Multiple Chronicle Conditions and Hospitalization Costs
Multiple chronicle conditions have been linked with increasing health care costs and hospitalization. Taking a look at different scholarly articles, varying arguments purport on the correlation between chronic conditions and hospitalization costs. Scholars argue that the establishment of self-management programs on chronicle diseases reduces health care utilization costs and improves personal health of the patients. Anchored on the information sources of the scholarly articles, this essay intends to undertake a literature review that argues for or against the thesis that establishes grounds for the conclusion drawn.
Self-Management Programs and Health Care Utilization Costs
(Friedman and Basu, 2004) suggest that self-management initiatives on chronic conditions, commonly known as the CDSMP program, enables patients to improve their personal health outcomes and behaviors. As a result, strain in the hospital utilities is reduced as lesser ER visits are recorded, averting health care costs. According to the article, a recent research conducted concluded a significant reduction of ER visits and hospitalization in a period of 6 to 12 months. In addition, a significant amount of $3.3 billion is saved when the CDSMP program is disseminated nationally in the US. This research finding affirms the importance of CDSMP rooted in public health care in an effort to control the costs, supporting the thesis. Furthermore, (Williams et al 2009) in his body of research added finding of (Friedman & Basu, 2004) that documented the value of CDSMP. His research suggests that the program attributes to enhanced care, improved health, and better care. In other words, he refers to this as the Triple Aim. Having in mind the cost-saving benefits of the program, the article suggests the importance of equitably reaching out to different population backgrounds. At times demographic and geographical factors pose to be a challenge in the effective dissemination of the program to the majority of the population, but when it arrives at matters of improving health care on chronic conditions effective measures ought to be put in place.
Readmission Rates and Hospitalization Costs
While (Friedman & Basu, 2004) and (Williams et al., 2009) focused on CDSMP program as a prime factor that would reduce hospitalization cost on multi chronic diseases, (Dartmouth, 2013) begged to differ. In his approach, Dartmouth viewed readmission rates of patients with multiple chronic conditions as a root factor that increased hospitalization costs in the majority of hospitals in the US. According to the article, readmission to US hospitals has raised a red flag due to high implications on cost and quality care, and growing concerns provided needs for preventive measures. As a result, a study that assessed the extent to which multi chronic conditions affect the readmission rates was carried out. The research findings suggested that readmissions rate posed to be high in areas with access to medical care and Medicaid beneficiary charges and occurrence of multiple chronic conditions in such zones is no exception, thus leading to an increase in health care utilization and cost. In addition, the significant impact of primary care physicians on the readmission rates in these areas is brought to question. Contrary to the expectation and earlier evidence, (Hernandez et. al. 2010) saw no reportable findings that could suggest any relationship between primary care physician and readmission rates of patients having fewer chronic conditions that would further affect the cost. Moreover, findings on the research dictate the need to target more chronically ill patients as it reduces the risk of readmission.
Prevalence of Multi Chronic Conditions and Hospitalization
Moreover, additional research has revealed the existence of high prevalence of multi chronic conditions patients with regards to hospitalization (Williams et al, 2009). High prevalence of these conditions suggests the need for better treatment and understanding of these people. Such regards sheds light on the questionability aspect of the effectiveness in improving coordination care, directing patients to better health care, and monitoring their conditions to reduce readmission rates. Even though (Hernandez et al 2010) research findings doubted the effectiveness of primary care follow-up, as a strategy to reduce readmission rates, (Williams et al 2009) emphasized the need of these basic concern and treatment. (Vest and Slawson, 2009) Research, on the other hand, indicates a higher utilization record amongst patients with multi chronic conditions. In his research, a number of two-thirds of total patients hospitalized had multi chronic conditions, a number considered too high. For the purpose of reducing the hospitalization costs, effective measures are proposed, with CDSMP considered to be one.
Cost Implications of Multi Chronic Conditions
(Williams et al 2009) research went further to scrutinize cost implication details imposed by multi chronic conditions patients. The conclusion drawn suggests that longer hospital stays had higher cost implications than high costs recorded on a daily basis. This research attempted to establish initiatives that ensured lengthy stay in hospitalization are potentially preventable in an effort to reduce cost through high-quality ambulatory care. Actions for the initiative were due to growing concerns of a decrease in preventable measures of hospitalization in the United States (Williams et al 2009). However, these preventable hospitalization measures are faced with challenges of increasing multi chronic conditions patients with time. Attempting to address the out-growing concerns (Vest & Slawson, 2010) suggested developing a health care system that educates clinicians on dealing with patients' situations humanely. The system would equip clinicians with skills to address end-of-life crises of patients that would reduce their likelihood leading them back to the hospital repeatedly, reducing hospitalization and saving cost. Thus workers in this spectrum ought to work together with an effort to achieving outcomes for their patients and reduce hospitalization.
Age Factor and Readmission Rates
Furthermore, the age factor contributes to the different levels of multi chronic conditions that might impact the readmission rates. Medicare and Medicaid, known prevalent areas for high multi chronic conditions, consist of older patients between the ages of 75-84. In addition, research records a low level of these conditions amongst the youth aged 18 to 34. (Kaboli et al 2012) research explains these findings as a combination of factors such as lifestyle, access to care social factors, and support that affects the chronic conditions of specific age brackets as earlier noted in the essay. Furthermore, males recorded a narrow scope of patients with chronic conditions experiencing lesser readmission rates compared with their female counterparts. These facts tend to affect the rate of readmission and, consequently, hospitalization and cost.
Conclusion
From the different scholarly articles, the conclusion drawn supports the thesis. A variety of the articles show a relation between chronic disease and the health cost imposed. Most scholarly articles support one another, and variation in thought existed only in readmission rates and CDSMP as prime factors causing a high cost. However, similarities from the sources existed in the essence that all articles complemented each other on the effect of increased multi chronic conditions of patients on hospitalization levels and consequently affecting cost. Light shed on this issue should bring effective measures put in place to counter effects of these conditions on hospital costs.
References
Dartmouth Atlas. 2013. Project and Lake Research Group. Revolving Door: A Report on US Hospital Readmissions. Robert Wood Johnson Foundation
Friedman, B and J. Basu. 2004.” The Rate and Cost of Readmission for Preventable Conditions”
Hernandez, Agrenier, G, B. Hammil and L. Curtis 2010. Relationship between Early Physician Follow up And 30 Day Readmission among Medicare Beneficiaries
Kaboli, P. J. Hockenberry, S.R Johnson and P. Johnes 2012.” Association between Reduced Hospital Length of Stay and 30 Day Readmission Rayte and Mortality.
Jencks, S, V Williams and E.A Coleman 2009.” Rehospitalization among Patients in the Medicare Fee for Service Program. “New England Journal of Medicine” 360:1418-28.
Vest J. and K.M Slawson 2010” Determinants of Preventable Readmissions in the United States: A Systematic Review”.
