NHS FPX 6008 Assessment 1 Identifying a Local Health Care Economic Issue

Name

Capella university

NHS-FPX 6008 Economics and Decision Making in Health Care

Prof. Name

Date

 Identifying a Local Healthcare Economic Issue

Rehospitalization due to environmental issues leading to chronic diseases is a significant healthcare economic issue at St. Vincent Medical Center (SVMC). Factors such as air pollution, poor housing conditions, and exposure to toxic substances contribute to chronic diseases like asthma, cardiovascular diseases, and diabetes, resulting in frequent hospital readmissions and a substantial economic burden (Stephens et al., 2021). In urban communities like Los Angeles, high levels of air pollution and inadequate housing are prevalent. For instance, South Los Angeles, a predominantly low-income and minority community, faces significant environmental health challenges due to its proximity to major highways and industrial regions, leading to increased rates of asthma and respiratory conditions (Kamai et al., 2023).

Air pollution contributes significantly to cardiovascular diseases and asthma, causing 6.7 million premature deaths globally (WHO, 2023). The “State of the Air 2023” report highlights Los Angeles’ high levels of ozone and particulate pollution, impacting residents’ health and increasing hospital readmissions (ALA, 2023). Poor housing conditions, including mold, pest infestations, and inadequate ventilation, also contribute to chronic illnesses like asthma, especially in children (Stephens et al., 2021). Addressing these environmental factors can help reduce rehospitalizations, improve health outcomes, and alleviate economic strain on SVMC.

Rationale for Choosing 

The rationale for selecting rehospitalization as a health economic issue is multifaceted. Chronic diseases, exacerbated by environmental factors such as air pollution and poor housing conditions, are among the leading causes of death and disability globally (Chan, 2021). Urban areas like Los Angeles, with high levels of pollution, experience higher incidences of respiratory and cardiovascular diseases, leading to frequent hospital readmissions. Disparities exist and impact profoundly due to factors like socio-economic status; for instance, minorities, pregnant women, children, and people working in poor conditions or low-income individuals are more likely to suffer. Addressing these environmental determinants can substantially lessen the impact of chronic diseases and enhance the standard of life for affected individuals (Kamai et al., 2023). Economically, avoidable hospital readmissions due to chronic diseases cost the U.S. healthcare system approximately $26 billion annually (Betancourt, 2024).

Reducing these readmissions at SVMC can lead to substantial cost savings and alleviate financial strain on healthcare systems. Personal experiences, such as growing up in a polluted urban area and witnessing family members suffer from respiratory conditions, underscore the importance of tackling environmental health issues. As a healthcare professional at SVMC, I have encountered numerous patients whose health conditions were exacerbated by poor environmental conditions. These interactions reinforced my belief in the necessity of addressing environmental factors to improve patient outcomes. It is essential to ensure social justice and health equity for urban underserved populations (Caron et al., 2023). By improving environmental health, SVMC can promote healthier communities, reduce health disparities, and achieve public health goals.

Impact of the Identified Issue on Various Aspects

Addressing rehospitalizations due to environmental issues at SVMC has necessitated a focus on preventive care and patient education, increasing the workload related to chronic disease management. SVMC has incurred higher costs and resource allocation to manage frequent readmissions, straining financial and operational capacities. The organization risks penalties and a tarnished reputation, as seen in a 2013 study where 67% of safety-net hospitals were penalized for rehospitalizations within 30 days of discharge (Murray et al., 2021). My colleagues at SVMC staff face increased stress and workload due to the high volume of chronic condition patients, impacting job satisfaction and performance. Work-life imbalance and dissatisfaction in healthcare staff lead to turnover, worsening the healthcare system (Tengilimoğlu et al., 2022).

Communities in Los Angeles, especially urban areas, experience higher rates of chronic diseases and hospital readmissions, reducing health and economic stability. Physicians are 1.5 times more likely to quit, and a one-third of nursing staff intend to leave within two years, showcasing the impact of dissatisfaction and chronic condition treatment burden (Kelly et al., 2020). Diverse and lower socio-economic groups, such as people of color, those with disabilities, and with low English proficiency, are disproportionately affected. They are at an increased environmental risk and restricted healthcare access, resulting in elevated chronic disease rates and hospital readmissions (Betancourt, 2024).

Gap Contributing to the Need to Address the Issue

The main gap driving the necessity to address rehospitalization caused by environmental issues contributing to chronic disease at SVMC is the need for more integration of environmental health considerations into chronic disease management and healthcare policy. Many healthcare systems do not adequately address the environmental determinants of health, leading to recurrent hospital admissions and ineffective long-term disease management (Glenn et al., 2024).  A study by (Manisalidis et al. (2020), highlights that communities with higher pollution levels experience significantly higher rates of hospital readmissions due to chronic respiratory and cardiovascular conditions. This evidence underscores the need for SVMC to incorporate environmental health strategies to mitigate the economic burden and improve patient outcomes. 

