Determinants of health and ways they impact persons health

Determinants of health
Determinants of health

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Determinants of health and ways they impact persons health

Introduction

  To improve the health status of the community, there is need to reduce the health inequalities. This is only achieved by understanding factors that promote as well as protect health of the community, which are commonly referred to as determinants of health (Fane & Ward, 2014). These determinants are categorised into social, cultural and economic factors.

This is important because despite the fact that the USA government is spending fortune in medical care, the health outcomes still remains low than most of the developed countries. In fact, the USA IS ranked the 34th in infant mortality in the world (Potter, Trussell, & Moreau, 2009).

 However, it is possible to envision the more promising end of this medical story if number of strategies are employed to understand as well as promoting the health of the community. This is achieved through analysis of health determinants as outlined by logic models (Blanchard  et al., 2013).

These models are important because they are oversimplified and approximate, thus helping  the identification of complex interplay, which would be important in taking action  to improve the health  of the population, which are developed by the new framework of health goals  for USA, commonly referred to as “ Healthy People 2020 (Fane & Ward, 2014).”

 This paper summarizes the main sociocultural and economic determinants of health and ways they impact the health of a person, leading to inequalities. Understanding these determinants is important because it helps improve the health of the community, thereby reducing healthcare inequalities. This aid in the identification of the specific areas for actions, which also facilitates the identification of the most feasible interventions that could aid promote quality care.

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 Determinants of health

Evidence based study indicates that certain healthcare behaviours affects   personal and community health. These includes behaviours such as smoking, poor nutrition, physical inactiveness, and excessive alcohol consumptions. Similarly, the amount of household income, educational achievement, ethnic background, employment and neighbourhoods also associated with profound effects of health (Perrin, 2013).

 To start with, income and wealth determinants impact the health of a person. Research indicates that increased income improves the health outcomes.  However, the relationship between health and income is not linear (Potter, Trussell, & Moreau, 2009). This is because money itself does not translate into good health. Instead, wealth is generally considered to give someone position within the society, which makes them, have better access to better economic opportunities (Salt, 2014).

This makes them live in healthy and safe communities, with better equipped facilities. Additionally, they are able to afford health insurance, and thus can access health more easily. Most have great amount of wealth and assets such as savings, low debt and high amount of savings that can be disposed to meet the health demands of the person where necessary (Blanchard  et al., 2013).

 Conversely, poor people are restricted to these amenities and are often exposed to environments that are health damaging. They lack sufficient amenities such as recreational facilities, grocery stores or even health care facilities (Fane & Ward, 2014).  These people will lack social supports or relationships, have poor self-esteem, lack sense of control and are more likely to suffer from chronic diseases and acute stress. This impact is particularly vital in children and infants.  Low income is associated with increased infant and childhood mortality.

It is also suggested that the hardship and economic deprivation in childhood significantly affect the adult health (Fane & Ward, 2014).  Thus, children in low income households are more likely to suffer from poor nutrition, which results to health complications in their adult life including obesity, cancer, mental health, and cardiovascular diseases. This forms a vicious cycle of poverty and health (Potter, Trussell, & Moreau, 2009).

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 The link between socioeconomic factors and health is clearer. However, the communities in which people live also influences their health. Literature indicates that people living in poor neighbourhoods report higher mortality rates, high incidences of chronic diseases and poorer health standards as compared with people living in safer neighbourhoods (Potter, Trussell, & Moreau, 2009).  One study conducted in Wake County, North Carolina indicated that people living in poorer neighbourhoods reported higher incidences of pre-term birth, greater levels of depression, high level of teen pregnancy and increased resistance and disorders among the adolescents (Fane & Ward, 2014).  

Additionally, different neighbourhoods makes it difficult to access healthy food, availability of parks and sidewalks and open spaces where people can exercise. The proximity of the people to environmental hazards also influences the quality of care (Diaz de León-Castañeda, Ramírez-Fernández, & Pinzon Florez, 2013).

Housing also influences the health being of an individual. Living in houses that are poorly ventilated, damp, overcrowded or with poor waste disposal strategies are associated with increased diseases, communicable infections and other preventive diseases (Salt, 2014). Housing structures are very important as people spend approximately 90% of their time within  their home, and thus  poor housing  can put people at risk of developing  health complications due  exposure to environmental hazards (Fane & Ward, 2014).

Additionally, overcrowding increases the risks of transmitting infectious diseases such as tuberculosis as well as other respiratory diseases (Blanchard  et al., 2013). It could lead to more healthcare complication in events of pandemics such as virulent influenza. Research estimated that low income households live in overcrowded conditions, where more than 70,000 housing units in USA are overcrowded (Potter, Trussell, & Moreau, 2009). The issue is more complicated with most people facing foreclosures which is associated with the downturn of the economy. This accelerates the risk of sharing housing, and doubling up of people with their families and friends (Cai & McAdam-Marx, 2013).

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 Academic achievement is strongly correlated with increased lifespan. Generally, people with less education are associated with more chronic complications and their life expectancies are shorter as compared with people with higher level of education (Blanchard et al., 2013).  This is indicated by the healthcare study, where adults who have finished high school are more likely to have better health outcomes as compared with dropouts (Salt, 2014). In the USA, the ager adjusted mortality of people who dropped out of high school is two folds higher than those who completed their education.

These people are more likely to suffer from chronic and acute healthcare complications such as hypertension, stroke, diabetes, asthma, ulcers and emphysema. On average, it is estimated that the college graduates live five years longer as compared to those who failed to complete high school education (Diaz de León-Castañeda, Ramírez-Fernández, & Pinzon Florez, 2013).

 Research indicates that education achievement and health are not only correlated at personal level but also in their future generation. For example, maternal education is associated with better health for the children. Similarly, children born by high school dropout’s parents are two folds likely to suffer from premature death. Educated mothers’ infant mortality rates are considerably lower than uneducated parents. This is because educational achievements, wealth and health are interrelated, and have significant impacts on person’s health.

 Another important health determinant is social exclusion, which is often associated with poverty. Social exclusion is associated with huge impacts in health such as premature deaths. Absolute poverty results to lack of basic materials, and is still rampant in developed countries (Salt, 2014).  Most of the unemployed people, ethnic groups, refugees, homeless and the disabled are often socially excluded. This denies them the opportunity to access decent living opportunities such as education, housing, transport or even the ability to participate in various activities of the lives that makes them participate fully. This exclusion and being treated as lesser beings leads to health complications (Cai & McAdam-Marx, 2013).

