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Mortality rate is the measure that is used to determine the health status of a given population. Over the years, the need to determine the mortality rate of any specific region has gained a lot of significance for most administrations across the globe. In specific, the unadjusted death rate, which is also referred to as the crude rate is determined by dividing the number of recorded deaths by that of the population that is deemed to be at risk in a pre-determined region. The result is however achieved by multiplying the results by some constant so that the result is not a fraction. The unadjusted death rate has been lauded as being a good measure for the overall magnitude of a population’s mortality level. The use of unadjusted mortality rate as an indicator of population health status is however deemed to possess its own flaws. Most significantly is that such an indicator has been deemed by many to develop a misleading impression. On the flip side, the unadjusted mortality rate is lauded as being a good measure of determining the overall magnitude of a population’s mortality. This significance is found to be vital in the eventual planning of health care services. A leading example is like if a population is deemed to have an high number of old people coupled by a high mortality rate, then the unadjusted mortality rate comes into handy to help in the planning for delivery if the needed health care services for this target population. As had earlier been noted, the unadjusted mortality rate has a noted flaw in that over time, the results by these rates may be misleading if there is a difference in the age composition of the population that is being compared. However, Anderson & Rosenberg note that it is without doubt that unadjusted mortality rate form a firm bases upon which to evaluate other rates, with the assistance of age standardization or what is referred to as age adjustment. The health care planning and decision making of an organization is also influenced greatly by the unadjusted mortality rate as it provides them with the simplest means for them to express the relative mortality risk as noted by Anderson & Rosenberg.

Florence Nightingale introduced public health and hygiene principal into nursing in her attempts to ensure proper care of wounded soldiers. Since then, there have been major strides in the domain of advanced nursing practices more so in the 20th century. More precisely, it is noted that nursing has in reality been one of the areas that have been in the forefront with regards to transformation within the healthcare domain. A change within the healthcare environment has also changed dramatically since the Nightingale era. More significantly, changes have been from an era where the population was made up mostly of persons with acute and infectious diseases to one that is aged and high rate of chronic diseases. On premise of the above excerpt, the new era of nursing is faced with the challenge of escalating costs in healthcare. In addition to this, there is also a rise in the number of people who are receiving poor services by the current health care services with the numbers expected to rise if the status quo is to withstand. This seemingly dangerous predicament is coupled amplified by the current shortages within the nursing sector as well as lack of proper leadership within the nursing domain. One of the ways that this foreseeable predicament can be altered is where the nursing provision services undergo some changes. As provided for in scenarios of page 24 of ‘Essentials of Health Economics Study Guide’.  In this case, the nurse hours and patient visits per day to a community clinic per day should be reduced so as to increase health care efficiency. The reduction would facilitate the improvement of health care production, lower the costs of health care provision and that of the supplies that are used. Such a shift can be witnessed as it is imperative that health care facilities inevitably do make purchases for all the provisions that are needed by the nurses, with little or no discussion amongst all the parties as to the costs that are perceived therein. In light of this, the community clinic can embark on gain sharing programs as a way improving the means through which the cost of supplies is undertaken. Despite several legal barriers to this, where the system is transparent and efficiently monitored, there would be a drastic reduction in the cost of health care provision.

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An effort to describe technology imperative can only be attained with an understanding as to the history of medicine. Such a history has in part, a track record in the development of medical technologies as well as the effect of the same on the care provided to patients. Economist Fuchs (1968) coined the term “technological imperative”, in an effort to describe the then and up to date noted tendency within the field of medicine to lay their priorities on the development and usage of new and emerging technologies with little regards of the costs that would be incurred in so doing. Since Fuchs’ definition, a lot of efforts have been put by scholars to further develop upon the concept. Such efforts have primarily been towards the understanding in their complexities technology as well as attempting to place the phenomenon within different social contexts. Such research was developed around concepts like contingent, processes of technology design that were socially embedded as well as the agential forces that were exerted through technology upon the social practices and institutions as well; where the same was meant to also include and at the same time extend the fields of healthcare. Notably further, changing medical environment having continuously affected the ability to deal with the escalating costs in medical care. This is because most of them present different aspects that are unique to their environment making it hard to develop conclusive results. In other cases, the changes are so diverse as to allow the risks that are involved therein to be subjected to some cases. A leading example is the development of HIV/AIDS vaccine, which the effect of having any human trials can only be subjected to such stiff scrutiny due to the effects of the disease itself. In contrast however, there have been paradigms that are of the opinion that technology imperative, which has also borne the name bio-medicalization, has shifted its emphasis from treating the ailments of the patients to that of service provision to customers. Such notions have evolved to what Clarke et al. (2003) refer sarcastically to as ‘Biomedical TechnoService Complex, Inc.’. there are shared views that the phenomenon of technology imperative has transformed to a new colonial era in the medicine world as well as the commodification of the health services coupled by concomitant expansions being witnessed within the political economy that pre-exist within the healthcare sectors.

