REPORT AND CRITICAL ANALYSIS
Executive summary
The aged population is among the vulnerable population in Australia and their numbers have significantly increased, with projections showing a potential further increase. The group requires increased care when receiving tertiary healthcare. The Australian government (Medicare), state and territory governments, local governments, and shared provision of funding are the main sources of funding in the Australian healthcare system. The healthcare system maintains and enhances healthcare by following the WHO six building blocks which include service delivery, health workforce, information, financing, stewardship, and medical equipment, vaccines, and technologies. There are numerous strategies put in place to help the aged acquire quality healthcare. some include the Private Health Insurance Scheme, the Ageing Act of 1984, Fee-for-Service, and the Pharmaceutical Benefits Scheme. Ethical issues facing the elderly include doctors’ character, lack of involvement, financial deficiencies, and cultural differences. To achieve better tertiary healthcare for the elderly, the recommendations include Integration of the healthcare system, partnerships with other institutions, and creating awareness.
Contents
2.0 Main Findings from Assessment 2. 4
3.4 Medical Equipment, Vaccines, and Technologies. 7
3.6 Stewardship/ Leadership and Governance. 8
4.1 Private Health Insurance Scheme. 9
4.3 Pharmaceutical Benefits Scheme. 9
5.0 Ethical Issues and Considerations Related to Service Delivery Decisions and the Aged. 9
6.0 Recommendations for Future Action. 10
6.1 Integration of Healthcare System.. 10
1.0 Introduction
Tertiary healthcare services are among the most essential services for the aged population. Research shows that old people have low immunity, which subjects them to attack low ability to fight diseases. The aged refers to the group of people aged 65 years and above. The projection for the aged population is steadily increasing. Also, there is an increase in chronic illness throughout Australia which require special tertiary healthcare. The following is the structure of this report: The first section presents the overview of tertiary healthcare for the aged examined in assignment 2. The section provides the methods of analysis used and major findings. Next is how tertiary healthcare responds to the needs of ageing Australians. It will involve how tertiary healthcare providers maintain, develop, and enhance the quality of service provision. The section will also outline the interconnectedness between the National Safety and Quality Health Service (NSQHS) Standards and the National Registration, Accreditation Scheme, and other professionals who self-regulate under the banner of the National Alliance of Self Regulating Health Professional (NASRHP). The next section will entail the possible improvements to service responsiveness to the ageing Australians. The other section will focus on three tertiary healthcare activities that can have ethical implications when handling the ageing population. The paper then presents the recommendations.
2.0 Main Findings from Assessment 2.
In assignment 2, the methods of analysis involved the WHO six building blocks. These are service delivery; health workforce; information, medical products, vaccines and technologies; financing; and leadership and governance. These methods were important because they provided the interconnectedness between different players to ensure efficient tertiary service provision to the ageing population. Lack of or limited supply of any of these six factors would cause a calamity in the provision of the services. For instance, financing enables the purchase of drugs, vaccines, and technological improvement. Efficient leadership will ensure proper use and allocation of funds for different needs in the tertiary department. The leaders cannot identify where to invest more resources or what types of medicine, technology and vaccines are needed unless the information is available. Thus, these six blocks act as the system of any tertiary institution and it helps provide efficient services to the elderly.
Assessment 2 presented numerous findings regarding the Australian health systems concerning the provision of tertiary care to vulnerable groups, and specifically the aged people. The assessment findings revealed that approximately 15% of the Australian population is the ageing group, and there is an anticipated rise in these numbers. The life expectancy for a 65-year old male Australian was 78 years in 1960, and the age increased to 85 years in 2015 (McPake and Ajay 2017). The ageing population requires special attention. A systematic approach reveals that the elderly have a low immune system which means that if attacked by diseases, their body capabilities to fight diseases are low. Secondly, assessment 2 findings revealed that there is a rise in chronic illnesses and that the ageing group are likely to contact two or more chronic diseases than any other age group. Below is a presentation of multimorbidity of Australians by age:
Figure 1 Multimorbidity by age. Adopted from the Australian Bureau of Statistics (2015)
Thirdly, change in technology and the occurrence of other new diseases like covid-19 requires a strengthened tertiary health system. Lastly, people aged 65 years and above have a four times likelihood of visiting hospitals compared to the younger population as shown below (AIHW 2017):
Figure 2 Hospital separation rates based on age. Adopted from the Australian Institute of Health and Welfare
Combining these three factors, there is a need for a strong tertiary healthcare system especially for the ageing Australians.
