Compare Health Care Performance Data in at Least two Countries - Nursing Essay Writing Assessment Answers

December 04, 2017
Author : Julia Miles

Solution Code: 1HDD

Question:

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Health care - Nursing Essay Writing Assignment Help

Comparing Health Systems

We are often interested to see how our national experiences of health and health care compare on an international scale. These comparisons create a broader perspective for researchers, policy makers and the general public. Being aware of the successes and setbacks of other countries may inform how new policies, health interventions or preventative measures are developed and implemented in one’s own country. International health comparisons can help making valid comparisons of health across different countries however it is important to make sure that what is being compared is able to be compared. Both the use and interpretation of international comparisons need to be considered carefully. If the data and methods that underlie these comparisons are not assessed, the results could be misinterpreted. There are methodological issues to consider in assessing data availability and quality, and in deciding which countries to compare. Decisions about the data used and the countries selected should be documented with adequate rationale to ensure the limitations and assumptions are clear and duly considered. These decisions can influence the differences observed between countries and the conclusions made.These are all considerations that you will need to make when you undertake this assignment.

Checklistfor international comparisons of health related data

Consider these questions when presenting or interpreting an international comparison of health-related data.

Data quality

  • Consistency—arethe data defined consistently across countries?
  • Methodology—doall countries use the same method to collect the data?
  • Coverage—dothe data cover similar parts of the population?
  • Timeperiod—dothe data refer to the same time period?

Choice of countries

  • Comparability—arecountries sufficiently similar to support comparison?

Presentation and interpretation

  • Presentation—arethe data presented appropriately?

Explanation—is the variation between countries adequately explained?

Underlying differentials—are differences within countries considered?

Context—can the data be used outside of an international comparison?

THE TASK

You are to research and analyse health care performance data in at least two countries one of which must be Australia (if you are studying in Australia) or Singapore (if you are studying in Singapore) and write anessayof comparing the following five (5) areas for each country.

Be careful to pick the other country that is comparable and has the quality of data required to complete the comparison.

The areas forcomparisonare listed below:

  1. Funding System (including health insurance systems)
  2. Governance System
  3. Selected Population Health Indicators

    1. Maternal Mortality Rate
    2. Infant Mortality Rate
    3. Life Expectancy at Birth

  4. Health Status

    1. Low birth weight
    2. Obesity
    3. Diabetes
    4. Asthma
    5. Hypertension (High Blood Pressure)
    6. Cancer

  5. Health System Performance

    1. % GDP Spent on Health
    2. Define each of the following measures and provide the results and commentary for comparison that the countries use to demonstrate that health care is:

      1. Acceptable
      2. Appropriate
      3. Effective
      4. Efficient
      5. Safe

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Solution:

Introduction

Researchers are often interested in comparing national healthcare and population health experiences on an international scale. Such comparisons serve to broaden individual perspectives and inform the general public about their country’s relative international position in terms of health outcomes. International health comparisons facilitate recognition of gaps in practice (based on best practices used in other countries) and help researchers identify ways in which these gaps might be fulfilled. Further, international comparisons also inspire better policy making and moving towards more positive health outcomes as a nation. International comparisons might also enable healthcare practitioners and policy makers to learn from mistakes made by healthcare providers in other countries and inspire them to plan better while implementing similar policies in their own country.

This paper is aimed at comparing healthcare and health outcomes of Australia and England. Comparison would be centred on various areas such as funding systems that are operational in both countries, governance system followed, population health indicators, and maternal mortality rate. England has been chosen for comparison with Australia as healthcare in both countries is funded both by private and public institutions. Both countries are also similar in nursing standards and principles that lay the foundation of healthcare provision.

  • Funding System

Healthcare system in Australia consists of a multi-faceted web of private and public providers. Although public hospitals receive funding from Australian, territory and state governments, they are primarily managed by state and territory governments (ABS, 2012). The Australian Government in combination with state and territory governments is also responsible for funding a range of other services including mental health services, health infrastructure and Aboriginal and Torres Strait Islander Services (Australian Government, 2015). Private hospitals on the other hand are privately funded and managed. In summary, Australian healthcare delivery system is divided into three major segments: primary healthcare, hospitals and other recurrent service providers. Public hospitals account for 40.4% healthcare expenditure and are funded by the Australian Government in combination with state and territory governments (Australian Government, 2015). Primary healthcare account for approximately 38.2% of total healthcare expenditure (ABS, 2012). In primary healthcare, non-referred medical services are majorly funded by the Australian Government with a small share of private funding. Funding of medications is equally shared by the Australian Government and private healthcare providers. Dental services are majorly funded by private healthcare providers. Other recurrent service sector accounts for 21.3% funding expenditure (ABS, 2012). In this sector, referred-medical services are majorly funded by the Australian Government with a small share paid by private providers. Funding for administration and research and other health goods and services comes from a combination of private and public sector (Australian Government, 2015).

