DQ: Economic theory must be utilized by the DNP-prepared nurse
DNP 815 Topic 6 DQ 2
Economic theory must be utilized by the DNP-prepared nurse. How can economic theory be applied to your proposed DNP Project?
REPLY TO DISCUSSION
Economic theory is concerned with choice and the assumption is made that choices are made after the consumer has been provided with full information. However, individuals who present within the healthcare sector are frequently unwilling or unable to collect the information required to make this choice. Health economics is used to promote healthy lifestyles and positive health outcomes through the study of health care providers, hospitals and clinics, managed care, and public health promotion activities. Health economists apply the theories of production, efficiency, disparities, competition, and regulation to better inform the public and private sector on the most efficient, cost-effective, and equitable course of action. Such research can include the economic evaluation of new technologies, as well as the study of appropriate prices, anti-trust policy, optimal public and private investment, and strategic behavior (Williams IP, Bryan S, 2017).
The continued growth in the economic evaluation of healthcare over the past years has led to a shortage of trained health economists globally, leading to several universities and/or national governments developing specialized health economics programs to train more health economists. One of the common problems with many of these training programs is that they only educate new health economists to the master’s level, and as such they are unable to cover the many skills needed by a successful health economist. It is important that those individuals who are involved in the provision and purchase of healthcare fully understand the background to this concept and understand some of the terms which are commonly used ( Shiell A, Hawe P, Gold L, 2018).
Without good economic analysis, healthcare is unlikely to progress and only by undertaking systematic reviews is it possible to identify alternatives to existing or new programs. Such evaluation is dependent on the quality of underlying medical evidence, and, because of this, clinical trials are now viewed as a natural vehicle for economic analysis. Health Economics is an applied field of study that allows for the systematic and rigorous examination of the problems faced in promoting health for all. By applying economic theories of consumer, producer and social choice, health economics aims to understand the behavior of individuals, health care providers, public and private organizations, and governments in decision-making (Eddama O, Coast J. A 2018).
References
Eddama O, Coast J. A systematic review of the use of economic evaluation in local decision-making. Health Policy 2018; 86 129–41.
Shiell A, Hawe P, Gold L. Complex interventions or complex systems? Implications for health economic evaluation. Br Med J (Clin Res Ed) 2018; 336 1281–3.
Williams IP, Bryan S. Understanding the limited impact of economic evaluation in health care resource allocation: a conceptual framework. Health Policy 2017; 80 135–43.
- We are discussing the economic and psychosocial theories of nursing. The six components of the psychosocial theory are Psychoanalytic theory supports the notion that all human behavior is caused and can be explained (deterministic theory).
- In each stage, the person must complete a life task that is essential to his or her well-being and mental health.
- One’s personality involves more than individual characteristics, particularly how one interacts with others.
- Humanism represents a significant shift away from the psychoanalytic view of the individual as a neurotic, impulse-driven person with repressed psychic problems and away from the focus on and examination of the client’s past experiences.
- Behaviorism is a school of psychology that focuses on observable behaviors and what one can do externally to bring about behavior changes
- Existential theorists believe that behavioral deviations result when the person is out of touch with himself or herself or the environment.
My DPI population largely reflects the humanistic and behavioral as patients are noncompliant with hypertension regime although we administer free blood pressure medication. We believe the intervention of the DASH diet may assist with the problem. In addition we also have discussed the economic theory of nursing. In this theory our patients consideration include the cost effectiveness of the procedure. As clinicians we evaluate our options and outweigh the cost. In theory, this often considers the long term cost effects. For instance, although providing free medications may seem expensive the cost of this intervention is far cheaper than the frequent emergency department visits patients seek in order to treat conditions covered by the PCP. Hence, the DPI would address this issue.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5520799/#:~:text=Economic%20theory%20suggests%20that%20a,benefits%20outweigh%20the%20opportunity%20cost.
Economic theory is based on a model of human behavior that assumes rationality, a primary motivation to be happy, and the ability to calculate subtle differences between possible trade-offs. The goal of economic theory is accurate prediction of the choices people make regarding resource allocation. . (Scott, et al 2001). Efficiency in resource use (getting the most out of limited resources) is a goal that every health-care organization can accept, regardless of one’s perspective (e.g., that of society, insurers, hospital administrators, or patients). Economic analysis is fundamentally about resource use and can serve an important role in health-care decision-making.
My DNP project is on patient centered fall prevention measures. The sequelae from falls are costly. Fall-related
injuries account for up to 15 percent of rehospitalizations in the first month after discharge from hospital. Inpatient fall rates range from 1.7 to 25 falls per 1,000 patient days, depending on the care area. Extrapolated hospital falls statistics indicate that the overall risk of a patient falling in the acute care setting is approximately 1.9 to 3 percent of all hospitalizations. Based on data from 2000, total annual estimated costs were between $16 billion and $19 billion for nonfatal, fall-related injuries and approximately $170 million dollars for fall-related deaths across care settings in the community. As health care moves toward patient-centered care, fall-related-injury prevention now has the potential to be addressed across the care continuum (Currie,2008. In the United States, there are approximately 37 million hospitalizations each year. Therefore, allocation of the scarce resources of nursing care becomes the responsibility of the frontline nurse.