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The social exclusions occurs inform of racism, discrimination, hostility, stigmatization as well as unemployment. These denies people their ability to participate in educative training, prevention programs or even accessing potential beneficial healthcare capacities. These issues are socially as well as psychologically damaging, and can have detrimental effects to these discriminated people (Pegram & Bloomfield, 2013). 

The longer these people live in prisons, psychiatric facilities and children’s homes, and the more likelihood of them to suffer from a wide range of disorders. These incidences are also associated with increased risk of divorce, addictions and disabilities. Research indicates that people with strong family relations have better health outcomes. For instance, the highest incidences of mental illness are from single parent families (Pegram & Bloomfield, 2013).

Addiction is a public health issue of concern as it is associated with social breakdown, which worsens the issue of healthcare disparities. Addiction in this context refers to overreliance of drug use such as alcohol and cigarrette smoking. This is associated with increased mortality associated with suicides, injuries and poisoning. Although unclear, cultural values and beliefs tend to influence the quality of care (Salt, 2014).

This includes activities such as religious values that prohibits people from seeking medical assistance. Other determinants includes population based healthcare facilities as well as services. These includes activities such as sewerage and water to ensure that people’s health is maintained. The extent of funding of these activities dictates the level of the maintenance of this infrastructure, their developments and also usages.

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Ways the determinants of health impact people’s health

 Most of the social factors mentioned above are described to have both interactive and independent effects. For instance, people with high level of incomes are more likely to have achieved higher education. They are also more likely to have more opportunities to live in safe, standard and healthy environments. Their neighbourhoods are more likely to be secure, thus promoting physical activeness. They are also able to purchase organic food as compared to those with low income households. These people are also more likely to have medical cover, which facilitates access to quality care (Cai & McAdam-Marx, 2013).

 Conversely, people living with poverty are more likely to have lower education achievement, indicating that they are most likely unemployed. They will often live in substandard housing, putting them at risk of communicable diseases due to overcrowding effects and poor sanitation (Cai & McAdam-Marx, 2013). These people lack enough resources to purchase quality foods, hence depends mainly with fast food, increasing the risk of obesity. These people are more likely to engage in risky behaviours such as drug abuse and prostitutions, putting them at greater risk.  This makes them experience higher levels of stress as compared with their counterparts (Pegram & Bloomfield, 2013).

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 Whereas most of these factors are interconnected as described above, there is growing evidence that these factors independently determine the health of the people. For instance, in the USA, the health status of all ethnic communities decreases as income level decreases. It is reported that people with 100% federal poverty guidelines (FPG) reports the worse health as compared to people in other income level (Pegram & Bloomfield, 2013). However, within each income levels, specific communities have worse health outcome as compared with others.

For instance, the African American normally reports poor healthcare outcomes as compares to the Hispanics and non-Hispanics white (Cai & McAdam-Marx, 2013). These marked differences across the ethnic communities are observed in other determinants of health. Therefore, to effectively reduce the increased   healthcare disparities, issues such as accessibility of educations, standard housing, safe living as well as working environments, healthcare facilities and all other opportunities that facilitate the healthy living of the community must be addressed (Diaz de León-Castañeda, Ramírez-Fernández, & Pinzon Florez, 2013).

Conclusion

 As indicated, it is evident that there is strong correlation between the health and people’s incomes and way of life including community environment, educational achievement, and ethnicity and housing conditions. It is indicated that those people with higher incomes, higher education achievement and those living in a health as well as safe environments have been associated with longer life expectancies and are associated with better health outcomes. Conversely, people with lower education levels, living below poverty line, substandard housing and those in poor neighbourhoods have poor health outcomes. This is attributable to the fact that these lack sufficient resources to treat   even the preventable diseases. This translates to increased health disparities among the various ethnic groups.

References

Blanchard, C., Gibbs, M., Narle, G., & Brookes, C. (2013). Learning from communities in the USA and England to promote equity and address the social determinants of health. Global Health Promotion, 20(4 Suppl), 104-112. http://dx.doi.org/10.1177/1757975913501006

Cai, B., & McAdam-Marx, C. (2013). The determinants of antihypertensive use and expenditure in patients with hypertension in the USA. Journal Of Pharmaceutical Health Services Research, 5(1), 11-18. http://dx.doi.org/10.1111/jphs.12041

Diaz de León-Castañeda, C., Ramírez-Fernández, D., & Pinzon Florez, C. (2013). Compared Analysis of Inequalities in Health and Influence of Social Determinants of Health in Cuba and USA. Value In Health, 16(7), A711. http://dx.doi.org/10.1016/j.jval.2013.08.2189

Fane, J., & Ward, P. (2014). How can we increase children’s understanding of the social determinants of health? Why charitable drives in schools reinforce individualism, responsibilisation and inequity. Critical Public Health, 1-9. http://dx.doi.org/10.1080/09581596.2014.935703

Pegram, A., & Bloomfield, J. (2013). The importance of measuring blood pressure in mental health care. Mental Health Practice, 16(6), 33-36. http://dx.doi.org/10.7748/mhp2013.03.16.6.33.e849

Perrin, V. (2013). Social Determinants Of Health. Health Affairs, 32(11), 2060-2060. http://dx.doi.org/10.1377/hlthaff.2013.1102

Potter, J., Trussell, J., & Moreau, C. (2009). Trends and determinants of reproductive health service use among young women in the USA. Human Reproduction, 24(12), 3010-3018. http://dx.doi.org/10.1093/humrep/dep333

Salt, R. (2011). Microcredit and the Social Determinants of Health: A Conceptual Approach. Public Health Nursing, 28(3), 281-290. http://dx.doi.org/10.1111/j.1525-1446.2010.00927.x

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Health assessment Essay Paper

Health assessment
Health assessment

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Health assessment

Whereas adequate pain control is every patient’s fundamental rights, it is important to ensure that pain management medications are not abused. The health care providers ae challenged in dealing with these ethical scenarios of deciding the way to go in pain control versus the risk of abuse and misuse of prescribed medication.

