Four challenges face the nursing workforce of today and tomorrow: the aging of the baby boom generation, the shortage and uneven distribution of physicians, the accelerating rate of registered nurse retirements, and the uncertainty of health care reform. This article describes these major trends and examines their implications for nursing. The article also describes how nurses can meet these complex and interrelated challenges and continue to thrive in an ever-changing environment.
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Keywords
Nursing workforce
physician shortage
registered nurse retirements
Over the first 15 years of the 21st century, the size, education, and age of the nursing workforce changed considerably. The annual number of nursing graduates increased rapidly. The growth of registered nurses (RNs) prepared with bachelor’s degrees exceeded those prepared with an associate’s degree starting in 2011, and the number of RNs who have obtained a graduate degree (master’s, PhD, or doctorate in nursing practice) increased fourfold. Moreover, the size of the workforce increased by approximately 1 million RNs, with employment growth occurring in hospital and nonhospital settings. Since 2000, the number of employed RNs older than age 50 years increased by 600,000, and these older RNs currently account for 30% of RNs working in hospital settings and 40% of RNs working in nonhospital settings (Buerhaus, Skinner, Staiger, & Auerbach, In press).
These changes in the RN workforce occurred alongside other forces. The new millennium began with a national shortage of more than 100,000 RNs that lasted until 2003, a brief but sharp economic recession in 2001, and the development and spread of the quality and safety movement. The Great Recession in 2007 to 2009 was followed by a slow and prolonged recovery, the implementation of health reforms created by the 2010 Patient Protection and Affordable Care Act (ACA), and the release of the National Academies Institute of Medicine Report, The Future of Nursing: Leading Change, Advancing Health (Institute of Medicine, 2010).
The increasing educational preparation of RNs, the growth in the size of the nursing workforce, and the ability to overcome nursing shortages, recessions, and health reform implementation establishes a strong foundation that can sustain the nursing profession as it faces new and unprecedented challenges that lie ahead. This article discusses four challenges that RNs throughout the country will face during the next 20 years. They include the aging of the nation’s baby boom generation, physician shortages, the retirement of RNs, and a new era of health reform implementation.
These challenges will undoubtedly affect nursing regulation, particularly those rules concerned with patient care safety in acute and non–acute care settings, use of technology, access to care, scopes of practice for both nurse practitioners (NPs) and RNs, and accreditation of nursing education programs. Regula ...
The document discusses the nursing shortage in the United States. It mentions that the nursing shortage is a recurring problem that the US healthcare system has faced for decades, but the current shortage is more severe due to factors like an aging population, rising chronic diseases, and an aging nursing workforce. The shortage is expected to worsen significantly by 2025 without interventions. Some of the reasons for the shortage include fewer nursing school enrollments, an increasing demand for healthcare services, and nurses retiring or leaving the profession faster than new nurses can be trained.
Healthcare causal essay sample from assignmentsupport.com essay writing ser...https://writeessayuk.com/
The document discusses challenges facing the US healthcare system as life expectancy increases and the population ages. Advancements in medicine have led to unprecedented growth in the elderly population. This will strain Medicare and increase demands for healthcare services, home care, and healthcare workers. It will also drive up overall healthcare expenditures. To support the growing elderly population, the government should promote education in health fields and encourage careers in geriatric, primary, and preventative care.
The document summarizes the historical transition and growth of the U.S. health care system from the 19th century to present day. It discusses key milestones like the establishment of private health insurance in the 1930s and government programs Medicare and Medicaid in 1965. Major changes included the rise of HMOs in the 1980s and an increased focus on preventative care and reducing costs. The paper also examines challenges facing the system like an aging population as baby boomers require more care and changing demographics bringing new diseases. Financing and technology are seen as important factors enabling advancement, but affordability remains a challenge given high expenditures in the U.S. system.
April 2011In the fall of 2010, the Alliance for Health R.docxjewisonantone
April 2011
In the fall of 2010, the Alliance for Health
Reform, with support from the Robert
Wood Johnson Foundation, held a series of
Capitol Hill briefings on issues pertaining to
the health care workforce. The first brief-
ing in the series examined the physician
workforce. It looked at supply and demand
issues that may be changing as a result
of health reform. Panelists were: Edward
Salsberg, National Center for Workforce
Analysis, HRSA; Thomas Ricketts, Cecil G.
Sheps Center for Health Services Research,
University of North Carolina at Chapel Hill;
and Jay Crosson of the Kaiser Permanente
Institute for Health Policy. The second
briefing focused on nurses, allied health
professionals, direct care workers and the
various provisions of the health reform law
pertaining to them. Panelists were: Joel
Teitelbaum, George Washington University;
Bob Konrad, Cecil G. Sheps Center; Linda
Burnes Bolton, Cedars-Sinai Medical Center
and Catherine Dower, University of Califor-
nia, San Francisco.
Health Care Workforce:
Future Supply vs. Demand
Physician and nursing shortages
make headline news on a regular
basis. Debates continue in policy
circles among researchers, analysts
and stakeholders on whether the
shortages are due to insufficient
numbers of providers, or maldistri-
bution of those providers.
Experts also debate over whether
the solutions are to build more
schools and enlarge classes to
graduate more physicians, expand
the number of residency slots, find
incentives to attract providers to
health professional shortage areas,
or change the way we deliver care.
We begin to see the complexity of
analyzing the problem and matching
the solutions to the challenges if we
also consider:
• Is there an adequate and efficient
ratio of primary care providers to
specialists?
• Are we training for the right skills?
• Are those with skills using them to
their maximum potential?
• Where do nurses and licensed and
unlicensed allied health profession-
als fit into the picture?
