A New Road to Health Care: From Treatment to Prevention

Healthcare systems place emphasis on three main functions, which include cost reductions, improvement of health outcomes, and improving patient satisfaction. In this regard, the preventive healthcare approach is more effective than the traditional treatment model with respect to these functions (Sultz & Young, 2014).  With respect to this, it can be argued that traditional healthcare systems that focus on treatment should change to preventive healthcare because of significant cost reductions. At present, there is no doubt that the increasing costs of healthcare pose a significant challenge. Therefore, one of the suggested ways that can be used to address this issue of increasing costs of healthcare is the change from treatment-based healthcare system to preventive healthcare system (Waters, Haby, Wake, & Salmon, 2000). Apart from the economic benefits associated with preventive healthcare, there are potential health benefits associated with prevention. Schoen, Doty, Robertson, & Collins (2011) maintain that preventing a disease is more sound approach than dealing with the outcomes of the disease when it reaches advanced stage. In addition, there is empirical evidence supporting the use of preventing measures as a cost-effective strategy to improve health (Koh & Sebelius, 2010; Waters, Haby, Wake, & Salmon, 2000). Preventive care has also been argued to be essential; this is because of the fact that in the treatment of serious conditions, early diagnosis is crucial. Essentially, beginning the treatment early increases the chances of recovery. In the current treatment-based healthcare system, those lacking medical insurance are unlikely to receive healthcare services. According to Koh & Sebelius (2010), the uninsured are three times unlikely to receive healthcare services when compared to their insured counterparts. This deficiency can be addressed by a preventive healthcare system. Besides, preventing care is increasingly being praised in various parts of the globe from medical professionals and politicians. For instance, the Obama administration has called for an increase in preventive care benefits on grounds that the government expenditure on prevention is too little (Church, 2003).

Current Practice in the Hypothetical Community

The current healthcare practice in the hypothetical community is characterized by emphasis on disease treatment. There are little efforts directed towards preventive healthcare. As a result, a significant amount of healthcare expenditure is allocated towards the treatment of diseases. The goals of the current treatment-focused healthcare system in the hypothetical community include reducing costs of healthcare, enhancing health outcomes, and enhancing patient satisfaction. Despite these goals, there is little focus directed towards health promotion and disease prevention, which have been established to play a crucial role in the achievement of the aforementioned goals of healthcare. In addition, the current practice in the hypothetical community is characterized by collaborative process that has the primary objective of ensuring that patients receive the recommended treatment plans. This process involves the coordination and planning of healthcare services in a manner that medical rehabilitation is achieved rather than disease prevention (Koh & Sebelius, 2010). Treatment-focused practice involves assessing the medical condition, development and implementation of a plan for receiving care, coordination of medical resources, communicating the healthcare needs of patients, and monitoring the progress of patients (Cohen, Neumann, & Weinstein, 2008). Cost-effective healthcare is also the goal that treatment-focused healthcare practice tries to achieve; nevertheless, this goal is yet to be fully realized.

Impact of Not Changing the Current Practice

There is a number of inefficiencies associated with the current healthcare practice used in the hypothetical community. First, treatment-focused healthcare practice fails to detect diseases, which implies that healthcare institutions have to deal with the symptoms of diseases that are at advanced stage. Such an approach to healthcare has a negative impact on healthcare outcomes since it reduces the likelihood of full recovery (Diamant, Wold, Spritzer, & Gelberg, 2000). Therefore, failing to change the current practice will have a negative impact on health outcomes. In addition, failing to adopt a new approach in healthcare practice will lead to an increase in the costs of healthcare. Also, the fact that a treatment-based healthcare approach is more expensive implies that most people will not access healthcare services in the event that the current practice is changed to adopt a healthcare system that is more cost-effective when compared to the current treatment-focused healthcare system (Haddix, Teutsch, & Corso, 2003).