In this context, the healthcare providers must perform health assessment adequately in order to identify the root cause of the chronic pain. Managing the causes of the chronic pain will simultaneously address the pain and consequently, reduce the incidences of potential abuse of narcotics (Wand, O’Connell, Di Pietro & Bulsara, 2011).

 In this context, initial evaluation includes   physical examination and patient history.  The health assessment will help the healthcare provider identify red flags and warning signs of prescription abuse/ narcotics addiction. These include signs such as anxiety, depression, as well as the pain syndromes. Other signs include manipulative attitude and aberrant behaviour such as requesting refills frequently or experiencing withdrawal syndrome (Manchikanti, 2010).

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 This helps in  categorization of the chronic back pain as a) non-specific  back pain; b) back pain associated  with spinal stenosis of radiculopathy; c) back pain originating from the non-spinal source and d) back pain due to specific spinal source.  For patients whose back pain is  categorised as  due to radiculopathy, specific spinal source or spinal stenosis;  they should  undergo Magnetic resonance  imaging  (MRI) as well as the Computed tomography (CT) to establish the exact diagnosis or  the exact cause of the disease; which will facilitate in guiding the specific care plan (Wand, O’Connell, Di Pietro & Bulsara, 2011).

 Other evaluations include laboratory assessment which should include complete blood count (CBC), erythrocyte sedimentation rates, and the level of C-reactive protein level. Urinalysis can also be performed to identify suspected infections as well other macronutrients levels such as alkaline phosphatase and the calcium levels. The laboratory findings can help diagnose the root cause of the infection.  

For acute low back pain, they should be treated with nonsteroidal anti-inflammatory drugs (NSAIDs) and muscle relaxants. I will also encourage non therapeutic interventions such as healthy diets, exercising, behavioural therapy and psychiatry sessions. This will help managing the chronic pain holistically (Manchikanti, 2010).

References

Manchikanti, L. (2010). Evaluation of Lumbar Facet Joint Nerve Blocks in Managing Chronic Low Back Pain: A Randomized, Double-Blind, Controlled Trial with a 2-Year Follow-Up. International Journal Of Medical Sciences, 124. http://dx.doi.org/10.7150/ijms.7.124

Wand, B., O’Connell, N., Di Pietro, F., & Bulsara, M. (2011). Managing Chronic Nonspecific Low Back Pain With a Sensorimotor Retraining Approach: Exploratory Multiple-Baseline Study of 3 Participants. Physical Therapy, 91(4), 535-546. http://dx.doi.org/10.2522/ptj.20100150

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State of New Jersey Health Report Cards

State of New Jersey Health Report Cards
State of New Jersey Health Report Cards

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State of New Jersey Health Report Cards

New Jersey States key health indicators

According to the census population data estimates, the state of New Jersey has a population estimate of 8,938,175 with the poverty rate of this state standing at 11.4%. According to the health indicators, some of the chronic diseases that are prevalent among this population include cancer, asthma, diabetes, chronic kidney diseases, HIV/AIDS, Heart diseases and stroke, and tuberculosis (Centers for Disease Control and Prevention. 2013).

The reports also indicates that access to health care services is more that the lack of health insurance with the understanding of public health care systems and having care providers remaining some of the key elements that determine the manner in which access to these services are employed. However, there is a need to increase the proportion of adults with the health care providers with the aim of improving healthcare outcomes. 

An increase in children’s lives expectancy has been impacted immensely by the reduction in mortality by infectious ailments that have been achieved through the administration of vaccines. Early childhood immunization is considered as safe with the employment of cost-efficient approaches of controlling preventable diseases through the use of vaccines. Vaccinations have on the other hand let to a 95%reduction in vaccine-preventable ailments among this populations.

According to the National Immunization Survey (NIS) 2012, New Jersey’s immunization rates of coverage for children are considered as above the national average for children aged between 19-35 months (The National Organization of Nurse Practitioner Faculties, 2012). Low birth weights and defects are determined as the leading causes of deaths among the infants in New Jersey with many factors attributed to the quality of prenatal care, nutrition, infections, medical problems, alcohol and drug substances use, stress, obesity, poverty, violence and the mothers ages.

State of New Jersey Health Report Cards

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A dramatic increase in children and adults including teens who are overweight in New Jersey is also one of the alarming factors about the well-fare of this population. The occupational injuries that are either fatal or non-fatal in nature are also serous public health issues that affect this population. Additionally, the use of tobacco is also another factor that is considered that cause of deaths and diseases among these people (U.S. Department of Health & Human Services, 2013).

Smoking is considered as the cause of chronic lung diseases, heart diseases, and strokes of the lungs, mouth, larynx and the esophagus. Exposure of the secondhand smoke contributes to the increase in heart diseases and cancers among the nonsmokers.

How these Indicators Influence Health Status

These indicators influence the health status of New Jersey considering the fact that the state has experienced a growing population of individuals who suffer from cancer, asthma, diabetes, chronic kidney diseases, HIV/AIDS, Heart diseases and stroke, and tuberculosis. Additionally, it has also been upon the state to address these issues through the development of appropriate care approaches for the patients who present these ailments(Green, Tones, Cross & Woodall, 2015).

On the other hand, the low birth weights and defects have also constituted deaths among the infants in New Jersey with many factors attributed to the quality of prenatal care, nutrition, infections, medical problems, alcohol and drug substances use, stress, obesity, poverty, violence and the mother’s ages. The increases in child and adults having obesity also influence the health status of the state including injuries and the use of tobacco.

State of New Jersey Health Report Cards

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What is and what are Not Covered under Medicare and Medicaid

In line with the health status of this population, Medicare covers services that include the lab tests; the visits that are made by the physiciansthe provision of wheelchairs and walkers for those of face fetal injuries, hospital care for the patients, home health care services and nursing home care including a skilled facility with effective nurses(Green, et.al.2015).

On the other hand, Medicaid is fully developed to serve most of the poor people within this population and it covers the clinical treatments, midwifery services, screening, diagnosis and treatment of the people aged between 21, doctor’s services, x-rays and medical and surgical services (Centers for Medicare & Medicaid Services, n.d.).