Some key factors affecting
the adequacy of the health
care workforce include
growth in the insured
population as a result of the
health reform law, an aging
U. S. population, an aging
health care workforce, the
Fast Facts
n 40 percent of practicing physicians are older than 55; about one-third of
the nursing workforce is over age 50.
n Economists say a third of physicians could retire in the next 10 years.
n More than half of nurses over 50 say they plan to retire in the next de-
cade.
n Team-based care and an expanded role for advance practice nurses and
physician assistants could mitigate the shortage of primary care providers.
n The Institute of Medicine recommended, in October 2010, that nurses be
allowed to practice to the full extent of their education and training. Cur-
rently only eleven states allow nurse practitioners to practice independent
of a physician.
n Student medical school debt averages $.
April 2011In the fall of 2010, the Alliance for Health R.docxjustine1simpson78276
April 2011
In the fall of 2010, the Alliance for Health
Reform, with support from the Robert
Wood Johnson Foundation, held a series of
Capitol Hill briefings on issues pertaining to
the health care workforce. The first brief-
ing in the series examined the physician
workforce. It looked at supply and demand
issues that may be changing as a result
of health reform. Panelists were: Edward
Salsberg, National Center for Workforce
Analysis, HRSA; Thomas Ricketts, Cecil G.
Sheps Center for Health Services Research,
University of North Carolina at Chapel Hill;
and Jay Crosson of the Kaiser Permanente
Institute for Health Policy. The second
briefing focused on nurses, allied health
professionals, direct care workers and the
various provisions of the health reform law
pertaining to them. Panelists were: Joel
Teitelbaum, George Washington University;
Bob Konrad, Cecil G. Sheps Center; Linda
Burnes Bolton, Cedars-Sinai Medical Center
and Catherine Dower, University of Califor-
nia, San Francisco.
Health Care Workforce:
Future Supply vs. Demand
Physician and nursing shortages
make headline news on a regular
basis. Debates continue in policy
circles among researchers, analysts
and stakeholders on whether the
shortages are due to insufficient
numbers of providers, or maldistri-
bution of those providers.
Experts also debate over whether
the solutions are to build more
schools and enlarge classes to
graduate more physicians, expand
the number of residency slots, find
incentives to attract providers to
health professional shortage areas,
or change the way we deliver care.
We begin to see the complexity of
analyzing the problem and matching
the solutions to the challenges if we
also consider:
• Is there an adequate and efficient
ratio of primary care providers to
specialists?
• Are we training for the right skills?
• Are those with skills using them to
their maximum potential?
• Where do nurses and licensed and
unlicensed allied health profession-
als fit into the picture?
Some key factors affecting
the adequacy of the health
care workforce include
growth in the insured
population as a result of the
health reform law, an aging
U. S. population, an aging
health care workforce, the
Fast Facts
n 40 percent of practicing physicians are older than 55; about one-third of
the nursing workforce is over age 50.
n Economists say a third of physicians could retire in the next 10 years.
n More than half of nurses over 50 say they plan to retire in the next de-
cade.
n Team-based care and an expanded role for advance practice nurses and
physician assistants could mitigate the shortage of primary care providers.
n The Institute of Medicine recommended, in October 2010, that nurses be
allowed to practice to the full extent of their education and training. Cur-
rently only eleven states allow nurse practitioners to practice independent
of a physician.
n Student medical school debt averages $.
FACTORS THAT AFFECT US HEALTH CARE IN THE FUTURE 9
The factors that may affect US health care in the future
Jack Alcineus
PM 730
Long Island University
Dr. Simone Martin
Introduction
The global health care industry has been growing fast in recent years, and the trend seems to go on perpetually. In the United States, expenditure on health care is in excess of 15% of the national gross domestic product (GDP). This, according to Deloitte, is the highest amount of expenditure on health care the world over. Further, the United States has a large population of people under insurance where only 15% do not have insurance. To be sure, an American either has private insurance or is covered by government-funded programs like the one fronted by the Affordable Care Act (ACA). This is quite necessary for a country where a single major medical bill is enough to send one into personal bankruptcy.
Interestingly, most of the American population is entering the geriatric phase of life fueled by the aging baby boomers. Further, Ikegami (2015) wrote that the US health care system is in the process of shifting from the situation where only the volume of patients treated mattered. This system relied on fees for service and which gave healthcare providers the revenue incentive to reach more patients. To be sure, the healthcare sector is shifting a value-based system where the value delivered to the patient will take center stage (Burwell, 2015).
Therefore, it is apparent that the healthcare sector will experience fundamental changes in terms of quality of service, a volume of people accessing healthcare services and the general healthcare situation across all the 50 states. In this light, this paper intends to highlight factors that will affect healthcare in the future and in what direction will these factors move the sector in general.
Demographic and social factors
The US might be among the developed economy countries that are aging the slowest but the population is still graying. In 2010, Pew Research Center said that 13% of Americans were 65 years of age or older. At the same time, the firm projected that this cohort would grow up to take up 18% of the American population by 2030 (Cohn & Taylor, 2014, April 10). Once people get older, their productivity drops significantly and they begin to experience a lot more medical complications than before.
To be sure, the aging population will add a huge strain to the healthcare sector in terms of geriatric care as well as complications tied to old age. Once a nation has a huge population of old people, there will be a high demand of healthcare services which, basically, imply that healthcare providers will be on high demand (Keehan, Stone, Poisal, Cuckler, Sisko, Smith... & Lizonitz, 2017). Interestingly, the increased demand will also lead to a higher demand for labor force in the sector to carry out duties like geriatric care, to provide physical therapy and other tasks like providing aid for ol.