In similarity with healthcare service provision, medical insurance in Australia is jointly funded by the Australian Government and the private sector. Australian Government has provisioned Medicare for the benefit of all Australian citizens (Australian Government, 2015). Medicare benefits Schedule (also known as MBS) component of Medicare has been designed to provide rebates on hospital and medical services to all residents of Australia. Pharmaceutical Benefits Scheme (also known as PBS) component of Medicare has been designed to provide rebates on a wide variety of medications that are only available by prescription (Australian Government, 2015). Finally, the National Healthcare Specific Purpose Payments (SPPs) enable territory and state governments to fund a wide range of healthcare services including the medicare component of public hospitals. Private health insurance (as of latest data available for the year 2011-2012) in Australia was provided by a total of 35 registered healthcare providers. Private health insurance is supplementary to Medicare and covers a wide range of services including hospital theatre and accommodation, allied health services, dental services, aids, ambulatory services and a significant portion of medical fees (ABS, 2012).

Healthcare in England is majorly provisioned by UK's public health service, known as NHS (National Health Service) and is free to all permanent residents of the country. NHS draws its funding from contributions to National Insurance and general taxation. There are two major parts of NHS: primary care and secondary care (The King's Fund, 2015). Where commissioning trusts in England are responsible for accessing local healthcare needs and negotiating with different service providers, provider trusts serve the responsibility of actually providing healthcare services (NT, 2015). For most people, healthcare is primarily delivered in primary healthcare settings. In this care setting, provider trusts (most commonly ambulance trusts and hospital trusts) deliver healthcare services with the help of funds allocated to them by commissioning trusts (DH, 2013). Hospitals tend to receive a major portion of NHS funding as they are required to deliver specialized and complex care. Assets (for example equipment) owned by hospitals are purchased for the nation and are kept safe in trusts (The King's Fund, 2015). Alternately, primary care might also be provided by a range of independent service providers including dentists, optometrists and General Practitioners. In similarity with primary care, secondary care in England usually takes place in NHS own facilities (DH, 2013).

England also has a private healthcare sector which facilitates fewer healthcare benefits as compared to those obtained through NHS. Employers might sometimes fund private healthcare in the form of added medical insurance provided to employees (The King's Fund, 2015). Additionally, private insurers might also market various policies directly to public. Private healthcare in England especially applies to specialist referrals which might not be covered by NHS general practitioners (NT, 2015). Further, some private hospital groups also market insurance plans directly to public. Private services however are rarely used as a healthcare option in England (DH, 2013).

  • Governance Systems

The continuum of healthcare services in Australia (including but not limited to district health services), area health services, primary health Centre’s, community health Centre’s and aged and extended care facilities) is represented by AHHA's Board and council members. This board consists of a maximum of eight directors who are elected from and by the National Council. Additionally, the immediate past president of the National Council might also participate in electing members of the board (AHHA, 2015).

With respect to processes and structures with which healthcare system in Australia is regulated, controlled and directed, significant complexities might be envisioned. Public hospitals and community public health services are majorly owned by state and territory governments whereas private hospitals and aged care facilities are owned by private or NGO sectors (Dwyer & Eager, 2008). Commonwealth service commissioning is limited to mainly NGO community care. State and territory governments are responsible for commissioning of public hospitals and NGO services whereas private and NGO sector is responsible for commissioning of private insurers (AHHA, 2015). In terms of service provision, commonwealth in Australia is responsible for provision of Health Services Australia, Australian Hearing Services and the Commonwealth Rehab Service. State and territory governments are responsible for the provision of public hospitals ambulance services and community public health services (Dwyer & Eager, 2008). Responsibility of provision of private healthcare services lies with the private and NGO sector in Australia. In terms of regulation, commonwealth is responsible for regulation of health insurance, food standards and residential aged care. State and territory governments on the other hand are responsible for regulation of public health and community workforce (AHHA, 2015).

