Emergency Care and Triage System
Because it is usually based on circumstances such as crowding and urgency, emergency care is the most sensitive sector of health care. A sudden, unexpected, and agonizing condition that is accompanied with physical and psychological discomfort necessitates immediate attention. Fundamentally, triage systems are intended to aid in the allocation of health-care decisions in emergency situations. As a result, procedures and processes are in place to direct triage care in such circumstances. First, patients should be evaluated and triaged to establish the best location within the emergency department. Following that, patients are assigned to specific clinical areas or transferred to waiting rooms. The complete transfer occurs when the treating paramedic's hand over the patient to the accepting emergency department clinician. To achieve this, a structured approach such as IMIST AMBO must occur between the two parties.
Health Disparities and Minority Groups
Disparities in health are defined as unequal burdens experienced by minority groups as compared to the dominant group in disease morbidity. Racial and ethnic disparities in health care are associated with poor outcomes despite the significant advances in the diagnosis and treatment of most diseases. In essence, ethnic and racial minorities receive lower quality of care, thereby experiencing greater mortality. The health disparities that are often reported are seen in cancer, diabetes, and cardiovascular disease. Causes of health disparities include poor education, poverty, environmental factors, and health behavior of minority groups. Existing solutions for health disparities include promoting wellness and healthy lifestyles, and ensuring that all people have access to basic health care at affordable cost (Betancourt, & Maina, 2004). Moreover, there should be an expansion of disease control programs, and immunization programs to eliminate unequal burdens. As a result, there will be an improvement of both the health of ethnic and racial minorities and the health of the nation.
Uninsured Individuals and Health Care Policies
Uninsured individuals receive health services whose cost is absorbed by different parties such as the federal, state and local governments. The health care policies available for uncompensated health care services include; support for providers that serve uninsured patients through disproportionate share hospital Medicaid funding by the federal and state government. Additionally, there are other state programs that directly help to offset the cost of caring for uninsured patients. There are also payments done by Medicare to hospitals; after adjusting the payment rates for hospitals, Medicare provides money that can be used to cater for uncompensated care (Coleman, & Lipton, 2010). Such payments are given under the prospective payment system, especially to hospitals that serve a large share of low-income beneficiaries.
Impact of Insurance Status on Patient Care
However, it is important to recognize the primary goal for all levels of government is to reduce the number of uninsured. As such, there are various initiatives aimed at subsidizing the cost of insurance covers. In most cases, there is a difference in how the uninsured are triaged when compared to those with insurance covers. Since the various health care policies cater for a certain proportion of the cost, hospitals usually provide incomplete services to such patients. In most cases, the patient is required to undertake to follow up tests or treatments with out-of-pocket money (Horwitz, Busch, Balestracci, Ellingson, & Rawlings, 2005). Lack of money leads to patients postponing such follow ups, thereby deteriorating in terms of their health due to undetected health issues.
Ethical Considerations in Emergency Care
When patients arrive in the emergency department, the triage nurse conducts a quick assessment and actions are taken according to protocols. As such, due to time constraints, actions are not taken based on the patients preferences. Moral and ethical problems arise in this complex environment for nurses who have to execute various interventions without informed consent of the patient. Even though the patients should have autonomy on the main decisions regarding their lives, nurses have ethical obligations to do the greatest good in most emergency cases. However, after the patient receives medical attention, they may not agree with some decisions made by the nurses. In some cases, such patients have ended up filing lawsuits to hospitals who made health decisions without their consent (Coleman, & Lipton, 2010). Even though it is the duty of the nurse to save lives of patients, it becomes difficult to deal with such patients.
Access to Care for Uninsured Patients
In emergency cases, there are no conflicts when a severely injured person is also uninsured. In essence, every patient in the emergency department should receive medical care regardless of whether they have insurance covers. The fundamental responsibility of any hospital is to save lives by providing quality care to people in need. Therefore, every patient should receive such attention during an emergency to make sure they gain health stability. However, if the person is uninsured, any further treatment required by such patients will require them to pay (Betancourt, & Maina, 2004). However, in some cases, the hospital can offer uncompensated care, especially if they receive funding from different programs to support health care activities.
Strategies to Make Health Care Affordable
There is the presence of large numbers of uninsured persons, especially the low-income earning families. Their inevitable need for care requires efficient strategies that will ensure that health care services are affordable. As such, there should be complex mosaic of government programs and private initiatives to defray the cost of that care. In addition, less fragmentation and better organization in hospitals can lead to more effective care delivery and treatment of uninsured patients. Health care providers should also collaborate in efforts to support and lobby for additional Medicaid funds. As a result, the cost medical care will be affordable to all individuals, and even the uninsured will be able to access care and treatment more cost effectively.
References
Betancourt, J. R., & Maina, A. W. (January 01, 2004). The Institute of Medicine report "Unequal
Treatment": implications for academic health centers. The Mount Sinai Journal of
Medicine, New York, 71, 5, 314-21.
Coleman, M., & Lipton, H. (January 01, 2010). Bereavement practice guidelines for health care
professionals in the emergency department. International Journal of Emergency Mental
Health.
Horwitz, S. M., Busch, S. H., Balestracci, K. M., Ellingson, K. D., & Rawlings, J. (January 01,
2005). Intensive intervention for uninsured emergency department patients. Academic
Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine,
12, 7, 647-52.