The nursing profession faces several challenges in the 21st century including a growing elderly population that requires more acute care, rising healthcare costs, and the need to adapt to rapid advances in medical technology. There is also a shortage of nurses exacerbated by an aging workforce and many nurses leaving their jobs to work abroad. Nurse managers play an important role in creating work environments that support nurses, improve patient outcomes, and help address these challenges facing the nursing profession.
Respond to at least two classmates who identified different areas of.docxpeggyd2
Respond to at least two classmates who identified different areas of disparity than your own. Do you agree or disagree with their assessment of the impact of economic policy on the disparity? Does the disparity discussed have a microeconomic or a macroeconomic impact on health care?
Post # 1
Trina Cox
Disparity in healthcare can be defined as, “differences between groups in health insurance coverage, access to and use of care, and quality of care” (Orger & Artiga, 2018). There are various healthcare disparities; however, the key areas of disparity I have chosen to identify and analyze include health insurance coverage, quality of care, and gender. As most people already know, health insurance is a type of insurance coverage that is designed to cover an insured person’s medical expenses (such as hospital, doctor, laboratory and pharmacy services). Although the number of uninsured Americans have decreased drastically since the passing of ACA, disparities in this area still exist. Some individuals’ annual incomes still are not enough to pay the low premiums that may be required of them to have access to health insurance coverage.
Quality of care can be described as, “the degree to which health care services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge” (AHRQ, 2017). Although it is an unethical act displayed by healthcare professionals; in some areas, all patients are not treated equally with regards to quality of care. According to Dr. Ananya Mandal (2019), discrimination occurs when healthcare providers treat individuals from certain population groups differently to other population groups, whether this is done consciously or not. It is common for this to occur when providers have stereotyped impressions of specific racial or ethnic groups.
Gender can play a major role in healthcare disparities among women, specifically, in some of the developed countries. Researchers have reported that determinants of gender differences, like welfare indicators (e.g., education and income), behavioral factors (e.g., smoking and drinking), and social factors (e.g., social support and socioeconomic status) have direct correlations with some of the existing disparities (Hassanzadeh, et al, 2017). Afghanistan is a country that still has a high rate of gender disparities among women, even though some improvements have occurred. In this country, the biggest disparities that I feel still exist are between women in rural versus urban areas, and those with some education, as opposed to those women with none; showing that as education of women increases, so does their health and that of their children because of the education and resources that they have.
I think several economic policies have impacted these disparities and they include differences in income levels, education, and geographic location. A person’s annual income may have a direct effect on his or her ability.
The document discusses the nursing shortage in the United States. It mentions that the nursing shortage is a recurring problem that the US healthcare system has faced for decades, but the current shortage is more severe due to factors like an aging population, rising chronic diseases, and an aging nursing workforce. The shortage is expected to worsen significantly by 2025 without interventions. Some of the reasons for the shortage include fewer nursing school enrollments, an increasing demand for healthcare services, and nurses retiring or leaving the profession faster than new nurses can be trained.
Healthcare causal essay sample from assignmentsupport.com essay writing ser...https://writeessayuk.com/
The document discusses challenges facing the US healthcare system as life expectancy increases and the population ages. Advancements in medicine have led to unprecedented growth in the elderly population. This will strain Medicare and increase demands for healthcare services, home care, and healthcare workers. It will also drive up overall healthcare expenditures. To support the growing elderly population, the government should promote education in health fields and encourage careers in geriatric, primary, and preventative care.
The document summarizes the historical transition and growth of the U.S. health care system from the 19th century to present day. It discusses key milestones like the establishment of private health insurance in the 1930s and government programs Medicare and Medicaid in 1965. Major changes included the rise of HMOs in the 1980s and an increased focus on preventative care and reducing costs. The paper also examines challenges facing the system like an aging population as baby boomers require more care and changing demographics bringing new diseases. Financing and technology are seen as important factors enabling advancement, but affordability remains a challenge given high expenditures in the U.S. system.
April 2011In the fall of 2010, the Alliance for Health R.docxjewisonantone
April 2011
In the fall of 2010, the Alliance for Health
Reform, with support from the Robert
Wood Johnson Foundation, held a series of
Capitol Hill briefings on issues pertaining to
the health care workforce. The first brief-
ing in the series examined the physician
workforce. It looked at supply and demand
issues that may be changing as a result
of health reform. Panelists were: Edward
Salsberg, National Center for Workforce
Analysis, HRSA; Thomas Ricketts, Cecil G.
Sheps Center for Health Services Research,
University of North Carolina at Chapel Hill;
and Jay Crosson of the Kaiser Permanente
Institute for Health Policy. The second
briefing focused on nurses, allied health
professionals, direct care workers and the
various provisions of the health reform law
pertaining to them. Panelists were: Joel
Teitelbaum, George Washington University;
Bob Konrad, Cecil G. Sheps Center; Linda
Burnes Bolton, Cedars-Sinai Medical Center
and Catherine Dower, University of Califor-
nia, San Francisco.
Health Care Workforce:
Future Supply vs. Demand
Physician and nursing shortages
make headline news on a regular
basis. Debates continue in policy
circles among researchers, analysts
and stakeholders on whether the
shortages are due to insufficient
numbers of providers, or maldistri-
bution of those providers.
Experts also debate over whether
the solutions are to build more
schools and enlarge classes to
graduate more physicians, expand
the number of residency slots, find
incentives to attract providers to
health professional shortage areas,
or change the way we deliver care.
We begin to see the complexity of
analyzing the problem and matching
the solutions to the challenges if we
also consider:
• Is there an adequate and efficient
ratio of primary care providers to
specialists?
• Are we training for the right skills?
• Are those with skills using them to
their maximum potential?
• Where do nurses and licensed and
unlicensed allied health profession-
als fit into the picture?