3.0 Examination of How Quality Service Provision is Maintained and Enhanced by Tertiary Healthcare.
Public hospitals have put various measures in ensuring the elderly receive efficient tertiary health services in the hospitals. The system also helps in providing efficient services to Australian Aboriginals. What makes this group similar is the incapacity of the majority of these groups of people to afford quality tertiary services. The assessment of how tertiary providers help the Aboriginals and the elderly will be conducted through the six WHO building blocks.
3.1 Service-Delivery
According to WHO (2018), efficient delivery of services encompasses access, quality, coverage, and safety when providing health services. Tertiary healthcare providers undergo intense training which ensures efficient service delivery (Fund 2017). Also, they ensure the working environment is clean because the elderly can easily contact other infections if the working environment is not clean.
3.2 Health Workforce
For the health staffs to work efficiently, they need to be equipped with human resources management skills and qualifications, based on need. Also, they should be conversant with using the complex tools and equipment that they use in diagnosing, treating, and managing different tertiary health concerns (WHOS, WHO & UNAIDS 2003). Also, some policies guide how the workforce works. Australian tertiary workforce adheres to various healthcare organizations’ policies for the provision of health services to the elderly and other disadvantaged groups like the Indigenous Australian such as the National Safety and Quality Health Service Standards and the Governance for Safety and Quality in Health Service Organizations among others (Australian Commission on Safety and Quality in Health Care 2018). Indigenous Australians were initially entitled to reimbursement for the assessment at 55 years and later at any grown-up age, given the earlier age of commencement of chronic disease in this population and higher rates of infectious ailment (Acri and Treisman n.d).
3.3 Information
Tertiary health institutions in Australia ensure they have properly organized health records. Also, the records are constantly updated whenever the need arises (Thomas et al. 2018, p.55). The Australian Government Department of Health outlines the strategy to ensure proper information through instituting a new Quality and Safety Commission, whose aim is to improve coordination and access to information, which will, in turn, improve the capacity to identify and respond to fiascos in delivery of superior aged care.
3.4 Medical Equipment, Vaccines, and Technologies
The procurement and supply policies should ensure that there is unbiased access to the health services by the elderly and the Aboriginals or any other group. Also, the medical equipment, vaccines, and technologies should be cost-effective to ensure that more people access regardless of their background or age. The healthcare system should ensure these products are cost-effective to ensure the old, who are mostly unemployment, and other disadvantaged groups like the aboriginals access them. To maintain the provision of quality healthcare services in the country, the government provides sufficient funding for the purchase of equipment (Greenslade 2020). Currently, there is a debate regarding how best to allocate financial resources to tertiary health providers (Richardson 2020).
3.5 Financing
To maintain the healthcare system in providing services to the aged and other financially unstable families like the Indigenous Australians, there are four main providers of financing. These are the Australian government (Medicare), state and territory governments, local governments, and shared provision of funding. Collectively, they help finance the purchase of different drugs and equipment used by the aged and financially challenged people who need tertiary services. The Australian government contributed 41% of the total public hospital funding. Also, the government gave 24% of the overall private hospital financing (McPake and Mahal 2017).
3.6 Stewardship/ Leadership and Governance
To ensure that there are effective strategic policy frameworks, quality leadership is essential (Slade, Phillip and Morris 2018). According to Dixit and Sambasivan (2018, p.4), leadership is one of the major drawbacks in the Australian health system, and this is viewed in the cause of the inefficiencies seen in some areas (Shaikh 2020). To improve this situation, Health LEADS Australia, which is the Australian health leadership framework, engages medical clinicians and doctors in the leadership of health services (Dickson et al. 2014, p.7). Also, there is a development of local leadership network among the Aboriginals in the health system to help improve tertiary health-seeking and access (Taylor, Lalovic and Thompson 2019).
The National Safety and Quality Health Service (NSQHS) Standards aim at creating better and safer healthcare in Australia. It achieves this through governing safety and quality in healthcare institutions. To ensure that the services provided are of quality standards, the National Registration, Accreditation Scheme (NRAS) registers only trained and qualified practitioners. They achieve this through working collaboratively with the Australian Health Practitioner Regulation Agency (AHPRA), who provides administrative support to the National Boards and NRAS. Numerous other ways present interconnectedness. For instance, NSQH helps NARS in achieving its aim of facilitating workforce mobility across Australia through partnering with healthcare consumers to understand what tertiary services are needed.
