Introduction
In many populations, various factors influence access to and the provision of appropriate care for patients. One of those crucial and critical factors is medical care coverage. In the areas of poverty throughout the United States, many people have limited or no access to medical care coverage. Populations at the poverty level often choose not to seek medical care for existing health problems due to the lack of ability to pay for the treatment they receive. This is a global problem that, unfortunately, requires significant and effective intervention.
Throughout this project outline, we will explore methods to identify changes and provide recommendations for moving forward. All patients deserve to have equal care, especially when it comes to their health. By utilizing the Quality and Safety Education for Nurses (QSEN), we will also investigate implementing a plan to assess ways to establish quality improvement, safety, informatics, teamwork, and collaboration, as well as evidence-based practice, in relation to issues of medical care coverage.
In this population health intervention project, several steps will be taken to gain an understanding of ways to limit the raised problem. First, an overview of the selected population, which suffers from a lack of medical care coverage, will be conducted. Then, disease-specific data will be provided, which will show the most common issues with the well-being of individuals.
Based on the knowledge gained, several Interventions will be proposed that can be beneficial in minimizing the problem of medical care coverage. In addition to these aspects, the project also considers the setting, budgetary needs, funding sources, and timeline for implementation. In the final part of the work, methods for evaluating future initiatives and a biblical worldview will be provided, which is critically important when considering and resolving issues concerning people.
Overview of the Selected Population
The first step of this research paper is to determine the population on which the paper will focus. In this case, particular importance is given to the population that lives below the poverty level. To gain an understanding of which areas fall into this group, it is necessary to refer to statistical data. Research showed that “Mississippi takes the top spot with an 18.70% poverty rate, Louisiana ranking second with 17.80%, New Mexico has a poverty rate of 16.80%, while West Virginia secures the fourth spot at 15.80%.” (“Poverty rate by state,” n.d., para. 5). This disappointing information determines the criticality of the situation and shows that at the moment a large number of individuals may not have health insurance.
When considering the impossibility of obtaining medical care coverage in rural areas with lower incomes, it is also worth paying attention to the income of the population. Additionally, it is emphasized that “an estimated 112 million (44%) American adults are struggling to pay for healthcare, and more than double that number (93%) feel that what they do pay is not worth the cost” (“112 million Americans struggle to afford health care,” 2022, para. 1). In particular, Black and Hispanic populations are experiencing difficulties with access to medical services not only due to economic but also social barriers and challenges in the modern society.
In the context of this population, it is crucial to observe and apply the QSEN competencies for patient-centered care. This is because, according to them, nurses face the task of involving individuals in the decision-making process regarding the treatment process (“QSEN competencies,” 2022). This competence entails considering the needs of each patient and providing tailored assistance accordingly.
Disease-Specific Data
A review of diseases prevalent in poverty areas showed unsatisfactory results. This is because in these areas, due to the low socioeconomic status and problems with access to health services, people suffer from many different diseases. Among issues associated with or caused by being poor can be distinguished pneumonia, AIDS, malaria, and tuberculosis (The Global Fund, 2021). Research stated that almost 12 million residents of the United States of America live with at least one neglected parasitic infection (Hotez & Booker, 2020). Furthermore, many of these individuals reside on the Gulf Coast, encompassing states such as Alabama, Texas, Louisiana, Mississippi, and Florida (Hotez & Booker, 2020). The primary and disturbing problem is the fact that this kind of disease has a long-lasting effect, which may present difficulties in implementing measures to combat it.
It is worth noting that there are certain healthcare trends specific to these areas that are leading causes of death. In addition to the previously mentioned lack of income, indicators such as institutional racism and discrimination are of particular importance. The Healthy People 2030 report showed that “residents of impoverished communities often have reduced access to resources that are needed to support a healthy quality of life, such as stable housing, healthy foods, and safe neighborhoods” (“Poverty,” n.d., para. 3). This circumstance causes that these individuals find themselves in a situation of unequal social and economic opportunities.
Another factor is the unmet social needs of individuals, despite evaluations and research in OECD Health Statistics (2022) highlighting an average health expenditure growth of 5% in 2020. Due to the lack of ability to meet these aspects, patients have many health problems, which require treatment and significantly reduce their quality of life.
Suggested Intervention
One of the proposed interventions that can contribute to resolving the problem is improving the ongoing physician shortage. This issue has been relatively permanent and relevant for the United States of America recently. This is because there is a shortage of medical institutions with specialists who can serve the population. After the global pandemic, many medical facilities have struggled to obtain specialists to work for them. Due to this circumstance, individuals often have to wait a long time for the opportunity to visit a physician and receive high-quality care.