Some key factors affecting
the adequacy of the health
care workforce include
growth in the insured
population as a result of the
health reform law, an aging
U. S. population, an aging
health care workforce, the
Fast Facts
n 40 percent of practicing physicians are older than 55; about one-third of
the nursing workforce is over age 50.
n Economists say a third of physicians could retire in the next 10 years.
n More than half of nurses over 50 say they plan to retire in the next de-
cade.
n Team-based care and an expanded role for advance practice nurses and
physician assistants could mitigate the shortage of primary care providers.
n The Institute of Medicine recommended, in October 2010, that nurses be
allowed to practice to the full extent of their education and training. Cur-
rently only eleven states allow nurse practitioners to practice independent
of a physician.
n Student medical school debt averages $.
April 2011In the fall of 2010, the Alliance for Health R.docxjustine1simpson78276
April 2011
In the fall of 2010, the Alliance for Health
Reform, with support from the Robert
Wood Johnson Foundation, held a series of
Capitol Hill briefings on issues pertaining to
the health care workforce. The first brief-
ing in the series examined the physician
workforce. It looked at supply and demand
issues that may be changing as a result
of health reform. Panelists were: Edward
Salsberg, National Center for Workforce
Analysis, HRSA; Thomas Ricketts, Cecil G.
Sheps Center for Health Services Research,
University of North Carolina at Chapel Hill;
and Jay Crosson of the Kaiser Permanente
Institute for Health Policy. The second
briefing focused on nurses, allied health
professionals, direct care workers and the
various provisions of the health reform law
pertaining to them. Panelists were: Joel
Teitelbaum, George Washington University;
Bob Konrad, Cecil G. Sheps Center; Linda
Burnes Bolton, Cedars-Sinai Medical Center
and Catherine Dower, University of Califor-
nia, San Francisco.
Health Care Workforce:
Future Supply vs. Demand
Physician and nursing shortages
make headline news on a regular
basis. Debates continue in policy
circles among researchers, analysts
and stakeholders on whether the
shortages are due to insufficient
numbers of providers, or maldistri-
bution of those providers.
Experts also debate over whether
the solutions are to build more
schools and enlarge classes to
graduate more physicians, expand
the number of residency slots, find
incentives to attract providers to
health professional shortage areas,
or change the way we deliver care.
We begin to see the complexity of
analyzing the problem and matching
the solutions to the challenges if we
also consider:
• Is there an adequate and efficient
ratio of primary care providers to
specialists?
• Are we training for the right skills?
• Are those with skills using them to
their maximum potential?
• Where do nurses and licensed and
unlicensed allied health profession-
als fit into the picture?
Some key factors affecting
the adequacy of the health
care workforce include
growth in the insured
population as a result of the
health reform law, an aging
U. S. population, an aging
health care workforce, the
Fast Facts
n 40 percent of practicing physicians are older than 55; about one-third of
the nursing workforce is over age 50.
n Economists say a third of physicians could retire in the next 10 years.
n More than half of nurses over 50 say they plan to retire in the next de-
cade.
n Team-based care and an expanded role for advance practice nurses and
physician assistants could mitigate the shortage of primary care providers.
n The Institute of Medicine recommended, in October 2010, that nurses be
allowed to practice to the full extent of their education and training. Cur-
rently only eleven states allow nurse practitioners to practice independent
of a physician.
n Student medical school debt averages $.
FACTORS THAT AFFECT US HEALTH CARE IN THE FUTURE 9
The factors that may affect US health care in the future
Jack Alcineus
PM 730
Long Island University
Dr. Simone Martin
Introduction
The global health care industry has been growing fast in recent years, and the trend seems to go on perpetually. In the United States, expenditure on health care is in excess of 15% of the national gross domestic product (GDP). This, according to Deloitte, is the highest amount of expenditure on health care the world over. Further, the United States has a large population of people under insurance where only 15% do not have insurance. To be sure, an American either has private insurance or is covered by government-funded programs like the one fronted by the Affordable Care Act (ACA). This is quite necessary for a country where a single major medical bill is enough to send one into personal bankruptcy.
Interestingly, most of the American population is entering the geriatric phase of life fueled by the aging baby boomers. Further, Ikegami (2015) wrote that the US health care system is in the process of shifting from the situation where only the volume of patients treated mattered. This system relied on fees for service and which gave healthcare providers the revenue incentive to reach more patients. To be sure, the healthcare sector is shifting a value-based system where the value delivered to the patient will take center stage (Burwell, 2015).
Therefore, it is apparent that the healthcare sector will experience fundamental changes in terms of quality of service, a volume of people accessing healthcare services and the general healthcare situation across all the 50 states. In this light, this paper intends to highlight factors that will affect healthcare in the future and in what direction will these factors move the sector in general.
Demographic and social factors
The US might be among the developed economy countries that are aging the slowest but the population is still graying. In 2010, Pew Research Center said that 13% of Americans were 65 years of age or older. At the same time, the firm projected that this cohort would grow up to take up 18% of the American population by 2030 (Cohn & Taylor, 2014, April 10). Once people get older, their productivity drops significantly and they begin to experience a lot more medical complications than before.
To be sure, the aging population will add a huge strain to the healthcare sector in terms of geriatric care as well as complications tied to old age. Once a nation has a huge population of old people, there will be a high demand of healthcare services which, basically, imply that healthcare providers will be on high demand (Keehan, Stone, Poisal, Cuckler, Sisko, Smith... & Lizonitz, 2017). Interestingly, the increased demand will also lead to a higher demand for labor force in the sector to carry out duties like geriatric care, to provide physical therapy and other tasks like providing aid for ol.
The nursing profession faces several challenges in the 21st century including a growing elderly population that requires more acute care, rising healthcare costs, and the need to adapt to rapid advances in medical technology. There is also a shortage of nurses exacerbated by an aging workforce and many nurses leaving their jobs to work abroad. Nurse managers play an important role in creating work environments that support nurses, improve patient outcomes, and help address these challenges facing the nursing profession.