4.0 Responsiveness to the Needs of the Ageing Australian Population and How it May be Enhanced by the Service.
Australia contains various strategies that are aimed at responding to the needs of the aged groups in providing tertiary healthcare services. One possible improvement is through increasing private sector involvement in tertiary healthcare services. The step will help the integration of the tertiary service-provision, through the reorganization of general practice governance. They will play the roles of refining effectiveness, efficiency and coordination of care conveyance by the commissioning of services. The following are other improvements for tertiary service provision:
4.1 Private Health Insurance Scheme
Started in the 1980s, the insurance scheme started by giving health and welfare insurance to Australians to help the unemployed families in times of illnesses.
4.2 Fee-for-Service
Another effective way to ensure the tertiary healthcare needs of the elderly are addressed is through introducing fee-for-service payment techniques into their plans for realizing Universal Health Coverage. McPake and Mahal (2017) outline that the act of Australia implementing public subsidy programs of private health insurance is not likely to be a proficient tactic for minimizing the health-associated cost problems of ageing populations. Hence, making it free will ensure ease of access by this vulnerable population.
4.3 Pharmaceutical Benefits Scheme
This scheme aims to ensure that regardless of the financial background, age, or any other factor, all populations receive excellent healthcare services. The scheme provided medicine worth $12.7 billion in 2019-20, with more than 5,200 medical products are available.
5.0 Ethical Issues and Considerations Related to Service Delivery Decisions and the Aged.
According to Lowe and Coffey (2019), the four main issues that the elderly face in obtaining healthcare services are deficiency of resources, shortage of providers, financial hurdles, and cultural barriers and biases. The ethical issues in providing healthcare services can be viewed from a wide perspective.
5.1 Doctors
Research by Rees, King and Schmitz (2009) on the Australian healthcare system showed nurses identify doctors as the key source of health issues. These issues arise due to their inabilities to consult, overtreatment, insufficient pain management, and under-treatment of patients. Also, the doctors focus on curing the patients without considering palliative care needs. In most cases, doctors want payment before delivering services –tertiary services are in most cases expensive. Majority of the elderly and Aboriginals have limited capacity to pay for them, hence they are denied.
5.2 Lack of Involvement
Another issue that the elderly face in receiving institutionalized healthcare services is that they are given limited opportunities to make decisions regarding their care. Research shows that in most cases, the schedules of these institutions conflict with the wishes of this population (Siewrt et al. 2020). Lack of awareness about healthcare services also denies the Aboriginals the opportunity to get efficient healthcare services. It is almost impossible to involve a community with limited or no knowledge of receiving efficient healthcare.
5.3 Financial Constraints
The Australian retirement age is 65 years and the projected number of people over 85 years is 500,000 in 2020, while the projections for 2050 is over 1.8 million (Australian Government Integrated Report 2019). Additionally, there is a continuous increase in the cost of the provision of healthcare services, especially for tertiary care. Affording these services is challenging, which denies them access to these much-needed services. The Aboriginals also face financial constraints which prevent access to efficient services (Puszka et al. 2016).
5.4 Cultural Barriers
Research shows that despite the Australian government, policymakers, and implementers pushing towards equitable provision of healthcare services, aboriginal Australians and Torres Strait Islanders still do not access quality healthcare services. The issue arises because they are economically, socially, politically and culturally disadvantaged (Larkins et al. 2016)
6.0 Recommendations for Future Action.
6.1 Integration of Healthcare System
The main challenge identified in providing service-delivery is a limited amount of health budgets, and they need to be delivered impartially, and cost-effectively. One way of addressing these challenges is through the integration of the healthcare system (Looman, Huijsman, and Fabbricotti 2019). The objective of integrated care is to connect patient services through overpowering obstacles so that patients access comprehensive care whenever needed (Kodner 2018).
6.2 Partnerships
Another recommendation is for the health sector to partner with other organizations. Increasing the number of partnerships subjects the health sector to the ability to gain more funding for technology. Improving technology will ensure the availability of efficient tertiary services.
6.3 Creating awareness
It is important to educate the elderly that regardless of their backgrounds and age, they have the rights to receive quality healthcare.
7.0 References
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