The Affordable Care Act and Its Focus on Prevention

There is no doubt that focusing on prevention has a number of benefits, including improving health, reducing the costs of healthcare, and improving the quality of care (Schoen, Doty, Robertson, & Collins, 2011). In this regard, the Affordable Care Act (ACA), through the Prevention and Public Health Fund, focuses on prevention by addressing the variables that influence people’s health, including workplace conditions available of affordable and quality food, transportation, education, and housing. Through focusing on the factors that cause chronic illnesses, the ACA helps in shifting the focus of the healthcare system from disease and sickness towards prevention and wellness (Schoen, Doty, Robertson, & Collins, 2011). The Prevention and Public Health Fund has the main objective of expanding and sustaining the needed capacity in disease prevention, facilitating early detection of the disease, managing the diseases before they increase their severity, and offering communities and states the resources required to encourage healthy living. In addition, there are preventive services that are covered under ACA, such as tests, screening, immunization shots, and wellness visits (Sultz & Young, 2014).

Description of the New System

The new system will be based on a preventive healthcare model, which will emphasize on adopting measures aimed at preventing diseases rather than treatment of diseases. The following sub-sections describe the specific aspects of the new healthcare system for the hypothetical community.

Education and Training Activities for Professionals and Community Members, Including Children

For medical professionals, they have to use patient-centered counseling that is effective, understand the procedures for and principles of screening, understand the important role that prophylaxis and immunization play in preventive care, and implement strategies aimed at promoting health of the population (Cohen, Neumann, & Weinstein, 2008).

With respect to patient-centered counseling, medical professionals can help members of the community in modifying their health-related behaviors through the use of strategies that draw upon an understanding of how individuals change. In this regard, medical professionals should be well informed of the behavioral change model and help patients to acknowledge their particular risk behaviors, make a decision on a personalized action plan, implement the plan, and address any relapses that may be observed (Diamant, Wold, Spritzer, & Gelberg, 2000).

With respect to understanding the procedures and principles of screening, it is imperative that medical professionals have the skills needed to test for health problems devoid of signs or symptoms that may indicate the existence of a problem. In this regard, medical professionals should be equipped to be able to screen patients for a number of diseases, including substance abuse and mental disorders; musculoskeletal disorders; congenital disorders; prenatal disorders; hearing and vision disorders; infectious diseases; environmental, metabolic and nutritional disorders; cardiovascular diseases; and neoplastic diseases. In addition, it is imperative for medical professionals to know when screening is an appropriate measure as well as the procedures to be utilized and how to utilize them in an effective manner (Diamant, Wold, Spritzer, & Gelberg, 2000).

Medical professionals should also understand the crucial role that immunization can play in lessening the occurrence of several illnesses, such as rubella, mumps, measles, polio, tetanus, diphtheria, and pertussis. Medical professionals should not only understand the crucial role that immunizations play, but also have knowledge on how and when to administer immunizations (Mahar, 2006).

Besides focusing on individual patients, medical professionals in the new system will focus on population-based care, whereby medical professionals are supposed to address the health needs of the whole population of patients enrolled in a specific health plan. As a result, the new healthcare system will develop new reimbursement methods aimed at encouraging medical professionals to adopt population-based practices, such as capitation, whereby medical professionals are paid a specific amount per patient on a monthly basis to offer comprehensive care.

In a preventive health care system, it is also imperative for medical practitioners to participate in public advocacy and education aimed at disease prevention. The involvement of medical professionals in public advocacy and education may involve various activities, such as advocacy for changes in public laws, ordinances, and policies; helping in the development of community education curriculum; speaking to community groups, churches, and schools; and writing articles in newspapers and other publications relating to preventive health. In addition, medical professionals should be able to identify health problems experienced in the local community, on which public advocacy and education can have a significant impact. Medical professionals should also be able to develop suitable strategies aimed at improving public knowledge, encouraging healthy behaviors, and discouraging behaviors that are not healthy (Koh & Sebelius, 2010).