Healthcare governance in England is the responsibility of the Healthcare UK Governance Board. The Governance Board in the UK is accountable equally to the Department of Health Ministers (DH) and the UK Trade and Investment (UKTI) department. The Governance Board is majorly responsible for signing off and directing planning of healthcare in UK along with delivery of strategy (Government of UK, 2015). The Board and its members chiefly participate in evaluating strategies and formulating annual business plans, protecting the NHS brand and quality of care delivered by the same and assisting in solving major issues relating to trade of healthcare services and goods. Further, Board members also provide valuable advice regarding expenditure and resource levels. Make up of this board is suggested by ministers of DH and UKTI and is subjected to periodic reviews by the ministers (Government of UK, 2015).

Looking at Governance systems of both countries, it might be suggested that healthcare governance is headed by dedicated healthcare boards where members are elected by National council and Department ministers. Board members also serve similar functions of commissioning and regulating healthcare systems in both these countries.

  • Population Health Indicators

Maternal mortality rate is defined as the number of women who die (owing to pregnancy related causes) while being pregnant or within 42 days of terminating their pregnancy per 100,000 live births. Looking at data obtained for Australia, this rate has been estimated at 6.0 in 2015. Maternal mortality rate in Australia witnessed a slight fall in 2012 (came down to 6 from 7 in 2011) and has remained constant since (The World Bank, 2015). On the other hand, maternal mortality rate in the UK has been estimated at 9 for the year 2015. The rate has been estimated to be similar in all four countries in UK with no significant differences in any country. In similarity with UK, maternal mortality rate in UK also witnessed a fall in 2012 (came down to 9 from 10) and has remained constant since then (The World Bank, 2015). Although maternal mortality rate in UK is slightly higher, it would be appropriate to suggest that both countries have similar maternal mortality rates.

Infant mortality rate is defined as the number of infants who die before they reach 1 year of age per 1,000 live births in any given year. In accordance with data obtained for the year 2015, infant mortality rate in Australia was recorded at 3. The rate witnessed a slight drop in the year 2013 (came down from 4 in 2012 to 3 in 2013) and has remained constant since then (The World Bank, 2015). England and Wales witnessed a total of 2,686 infant deaths in the year 2013 thereby resulting in an infant mortality rate of 3.8. This rate has remained constant since 2013. Looking at infant mortality rates of both countries, it might be suggested that rates are comparable and nearly similar in both countries. Data for both countries has been collected by the World Bank and is for the same time period (The World Bank, 2015).

Life expectancy data is most commonly used as an indicator of population health and clearly reflects overall population mortality of a country. In accordance with recently obtained statistics, a boy born in Australia between 2011-2013 has a life expectancy of 80.1 years (AIHW, 2015). On the other hand, a girl born in Australia between 2011-2013 has a life expectancy of 84.3 years. This rate has significantly improved from 1881-1890 when a boy born in Australia could only expect to live for 47.2 years and a girl born in Australia could expect to live for 50.8 years (AIHW, 2015). Looking at data from England, life expectancy of a baby boy born between 2012-2014 is 83.3 years and life expectancy of a baby girl born between 2012-2014 is 86.7 years. Life expectancy in both countries is comparable and points out to sound healthcare systems. Data for both countries have been collected with the help of national surveys and belong to the same period (Office of National Statistics, 2015).

  • Health Status

In Australia, low birth weight occurred in 6% of live born babies between 1991 and 2004. This rate decreased to 4% for live born babies between 2010-2014 ABS, 2014). In England and Wales, 7.0% of live births were low birth weight (Office of National Statistics, 2014). Although comparable, this rate is slightly higher than that in Australia.

In accordance with data presented by the Australian Bureau of Statistics, approximately 63% adults in Australia are obese. Corresponding obesity rates for children in Australia are 25% (AIHW, 2015). Obesity rates in England for adults were noted to be approximately 57.6% in men and 57.2% in women. Corresponding rates for children were 18.9% (Government of UK, 2015). These statistics reveal that population in UK is healthier as compared to Australia.

Facts about diabetes reveal that around 280 Australians develop diabetes everyday. Approximately 1.7 million Australians are estimated to have diabetes (this figure includes both type 1 and type 2) (Diabetes Australia, 2015). In contrast, a total of approximately 2.9 million people in England were diagnosed with diabetes in the year 2015. This comparison indicates a better health status of Australians as compared to population in England (Diabetes UK, 2015).

1 in 10 people in Australia (which is roughly over 2 million) were diagnosed with asthma in the year 2014-2015 (AIHW, 2015). Corresponding statistics for UK for the year 2014-2015 were 5.4 million indicating far higher rates as compared to Australia (Asthma UK, 2015).