Respond to at least two classmates who identified different areas of.docxpeggyd2
Respond to at least two classmates who identified different areas of disparity than your own. Do you agree or disagree with their assessment of the impact of economic policy on the disparity? Does the disparity discussed have a microeconomic or a macroeconomic impact on health care?
Post # 1
Trina Cox
Disparity in healthcare can be defined as, “differences between groups in health insurance coverage, access to and use of care, and quality of care” (Orger & Artiga, 2018). There are various healthcare disparities; however, the key areas of disparity I have chosen to identify and analyze include health insurance coverage, quality of care, and gender. As most people already know, health insurance is a type of insurance coverage that is designed to cover an insured person’s medical expenses (such as hospital, doctor, laboratory and pharmacy services). Although the number of uninsured Americans have decreased drastically since the passing of ACA, disparities in this area still exist. Some individuals’ annual incomes still are not enough to pay the low premiums that may be required of them to have access to health insurance coverage.
Quality of care can be described as, “the degree to which health care services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge” (AHRQ, 2017). Although it is an unethical act displayed by healthcare professionals; in some areas, all patients are not treated equally with regards to quality of care. According to Dr. Ananya Mandal (2019), discrimination occurs when healthcare providers treat individuals from certain population groups differently to other population groups, whether this is done consciously or not. It is common for this to occur when providers have stereotyped impressions of specific racial or ethnic groups.
Gender can play a major role in healthcare disparities among women, specifically, in some of the developed countries. Researchers have reported that determinants of gender differences, like welfare indicators (e.g., education and income), behavioral factors (e.g., smoking and drinking), and social factors (e.g., social support and socioeconomic status) have direct correlations with some of the existing disparities (Hassanzadeh, et al, 2017). Afghanistan is a country that still has a high rate of gender disparities among women, even though some improvements have occurred. In this country, the biggest disparities that I feel still exist are between women in rural versus urban areas, and those with some education, as opposed to those women with none; showing that as education of women increases, so does their health and that of their children because of the education and resources that they have.
I think several economic policies have impacted these disparities and they include differences in income levels, education, and geographic location. A person’s annual income may have a direct effect on his or her ability.
The Impact of Immigrant Workforce in the Senior Care Economy 2.docxlillie234567
The Impact of Immigrant Workforce in the Senior Care Economy 2
The Impact of Immigrant Workforce in the Senior Care Economy 15
The Impact of Immigrant Workforce in the Senior Care Economy
Dominique Elmadi
Bay Atlantic University
ECON 505
Bintou Lingani
December 2, 2022
Table of Contents
ABSTRACT 3
INTRODUCTION 4
LITERATURE REVIEW 6
CONCLUSION 14
REFERENCES 15
ABSTRACT
This paper presents the challenges and opportunities of the senior care economy. The demographic trends in the United States show an aging nation. The last two decades have seen the country grow continuously older, resulting in a growing elderly care economy which translates in the creation of a great number of jobs, now and in the future, for senior housing and care options. Home health care workers are estimated to be the third fastest growing occupation.
At the same time, a shortage of paid caregivers has led immigrants to play an important role, both in nursing homes as in-home care, filling the gap. This paper focuses on 3 states where one-fourth of these older Americans live: California, Florida, and Texas, analyzing the trends in senior care, the options available, the costs and the contribution of the immigrants to the labor force.
By 2025, the in-home health care industry is expected to generate $225 billion in revenue and employ close to 3.5 million workers; therefore, the growth of the industry is good news for the economy. The industry provides jobs for a wide range of workers, including nurses, home health aides, as well as individual care aides. The shortage for low and middle skilled home health caregivers is a challenge which also entails an opportunity to provide such services, while promoting economic development and job creation and could be addressed, among other initiatives, by immigration pilot programs for caregivers.
INTRODUCTION
Many studies concur that “In the US, the number of people aged 85 and up will more than double to 14.4 million by the year 2040” (ACL,2020). This means that there will be more demand for senior care in the upcoming years and it is important to navigate about the economic options available for them, while at the same time analysing the impact of these options on the economy. According to several studies, the trends imply that there will be a rising need for senior housing and care options for seniors who need some level of care. However, the future is not all bright. Growing workforce shortages and the resulting increasing cost of labor are leading concerns for the industry, which relies on people to provide services and care at the bedside. The worker shortage will be one of the biggest difficulties in this industry segment.
Since the 1990s, the number of immigrants in the United States has grown dramatically. Immigrants make up a significant share of the U.S. workforce, and their impact is especially evident in the senior care economy. .
- Healthcare spending in the US is concentrated among a small portion of the population and must be reduced to control costs. Chronic conditions are a major driver of spending and will continue growing.
- There is an explosion of healthcare data from a variety of sources, but most of this data is unstructured and difficult for computers to interpret. Leveraging this data through analytics could provide insights to improve care and reduce costs.
- Continuous care that extends beyond traditional clinical settings will be needed to effectively manage chronic conditions, which account for most US healthcare costs and 157 million Americans by 2020. Big and small data analytics that incorporate lifestyle, behavioral and socioeconomic factors may help with continuous care and population health management.
Elderly falls are a significant issue in healthcare facilities. Several factors contribute to increased falls among elderly patients, such as long hospital stays which cause patients to collapse while waiting for care, and poorly designed facility layouts with staircases but no elevators. A proposed solution is to implement bed alarms to alert staff when patients attempt to exit beds, which may help decrease fall rates among elderly patients aged 65 and older during 30-day hospital stays compared to not using bed alarms. Falls among the elderly are a major health issue that result in injuries, increased healthcare costs, and even death.