Direct and Indirect Burdens Of Health Risk Behaviors

The chronic diseases and conditions among this population that includes the contraction of cancer, asthma, diabetes, chronic kidney diseases, HIV/AIDS, Heart diseases and stroke, and tuberculosis remains some of the costly and preventable health issues in New Jersey (Green, et.al.2015). These diseases are considered some of the top causes of deaths among the population of this country.

As a result of this, families are forced to put up with the costs of these illnesses that is dependent on their experiences (Green, et.al.2015). Families are therefore forced to select treatment approaches based on the severity and nature of these ailments with the choices of these options dependent on their ability to access resources and other barriers to accessing health care systems.

State of New Jersey Health Report Cards

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Policy and Its Impacts on Key Health Indicators

Policy plays an essential role in impacting the health indicators considering the fact that this incorporates the public and governmental interventions in changing the environment as well as promoting the behaviors of individuals with the aim of enlightening on how to prevent chronic diseases within the society(Green, et.al.2015). Through policies, the state and the general public are in a position to reduce the contraction of chronic diseases, a factor that promotes the health of the society.

References

Centers for Disease Control and Prevention. (2013). Behavioral risk factor surveillance system. Retrieved from http://www.cdc.gov/brfss/

Centers for Medicare & Medicaid Services. (n.d.). Retrieved June 11, 2013, from http://www.cms.gov/

Green, J., Tones, K., Cross R., & Woodall, J. (2015). Health promotion: Planning and strategies (3rd ed.). Thousand Oaks, CA: Sage.

The National Organization of Nurse Practitioner Faculties. (2012). Nurse practitioner core competencies. Retrieved from http://c.ymcdn.com/sites/www.nonpf.org/resource/resmgr/competencies/npcorecompetenciesfinal2012.pdf

U.S. Department of Health & Human Services. (2013). About the law. Retrieved from http://www.hhs.gov/healthcare/rights/index.html

State of New Jersey Health Report Cards

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Home Visit with Sallie Mae Fisher Video

Home Visit with Sallie Mae Fisher Video
Home Visit with Sallie Mae Fisher Video

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Home Visit with Sallie Mae Fisher Video

 The major problems that can be identified from the home visit with Sallie Mae Fisher video, it is the social alienation of the patient, she is psychologically disturbed and with the lack of appetite the medicine will not be effective enough. She misses her husband a factor that increases the pain and the suffering that she is undergoing. She, however, points out that he used to smoke so often a factor that may be led to the condition that she is undergoing.

The discharge instructions have not been followed to the letter. There is no oxygen supply at the homestead since this was one of the discharging factors that would assist her to recover much faster at home. Lack of family to offer support also affects how the patient will cope with the ailment. The medications were not filled in time because her daughter works full time and she also has her issues to deal with.

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Home Visit with Sallie Mae Fisher Video

For the betterment of the patient, it is vital that some questions should be addressed to improve the health of the patient. The nurses should be aware of all the medicines that the patient should be taking at a given time. As evidenced, the patient mentioned that a nurse who has visited earlier didn’t assess the medications that were not available. Better and proper education should also be provided to the patient so that she can understand why some things are mandatory. Regarding the supply of oxygen in the house, she should be aware that the requirement is necessary, and it should be fixed immediately.

Home Visit with Sallie Mae Fisher Video

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Since the patient doesn’t have any family support, she should regularly be visited, or a nurse should permanently be at her home to guide her in the healing process. Psychologically, she should be involved in other activities that would make her concentrate on her health other than being psychologically being affected by those that she misses. The patient will be better if exercise is introduced into her life. Exercising rejuvenates an individual’s body energy, and this makes blood circulation to be efficient, and this will work well with the heart condition that she has.

Therapy and a holistic, multidisciplinary approach to the older people with heart conditions must be followed to the letter. It has been evidenced how effective the nurse visits have helped such kind of patients to cope with their conditions. Follow-ups by doctors and nurses are recommended, but they should be regular so that better techniques will be availed that will be used to improve the patient’s survival (Koelling et al. 2005)

Home Visit with Sallie Mae Fisher Video

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Dialogue

Nurse: “Good afternoon Sallae Mae, my name is Christine, and I will be your nurse today. I have learned that you are having issues with taking your medication?”

Mae: Yes I have not been consistently taking my drugs in the right procedure as prescribed, however sometimes I feel pain and headache all over my body that leads to lack of appetite, and how can I do it better nurse?”

Nurse: All the medications that you have been prescribed with have significance in your healing. Take them at the time prescribed so that your health will improve. In regards to the pain, body systems respond to the drug and they may cause such pain since they are fighting infections so that your body parts can function properly.  I also realize that you do not have oxygen supply as indicated in the discharge prescription?

Mae: “True, I don’t want any oxygen in this house, I am just tired all I think about is my late husband, and recently I have no appetite. I am so depressed and I feel hopeless when I think of him”

Nurse: “That should not be the case mom; oxygen supply enables your breathing to be better and prevents polluted air into your systems. It will clean your lungs for healthy breathing and improve blood circulation. Be strong you need to allow your daughter to come and visit you to enable you reduce your loneliness. Hope you understand me, mom.”

Mae: “Yes I apparently don’t blame you, but I can’t stop thinking about him when my only daughter doesn’t have enough time to come and check on me, nurse.”

Nurse: “I have a solution to that, I will volunteer to be visiting you after every two days, and we start an exercise session so that you won’t be thinking about family members so much. I will also talk to your daughter to at least spare some hours and visit you. You will get better mom and all the best. I will visit you two days later and eat well never lose hope. Bye for now,”

Mae: “Bye nurse, take care too.”

References

 Koelling, T. M., Johnson, M. L., Cody, R. J., & Aaronson, K. D. (2005). Discharge education improves clinical outcomes in patients with chronic heart failureCirculation111(2), 179-185.

Home Visit with Sallie Mae Fisher Video

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Safe guarding in health and social care

Safe guarding in health and social care
Safe guarding in health and social care

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Safe guarding in health and social care

Reasons particular people are more vulnerable to abuse and harm self and others

A vulnerable group includes peoples who are eligible or are in receipt of community care.  This includes people with physical disabilities, learning disabilities, and people with cognitive deficits, people who are frail physically and mentally. Drug addicts and alcoholics are also identified as vulnerable group.  These people are generally weak and are unable to defend themselves from harm or abuse and therefore need safe guarding in health and social care.

