::written circa. Fall 2013.
As a continuation into the review of tobacco associated lung cancer, in the United States, the pre and post care delivery in such individuals can spark the curiosity of many. To recap, lung cancer, associated with smoking, is the number one preventable cause of death in the United States. Chronic environmental tobacco-use can impose many adverse systemic affects, in addition to the metastatic cancer itself. Exposure to such determinant can inevitably lead to various life-threatening conditions, such as chronic obstructive pulmonary diseases (COPD), i.e. bronchitis and emphysema. And yet, lung cancer is still the leading cause of death in North America (Goljan, 2011). With that said, the delivery of healthcare in inpatient vs. outpatient facilities can show to have many differences. And in the end, the management of care can drastically affect the overall financial future of the patient at hand.
As previously reviewed, secondary preventative diagnoses for clinically relevant tobacco associated lung cancer include chest x-rays, sputum cytological examinations, fine needle aspirations and bronchoscopy. However, such technological advancements are more commonly used in inpatient facilities. Inpatient facilities are more commonly used for emergent cases and/or invasive surgical procedures (ie. lung transplants) (Shi & Singh, 2012). With that said, resources utilized in such a facility can inevitably bare a significant upbringing in expenditures for the patient. Though, it may not considerably be a burden for 2% of the nation, it certainly can cause drastic damages to families associated in the middle class and below. However, social hierarchical economics are not the topic at hand. Furthermore, costs associated with severe COPD patients are estimated to be approximately $4000-$5000 higher, than those individuals diagnosed with lung cancer (American Medical Association, 2006). This can be attributed to the fact that severe COPD conditions can be much more related to an emergency scenario, compared to long-term lung cancer. And, as a result, require much more intensive care. Patients with severe COPD can undeniably be treated, with the hospitality of an intensive care unit, for more than 4 to 5 days.
Continuing on, unfortunately, the downside to lung cancer is the fact that there is no cure currently available. This is, of course, aside from the low probability of acquiring the costly lung transplantation procedure. Once diagnosed with lung cancer, the main course of long-term treatment is palliative care. As noted, palliative care relates to only the management of pain and symptoms (Shi & Singh, 2012). This includes psychosocial and spiritual care. However, palliative management can also foreshadow the use of an assortment of pharmaceutical drugs, primary care visits, and eventually frequent laboratory examinations. In the end, compounding the idea of raising the bar of costs for end-term patients. Furthermore, outpatient facilities commonly lack the availability of emergency equipment, which can inevitably affect the ability of to provide immediate care.
One of the more important health administrative battles today, associated with outpatient and inpatient facilities, is the cost effectiveness of being able to provide that care to begin with. This imposes great strain on being able to efficiently run a small business, especially an outpatient care facility. Both internal and external factors can have many implications on healthcare delivery, such as the ability to hire a competitive pool of individuals, acquiring facility equipment, space-expansion, and cost to provide care itself. Of course, these examples are among many others. Without a doubt, political and governmental influence on healthcare can be a crucial door for aspiring healthcare administrative graduates. It was noted, according to the Affordable Health Care Act, uninsured patients and those without a primary care physician, are forced to rely on inpatient care. As a result, this inevitably drives health care costs up, due to the use of expensive technological equipment (Gruber, 2011). Interestingly, the facilities that are assumed to drive healthcare costs down (i.e. those facilities that are considered outpatient-care) are continuously heavily taxed. And in the end, jeopardizing the cost effectiveness of both those who deliver healthcare and those who are in need of it.
Goljan, E. (2011). Rapid review: pathology. 4th edition. Philadelphia, PA. Elsevier & Saunders.
Shi, L., Singh, D. (2012). Delivering healthcare in america: a systems approach. Burlington, MA. Jones & Barlett Learning, LLC.
Au, D., Udris, E., Fihn, S., McDonell, M., Curtis, J. (2006). Differences in healthcare utilization at the end of life among patients with chronic obstructive pulmonary disease and patients with lung cancer. American Medical Association. 326-331.