ABS reports that a total of 11.3% (or 2.6 million Australians) were diagnosed with hypertension in the year 2014-2015 (ABS, 2015). Hypertension statistics for residents of England on the other hand suggest that a total of 31.5% men and 29% women are affected (Government of UK, 2015).

Finally, estimated number of new cancer cases that would be diagnosed in Australia in the year 2016 were 139,466. Out of these, 72,048 were males and 58,418 were females (Australian Government, 2015). Corresponding statistics for England revealed that an estimated number of 352, 197 cases of cancer would be diagnosed in the country in 2016 (Cancer Research UK, 2015).

  • Health System Performance

In the year 2013-2014, a total of approximately AUD 58.8 billion was spent on public as well as private sector hospitals. Expenditure related to primary healthcare was estimated to be AUD54.7 billion with an additional AUD 32.0 billion spent on healthcare related goods and services (AIHW, 2015). This amounted to 9.7% of Australian GDP in the year 2013-2014. Looking at corresponding statistics from the UK, a total of 9.4% of national GDP is spent on healthcare in every country in the UK (The World Bank, 2015).

Healthcare measures implemented in a country are defined as acceptable when they are available and well utilized by all residents of that country. Both Australia and England ensure that healthcare facilities provisioned by public and private sectors are acceptable by masses. Australian healthcare sector encompasses a web of primary and secondary care delivery sectors which are specialized in healthcare service delivery. Similarly, healthcare in the UK is tightly governed by NHS in collaboration with specialized hospitals and specialty services which are covered by private service providers.

Healthcare is known as appropriate if it sufficiently fulfills the healthcare needs of the population. In other words, improved healthcare benefits might be expected after receiving healthcare for it to be called as appropriate. Australia runs a wide range of medical services such as dental services, aged care facilities, healthcare for Aboriginal and Torres Straight Islanders and mental healthcare services etc. These services have been specifically designed to cater to the culturally vast population of Australia and ensure improved health outcomes for them. Financial aid in the form of Medicare and private grants (The Government of Australia, 2015). Similarly, England ensures appropriate healthcare delivery by dedicating a trust for recognizing the needs of local populations and negotiating with service providers to provision care accordingly. Additionally, healthcare is freely available to all permanent residents of the country (Government of UK, 2015).

Effective healthcare refers to a range of services that are proven to benefit the masses. In other words, benefits deliver by these services far outweigh risks of provision. Both Australia and England ensure effectiveness of healthcare service provision by making sure that healthcare services are accessible by all residents and are available freely or at minimal costs (AIHW, 2015). Medicare in Australia and NHS in England re-evaluate their service effectiveness periodically and tend to improve upon the same (The King's Trust, 2013).

Efficient healthcare refers to a system which ensures accessibility at all times and is appropriately equipped to cater to healthcare needs as required. Both Australia and UK pair nationalized services with NGO's and local community services so as to ensure that local needs of the community are appropriately identified (AIHW, 2015). Nursing practitioners and clinicians are trained to access needs and document in detail. Healthcare Centre’s are being improved technologically so as to support functionality such as video conferencing and sharing of reports and diagnosis over the internet (NT, 2015).

Safe healthcare is defined as a range of services that are patient centered and are aimed at achieving zero error rates. Safety in Australia is ensured with the help of a dedicated body known as Australian Commission on Safety and Quality in Healthcare. This body has been established by the Commonwealth and oversees definition and implementation of safety and quality standards. Additionally, Professional Standards of Practice as defined by the Australia legislation are strictly followed and deviations might be recorded as medical negligence and punished accordingly (Australian Government, 2015). NHS England also has a dedicated set of codes and practices that are strictly followed by all healthcare service providers governed by NHS (NT, 2015).

  • Conclusion

The paper was aimed at presenting a comparison between health and healthcare standards in two countries. England was chosen for comparison with Australia as healthcare in both countries is based on similar standards and codes of practice. Ease of data availability was another reason for selecting England for comparing with Australia. Comparison of funding systems revealed that where Australian healthcare is funded from a combination of government and private players, healthcare in England is chiefly funded by NHS (which in turn draws funding from general taxation and insurance contributions). Governance systems in both countries consist of establishment of a governance board where members are elected either by members of National Council or by ministers. Both countries compare fairly in terms of their health status and health system performances and spend almost an equal amount of their GDP on healthcare.

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