Controlling Future Health Care Costs Sep2011ri27525
The document discusses rising healthcare costs in the United States and potential drivers of future costs. It notes that healthcare spending is projected to grow significantly by 2020 and be a large portion of the country's GDP. Three main drivers of costs are expected to be hospital services, prescription drugs, and physician/clinical services. Additionally, new medical technologies and treatments contribute to higher costs. However, the biggest factor may be increasing rates of diseases like obesity, diabetes and heart disease among younger populations due to worsening lifestyle and risk factors. This could negate gains from medical advances and result in higher overall disease burden and healthcare expenditures than currently projected. Emphasis is placed on promoting healthy behaviors to curb unnecessary costs and improve wellness.
Paper 3 healthcare status in chittagong city revised 28 janMohammad Haider
The document discusses the healthcare status and challenges faced by urban poor populations in Chittagong City, Bangladesh. It finds that overall healthcare access is moderate to very poor, especially in Sandwip Colony, due to a lack of public healthcare services and facilities like community hospitals and clinics. Establishing more accessible community healthcare facilities that provide free treatment and specialist doctors could help address issues around maternal, child, and general healthcare access for the urban poor. Further policy reforms and structural improvements are still needed to strengthen urban poor populations' access to essential healthcare services in Chittagong City.
Chapter Five Older People and Long-Term Care Issues of Access.docxmccormicknadine86
Chapter Five
Older People and Long-Term Care: Issues of Access
1
2
Why the new interest in long-term care?
The Baby Boomers are adding to the growth in the population over 65.
There is increasing fear of dependency on long-term care.
Adult children of the elderly having to find care for their parents.
Healthcare reform promises great changes that are not well understood.
3
3
The Growing Population Needing Care
The need for ADL and IADL assistance continues to grow.
Table 8-1 presents the broad range of services needed by the disabled.
Most of the population needing long-term care do not live in nursing homes.
Many factors contribute to the inability to predict the exact number needing services in the future.
4
4
The Growing Population Needing Care
Future populations may be better educated which is associated with lower levels of disability.
Ethnic composition suggests a greater need for care and government support.
Boomers will bring greater numbers of people needing services.
The number of those over 75 will greatly increase.
5
5
The Growing Population Needing Care
Disability rates will increase among those who are not in nursing homes.
The most common disability is physical.
In addition, the nursing home population is expected to have profound increases until it triples by 2030.
The number of younger persons with disability has also increased.
6
6
Issues of Access
The current system is far from ideal.
There is not an adequate supply particularly for the poor.
The system itself continues to be so fragmented that many are not aware of what is offered.
Financing is an underlying problem.
7
7
The Costs of Care
Expenses for this care are sizable and will increase in the future.
Private insurance only pays for a small percentage of the care.
Medicaid pays for over 85% of nursing home care.
8
8
The Costs of Care
Annual costs of nursing home care can average $58,000 per year and may exceed $100,000. For many, the costs of this care is just not affordable.
With the addition of the Baby Boomers, costs will most certainly increase in the future.
The effects of reform are not currently known.
9
9
The Care-giving Role of Families
About 74% of dependent community-based elders receive care from family members.
The majority of caregivers are women.
The number and willingness of family caregivers may decline as the Boomers become in need for assistance.
10
10
The Role of Private Insurance
Private insurance for long-term care is a relatively new product.
Improvements in coverage are being made, but only an estimated 20% of the population will use it.
CCRCs and LCAHs hold promise for the future.
11
11
The Role of Medicaid
Medicaid is changing under PPACA to include more eligible adults who will receive benchmark coverage.
Medicaid is used for those elders who meet certain criteria.
Medicaid does not pay for the full range of services including home-based care.
Some states are using a waiver to offe ...
Chapter Five Older People and Long-Term Care Issues of Access.docxtiffanyd4
Chapter Five
Older People and Long-Term Care: Issues of Access
1
2
Why the new interest in long-term care?
The Baby Boomers are adding to the growth in the population over 65.
There is increasing fear of dependency on long-term care.
Adult children of the elderly having to find care for their parents.
Healthcare reform promises great changes that are not well understood.
3
3
The Growing Population Needing Care
The need for ADL and IADL assistance continues to grow.
Table 8-1 presents the broad range of services needed by the disabled.
Most of the population needing long-term care do not live in nursing homes.
Many factors contribute to the inability to predict the exact number needing services in the future.
4
4
The Growing Population Needing Care
Future populations may be better educated which is associated with lower levels of disability.
Ethnic composition suggests a greater need for care and government support.
Boomers will bring greater numbers of people needing services.
The number of those over 75 will greatly increase.
5
5
The Growing Population Needing Care
Disability rates will increase among those who are not in nursing homes.
The most common disability is physical.
In addition, the nursing home population is expected to have profound increases until it triples by 2030.
The number of younger persons with disability has also increased.
6
6
Issues of Access
The current system is far from ideal.
There is not an adequate supply particularly for the poor.
The system itself continues to be so fragmented that many are not aware of what is offered.
Financing is an underlying problem.
7
7
The Costs of Care
Expenses for this care are sizable and will increase in the future.
Private insurance only pays for a small percentage of the care.
Medicaid pays for over 85% of nursing home care.
8
8
The Costs of Care
Annual costs of nursing home care can average $58,000 per year and may exceed $100,000. For many, the costs of this care is just not affordable.
With the addition of the Baby Boomers, costs will most certainly increase in the future.
The effects of reform are not currently known.
9
9
The Care-giving Role of Families
About 74% of dependent community-based elders receive care from family members.
The majority of caregivers are women.
The number and willingness of family caregivers may decline as the Boomers become in need for assistance.