Also Read: DQ: Explore various science-based theories
References
Currie L. (2008) Fall and Injury Prevention. Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Rockville (MD): Agency for Healthcare Research and Quality (US); 2008 Apr. Chapter 10. Available from: https://www.ncbi.nlm.nih.gov/books/NBK2653/
Scott, R. D., Solomon, S. L., & McGowan, J. E. (2001). Applying Economic Principles to Health Care. Emerging Infectious Diseases, 7(2), 282-285. https://doi.org/10.3201/eid0702.700282.
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Application of Economic Theory
Class,
I would like to share with you the below article which presents two applications of economic theory to the delivery of nursing services in acute care hospitals and evaluates its usefulness in guiding nursing administration research.
Jones, T. and Yoder, L (2010). Economic Theory and Nursing Administration Research—Is This a Good Combination? Nursing Forum, (45) 1, 40-53. DOI: 10.1111/j.1744-6198.2009.00160.x
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Economic Theory and Nursing Research
Students,
Is there a research question from your practice that could be situated in an economic framework for study? Which sorts of nursing questions can you imaginatively explore using economic concepts and analysis?
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Replies
Scarcity and Health Care Economics
Students,
Scarcity is the key component of economics and means having too few resources to satisfy the needs and wants of humankind. Without scarcity, the science of economics would not exist because there would be no need to make choices or tradeoffs. Choices made to overcome scarcity via alternatives are of particular interest to economists. Contemporary economics can be broadly divided into two fields: (1) Microeconomics: Behaviors in individual markets and small economic units to understand their behavior within the market; and (2) Macroeconomics: The “big picture” market that consider aggregate functions of all markets
Health care economics is a recently developed specialized field and is differentiated by the level of government intervention, intractable uncertainty, asymmetrical information, and externalities it involves. Uncertainties in particular lead to inefficient resource allocation in health care that forces non-market institutions to compensate for inequalities.
Why are uncertainties related to disease incidence and treatment efficacy of particular concern to health care economists?
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Replies
Macroeconomics and microeconomics are the two branches of economic discipline, but the majority of health economics’ theoretical basis is microeconomics which focuses on the behavior of market actors and analyses how their behavior influences supply and demand (Olsen, 2017). The relationship between health and wealth propounds that the reduction in poverty strongly impacts life expectancy, whereas an increase in wealth has no further positive impacts on longevity. Scarcity is one of the key concepts at the heart of economics, and it is a dismal fact that resources are scarce. The concepts of cost-effectiveness and productivity represent that it is possible to reduce the amount of labor or capital without decreasing the quantity produced.
The economic evaluation of healthcare interventions has focused on the measurement of health outcomes and alternative measures to preventive healthcare. Healthcare expenditure in rich countries has a high proportion of government-funded healthcare and a high life expectancy.
Olsen, J.A. (2017). Principles in health economics and policy. Oxford University Press.
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Reform and healthcare delivery continues to be at the forefront of policy debate, given the slow-growing percentage of the gross domestic product GDP) and budget deficit in health care. Economic theory has been a major topic in healthcare conversation; different economic philosophies and theories and the passage of the Affordable Care Act (ACA) increased the involvement in health care (Hartman, 2010). The surprising increase in healthcare costs in recent decades and the effort to control increased the relevance of the economic analysis of clinical interventions. The use of cost-effectiveness to guide reimbursement decisions wherein keeping individuals healthy is key to profitability. The development of strategies for disease prevention, self-care, or adherence to beneficial clinical treatments can also have payoffs. Health outcomes are measured, such as the number of avoided infections or the cost per life saved.
My DNP project is about Central line-associated bloodstream infection (CLABSI). This remains an important component of any efforts of quality improvement given its impact on patients and healthcare organizations, and it is associated with an increased length of stay in the hospital and a cost of $16 000 – $69 000 on each event. The metrics for reimbursement negotiations and hospital ranking, and CLABSI (Ormsby et al., 2020). Bloodstream infections have a significant impact on patient outcomes, including mortality, length of stay, and healthcare costs.
Economic theory is concerned with choice and the assumption is made that choices are made after the consumer has been provided with full information. However, individuals who present within the healthcare sector are frequently unwilling or unable to collect the information required to make this choice. Health economics is used to promote healthy lifestyles and positive health outcomes through the study of health care providers, hospitals and clinics, managed care, and public health promotion activities. Health economists apply the theories of production, efficiency, disparities, competition, and regulation to better inform the public and private sector on the most efficient, cost-effective, and equitable course of action. Such research can include the economic evaluation of new technologies, as well as the study of appropriate prices, anti-trust policy, optimal public and private investment, and strategic behavior (Williams IP, Bryan S, 2017).