Hospitals and Changes They Have Made from Treatment to Prevention

With respect to the change from treatment to prevention, hospitals operating within the hypothetical community must adopt changes that place emphasis on proactively keeping the population well. This demands that hospitals make huge investments in prevention, which can result in declines in hospital admissions by about 20% (Haddix, Teutsch, & Corso, 2003). Instead of waiting for patients to visit, hospitals should adopt a concept Diamant, Wold, Spritzer, & Gelberg (2000) refer to as population management. The concept entails scanning large populations with the aim of ascertaining the most pressing health needs and coming up with the ways through which those needs can be dealt with. A population refers to the specific community, in which a hospital intends to improve health outcomes, costs, and quality. Population health management involves a network of organizations and doctors working together to offer a continuum of care that begins from the homes of patients, hospitals, medical homes, rehabilitation centers to nursing homes (Haddix, Teutsch, & Corso, 2003). The implications on hospitals for this change from intervention to prevention is that hospitals in the hypothetical community should move away from the traditional approach characterized by patents visiting towards a more proactive role in preventive care through taking services to the people. Through population health management, it is evident that hospitals are involved in primary prevention level. In this regard, hospitals in the hypothetical community are recommended to make significant investments in primary prevention activities, such as public health education and immunizations. Besides primary preventions, hospitals also make substantial investments in secondary and tertiary prevention (Mahar, 2006). Secondary prevention comprises of strategies that can be used in the detection and addressing of a disease before its symptoms emerge. Tertiary prevention focuses on methods aimed at reducing the negative effects associated with symptomatic illnesses using treatment and rehabilitation. Essentially, the changes in the hospitals should be geared towards playing a proactive role in healthcare rather than playing a passive role characterized by patients visiting the hospital (Schoen, Doty, Robertson, & Collins, 2011).

Health Centers, Clinics, and Preventive Services that they Offer

There are a number of preventive healthcare services that can be offered by health centers and clinics, including immunizations, physical examinations, screening tests, counseling services like exercise and nutrition guidance, and surgical procedures aimed at stopping the progression of a particular disease (Schoen, Doty, Robertson, & Collins, 2011). In terms of population, the preventive services tailored for adults will include alcohol abuse counseling and screening, screening for blood pressure, aspirin use in order to curb cardiovascular disease, cholesterol screening of colorectal cancer, screening for diabetes, screening for HIV, depression screening, obesity screening, and immunization vaccines. For women, the preventive services could include anemia screening, counseling for breast cancer genetic test, breast cancer screening and counseling, breastfeeding counseling, contraception, and folic acid supplements (Schoen, Doty, Robertson, & Collins, 2011).

Doctor’s Offices

In the new healthcare system, doctors will not only be waiting for patients to visit. Instead, their practice will focus both on individual patients presenting themselves at the clinic seeking care as well as the focusing their practice on population care (population-based care). This involves monitoring the health state of the population, problems associated with health care, sources of the diseases, and applying population-based care principles to the population. In addition, doctors will be actively involved in public advocacy and education through identifying health problems in their community, for which education and advocacy can result in significant effect followed by determining suitable strategies that can be used to improve public knowledge as well as encourage behaviors that are healthy (Haddix, Teutsch, & Corso, 2003).

Insurance Companies

Insurance companies will play a significant role in the preventive health care system by providing coverage for preventive services, including wellness exams, all forms of screening for all populations, immunization services, and all forms of health-related counseling for all populations.

Stakeholders

The stakeholders in the new healthcare system for the hypothetical community will comprise of providers, employers, payers, patients, the community and interest groups representing people with specific diseases, such as American Diabetes Association.

“Day in Life”

When entering a patient facility, residents of the hypothetical community will expect to find medical professionals who are well trained in population-health principles together with individualized care principles. Patients will not only receive treatment for the disease they are currently having, but physical exams will be performed to prevent potential serious diseases before they develop. Essentially, medical professionals will not only be trained to deal with symptomatic illnesses but also asymptomatic illnesses (Haddix, Teutsch, & Corso, 2003).

Description of Mental Health Awareness, Diagnosis, and Treatment within the New Preventive Healthcare System

In order to promote mental health awareness in the new preventive healthcare system, emphasis will be placed on increasing awareness regarding how mental health can be promoted and prevented as well as reducing stigma associated with mental illness. In addition, emphasis will be placed on enhancing the capacity of community organizations, post-secondary institutions, schools, caregivers and families for them to promote mental health among children, youth, and adults. In addition, organizations will be encouraged to develop mentally healthy workplaces (Haddix, Teutsch, & Corso, 2003). Mental health tests and diagnosis that will be incorporated into hospitals within the hypothetical community will include psychological evaluations, lab tests, and physical examinations. Hospitals will have equipment in order to undertake these diagnoses of mental illness. In addition, hospitals will have equipment to enhance their treatment capacity for mental health. Hospitals will liaise with social workers to improve treatment of mental diseases.