Thus, to simulate the problem of the ongoing physician shortage, medical school enrollment is necessary. This step will provide an opportunity to increase the number of qualified specialists who can work in areas with patients of low socioeconomic status. This measure may also require significant financial investments from the State and other interested parties. Therefore, it is necessary to develop programs to attract more investors to educational institutions.
The second proposed intervention is the implementation of telehealth and remote patient monitoring models. Research stated that it is “an essential, cost-effective and reliable means to expand capacity in a health system marked by significant and persistent specialty shortages and geographic disparities” (“5 ways to improve access to health care,” 2023, para 11). In addition, this initiative will provide an opportunity to increase the number of patients who can be treated, as some will be able to be monitored with the help of new technologies.
The following intervention that can be useful in combating the situation under discussion is to increase efficiency within the healthcare system. It may involve creating programs for more affordable individual insurance for those who cannot afford expensive plans. Furthermore, this aspect may suggest consideration of primary care interventions for preventive care.
This step will positively affect limiting patients with severe infectious diseases that require special attention from specialists. The last but no less critical suggestion is the focus on evidence-based patient care. This intervention will provide an opportunity to improve the quality of medical services by finding effective treatment methods.
Setting
First, healthcare administrators need to evaluate medical care coverage. This is because, at this level, it is possible to identify the most urgent and disturbing problems and find ways to limit them. Moreover, this aspect also includes the distribution of the healthcare organization’s finances, which must be determined based on the needs and desires of patients. Of particular value is paying attention to regulations and laws related to providing medical care coverage for patients. It is the duty of administrators to consider ways to help as many individuals as possible to improve their quality of life and patient satisfaction.
From the perspective of the political sphere of society, it is necessary to consider the aspect of funding. The primary value of this aspect lies in its leading goal of providing universal health coverage. The research highlighted that a country should view universal health coverage as an inherent right and entitlement of its citizens to access healthcare, ensuring complete subsidies for those who are economically struggling and vulnerable (Tangcharoensathien et al., 2021). In addition, expanding access to medical care coverage for the entire world population, especially for those with low incomes, should be a key part of the candidates’ political platforms. These representatives of the political field should advocate for funding programs that provide the necessary care to patients.
Budgetary Needs
The problem of providing medical care coverage for the population living below the poverty line is a global concern. In other words, the United States is one of the countries struggling with this issue, but there are a large number of countries in which healthcare is of critical importance to the population (“Improving health insurance systems,” 2021). Due to the scale of the discussion, it is impossible to determine the budgetary needs to improve it with certainty. This circumstance arises because the globality and complexity of the problem necessitate a multi-stage approach and the involvement of numerous stakeholders. Thus, a large number of funding sources may be required relative to the budget, which will contribute to improving the situation regarding medical care coverage for poor groups of the population.
One alternative that can be considered when evaluating budgetary needs is reviewing deductible pricing and provider costs. This is because “provider prices paid by commercial insurers are largely dictated by market conditions—with hospitals and other health care providers commanding higher prices when they have more leverage in negotiations with insurers” (Pany et al., 2022). In this case, there is a need to revise deductible pricing since its high rates can become a barrier to obtaining medical care for people with low socioeconomic status. This is because they can cause problems such as high out-of-pocket expenses.
Funding Sources
As mentioned earlier in this research paper, funding is crucial when considering ways to address the issue of access to medical care coverage. Thus, one of the sources may be government funding, which will consist of the development of more specialized plans, such as the Affordable Care Act. The primary goal of this initiative should be to expand accessibility for individuals with low economic status and living below the poverty line. On the other hand, it is possible to draw attention to existing plans to highlight current problems and transform the issue of healthcare coverage.
Another possible initiative regarding the source of funding is reviewing tax money and its funding for medical care coverage. First, this method will provide an opportunity to determine the gaps and inefficiencies in this system. With the help of this analysis, it is possible to redistribute taxes to cover all necessary expenditure items. In addition, this approach can be effective because it will contribute to raising the provision of healthcare for people living below the poverty line. This aspect is supported by the fact that when identifying gaps, it is possible to draw attention to the problem of a larger number of stakeholders, government agents, and investors.
It is essential to note that when seeking additional funding or improving existing sources, it is crucial to consider aspects such as group work and collaboration. This QSEN competence is valuable because, when working together, it is possible to achieve a more productive decision-making process and limit health problems. Thus, when considering the need to increase access to health insurance for people experiencing poverty, it is important to collaborate with all parties involved in this industry.
