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Hospitals face a variety of financial challenges as the most utilized of health care settings. In recent years, exterior factors have caused hospitals to experience less frequent admission rates, length of stay, financial backing for the increased prices of certain procedures, and bad debt losses (Gapenski & Reiter, 2016). This has resulted in a decrease in the number of operational hospitals. Additionally, while a variety of hospital infrastructure exists, certain financial challenges remain universal between establishments. For instance, due to the labor intensiveness of a hospital, organizations are required to increase staffing and reduce the chances of being without available employees. Similarly, the provision of services or equipment may be the responsibility of the hospital and require a financial investment.
Ambulatory, or outpatient, care refers to services that are offered to patients that have not been institutionalized within a hospital setting. The rise and improvement of modern ambulatory care can be attributed to the advancements made by recent technology. These include transportation as well as mobile equipment, which are often costly for a healthcare organization. As such, ambulatory care services require substantial financial investment into equipment and services that can be administered in outpatient settings. Generally, outpatient or ambulatory care provides patients with less expensive alternatives to inpatient care, which suggests that the financial outcomes of this health care setting are also decreased.
Home health care poses a number of unique challenges in terms of finance. First and most important, medical homes require the attendance of a personal physician. The issue associated with this includes shortages of available professionals, the ability to formulate a continuous relationship and comprehensive care, and an organizations capability in providing such physicians with resources and payments. Second, because a physician is responsible for the care of a patient in a medical home in their entirety, equipment, medication, and specialization will also provide a financial burden. Third, work done outside hospital settings will also involve enhanced access to information and resources. While a database may allow for this access, its creation, maintenance, and usability will also be affected by financial factors.
Long-term care refers to services provided to patients that have some form of limitations in terms of functional ability. Due to the fact that such care can be both in and outpatient, certain financial challenges mentioned prior apply equally. However, due to certain other factors such as required care, frequency of care, and length of care, financial elements may differ. Commonly, patients include the elderly, which may require services of nutrition, hygiene, and mobility. On the other hand, some more specific but less common patient challenges may require more financial investment either through equipment, services, or medication. Due to the fact that long-term care prioritizes ongoing treatment, extended time spent on such procedures also increases the likelihood of financial expenses.
Integrated delivery systems, or IDS, imply the provision of the aforementioned services as well as business support through one entity. An IDS primarily aims to provide necessary services to a specific population at cost-efficient pricing. As such, an IDS poses managerial, financial challenges as well as those that come with implementing the system. Due to the size of an IDS, managers would be required to observe the overall interaction between the different health care settings. This may result in increased costs either through the purchasing of new equipment, organizational systems, or payments to managerial staff.
The implementation of an effective and competitive IDS would require the limitation of unnecessary services, which can pose a financial difficulty to the organization. Additionally, the introduction of a new format would require a universal and comprehensive organizational tool or database. Any integration process must overcome barriers, such as legal limitations, budget capacities, and structural obstructions in order to see successful implementation. As such, an IDS would have to face these issues while mitigating financial risks in order to provide a complete and cohesive integration.
Reference
Gapenski, L. C. & Reiter, K. L. (2016). Healthcare Finance: An Introduction to Accounting and Financial Management. 6th e.d. Health Administration Press.
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