45 percent Medicare tax rate on all salaries and wages earned by the employee during the year. Enter the figures in the payroll register. 5. Determine the amount of federal income tax to be withheld from each employee’s total earnings. Use the tax tables in Figure 10.2 to determine the withholding for Russell. Withholdings are $112.00 for Bahamon, $323.00 for Garcia, and $258 for Price. Enter the figures in the payroll register. 6. Compute the net amount due each employee and enter the figures in the payroll register. 7. Total and prove the payroll register. Bahamon and Russell are office workers. Garcia and Price are delivery workers. 8. Prepare a general journal entry to record the payroll for the week ended December 21, 2019. Use 32 as the page number for the general journal. 9. Prepare a general journal entry on December 23 to summarize payment of wages for the week. Analyze: What percentage of total taxable wages was delivery wages? View Solution:
Alexander Wilson operates Metroplex Courier and Delivery Service He has

 

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Explain how you would approach a family who wants “everything” done for a patient with only a limited time to live. Modify my post

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Explain how you would approach a family who wants “everything” done for a patient with only a limited time to live.
Modify my post

Question: An explanation of the role of the advanced practice nurse in facilitating the discussion of end-of-life care with patients and their families. Explain how you would approach a family who wants “everything” done for a patient with only a limited time to live. Then, explain when it is appropriate to involve hospice and how to approach patients and/or families who refuse hospice services. Finally, explain potential outcomes of the patient in the case study you selected and how you would facilitate the discussion of end-of-life care with this patient’s family. We are in a unique position to guide patients and their families through an increasingly complex health care system toward the goal of a “good death” one that is comfortable and self-determined.

Answers:

An explanation of the role of the advanced practice nurse in facilitating the discussion of end-of-life care with patients and their families

With the aging of the US population, the number of seriously ill patients with complex conditions is expected to rise and the overwhelming majority of deaths occur among the older adult population. Older adults typically die slowly of chronic diseases, with multiple coexisting problems, progressive dependency on others and heavy care needs that are met mostly by family members. The dilemma of end-of-life care becomes a crucial issue for the advance practical nurses. As a nurse practitioner, we have a crucial role in facilitating end-of-life care discussion with patients and families. It is not that easy to explain to them about hospice or comfort measures. A lot of patients and families have misconception about end-of-life care. They are thinking about the literal word of killing or giving up someone’s life. We are here to assist elderly patients with their advanced chronic illness and their families as they experience the final phase of life. We are here to serve the patients and family members caring for patients to promote excellent communication with family, encourage appropriate advance care planning and decision making, support home care, demonstrate empathy for family emotions and relationships, and attend to family grief and bereavement (Rabow, 2004). We should have the ability to listen which is the most valuable skill that can be used and allow them the opportunity to tell “their story.” End-of-life issues are very sensitive. That is when we are all most vulnerable, cared and thinking of what we did or did not do in our lifetime. NPs who can be empathetic and “be” with the patient at this very important time will have one of the most rewarding experiences of their career (Knox, 2010).

 

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EXPLAIN HOW YOU THINK YOU WOULD REACT IF, NOW OR IN THE FUTURE, YOU DISCOVERED THAT YOU WERE INFERTILE.

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EXPLAIN HOW YOU THINK YOU WOULD REACT IF, NOW OR IN THE FUTURE, YOU DISCOVERED THAT YOU WERE INFERTILE.

1.) Explain how you think you would react if, now or in the future, you discovered that you were infertile. What do you think you would do about having children? Would you have children or did you do to have children? Explain in detail. In addition, if you already experience this, please, explain how you reacted and what did you do about having children? Did you have children or did you not have children? Explain in detail.

2.) Discuss your attitudes and opinions about gay and lesbian couples having children through assisted fertility techniques or through adoption. Explain in detail.

3.) Picture groups of kindergarten boys and girls playing on the playground at recess. List at least three clear differences you are likely to see in the groups’ activities, interactions, and behaviors. Based on what you’ve read in this chapter, what might explain these differences? Explain in detail.

4.) Imagine you are looking for a new romantic relationship and you meet someone with whom you really it off. You enjoy the same activities, you share similar attitudes and beliefs, and you find each other physically and sexually attractive. As the relationship progresses and begins to grow more intimate, your new partner confides in you that he or she is transgender and has undergone sex reassignment surgery. How do you think you might react to this news? What do you think might happen from that point on in the relationship? Explain in detail.

5.) Imagine that you wake up tomorrow morning and your sexual orientation has changed (from straight to gay, from gay to straight, or from either to bisexual, etc.). Discuss how you might feel about such a change and how such a transformation would alter your life and your view of the world around you. Explain in detail.

6.) Imagine for a moment that you are the parent of a son or daughter (your choice) who informs you that he or she is gay. How do you think you would react? What would be the three most important things you would want to tell your child after hearing the news? Explain in detail.

 

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