PPACA Response Paper

Hospital Readmission has a high burden to both healthcare systems and patients. Most readmission is thought to be related to the quality of healthcare system. In the US, nearly 20 percent of Medicare patients are readmitted within 30 days after discharge and related with an estimated annual cost of 17 billion (1). Hospital readmission for patients early after an inpatient stay can be a traumatic experience (2).

“The cost to the family and the larger society can be used as one measure of the effectiveness of current and future treatments” (Perkins et al.). It is said that the estimate of the annual cost of a pediatric stroke hospitalization in the United States is about $42 million, however, this amount decreases in comparison with adult stroke. Either way you see it pediatric stroke is still very expensive, because from those children that survive stroke maybe about 50% to 80% will have permanent neurological damage such as hemiparesis

The number of persons over the age of 65 will double by 2030. The older population may also present with comorbidities that demand more physician services. Of the 83 million people over age 62, 14 million will have diabetes, and 21 million will be obese. However, first year enrollment in medical schools has declined every year since 1980.Other conditions that will drive demand for physician services include rates of heart disease and cancer, two of the leading causes of death in the U.S. It is projected that the shortage will most affect the primary care sector of physician services.

Congestive Heart Failure Acute Decompensated Heart Failure (ADHF) is a clinical syndrome of worsening signs or symptoms of heart failure requiring hospitalization or other unscheduled medical care (Felker 2014). ADHF formerly known as congestive heart failure is one of the leading cause for hospitalizations in the United States. ADHF accounts for approximately 1 million hospitalizations per year in the United States (Arnold & Porepa 2012). According to the Acute Decompensated Heart Failure National Registry, patients hospitalized with ADHF have a substantial risk of in-hospital mortality and rehospitalization. Pathophysiology

1) In mitral stenosis a diastolic murmur is present due to stenosis, or narrowing of the valve. The murmur is heard when the mitral valve fails to open appropriately in diastole. The leaflets of the valve are usually thicker, stiffer, and become misshapen from the effects of rheumatic fever or a congenital defect (Porth, 2011). The crackles in her lungs are likely due to left sided heart failure leading to pulmonary hypertension.

Given this view, there is an increased interest in the difficult problems, risks, needs, and concerns of survivors who have completed treatment and are cancer-free. (NCCN, 2009) in its research it was found that physical and mental quality of life for colorectal cancer survivors was poor when compared to those of the same age but do not have bowel cancer. In support of NCCN findings, NICE (2012) went further and stated that though issues and symptoms were very high within the first three years, long-term effects of treatment can persist and include fatigue, sleep difficulty, fear of recurrence, anxiety, depression, negative body image, sensory neuropathy, gastrointestinal problems, urinary incontinence, and sexual dysfunction. The difficult challenges of colorectal cancer survivors can and should be addressed by health care providers and the research community to ensure effective interventions and models of care to manage these long-term effects of colorectal cancer treatment and long term care of bowel cancer survivors, and improve existing models of survivorship care. Therefore care should shift from surveillance for recurrence initially to management of co-morbidities and receipt of appropriate preventive long-term care objectives.

Being diagnosed with mumps is a risky situation for the ones surrounding the diagnosed people. The amount of people diagnosed with mumps is very less compared to the past times. Before, there were about 34,000 patients diagnosed with mumps. From 2000 to 2006, there were 79 people diagnosed with mumps. In Toronto, people ages 18 to 35 are affected the most from mumps.

Sepsis impacts the U.S. healthcare based on its high incidence, mortality rates, financial costs and long-term adverse effects on sepsis survivors. To reduce this impact, the rapid initiation of bundled care based on the SSC can reduce the severity of severe sepsis and septic shock thereby, reducing patient mortality and long term adverse effects. The objective of this paper is to discuss the benefits of implementing a sepsis bundle focusing on the SSC recommendations and the improved effects realized on patient outcomes and morality rates. The clinical question is as follows:

The cost of nonadherence is estimated to cost the US healthcare system $100 to $300 billion a year (Phrma, 2015). This figures includes cost of hospitalization, premature death and nursing home admission. Adding an additional $2,000 to the annual per patient cost, 40% of the nursing homes admission has been associated with non-adherence (Phrma, 2015). Socioeconomic factors One’s socioeconomic levels can contribute to negatives outcomes related nonadherence.

There are 5 million people in the United States with heart failure and an estimated 400,000 to 550,000 new patients are diagnosed each year. Annual

Preventatives for Medication Errors Administration of medications has become more complex and the process more exacting. About 15% of adverse events occurring in hospitals are related to medication. An estimated 98,000 people die every year from medical errors in U.S. hospitals, and a significant number of those deaths are associated with medication errors (Tzeng, Yin & Schneider, 2013). About 700,000 emergency department visits and 120,000 hospitalizations are due to ADEs annually ("Medication safety basics," August ). These errors occur commonly when the nurse becomes easily distracted and loses focus on the task at hand.