Timeline for Implementation
The timeline for the implementation process is a challenging topic to consider when addressing the issue of medical care coverage for low-income individuals. This is because it is difficult to determine precisely due to the slow pace of moving things through Congress. However, it can be suggested that implementing better funding for patients living in poverty to receive better healthcare may take approximately a year. This timeline is quite short when compared to the scale of the problem; however, it may be sufficient for all the Congressional procedures and processes involved to address the discussed issue.
Evaluation Methods
After implementing the necessary measures to promote initiatives that expand health insurance availability to low-income individuals, as well as their budgeting and financing, it is essential to determine the evaluation methods. The use of quality measurement and quality improvement can provide the desired effectiveness in this aspect. This is supported by the fact that “quality improvement seeks to standardize processes and structure to reduce variation, achieve predictable results, and improve outcomes for patients, healthcare systems, and organizations” (“Quality measurement and quality improvement,” 2021, para. 2). This measure of obtaining and analyzing the results of the proposed interventions should affect the study of both the performance indicators of medical workers and the level of patient satisfaction. This step is necessary, as it allows for creating a complete picture of the changes that any intervention has entailed.
Quality and Safety Education for Nurses’ competencies for quality improvement emphasize the importance of this aspect in the provision of medical care and health services. When working with patients and ensuring their well-being, medical professionals and organizations face the task of continuous improvement and quality improvement (Nashetal et al., 2021). Thus, given that people living below the poverty line face challenges with the quality of life and access to health services, ensuring quality improvement is critical.
The Accountable Care Organization is an organization that can help address the problem under discussion. This is because this initiative aims to provide the highest quality and value of healthcare services for patients. It is stated that various types of regularly collected healthcare data, including administrative records and clinical information, have the potential to be employed in assessing the effects of interventions aimed at enhancing the quality of care (Clarke et al., 2019). Moreover, there is a significant advantage in utilizing existing data to evaluate the influence of medical interventions. The uniqueness of the Accountable Care Organization in assessing the measures being implemented lies in its involvement of various parties in the industry to provide clinically efficient patient care.
Biblical Worldview
All individuals deserve to be treated fairly and equally, especially in terms of healthcare treatment options. In this case, the Bible serves as a valuable source of guidance and principles that should be considered when developing solutions to the problem discussed in this work. The Holy Scripture notes, “My brothers, show no partiality as you hold the faith in our Lord Jesus Christ, the Lord of glory” (English Standard Version, 2001, James 2:1). In other words, individuals should direct efforts to spread equality in all spheres of society. This aspect involves paying close attention to issues such as differences between individuals in economics, politics, and, most importantly, healthcare.
The Bible contains many meaningful lessons and aspects that resonate with numerous people and communities. In particular, this religious text is essential for healthcare providers, who are the first people with whom patients interact. These specialists should promote biblical values such as justice and respect as integral parts of the health service delivery process. Therefore, the biblical scripture should serve as a guide for the formation and promotion of ethical standards and norms that healthcare providers should pursue. In other words, they must realize the value and critical need to expand the availability of health services for people with low incomes.
Conclusion
In conclusion, this population health intervention project focuses on addressing the issue of limited access to essential aspects of certain population segments, such as medical care coverage. The selected population was the United States of America, specifically those living below the poverty line. Residents of Mississippi, Louisiana, New Mexico, and West Virginia are the most concerned.
It is also worth emphasizing that, in addition to low economic status, individuals living below the poverty line face institutional racism and discrimination. These aspects are also factors in reducing access to quality health services. Regarding diseases, infectious diseases have the most significant prevalence among the poor population, which, due to the lack of treatment, are progressing and are increasingly difficult to treat.
Among the proposed solutions to the issues discussed in this paper, addressing the current physician shortage and adopting telehealth and remote patient monitoring models stand out as promising strategies. Additionally, enhancing the efficiency of the healthcare system and prioritizing evidence-based patient care may prove effective. When implementing any of the mentioned initiatives, it is essential to consider aspects such as budgetary needs and funding sources. This step is critical, as it involves reviewing deductible pricing and provider costs, government funding, the development of more specialized plans, and examining tax money and its allocation for medical coverage. Particular importance is given to introducing QSEN implications and concepts, as well as the biblical worldview, into this process to enhance the efficiency and productivity of work on changes in the medical industry for the population.
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