The scenario arising from the case of For Profits Labs, Inc. (FPL) indicates a competitive market where the company, FPL seemingly is the most profitable. With reference to the fact provided that most companies in the business make a return of 10 per cent of their assets, FPL is making huge turnover as its assets range at $8 million, but makes a return of $1 million as compared to $800 000 as would have been had they made the 10 per cent expected within the industry. Another notable aspect in this market is that the industry has very few firms, and further, whereas the firms in business charge around $300 for blood counts they pay their technicians about $20. In the long run, there will be an eventual undercutting by the firms in an attempt to attract more clients as their profit margin is considerably high. The market will thus experience more competitors as the business is seemingly with potential for competitors, and a high probability for the firms to lower the blood counts charge and or raise the amount paid to the technicians. Another probable future is there being more restrictions in the business. In an attempt to avoid an escalation in the pay demanded by the technicians, the firms could develop binding contracts with the technicians to exclusively work with their firms within specific periods of time.

Medicaid was created in 1965 and the program has had the participation of all the states since 1982. The program assists over 70 million people with about 60% of the total payments being towards the aged the blind and persons with disabilities. The program, Medicaid, is an all-federal program, but is jointly operated by the states and administered by the states. The program is however been faced with an ever increasing pressure of the number of people it has to cater for. Over time, the number of people eligible to be covered by Medicaid is increasing way faster than the inflation rate. This has been seen as the greatest pressure that faces the program due to the fact that the fiscal burdens that befall the federal and state have increased generally. The current state of affairs could however worsen if action is not taken soon. One way that would considerably ease the current pressure would be to develop policies that would conceivably place the total responsibility of Medicaid under the federal government. Such policies would lead to considerable savings in the administration of the program and offer greater consistency in the program’s coverage. Inherently, the fiscal position of the federal government would worsen on one hand but easing that of the states on the other.

In the United States, the healthcare system is complex. The complexity is furthered by the payment methods, which research shows threatens the future of medicine in the country. Reimbursement refers to the process of compensating or repaying for the health care services offered. One of the most common reimbursement systems in place is the fee-for-service reimbursement. This method provides for the payment for each of the services that have been provided for to the service providers. This system is further characterised by different methods through which they can be serviced. These can be; self-pay, retrospective payment and lastly managed care. This system provides that a physician determine the condition to be treated. The patient or the provider submits a claim and where the service is found to be covered by the policy, the patient or the provider is reimbursed. This system is however disadvantaged by the fact that the fee-for-service plan tends to have higher deductibles or co-payments as compared to other health insurance plans. Another disadvantage is that the health insurance plans find the fee-for-service plan as being uncertain. This is because the reimbursement costs to the providers is generally unknown as the services that are provides to the patients are also unknown.

Sanofi is one of the pharmaceutical companies that have received a lot of criticism in the recent past. Such criticism is however not new to the industry which has received sharp criticism for a variety of reasons with such assertions being supported by Relman and Angell. The article goes to great lengths to describe the misdeeds of the pharmaceuticals. In light to the contents of the article as to how the American community has continuously costly fees for less than innovative therapies, the criticism towards Sonafi are edged towards similar claims. The said criticisms came after the company increased the price of one of their drugs, Ambien (Tesoriero, 2008). The American society is one whose economy is based upon capitalistic principle and as such advocates for market liberties. The American community however found this increase in price as an abuse to the capitalistic principles as it was augmented upon their loss of patent protection rather than market forces. Such acts are deemed to be as an abuse of capitalistic notions as their sole purpose is to force the consumers to shift to purchasing other similar products in their attempt to monopolise the future markets. This was actually the case as the move was meant to encourage the patients to shift to buying Ambien CR.