In this context, abuse refers to the violation of a person’s human rights as well as their civil rights by another stronger being.  Abuse takes many forms including sexual abuse, emotional abuse, and psychological abuse, physical, financial or institutional abuse (Callewaert, 2011). Some of the signs and symptoms include unexplained injuries and frequent illnesses. If the care giver gives implausible injuries explanation is an indicator of neglect or physical abuse.  

Other indicators include frequent ER visits for vulnerable people with chronic diseases or if the functionally impaired vulnerable person comes to the hospital without any company (Podnieks, Penhale, Goergen, Biggs & Han, 2010).

Safe guarding in health and social care

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Sexual abuse includes all sexual practices where the vulnerable people have not given consent such as rape, sexualised language and inappropriate touching. Physical abuse includes pushing, pulling, burning, forcefully restraining a person and misusing their medication. Psychological abuse includes all activities that cause a person to have emotional distress such as verbal abuse, humiliation, intimidation and harassment. 

Financial abuse includes stealing from the person, fraud and resource exploitation.  Neglect is a type of abuse that involves denying the vulnerable person the adequate medical and social care (Alexandra Hernandez-Tejada, Amstadter, Muzzy & Acierno, 2013).

 In discrimination type of abuse, the person is treated in unfavourable manner due to their gender, age, type of disability and ethnic background. Lastly, the institutional abuse includes failing to give services to the vulnerable person due to reason to another.

It is important to note that abuse can take place in various settings including the vulnerable person’s homes, nursing homes, state facilities, and at the hospitals. The main issue is early identification of abuse. This is because of the many abuse of the vulnerable people, only a small fraction of them is detected (Ansello & O’Neill, 2010).

Safe guarding in health and social care

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 The vulnerable groups are at risk of self-harm and abuse mainly because they often dependent of care givers to manage their daily activities such as dressing, bathing and in the maintenance of their personal hygiene. Additionally, these people tend to have little ability to utilize their self-defence tactics or mechanisms to avoid violence. It is also commonly assumed that these people with disability do not comprehend what is happening to them; hence, even when the persons disclose what has happened to them, they are often not believed. The following are the reasons why the some people are vulnerable to abuse and self-harm.

 One of the reasons for vulnerability of the special group is the issue of dependency. The special group are more vulnerable if they are dependent to other people for daily activities.  Evidence base studies reports that 97%-99% of the people who abuse the vulnerable individuals are care givers and trusted individuals, and it is estimated that 44% of the victims relate to the persons extent of disability. In most cases, the abuse may not be reported because of fear of the vulnerable person’s safety, shock, and reluctance of the witnesses to get involved or in breaking the silence code (Callewaert, 2011).

 Communication abilities are other reasons why vulnerable individuals are prone to abuse or self-harm. The vulnerable person may lack means of communicating to others about their abuse. This could be due to poor articulation and lack of effective expressive skills. In some cases, the vulnerable person may need assistive devices to communicate which could be lost, taken away or even become misplaced, hindering communication between the abused person and the person in charge.

In some cases, the vulnerable may lack enough resources (in terms of monetary), which can be used to replace the faulty or lost communication devices. This is worse of the person is physically unable to move due to the nature of their disability, which would make themselves unable to move or run way from the abusive situation. In adequate resources will make the individual person run away from the abuser or terminate their services (Podnieks, Penhale, Goergen, Biggs & Han, 2010).

Safe guarding in health and social care

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 Other reasons that are associated with increased vulnerability include social isolation where the vulnerable person lives in over protected environments. The lack of physical access makes the vulnerable individual lack skills to communicate to the community that they are suffering.  The presence of misleading roles as well as expectations in the society can make the abused individual remain silent, increasing risk of abuse.

For instance, the vulnerable groups are normally advised to be submissive and compliant, and are not support to question their authority. This lack of social exposure could make the vulnerable person to continue to suffer (Podnieks, Penhale, Goergen, Biggs & Han, 2010).

 Stigmatization, discrimination and stereotyping are other reasons why the vulnerable persons continue to be abused. For instable, the disable people may be discriminated in their work environments. Most of the discrimination cases in the justice systems are often dismissed, denying the vulnerable discriminated individuals their human and civil rights. It is often believed that the vulnerable people such as the disabled are asexual.

People believe that the disabled people (for instance) cannot hold intimate relationships. It is also commonly assumed that the vulnerable people intellect is compromised. This makes it difficult for people to believe their abuse complaints. In incidences where the vulnerable persons have signs and symptoms of abuse, the abuser may quickly claim that they are self-inflicted, putting the vulnerable person to greater risks of abuse and sexual assaults (Hawkes, 2015).

Safe guarding in health and social care

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Risk factors which may lead to incidents of abuse and harm self and others

As mentioned above, vulnerable groups of people are likely to face abuse from their care givers. Risk factors sometimes can be correlated with causes or causatives of abuse of the vulnerable persons. In some cases, the risk factors could also be the risk indicators of the confounders that influence the causal factors on abuse of the vulnerable group. 

For instance, care givers mental status such as depression is causal factors that lead to abuse of the disabled or elderly persons; it is also a risk indicator that this kind of care giver is likely to neglect the disabled or the elderly persons because the care giver is socially withdrawn or lack of interests associated with depression (Hawkes, 2015). Another example of causal relationship is that of shared living with vulnerable person’s abuse.  

Therefore, it is important to identify the risk factors that are associated with abuse incidences as they help in identifying indicator of abuse or maltreatment. To begin with, the health status of the person influences how the person will be treated.   The vulnerable group have reduced decision making ability due to their reduced cognitive functionality. Additionally, the dynamic health status and restricted mobility makes it difficult for the vulnerable person to seek refuge or rescue. The reduced energy levels in these people reduce their ability to perform daily living activities or become independent (Callewaert, 2011).

Safe guarding in health and social care

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The living arrangement has also been identified as a risk factor for abuse. Vulnerable people living alone are likely to be less physically abused. One study conducted indicated that Alzheimer patients living with their immediate families were more likely to be abused. This is because shared residence tends to increase their contact opportunities with the care givers and relatives, hence increasing the rusk for abuse or violent behaviour.