10
10
The Role of Private Insurance
Private insurance for long-term care is a relatively new product.
Improvements in coverage are being made, but only an estimated 20% of the population will use it.
CCRCs and LCAHs hold promise for the future.
11
11
The Role of Medicaid
Medicaid is changing under PPACA to include more eligible adults who will receive benchmark coverage.
Medicaid is used for those elders who meet certain criteria.
Medicaid does not pay for the full range of services including home-based care.
Some states are using a waiver to offe.
Running head MODULE 1- ASSIGNMENT 1MODULE 1-ASSIGNMENT .docxjeanettehully
Running head: MODULE 1- ASSIGNMENT
1
MODULE 1-ASSIGNMENT
17
Module 1 – 3 Golden Age Hospital
DeMario J. Stackhouse
MHA – 599
Dr. Tina Evans
Trident University International
Background
Currently, the Mission Viejo municipality has a larger population of approximately 500,000 people according to the latest census of 2012. The total population comprises of 48.5% males and 51.5 % female. The county has two main healthcare facilities that provide services to the community of radius of approximately 10-miles. The Mission Hospital Regional Foundation Centre acts as a communal ship due to its functions. Besides, the mission health Centre is prominent to partner with other facilities such as CHOC Children’s (Burgess, Shaw & Kellas, 2011). The two healthcare facilities provide services to a total of nine municipalities at Viejo. These municipalities are San Juan Capistrano, Aliso Viejo, Laguna Niguel, Lake Forest, Laguna Hills, Laguna Woods, Mission Viejo, Ladera, and Rancho Santa Margarita. The county has communities and homes which comprises of the aging population and retired persons of fifty-five years and above.
Common senior medical situations
The makeup of the Golden Age Hospital in the Mission Viejo and its surroundings is useful because it provides quality healthcare services to infected people and the old. Many common health situations affect the old age in the municipality. These most common health conditions include heart attack conditions, lungs problems, and coronary diseases, which has been reported in places like Aliso Viejo and Laguna Hills (Collins, Connor, Mott & Hickey, 2015). Currently, dealing with these common healthcare conditions is challenging because there are no enough health facilities that can provide all needed services to the public. In most cases, senior medical situations need special attention which should be addressed with more care. Therefore, there is need for an extra wing at the Golden Age Hospital that should be specifically responsible to handle senior medical conditions only.
Major Medical Institutions
The senior healthcare institution in the municipality is the two hospitals located in Viejo that primarily provide acute healthcare services and respite healthcare services to the elderly. These healthcare services are susceptible; thus, it can allow caregivers to attend to other daily routines.
Market Research and Segmentation
Targeting and location of Golden Age Hospital
According to the current situation in the city, there is a need for more wing of the facility to prove healthcare services to the aging population that requires more attention. The development and modernization of more extensions in the facility will help to provide supplementary services to the two existing hospitals to deliver excellence healthcare services to old people. Statistically, in the nine counties, around 17.5 % of the total population is fifty-five years of age assuming the average age is 77 years (Ha ...
The macro trends in healthcare and the associated careershivani rana
This document discusses emerging macro trends in the US healthcare system and their impact on future healthcare jobs. It identifies trends like changes in the economy, demographics, lifestyles, technology and government policies. It notes that healthcare accounts for 18% of the US economy and that between 2010-2020 there will be over 5 million new healthcare jobs. It explores how trends like an aging population, increased chronic diseases, technology and policies like the Affordable Care Act are changing the system. Various career opportunities that may emerge like health economists, home healthcare workers, public health educators and health IT analysts are also outlined.
This document discusses the challenges that the elderly face in accessing affordable and adequate healthcare. As the elderly population increases in size, more will require long-term care which is very expensive. Many elderly live on fixed incomes from social security and have to choose between basic needs like food and medication due to rising healthcare costs. The limited coverage of Medicare often leaves elderly shouldering thousands of dollars in medical bills. Improving preventative care and increasing the number of geriatricians could help alleviate costs and ensure the needs of the growing elderly population are met in the future.
The Workforce of the Future - Ben Frasier.pdfBenFrasier
As a nation, we are faced with a critical health care worker shortage that needs both immediate and long-term solutions. Everyone is affected by healthcare: as citizens whose health and that of our loved ones is affected by how well our healthcare system is functioning; as healthcare staff who are facing increasing levels of burnout and lack of motivation to work within a broken system; as healthcare administrators whose job it is to optimize resources to ensure that patients receive comprehensive and equitable care and that healthcare workers receive the support they need to thrive in a safe working environment; to legislators whose job it is to create practices and policies that allow the healthcare system to achieve these goals.
You have been asked to explain the differences between certain categ.docxshericehewat
You have been asked to explain the differences between certain categories of crimes. For each of the following categories of crime, provide a general definition of the category of crime and give at least two detailed examples of specific crimes that fall into each category:
Crimes against persons
Crimes against property
Crimes of public morality
White-collar crime
Cyber crime
Then for the following scenarios, discuss the categories of crimes involved in each scenario and explain the specific criminal charges that you would apply to each scenario. You can utilize the Library, Internet and other resources to research the criminal statutes of a state of your choice in order to help you determine which criminal charges should be applied:
David S. was running around a public park without his clothes on, singing and shouting loudly, at 3 in the morning. Police arrived after neighbors called to complain. They saw David S. tipping over a garbage can and when they shouted for him to stop, he threw the garbage can into a car, breaking one of its side windows. The police arrested David S, His blood alcohol level was twice the legal limit.
Gary M. was arrested by the FBI when he showed up at a local mall to meet a "14 year old girl" for a date, which he arranged over the Internet. He didn't know that the "14 year old girl" was actually a 35-year old male FBI agent.