Conclusion

Addressing rehospitalizations due to environmental issues leading to chronic disease is crucial for improving health outcomes and reducing economic strain on healthcare systems. By integrating environmental health strategies into chronic disease management, we can mitigate these impacts. This approach will promote health equity and enhance the quality of life for affected communities.

References

ALA. (2023, April 19). Nation’s air quality divided: New report reveals growing disparities in exposure to air pollution. Www.lung.org. https://www.lung.org/media/press-releases/state-of-the-air-2023 

Betancourt, J. R. (2024). Guide to preventing readmissions among racially and ethnically diverse Medicare beneficiaries. www.cms.gov https://www.cms.gov/About-CMS/Agency-Information/OMH/Downloads/OMH_Readmissions_Guide.pdf 

Caron, R. M., Noel, K., Reed, R. N., Sibel, J., & Smith, H. J. (2023). Health promotion, health protection, and disease prevention: Challenges and opportunities in a dynamic landscape. AJPM Focus, 3(1), 100167–100167. https://doi.org/10.1016/j.focus.2023.100167 

Chan, S. W.-C. (2021). Chronic disease management, self-efficacy and quality of life. Journal of Nursing Research, 29(1), e129. https://doi.org/10.1097/jnr.0000000000000422 

Glenn, J., Kleinhenz, G., Smith, J. M. S., Chaney, R. A., Moxley, V. B. A., Donoso, P. G., Stone, S., Hanson, C. L., Redelfs, A. H., & M. Lelinneth B. Novilla. (2024). Do healthcare providers consider the social determinants of health? Results from a nationwide cross-sectional study in the United States. BMC Health Services Research, 24(1). https://doi.org/10.1186/s12913-024-10656-2 

Kamai, E. M., Calderon, A., Horne, V., Bastain, T. M., Breton, C. V., & Johnston, J. E. (2023). Perceptions and experiences of environmental health and risks among Latina mothers in urban Los Angeles, California, USA. Environmental Health, 22(1). https://doi.org/10.1186/s12940-023-00963-2 

Kelly, L. A., Gee, P. M., & Butler, R. J. (2020). Impact of nurse burnout on organizational and position turnover. Nursing Outlook, 69(1), 96–102. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7532952/ 

NHS FPX 6008 Assessment 1 Identifying a Local Health Care Economic Issue

Manisalidis, I., Stavropoulou, E., Stavropoulos, A., & Bezirtzoglou, E. (2020). Environmental and health impacts of air pollution: A review. Frontiers in Public Health, 8. https://doi.org/10.3389/fpubh.2020.00014 

Murray, F., Allen, M., Clark, C. M., Daly, C. J., & Jacobs, D. M. (2021). Socio-demographic and -economic factors associated with 30-day readmission for conditions targeted by the hospital readmissions reduction program: A population-based study. BMC Public Health, 21(1). https://doi.org/10.1186/s12889-021-11987-z 

Stephens, T. C. B., Strane, D., Bhambhani, S., & Kenyon, C. C. (2021). Housing and asthma disparities. Journal of Allergy and Clinical Immunology, 148(5). https://doi.org/10.1016/j.jaci.2021.09.023 

Tengilimoğlu, D., Gönüllü, U., Işık, O., Tosun, N., Zekioğlu, A., Tengilimoğlu, O., & Younis, M. (2022). The problems experienced by employees with chronic disease during the COVID-19 pandemic. International Journal of Environmental Research and Public Health, 19(1), 578. https://doi.org/10.3390/ijerph19010578 

NHS FPX 6008 Assessment 1 Identifying a Local Health Care Economic Issue

WHO. (2023, December 15). Household air pollution. Www.who.int. https://www.who.int/news-room/fact-sheets/detail/household-air-pollution-and-health?gad_source=1&gclid=CjwKCAjwnqK1BhBvEiwAi7o0X8SYP7Wu4-32p2lHDPSXRqFsjdh46E9tru_Kpk6awz4fhmYeHNmp7xoCcAcQAvD_BwE 

Zhang, Y., Zhang, Y., Sholle, E., Abedian, S., Sharko, M., Turchioe, M. R., Wu, Y., & Ancker, J. S. (2020). Assessing the impact of social determinants of health on predictive models for potentially avoidable 30-day readmission or death. PLoS ONE, 15(6). https://doi.org/10.1371/journal.pone.0235064