In nursing home settings, abuse of the vulnerable groups is likely to take place if the standards of the nursing home are low, the settings have inadequate staff. Interactions between untrained staff and the vulnerable groups living in these home care settings. In most cases, these home care settings have deficient physical environments and the policies in these institutions are based on the homecare settings interests instead of the vulnerable groups (Hawkes, 2015).

Cultural factors are key determinants of abuse on the vulnerable people. For instance, in some cultures, domestic violence is viewed as illegitimate and is most likely hidden.  This is because if family friends, neighbours and kin learn of the behaviour, they are likely to result in informal sanctions. In this case, person’s abuse is likely to be hidden from the society and the relevant authority.

Other cultural factors include the general assumptions that vulnerable people are weak, dependent and weak. In some cultures, there has been erosion of bonds between the generations; especially where young people have migrated to the urban centres in communities where the elderly people are cared for by their young ones. The elderly people are left alone and become socially isolated (Callewaert, 2011).

Safe guarding in health and social care

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 The intra-individual characteristic of the abusers is another risk factor for patient abuse. If the care giver suffers from psychotic disorders or is using substance use; then it is likely that the care giver will mistreat the vulnerable person.  The type of abuser dependency is another risk factor that determines if the vulnerable will be abused or not.  The risk of abuse is higher if the vulnerable person depends financially on the care giver.  

The study indicates that caregivers may lack coping strategies or lack resilience. This is often associated depression and increased anxiety. In some cases, the perspectives of the care givers determine their attitudes. Aggressive and abuse caregivers believe that the care giving on these vulnerable   persons as burdensome without any reward (Podnieks, Penhale, Goergen, Biggs & Han, 2010).

The intra-individual characteristics of the victims also increase risk of abuse. One study conducted in Netherlands found that victim’s verbal and physical aggression influenced how they would be treated by the care givers. The study also indicated that financial mistreatment of the care givers can make them become aggressive.  Several studies have associated gender as a risk factor for abuse; which reports higher number of victims with adults. The study indicates that women tend to have more emotional and physical abuse as compared to males.

The relationship between the perpetrator and the victim has been investigated. Although the study findings in inconclusive, it is believed that the most of the abusers are spouses of the victims. Other studies have reported race or ethnicity as the key concern; but the study findings cannot be generalized (“Older people have high risk of suicide after self-harm”, 2012).

Safe guarding in health and social care

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 Other risk factors mentioned include the intergenerational transmission. Research indicates that adults who had undergone child maltreatment, neglect and abuse are likely to maltreat or harm others. Similarly, social factors play a major role as risk factors for abuse of vulnerable individuals.

Poverty, unemployment and low socioeconomic status increases the likelihood of the vulnerable groups to be maltreated or abused; especially if poverty interacts with other social factors such as depression, drug use and social isolation. This could lead to aggression of the care giver on the vulnerable persons (Parle, Kaura, Sethi & Jena, 2013).

References

Alexandra Hernandez-Tejada, M., Amstadter, A., Muzzy, W., & Acierno, R. (2013). The National Elder Mistreatment Study: Race and Ethnicity Findings. Journal Of Elder Abuse & Neglect, 25(4), 281-293. http://dx.doi.org/10.1080/08946566.2013.770305

Ansello, E., & O’Neill, P. (2010). Abuse, Neglect, and Exploitation: Considerations in Aging With Lifelong Disabilities. Journal Of Elder Abuse & Neglect, 22(1-2), 105-130. http://dx.doi.org/10.1080/08946560903436395

Callewaert, G. (2011). Preventing and Combating Elder Mistreatment in Flanders (Belgium): General Overview. Journal Of Elder Abuse & Neglect, 23(4), 366-374. http://dx.doi.org/10.1080/08946566.2011.608059

Hawkes, N. (2015). Young goths may be more vulnerable to depression and self harm, study finds. BMJ, h4643. http://dx.doi.org/10.1136/bmj.h4643

Older people have high risk of suicide after self-harm. (2012). Mental Health Practice, 15(9), 5-5. http://dx.doi.org/10.7748/mhp2012.06.15.9.5.p8562

Parle, M., Kaura, S., Sethi, N., & Jena, P. (2013). ROLE OF MEDIA IN SAFE GUARDING HEALTH OF THE SOCIETY. INTERNATIONAL RESEARCH JOURNAL OF PHARMACY, 4(10), 16-20. http://dx.doi.org/10.7897/2230-8407.041005

Podnieks, E., Penhale, B., Goergen, T., Biggs, S., & Han, D. (2010). Elder Mistreatment: An International Narrative. Journal Of Elder Abuse & Neglect, 22(1-2), 131-163. http://dx.doi.org/10.1080/08946560903436403

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Treating Addison’s Disease Essay

Treating Addison's Disease
Treating Addison’s Disease

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Treating Addison’s Disease

 Side effects of using corticosteroid to treat Addison’s disease

 Patients diagnosed with Addison’s disease needs to take up their medication daily in order to replace the inadequate hormones. This normally helps the patients to live a normal life. Treatment mainly involves use of corticosteroids (steroid therapy) to replace hormones lost and those not produced by the aldosterone. Although these medications are effective, corticosteroids are associated with short term and long term side effects (Bentley, 2011)

The short-term side effects includes stomach upset, increased irritability, weight gain due to water retention, increased fat on the face, unusual hair growth , high blood pressure, and risk of other infections. The long-term side effects include muscle weakness, brittle bones, and stunted growth among the children. To minimize such side effects, people taking the drugs should be watched carefully and of necessary, their doses reduced as low doses can be effective and have minimal side effects (In Arieti, 2014).

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  Factors that make it problematic for management Addison’s disease in adolescents

  The process of diagnosing Adrenal insufficiency is usually a challenge. This is because most of clinical manifestation are nonspecific, and tend to vary according to the underlying causative agent and extent of disease progress. It is important to make early diagnosis as the disease can be life threatening if not diagnosed early enough.  The signs and symptoms and management of the diseases are the main challenges faced by the adolescents diagnosed with Addison’s disease.  These include issues such as fatigue, malaise, and general muscle weakness. This negatively impacts on quality of life and their daily activities (Helms, 2015). 

