This is almost 20% of the gross domestic product (GDP), meaning that for every $5 spent in the federal budget, about $1 will go to healthcare. health care reached $3.0 trillion, or $9,523 per person ( Centers for Medicare & Medicaid Services, 2014).
Per capita health spending in the United States was 42% higher than Norway, the next highest per capita spender. In fact, it spends approximately 2.5 times more than the average of other high-income countries. The United States spends more on healthcare than any other nation. population has been escalating to the point at which federal and state budgets, employers, and patients are unwilling or unable to afford the bill ( Harris, 2014). Unsustainable growth in healthcare costs without accompanying excellence in quality and health outcomes for the U.S. Table Table1 1 provides an overview of key factors that have been driving healthcare reform.
Venture forthe director of nursing full#
This new health paradigm requires the nurse to be a full partner in relentless efforts to achieve the triple aim of an improved patient experience of care (including quality and satisfaction), improved outcomes or health of populations, and a reduction in the per capita cost of healthcare.ĭriving Forces for Change: Cost and Quality Concerns This article discusses the driving factors leading to healthcare transformation and the role of the registered nurse (RN) in leading and being a fully contributing member of the interprofessional team as we shift from episodic, provider-based, fee-for-service care to team-based, patient-centered care across the continuum that provides seamless, affordable, and quality care. To be a major player in shaping these changes, nurses must understand the factors driving the change, the mandates for practice change, and the competencies (knowledge, skills, and attitudes) that will be needed for personal and systemwide success. There are transformative changes occurring in healthcare for which nurses, because of their role, their education, and the respect they have earned, are well positioned to contribute to and lead. These shifts require a new or an enhanced set of knowledge, skills, and attitudes around wellness and population care with a renewed focus on patient-centered care, care coordination, data analytics, and quality improvement. Nurses are positioned to contribute to and lead the transformative changes that are occurring in healthcare by being a fully contributing member of the interprofessional team as we shift from episodic, provider-based, fee-for-service care to team-based, patient-centered care across the continuum that provides seamless, affordable, and quality care. As a nation, we have taken incremental steps toward achieving better quality and lower costs for decades. Greater coordination of care-across providers and across settings-will improve quality care, improve outcomes, and reduce spending, especially attributed to unnecessary hospitalization, unnecessary emergency department utilization, repeated diagnostic testing, repeated medical histories, multiple prescriptions, and adverse drug interactions. The Affordable Care Act includes programs now led by the Centers for Medicare & Medicaid Services aiming to improve quality and control cost. Caring for and paying for medical treatments for patients suffering from chronic health conditions are a significant concern. Cost and quality concerns along with changing social and disease-type demographics created the greatest urgency for the need for change. Factors driving healthcare transformation include fragmentation, access problems, unsustainable costs, suboptimal outcomes, and disparities.
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