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How would address the patient/family who is uninsured but Ventilator dependent and family is insisting on trach/peg?

How would address the patient family who is uninsured but Ventilator dependent and family is insisting on trach peg

 

 

Discharge of A Patient

Offering care to the patient as appropriate goes beyond ensuring that the patients are healthy and well since the financial aspects have to be considered. Some of the patient care services and treatments can be expensive, hence requiring the help of insurance. However, there are cases where a patient needs to use expensive medical equipment for a long time, but they are not insured, and they cannot afford such due to poor economic backgrounds (Chiu et al.,2018). One such case is a patient or family who is uninsured but ventilator dependent, and the family is insisting on a tracheostomy and a percutaneous endoscopy gastrostomy (PEG).

The patient is evidently ventilator dependent, indicating that they have to use it for a longer period of time even though there are high costs involved.  However, the cost implications are great since the patient may not afford it. Such a situation comes with biomedical considerations and financial matters in the clinical decision-making process (Musen et al.,2021). Various decisions can be made, such as referring the patient/ family to a safety net provider like a public clinic or looking for ways to reduce costs through billing adjustments or fee waivers. The decision taken in such a case substantially impacts various aspects, such as the safety net provider’s continuity and quality of care.

In addressing such an issue, it is important for a healthcare professional to have an adequate understanding of the benefits strategy to getting individualized solutions, commitment to informed consent, and billing regulations. Since the patient still needs to use the ventilator and the family is insisting on PEG/TRACH, I would first explore the option of the patient being transferred to a public health facility associated with a safety net provider. This is an option that can see the patient and their family paying lower costs which they can be able to afford without insurance.

 

References

Chiu, A. S., Jean, R. A., Ross, J. S., & Pei, K. Y. (2018). The early impact of Medicaid expansion on uninsured patients undergoing emergency general surgery. Journal of Surgical Research232, 217-226. https://doi.org/10.1016/j.jss.2018.06.037

Musen, M. A., Middleton, B., & Greenes, R. A. (2021). Clinical decision-support systems. In Biomedical informatics: computer applications in health care and biomedicine (pp. 795–840). Cham: Springer International Publishing. Doi: 10.1007/978-3-030-58721-5_24

 

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