The continued growth in the economic evaluation of healthcare over the past years has led to a shortage of trained health economists globally, leading to several universities and/or national governments developing specialized health economics programs to train more health economists. One of the common problems with many of these training programs is that they only educate new health economists to the master’s level, and as such they are unable to cover the many skills needed by a successful health economist. It is important that those individuals who are involved in the provision and purchase of healthcare fully understand the background to this concept and understand some of the terms which are commonly used ( Shiell A, Hawe P, Gold L, 2018).
Without good economic analysis, healthcare is unlikely to progress and only by undertaking systematic reviews is it possible to identify alternatives to existing or new programs. Such evaluation is dependent on the quality of underlying medical evidence, and, because of this, clinical trials are now viewed as a natural vehicle for economic analysis. Health Economics is an applied field of study that allows for the systematic and rigorous examination of the problems faced in promoting health for all. By applying economic theories of consumer, producer and social choice, health economics aims to understand the behavior of individuals, health care providers, public and private organizations, and governments in decision-making (Eddama O, Coast J. A 2018).
References
Eddama O, Coast J. A systematic review of the use of economic evaluation in local decision-making. Health Policy 2018; 86 129–41.
Shiell A, Hawe P, Gold L. Complex interventions or complex systems? Implications for health economic evaluation. Br Med J (Clin Res Ed) 2018; 336 1281–3.
Williams IP, Bryan S. Understanding the limited impact of economic evaluation in health care resource allocation: a conceptual framework. Health Policy 2017; 80 135–43.
Economic theory is based on a model of human behavior Health and health economic models are problem-solving analytic, efficient, and cost-effective models that use a variety of mathematical information to explain health policy decisions and are also routinely used to support health policy and resource allocation decisions ( Pouwels et al., 2022). The economic theory is applicable to this scholar’s DNP project as interventions to reduce the prevalence of Methicillin-Resistant Staphylococcus Aureus (MRSA) can be grossly expensive. According to Tchouaket Nguemeleu et al. (2020), healthcare-associated infections such as MRSA are grave public health issues existing worldwide and relate to exorbitant treatment costs, complications, reduction of quality of life, and mortality. In addition, Zhen et al. (2020) mentioned that MRSA is notably connected with increased hospital costs, increased hospital mortality rates, and longer lengths of hospitalization.
MRSA treatments and interventions although costly are fundamental as implementing screening will ultimately decrease an outbreak which will be even more costly to treat hence, decision-makers and leaders opt to increase efficiency and effectiveness in the healthcare industry with limited scarce resources and the consequences with the use of these alternatives. Before policy and interventions are approved, decision-makers must explain why more resources are allocated to specific services (Hicks, 2020). Hence, the benefit of implementing a specific intervention although expensive must outweigh the consequences of not implementing the intervention and the allocation of the limited resources.
Gidengil et al. (2015) mentioned that a national policy model was generated to analyze and evaluate the cost-effectiveness of approaches to prevent and reduce MRSA colonization and infection. Therefore, decision-makers are usually presented with huge alternatives and approaches that can minimize and improve an intervention, but the cost and the successful usage of the intervention are paramount. This DPI project when done on this small scale using strategies from the national policy will be cost-effective in ensuring that MRSA infection is identified early on admission and treated to prevent colonization and widespread increase in the infection rate in the facility. Hence, the implementation of this intervention would impact the rates of MRSA infection transmission and hence a decline, thus reducing morbidity and mortality rates.
References
Gidengil, C. A., Gay, C., Huang, S. S., Platt, R., Yokoe, D., & Lee, G. M. (2015). Cost-effectiveness of strategies to prevent methicillin-resistant Staphylococcus aureus transmission and infection in an intensive care unit. Infection control and hospital epidemiology, 36(1), 17–27. https://doi.org/10.1017/ice.2014.12
Hicks, L. (2020). Economics of Health and Medical Care. Jones & Bartlett Learning.
Pouwels, X. G. L. V., Sampson, C. J., Arnold, R. J. G., & Open-Source Models Special Interest. (2022). Opportunities and Barriers to the Development and Use of Open-Source Health Economic Models: A Survey. Value In Health, 25(4), 473–479. https://doi-org.lopes.idm.oclc.org/10.1016/j.jval.2021.10.001
Tchouaket Nguemeleu, E., Beogo, I., Sia, D., Kilpatrick, K., Séguin, C., Baillot, A., Jabbour, M., Parisien, N., Robins, S., & Boivin, S. (2020). Economic analysis of healthcare-associated infection prevention and control interventions in medical and surgical units: Systematic review using a discounting approach. The Journal of hospital infection, 106(1), 134–154. https://doi.org/10.1016/j.jhin.2020.07.004
Zhen, X., Lundborg, C. S., Zhang, M., Sun, X., Li, Y., Hu, X., Gu, S., Gu, Y., Wei, J., & Dong, H. (2020). Clinical and economic impact of methicillin-resistant Staphylococcus aureus: a multicentre study in China. Scientific reports, 10(1), 3900. https://doi.org/10.1038/s41598-020-60825-6