Cancer has been termed as one of the highest causes of death in the world today. The globe over, pharmaceuticals are in a frenzied attempts to try and contain this chronic disease. One of the types is ALK-positive lung cancer, whose mortality rate is just as high as any other cancer. In most cases, patients are taken through chemotherapy and put in drugs in an attempt to lessen the symptoms, but there has been no conclusive cure. This has thus been one of the areas that attempts have been made to make headway. Recently there have been trials on a targeted therapy referred to as crizotinib being carried out in Vienna, Austria. The results of phase III have shown that crizotinib is more effective in treatment as compared to the standard chemotherapy that is offered to patient suffering from advanced stages of ALK-positive lung cancer. The standard chemotherapy was conducted using pemetrexed or docetaxel.  With the efficacy and safety studies being carried out on 347 globally randomized patients, the study proved that crizotinib led to a prolonged progression-free survival to a median of 7.7 months.  This was an improvement from the 3.o months that was experienced from patients under chemotherapy.

Challenges in establishing a system through which compensation for physicians can be adequately affected is one that has been recognised from the days of formalized medical practice. One of the most common means of paying physicians is fee-for-service approach. Under such a plan, the physician is compensated for each and every other service that they provide to their patients. In the case of outpatient setup, in the case of reimbursing for a routine office visit, results in the physician being awarded a fixed payment. Another model is the capitation model. Under this method, the physician is paid a fixed dollar amount for each and every patient that seeks care under their practice within a specified period of time. Several factors are relied upon to determine the dollar amount per patient. This may range from the calculation of the average demographic, the patient’s healthiness and the range of services that the physician can offer. The third one is where they are compensated via an annual salary. This is commonly practiced for hospital-based physicians as well as large practices. This system offers a fixed salary to the physicians regardless to the number of patients they attend to in the course of the year.

Cost effective analysis is the family of analytic techniques that are designed in order to assist in comparing two or more alternate courses of action with reference to their costs and outcomes. The article ‘Health policy analysis: Pharmaceutical Priority Setting and the Use of Health Economic Evaluations: A Systematic Literature Review’ however has failed to elaborate on defining the term so as to bring to light a person who first comes across the term understand it in its full length (Sandra, undated).  This is a complete contrast to several other journals on the same topic. The article is however of great assistance in explaining how cost effective analysis are applied in the medical field. The article does not only give theoretical approaches to the concept but also offers analytical data to the same. This last aspect of the article makes it recommendable for people with prior knowledge as to the concept of cost effective analysis to understand how to utilise the concept in the health industry. Another positive side of the article is that it has examples on how the concept has been utilised in the development of health policies which is the core purpose of cost effective analysis.

Health care professionals, like other professions need have effective communication skills so as to expedite their services efficiently and effectively.  These skills, communication skills, can either be verbal or non-verbal. Where verbal, the communication needs to be in a language that is well understood by those it is addressed to and also communicated in a manner that is acceptable to the target audience. On the other hand, non-verbal communication requires a lot of care as in most cases could lead to misunderstanding and wrong impressions innocently. In light of this, the personal presentation, body language and other aspects of non-verbal communication need be well addressed. Amongst the health professionals, speech and written communication have however been deemed as some of their greatest weaknesses in communication. Interchangeably, the two relate each other in the weakness. This is because, the services of those in the medical field is directed towards their patients. However, more often than not, those in the medical profession speak and write in terms that most of their patients, more so those not privy to the medical terminology. Those two weaknesses are a great setback to the profession as in most cases, those who are supposed to be the consumers of the information are left without an understanding as to the message relayed to them unless the information is interpreted to them in simpler and understandable language to a layman.

Technology in the world of medicine has improved tremendously over the recent years.  However, despite the sophistication that has been witnessed in this field, communication has remained as being the primary means through which doctors and patients are able to exchange information. For this reason, the demographic and ethnographic factors that are play therein are at all an important factor for there to be considered for effective communication to be practiced. According to Joan Engebretson, effective communication can only be manifested if demographic and ethnographic considerations are considered. With reference to her article, such considerations can also be applied not only when dealing with clients but can also be passed on to the workplace. Bearing in mind that the workplace is made up of people from diverse demographic and ethnographic backgrounds, by ensuring that these diversities are considered, the workplace can become a place where effective communication is practiced. One way to ensure that this is practiced is by ensuring that all the workmates are aware of the different demographic and ethnographic diversities within the workplace. Further to this, the workmates should also ensure that when communication with colleagues from different demographic and ethnographic backgrounds, they are addressed with respect to such diversities.

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