 Importance of inter-professional team for treatment of Addison disease

Team-work in management of Addison disease is important as it aids in improving patient quality of life, reduce mortality, improve communication, reduce errors, and increase patient satisfaction. In this case study, healthcare staff from the following disciplines should work together when delivering care to Addison’s patients. These include physicians, nurses, nutritionists, pharmacists, and physiotherapists. This will help in developing a detailed case related information, which facilitates the decision making processes (Bar, 2013).

References

Bar, R. S. (2013). Early diagnosis and treatment of endocrine disorders. Totowa, N.J: Humana Press.

Bentley, P. J. (2011). Endocrine pharmacology: Physiological basis and therapeutic applications. Cambridge [England: Cambridge University Press.

Helms, R. A. (2015). Textbook of therapeutics: Drug and disease management. Philadelphia,

Pa: Lippincott Williams & Wilkins.

In Arieti, S. (2014). American handbook of psychiatry. New York: Basic Books.

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The Department of Emergency Essay

The Department of Emergency
The Department of Emergency

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The Department of Emergency

Question 24

The Department of Emergency has the role of providing emergency services that are comprehensive to all patients 24 hours in 7 days of a week throughout the year. In particular, it offers patient care services including:

  • Accepting every patient who comes with acute illness and provide treatment for them.
  • Accepting 5-level triage patients as stipulated in the Canadian Triage Acuity Scale System (CTAS); and ensure assessment and sorting of patients is done according to acuity.
  • Performing emergent resuscitation and medical intervention.
  • Planning for the assessing, diagnosis, treatment as well as referrals for specialized medical treatment for all patients when necessary.
  • Providing advanced Trauma Care for patients with trauma.
  • Liaising with all other departments in the hospital for admission of patients and follow-up.
  • Providing care when a disaster occurs within the community by operating an Urgent Care Centre in a manner that is almost continuous to ensure needs of patients’ presentations that are less acute are met as well as receiving and assessing the stability of direct admissions, which includes Medivac patients on their way to critical or specialized care units within the hospital.

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Emergency and admission procedures for both new and existing patients have been laid down for any medical, psychiatric and surgical emergency, for the initiation of life-saving care procedures in a timely manner. In particular, for all emergency situations the basic procedures for both new and existing patients begins with diagnosis, initiation of treatment, discharge in case of recovery, admission for treatment continuation or monitoring, appropriate referral for specialized care in case of complications, and then follow up services.

The department of emergency medicine uses an electronic information system for the purpose of recording patients’ details when available or await for them afterwards, and transfers them to the relevant intensive care units for surgical and acute medical emergencies since they these services are only offered for a short time in the department prior to the transfer of the patients to appropriate in-patient units.

The system’s main users are the emergency department personnel, and its easy access and security is guaranteed due to its location in the King Khalid University Hospital (KKUH) Building’s ground floor, near the building’s main entrance.

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Interdisciplinary geriatric teams Essay Paper

Interdisciplinary geriatric teams
Interdisciplinary geriatric teams

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Interdisciplinary geriatric teams

At my current practicum site, which is the hospital setting, the interdisciplinary geriatric team used comprises doctors, nurses, and pharmacists. The hospital-based team provides the geriatric patient with acute care in the hospital setting. Nurses and doctors carry out a preliminary evaluation, monitor the health status of the patient by making rounds, and work together in formulating an effective treatment plan (Liken, 2011).

The interdisciplinary geriatric team used in home care settings includes a nurse practitioner, a geriatrician, a social worker and a doctor who regularly visit the elderly in his home to help the patient with his medical problems and to monitor the capability of the patient to live at home. Long-term care includes nursing home services, assisted living services and life care communities. The interdisciplinary team includes social workers, nurses, occupational therapist, geriatrician, pharmacists, an ethicist and physicians (Deschodt, 2016).

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Since the patient’s medical problems are usually complex, chronic, and at times typified by reduced cognitive ability, the elderly patient is not really able to keep living at his home. Whenever this happens, the long-term care facility provides an interdisciplinary geriatrics team with a setting for monitoring and treating the chronic diseases of the elderly patients on an ongoing basis (Wieland, 2013).   

The role of advanced practiced nurse (APN) differs according to the site of care in that in the hospital setting, the APN takes medical histories of the frail patient and performs physical exams; prescribes treatments and medicines; and diagnoses and treats chronic and acute problems. In the long term/nursing home/assisted living care setting, the APN basically augments the role of the doctor.

In nursing homes, APNs provide consultative services to nursing homes and in collaboration with doctors, they provide primary care to individual residents (Bakerjian, 2011). In the home care setting, the APN provides high-touch, high-tech services to a patient with acute health care needs. The nurse is also responsible for family and patient teaching and for contacting community resources as well as coordinating the continuing care of the patient (Deschodt, 2016).

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Based on the model used for the interdisciplinary geriatric team at my practicum site, care should be facilitated for the patient in the case study in that the nurse practitioner, doctor and pharmacist need to provide integrated and coordinated care with shared resources and responsibilities and collectively set goals. Care should not be duplicated and the most qualified practitioner needs to provide care for each of the patient’s problem (Liken, 2011).

References

Bakerjian, D. (2011). Care of nursing home residents by advanced practice nurses: A review of the literature. Res Gereontol Nurs, 1(3): 177-185

Deschodt, M., Claes, V., Grootven, B., Heede, V. K., Boland, B., & Milisen, K. (2016). Structure and processes of interdisciplinary geriatric consultation teams in acute care hospitals: A scoping review. Int J Nurs Stud, 55(9): 98-114

Liken, M. A. (2011). Interdisciplinary geriatric teams: experiences of Alzheimer’s family caregivers. National Academies of Practice Forum: Issues in Interdisciplinary Care, 1(7):123–130.

Wieland, D., Kramer, B. J., Waite, M., Rubenstein, L. Z. (2013). The interdisciplinary team in geriatric care. American Behavioural Scientist, 29(6): 655-664

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Quality Health Care Case Study

Quality Health Care
Quality Health Care

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Quality Health Care

Case Study

Introduction

Massachusetts General Hospital was established in the year 1811 and has ever since been committed to the delivery of quality health care. Through the course of history, the medical institution has been committed to the advancement of care through appropriate pioneered research and education to its professionals(Maillet, Lamarche, Roy, & Lemire, 2015). Currently, Massachusetts General Hospital based in Boston is ranked among the top 16 pediatric and adult institutions that offer a bed capacity of 947 and surgical facilities that can admit close to 48,580 patients.

