Policy makers, health care providers, and patient advocacy groups across the United States have helped to promote advance health care planning. This type of planning entails preparing for future medical care in case an individual is unable to make his or her own decisions at the end of life. Advance care planning helps individuals with chronic diseases to have the choice of being guided when they are not able to speak for themselves, including assurance of the availability of finances (Conroy, 2010). Sadly, many American families fail to engage in advance planning. One common reason for this failure is that many families do not view such planning as urgent. Additionally, many families fail to undertake advance planning because of their belief that it is unnecessary to do so; they believe that the fate of an individual is usually determined by external factors, including relatives, community, and, most of all, God (Conroy, 2010). Many families believe that planning for bad things in advance may cause them to happen, so they avoid planning in advance. Moreover, patients and their family members have failed to picture the event of being dependent on others in the future. This entails the situation where the patient will be expected to depend on other family members for medical support. For that reason, most people want to remain independent when they are old, and the idea of depending on others makes them uncomfortable.
Family members also fail to plan early because of the hope that life will improve in the future. People tend to live in the faith that life will get better tomorrow, which causes them to overlook the idea of early planning. Some aged people do not have close relationships with their family members, making it hard for the family to undertake early financial arrangements for the elderly (Seymour & Horne, 2010). Another reason why many American families fail to plan for health care early is their fondness for living life one day at a time. Many families do not see the need or importance of planning for future events. Finally, many families have focused their resources on other day to day activities. Therefore, they see no need to plan when there are no surplus resources (Seymour & Horne, 2010).
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Education strategies should provide patients and their family members with guides that can assist them in dealing with their reluctance to engage in early financial planning. The educational strategies should be integrated with other interventions, such as consulting experts, to help families in planning for the future. Health care providers and other professionals should focus on teaching patients and their families the importance of early planning so as to change their attitudes and beliefs toward this concept. The government should also establish programs and campaigns to reach out to people regarding the importance of advance care planning for their aged family members (Conroy, 2010).
Ambulatory care entails medical care that is offered to patients on an outpatient basis, including observation, treatment, and rehabilitation services, among others. Health care reformers have looked for different ways in which access to medical services can be expanded. Traditionally, hospitals have been placed at the center of health care delivery. However, the focus has changed, and more attention is now focused on ambulatory care (Berenson, 2016). A number of factors have contributed to this shift. The first factor is technological advancement, which is now helping a large number of outpatient facilities to offer coordinated treatment to patients. Additionally, there has been the development of anesthesia, which is less invasive and requires a shorter recovery time (Berenson, 2016).
Another factor is the availability of physician support. Many health care facilities are now forming partnerships with physician teams to perform various procedures in ambulatory care facilities. They are used as a source of referrals between the facilities and health care organizations. Hospitals are able to compete favorably through the establishment of ambulatory services that are less expensive compared to the capital investments normally associated with health care facilities. Ambulatory care units can be set up for fewer expenses than it takes to build a hospital. Patients expect ambulatory care to be conveniently and easily accessible (Berenson, 2016). Many patients want to have brief visits with health care providers, something that ambulatory care services are able to provide. Both public and private payers have also played a significant role in the shift of health care services, such as the transition from surgical to ambulatory care. Payments that are more capitalized tend to encourage the use of sites that are more cost-effective. Moreover, most patients tend to prefer outpatient or ambulatory care services as they are less risky and disruptive to their day to day activities (Berenson, 2016).
A number of issues have been raised in association with the shift from inpatient care to ambulatory care. The shift has led to fragmented care. Outpatient care is mainly split into different uncoordinated units. Additionally, the fragmentation is backed up by lack of systems that can help with needs associated with managing patient care in several locations. Individuals associated with reforming the health care system have been able to identify that a broken health care system cannot be fixed by increasing the access. It is important that the change in how health care is delivered be focused more on health instead of treating the disease (Berenson, 2016). The shift can also help in attaining the goal of improving community health as well as increasing timely access and quality health care that is focused on the patients. The ambulatory health care entails systems that are more user-friendly and patient-centered. However, it is hard to monitor the quality of the health care delivered to the patients. Therefore, this could start quality issues from different outpatient facilities.
The factors limiting access to mental health care are significantly affecting many Americans. More than half the population of adults with mental illness across the United States lacks access to mental health care treatment. Firstly, financial issues are the major barrier to mental health care (Mojtabai et al, 2010). The cost of treatment is still a huge limiting factor of access to mental health services even after the establishment of affordable care act that calls upon medical insurers to offer coverage to patients with mental and behavioral issues. Lack of enough finances tends to limit many people from seeking medical help for their mental illness. Additionally, lack of enough financial resources can result in inadequate and inconsistent treatment.
Another common barrier includes a lack of enough mental health professionals. There is a significant shortage of mental health care providers across the United States compared to any category of health professionals. Rural areas are the most affected areas with less number of mental care professionals (Mojtabai et al, 2010). Urban centers, on the other hand, a large number of patients compared to the available providers which often results in long waiting lists. Lastly, lack of awareness and education of mental health is another significant barrier. Mental illness is difficult to recognize as it has complicated signs and symptoms. Symptoms of mental illness are usually associated with attitude and personality issues. Therefore, there are people who have a mental illness, but lack proper information on how to deal with it (Mojtabai et al, 2010).
- Berenson, R. A. (2016). Improving Performance, Not Just Whatʼs Measured. Journal of Ambulatory Care Management, 39(2), 111-114.
- Conroy, S. (2010). Advance Care Planning for older people. Advance Care Planning in End of Life Care, 39-44.
- Mojtabai, R., Olfson, M., Sampson, N. A., Jin, R., Druss, B., Wang, P. S., … Kessler, R. C. (2010). Barriers to mental health treatment: results from the National Comorbidity Survey Replication. Psychological Medicine, 41(08), 1751-1761.
- Seymour, J., & Horne, G. (2010). Advance Care Planning for the end of life: an overview. Advance Care Planning in End of Life Care, 16-27.
