Hospital Risk Recommendation and Analysis

1. Make at least two recommendations for improving the timing and accuracy of financial and management risk. Provide specific examples to support your response. Analyze the categories of cost drivers and associated risks (genetic risks, biological risks, behavior risks, and environmental risks) and determine which of the four should receive the most focus when addressing public health concerns such as infectious diseases. Explain your rationale.

To improve the timing and accuracy of financial and management risk, focusing more on individual training and augmenting the safety and reliability of machines would be a decent solution. While machines provide ease of use and possibly are more efficient, they lack the personability of human caregiving and are still fallible in their diagnoses. For example, “Managing the unexpected is an essential everyday concern in high-risk organizations” (Briner, Kessler, Pfeiffer, Wehner, & Manser, 2010, para. 5), and their accuracy is entirely dependent on execution cost driver such as maintenance or personnel to operate the machinery. They are also subject to structural cost drivers. Therefore, actually procuring the machinery is a matter of economics and all that entails such as the scope of the technology, its complexity, and usage. Cost drivers are essentially units and fundamental foundations of the cost of a particular activity that illustrates the relationships that affect the activity, like the specialist’s utilization of the machine or maintaining it. With Constructive Technology Assessments (CTA), “choices are constantly being made about the form, the function, and the use of that technology” (Retèl, Joore, Linn, Rutgers, & Van Harten, 2012, para. 9). Therefore, this also applies to develop technology and financial viability. 

When addressing public health concerns, environmental risks should receive the most focus. While genetic risks, such as alcoholism, can influence one’s life, this is mostly dependent on the environment in which an individual chooses to be in. The same could be said of behavioral risks because they also receive much influence from an individual’s environment. On the other hand, biological risks such as AIDS/HIV are the odd man out. While they do not completely adhere to the individual’s environment, they are still subject to an individual’s behavior, which in turn is subject to their environment. With that said, it seems that an individual’s environment will decide all of the other risk factors and his or her severity.

2. Analyze the four options that can be used to compare costs and effects of a particular program in a world of limited resources (positive health effects, negative health effects, positive costs, and negative costs) and determine which one is the most useful overall. Provide specific examples to support your response. Analyze the concept of “quality-adjusted life years” and determine if you agree with this approach to prioritize health services programs. Explain your rationale.

Although positive health effects would be the most altruistic answer, they might not be the most useful. On the other hand, comparing cost effects would suggest that optimizing the cost of a particular program is the most effective one considering the demand for health care as opposed to our limited resources. Negative health effects and negative costs simply do not seem conducive to practicality. Rather than seeking out solutions, they are more of a preventative measure. However, using the model of quality-adjusted life years (QALY) renders cost effects as a more utilitarian choice that depends on the health and personal feelings of a patient. Basically, QALY is a tool to calculate the measure of a person’s life quality and quantity. 

Arguably, there are states of health that could potentially be considered worse than death. For example, a patient may decide that paralysis, blindness, amputation, or a number of other lifelong disabilities, physical or mental will increase the amount of time they would not live in full health, so he or she might consider that to be a worse state. In other words, we cannot really define good health as a universal term, and, at the same time, we need to consider if adding years to a patient’s life is really what he or she wants. If this is the case, then negative health and cost values could feasibly be considered; however, this would most likely be a case-by-case basis and the severity of each case. At that point, it becomes a question of accomplishing the greatest amount of good with the smallest amount of pain. So, in actuality, prioritizing positive health effects would be the best solution while leaving room for patients’ decisions. While QALY remains a controversial debate, prioritizing programs is the only way, thus far, that allows us to utilize our limited resources to treat the ill. 

References

Briner, M., Kessler, O., Pfeiffer, Y., Wehner, T., & Manser, T. (2010). Assessing hospitals' clinical risk management: Development of a monitoring instrument. BMC Health Services Research. Retrieved from https://bmchealthservres.biomedcentral.com/articles/10.1186/1472-6963-10-337. doi: 10.1186/1472-6963-10-337

Retèl, V. P., Joore, M. A., Linn, S., Rutgers, E. J., & Van Harten, W. H. (2012). Scenario drafting to anticipate future developments in technology assessment. BMC Research Notes. Retrieved from https://bmcresnotes.biomedcentral.com/articles/10.1186/1756-0500-5-442. doi: 10.1186/1756-0500-5-442