The medical facilities mission stands at a guided approach in meeting the needs of patients and families through the delivery of quality care within a safe and compassionate environment that is advanced through innovative research and education with the intent of improving the well-being of the community. This paper aims at conducting a study on some of the internal and external factors that affect the manner in which healthcare is dispensed in this hospital.

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Internal Factors that Impact the Business

Within different health care facilities, it is essential to consider that many of the employees and the management experience distress. These distresses are attributed to the internal and external factors that affect business (Maillet.et, al.2015). As compared to the external factors, it is vital to note that the internal factors tend to have more direct impact on an organization. In consideration of the Massachusetts General Hospital, it is essential to consider that some of the internal challenges that the organization faces include:

  1. Finances and Resources

The availability of finances and resources has the capacity to impact medical services within an institution of health. This is in consideration of the fact that the demands of medical services tends to be beyond the capacity of a health care institution. On the other hand, healthcare resources tend to be limited with the expectations of the patients considerably higher, a factor that points out to the low quality of health care services (Maillet, et, al.2015).

This has been considered to affect the quality of the health care providers. The limited access to resources translates to less medical aids, infrastructures and equipment’s that spur the process of healthcare delivery within a healthcare system.

  • Service Delivery

The quality of medical services and care primarily depends on service delivery, a factor that requires knowledge and technical skills of the practitioners. Physicians who are poor in the delivery of health services to patients undermine the standards of care, a factor that negatively impacts the delivery of health care services within an institution(Maillet, et.al.2015). This requires that physicians improve their knowledge and competencies with the aim of delivering quality medical services that impact the medical facility.

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  • Human Resource Management

Within a healthcare organization, it is essential to consider that the Human Resource management approaches play a significant role in impacting the quality of health care services. HR management in this case plays an essential role in the manner in which patients are served(Maillet, et.al.2015). On the other hand, the HR and its functions of employing and terminating employees contribute to the success or failure of an organization. The allocation of resources is also another significant element that the HR plays in the dispensation of quality services within an institution of health.

  • Research and Development

In the field of health care services, the element of research and development remains essential since the decision makers rely on this information  on how to improve the health care systems(Maillet, et.al.2015). The role of an effective Health Care Research and Development aids in the provision of information that may lead in the improvement of health care services. This clearly determines that an ineffective research and development approach within a medical institution may hinder the manner in which healthcare services are dispensed, thus impact an organizations functions.

External Factors affecting Health Care Services

It is essential to consider the fact that there are some external factors that additionally affect the manner in which health care services are delivered within an institution. These factors would include:

Economic factors:

It is vital to consider the allocation of decision making under the consideration of economic factors needs to be considered in the offering of effective services within a health institution. Economic factors in this case infer to the resource pressures that have always placed constraints within the health institutions and influence the manner in which decision are made within the health care sector.

According to Maillet et, al (2015), financial constraints are known to contribute to decisions that limit and reduce the investments made on health care. This clearly determines the fact that economic factors have an impact in the delivery of health care services.

Political Factors

It is essential to consider the fact that the lack of political stability within a nation has the capacity to influence health care. On the other hand, political figures are prone to develop legislations that either limits the manner in which healthcare services need to be dispensed within a facility, thus impacting the manner in which healthcare services are delivered(Maillet, et.al.2015). This can be seen in the manner in which laws are developed in regards to costs and prices in healthcare that impact the patients and affect other health institutions.

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Social Factors

Sex, age and hereditary factors remain some of the elements that also determine the manner in which quality healthcare services are offered. The choices that are made are in other words arrived at under the consideration of social factors such as the cultures of the patients, a factor that may limit the delivery of quality health care(Maillet, et.al.2015). 

On the other hand, the structure of the society has a contribution in healthcare delivery since the elements of social support and networking in connection to cultures are considered in healthcare. The development of environments that are socially unfavorable in this case may impact health care systems.

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Technological

Medical technology is a term that is used to determine the equipment’s, procedures and processes under which medical care is dispensed within a medical facility. An instance of technological changes in the medical field would include the development of new surgical procedures, new medical equipment’s and so on(Maillet, et.al.2015).

It is in this case essential to note that the aspect of technology has an adverse effect on health care and the manner in which quality is offered within a medical institution. The lack of appropriate technological outputs in this case limits the delivery of quality healthcare services within a health institution, a factor that affects an organization.

Conclusion

It is vital to consider that the healthcare sector is comprised of many institutions, resources, people and organizations that are comprised together by established policies whose purpose is geared towards the promotion, restoration and the maintenance of health care services. In this case, hospitals are required to effectively function through a system that ensures that its structures execute high-quality services to the patients(Maillet, et.al.2015).

Organizations that have these kinds of structures are known to take the vertical organizational structure through the inclusion of many layers of management, a factor that determines the level where Massachusetts General Hospital is classed. These numerous layers of management are developed to ensure that roles and responsibilities are shared and tasks are achieved exactly as required.

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The organizational structure of Massachusetts General Hospital in this case works through the inclusion of several layers of management that are tasked with different responsibilities. These structures are made up of the boards of directors that consist of influential members within the health fraternity. On the other hand, the Board members leave it upon the executives to oversee the decisions and the day to day operations of the hospital and the manner in which they are performed(Maillet, et.al.2015).

On the other hand, the department administrators are also considered in the structure of the organization and are tasked with the responsibility of reporting to the management. Departments within the medical institution have department administrators who oversee the functions of the department within this hospital. 

It is additionally essential to consider that the patient managers are also part of the hospitals structure and are mainly tasked with the responsibility of overseeing patient care within the institution. Lastly, the service providers include the staff members that conduct the operations of medical facilities on a daily basis. It is in this case essential to consider that the healthcare sector is comprised of many institutions, resources, people and organizations that are comprised together by established policies whose purpose is geared towards the promotion, restoration and the maintenance of health care services.

References

Maillet, L., Lamarche, P., Roy, B., & Lemire, M. (2015). At the heart of adapting healthcare organizations. Emergence: Complexity & Organization, 17(2), 1-11. doi:10.emerg/10.17357.03ec71f53f2d5b9105642fb36f20c406

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