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Brief Description of Current Event:The article I chose discusses recent legislation from congress, that permits fewer penalties from Medicare for readmission for hospitals serving large populations of low income citizens(Rau 2018). Since 2012 Medicare has penalized hospitals for having patients discharged that end up re admitted within a month, this was instituted to try to promote better care for these patients (Rau 2018). It has been argued since that patients end up re-admitted to the hospital through no fault of these institutions but because of issues such as patients not having regular doctors, access to healthcare facilities, money to pay for prescriptions or a multitude of other factors(Rau 2018). These institutions serving large populations of low income citizens were more susceptible to these financial penalties and have been struggling to stay a float(Rau 2018).
The main issue this article brings about is can hospitals that serve the low income population be judged against hospitals who serve the high SES population, with a particular emphasis on quality of care(Rau 2018). The new policy that begins October 1st will reduce penalties serving the high volumes on low income patients by about half, in return will hospitals serving low volumes of low income patients penalties will rise( Rua 2018).
In my opinion the assigned reading and discussion of social determinants of health ties into this article. This article does a adequate job of considering the point that an individuals health is not a direct reflection of just there genetics and individuals behaviors. That what determines there health is far broader than that with considerations such as access to health care, social support, life stressors, and finical ability to pay for medications, copays, etc.
The article argues that it is not far to compare health outcomes of lower SES individuals to those of a higher SES class, re admission to hospitals serving high volumes of low income populations was not necessarily due to quality of care during stays in these facilities but due to external factors effecting health. Therefore penalizing and judging quality of care of these hospitals based on re-admission rates would be unfair specifically when comparing them to hospitals who serve a more affluent population.
Another aspect of public health that is relevant to this particular current event is the ecological model for health promotion. This article is an good example of intervening on the public policy level, which will intervene on national level taking all levels of the ecological model into consideration. When taking aspects of intrapersonal, interpersonal, organizational and community into consideration you are able to intervene on a larger scale.
When considering health disparities on all levels on the ecological model you can see that these levels are interdependent on one another and intervention on one level can trickle down to another level. For example in the article reducing finical penalties on hospitals serving large volumes of low income citizens may lead to surplus in finances at the end the year which could allow hiring of more health care providers or opening more health care facilities with in the community. More access to health care in the community could lead into integration of organizations for health care promotion into school and workplace. Which in return could aid in helping changing social norms about health care and increasing access to positive social support groups which aids in changing individual health behaviors.
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