Prevention for All Ages and Development Stages of the Population

Disease prevention will involve almost every aspect of the community in order to target all ages of the population. For instance, learning institutions will be used to target children and young adults. Essentially, schools will be used as the platform for disseminating knowledge relating to healthy behaviors. Workplaces will be used to target older people by collaborating with organizations to set up workplace environment and policies that encourage healthy behaviors among people. In addition, various health promotion campaigns will be tailored in accordance with the needs of target populations. Examples of such campaigns will include encouraging community members to go for immunizations and organizations’ community meetings aimed at educating members of the public and encouraging them to adopt healthy behaviors. Essentially, health promotion and disease prevention efforts will be customized in accordance to the needs of the target population (Diamant, Wold, Spritzer, & Gelberg, 2000).

Financial Impact of Changing the System

There is no doubt that the new preventive healthcare system is a good investment. In this regard, it has been reported that preventive care is capable of reducing patient visits to a hospital by 20%, which is a direct indicator of positive health outcomes associated with preventive healthcare (Cohen, Neumann, & Weinstein, 2008). Regardless of the initial costs associated with the implementation of the preventive healthcare, such as public education and enhancing the preventive capacity of hospitals, the long-term health and costs savings outweigh initial costs. Case studies of preventive care for different diseases have reported significant cost savings, at the same time improving the quality of care.

Conclusion

The need to change from the intervention-based towards preventive-based healthcare system in the hypothetical community is mainly motivated by the need to improve health outcomes, reduce costs, and improve patient satisfaction. The current healthcare practice in the hypothetical community is mainly intervention-based, which implies that little efforts have been directed towards the early detection and alleviation of diseases. Failing to change from the current treatment-based healthcare towards a prevention-based healthcare will have significant ramifications, including poor health outcomes, an increase in the costs of healthcare, and limit access to healthcare. The new preventive healthcare system will be characterized by medical professionals playing a proactive role rather than a passive role in the provision of care by using population-based approaches to care delivery. Preventive care services that will be offered in hospital settings will include immunizations, physical exams, screening tests, and counseling services.

References

Arnrich, B., Mayora, O., Bardram, J., & Tr?ster, G. (2009). Pervasive healthcare: Paving the way for a pervasive, user-centered and preventive healthcare model. Methods of Information in Medicine, 49 (1), 67-73.

Church, V. (2003). Economic costs of diabetes in the US in 2002. Diabetes Care, 26 (3), 917-932.

Cohen, J. T., Neumann, P. J., & Weinstein, M. C. (2008). Does preventive care save money? Health economics and the presidential candidates. New England Journal of Medicine, 358 (7), 661-663.

Diamant, A. L., Wold, C., Spritzer, K., & Gelberg, L. (2000). Health behaviors, health status, and access to and use of health care: A population-based study of lesbian, bisexual, and heterosexual women. Archives of Family Medicine, 9 (10), 1043.

Haddix, A. C., Teutsch, S. M., & Corso, P. S. (Eds.). (2003). Prevention effectiveness: A guide to decision analysis and economic evaluation. Oxford: Oxford University Press.

Koh, H. K., & Sebelius, K. G. (2010). Promoting prevention through the affordable care act. New England Journal of Medicine, 363 (14), 1296-1299.

Mahar, M. (2006). Money-driven medicine: The real reason health care costs so much. New York: Harper/Collins.

Schoen, C., Doty, M. M., Robertson, R. H., & Collins, S. R. (2011). Affordable Care Act reforms could reduce the number of underinsured US adults by 70 percent. Health Affairs, 30 (9), 1762-1771.

Sultz, H., & Young, K. (2014). Health care USA. Burlington, MA: Jones & Bartlett Learning.

Waters, E. B., Haby, M. M., Wake, M., & Salmon, L. A. (2000). Public health and preventive healthcare in children: Current practices of Victorian GPs and barriers to participation. The Medical Journal of Australia,, 173 (2), 68-71.