In your opinion and based on what you have learned about the Affordable Care Act, which facet of Donabedian’s model did the Affordable Care Act seek first and foremost to address? What were the expectations for how the other two facets would be impacted?
Affordable Care Act (ACA)-it is the comprehensive healthcare reform signed into law by President Barack Obama in March 2010. Formally known as the Patient Protection and Affordable Care Act but often just called Obama care the law includes a list of health care policies intended to extend health insurance coverage to millions of uninsured Americans.
The Act expanded Medicaid eligibility, created health insurance exchanges and prevents insurance companies from denying coverage (or charging more) due to pre-existing conditions. It also allows children to remain on their parents' insurance plan until age 26.
Which facet of Donabedian's model did the affordable care act seek first and foremost to address :
The Donabedian model is a conceptual model that provides a framework for examining health services and evaluating quality of health care.According to the model, information about quality of care can be drawn from three categories: structure,process, and outcomes. Structure describes the context in which care is delivered, including hospital buildings, staff, financing, and equipment. Process denotes the transactions between patients and providers throughout the delivery of healthcare. Finally, outcomes refer to the effects of healthcare on the health status of patients and populations.
Donabedian's model to analyse quality includes three factors: structure, process, and outcome.
The best facet of donabedians model that the affordable care act seek first and foremost is it avoids the need of multiple processes and outcomes required complex setting, like intensive care units or acute hospitals in general. Thus the process is the best facet.
The expectations how the other facets would be impacted :
process and outcome effect is a simple separation between means and ends. Perhaps more correctly. one may think of an unbroken chain of antecedent means followed by intermediate ends which are themselves the means to still further Health itself may be a means to a further objective.
Several authors have pointed out that this formulation provides a useful approach to evaluation.
It may be designated as the measurement of procedural end points and included under the general heading of process because it rests on similar considerations with respect to values, standards and validation.
structure include administrative and related processes that support and direct the provision of care.
It is concerned with such things as the adequacy of facilities and equipment the qualifications of medical staff and their organization. the administrative structure and operations of programs and institutions providing care.
The assumption is made that given the proper settings and instrumentalities good medical care will follow.
This approach offers the advantage of dealing, at least in part with fairly concrete and accessible information. It has the major limitation that the relationship between structure and process or structure and outcome is often not well established.
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