Elaine R. was an accountant working for a large corporation. She had been falsifying the accounting records and sending some of the corporate funds to her own bank accounts in an offshore bank. The corporation found out what she had been doing and reported her to the police.
Please submit your assignment.
.
You have been asked to help secure the information system and users .docxshericehewat
You have been asked to help secure the information system and users against hacking attempts. Complete the following:
Take this opportunity to describe the 4 different approaches and techniques a hacker would use to steal the organization's data.
For each approach, discuss what methods can be used to circumvent the attack, prevent it, or minimize the disruption caused by the event.
Include 2–3 pages of material covering the 3 discussion areas in Section 5 of your Key Assignment document (including the completed previous 4 sections).
social engineering,dumpster diving,identify theft,cyberterrorist
.
You have been asked to participate in a local radio program to add.docxshericehewat
You have been asked to participate in a local radio program to discuss the role of corrections in the community. The audience will debate whether the focus should be on rehabilitating offenders, punishing offenders, or isolating chronic offenders. You must decide which role should be the focus of the community's corrections policy and prepare to explain your viewpoint on the role of corrections by anticipating questions from callers and relating corrections issues to the topic you are researching.
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You have been appointed as a system analyst in the IT department of .docxshericehewat
You have been appointed as a system analyst in the IT department of a selected university in Malaysia. You are responsible to develop an online admission system for the university. For this reason, you have to do an analysis and design to model the online system that could be developed later. Identify the requirements for the system and produce a software requirement specification (SRS) to document all the details.
.
You choose one and I will upload the materials for u.Choose 1 of.docxshericehewat
You choose one and I will upload the materials for u.
Choose 1 of the following 3 questions, and answer it in a paper of no more than 1000 words. Submit that paper by
November 4
at midnight PST in the appropriate IICS515 Moodle dropbox.
4. Monday October 27 lecture
Themes: Global Media Governance and Regulation; The Internet and Digital Media
Readings: Chapter 5, “The Medium: Global Technologies and Organizations,” and Chapter 6, “The Internet”
In this lecture, we discussed the definition and history of communication rights as one element or dimension of communication policy, and used it to bring to life a subject—policy—that sometimes seems abstract and technical in nature.
In doing so, we noted the evolution from a “negative” rights view of communication rights, as expressed in Article 19 of the United Nations Universal Declaration of Human Rights in 1948, to the more “positive” definition of communication rights explained in the lecture content derived from the work of Marc Raboy (and Jeremy Shtern).
Remember that “negative” does not mean “bad” here nor “positive” good. “Negative” and “positive” rights—which are ways of thinking about all human rights, not just communication rights—are instead ways of characterizing the orientation of rights toward individuals and society. Negative rights are defined in terms of freedom
from
things, and positive rights in terms of freedom
to
have or do certain things. Both negative and positive rights derive their legitimacy from fundamental and universal consideration of what it means to be human and to be treat people as human beings.
In our case study at the end of the lecture, we then discussed how a “positive” approach to communication rights could help us better understand and perhaps act against cyberbullying.
In your paper, and in your own words, define “communication rights,” and then briefly explain the evolution from the negative to the positive rights approach to communication rights.
Once you have done that, and with reference to the cyberbullying pamphlet from the Canadian government attached to your lecture notes, demonstrate how a “positive” rights approach to communication rights can help us better understand and prevent cyberbullying. In other words, what are the limitations of approaching cyberbullying from a “negative” rights perspective, and what does a “positive” approach to communication rights do to help us understand and perhaps act against cyberbullying?
Cyberbullying is a problem in international communication that affects many, especially vulnerable teenagers, as illustrated in the case of the late Amanda Todd (from British Columbia).
You do not need to use the McPhail chapter here, as it is not directly relevant to this question. Rather, draw on the lecture notes and the podcast as your sources here.
5. Wednesday October 29 lecture
Themes: Global Media Case Study in Media and the Arab World; Orientalism
Readings: Said, Edward (1978)..
You are Incident Commander and principal planner for the DRNC even.docxshericehewat
You are Incident Commander and
principal planner for the DRNC event. As you commence the planning process, consider the two fundamental types of error committed by policy makers in their reliance on intelligence reports to formulate policy. What would you do to minimize these errors from occurring and adversely affecting your policy decisions?
Min 500 words, In text references, APA format
.
You DecideCryptographic Tunneling and the OSI ModelWrite a p.docxshericehewat
You Decide
Cryptographic Tunneling and the OSI Model
Write a paper consisting of 500-1,000 words (double-spaced) on the security effects of cryptographic tunneling based on an understanding of the OSI (Open Systems Interconnect) model (Review the OSI Simulation in the Week 3 Lecture).
Provide input on the type of cryptographic tunneling protocols (e.g., L2TP, IPSEC, SSL, etc.) that may be used, the layer(s) of the OSI at which each operates, and also recommend how they may be implemented. Cryptographic tunneling is inherent in building any common virtual private network (VPN).
.
You are working as a behavioral health specialist in a neurological .docxshericehewat
You are working as a behavioral health specialist in a neurological research center and are responsible for participant education. There are three participants to choose from: Stephanie has experienced a stroke; Jamie has experienced an amputation; and Robert has experienced a traumatic brain injury. Choose one participant to work with.
We are chosing Robert and his traumatic brain injury
Prepare
a 1,000- to 1,200-word paper that explains the functions and limitations of neural plasticity in the participant's recovery process.
Include
two to three peer-reviewed sources.
.
You are to write up a reflection (longer than 2 pages) that discusse.docxshericehewat
You are to write up a reflection (longer than 2 pages) that discusses what happened in the prisoner's dilemma activity we did in class on Monday, April 20. Some points to cover include why you took the action you took, what you thought others were going to do and why, and what actually happened. And what implications this has for situations in the work place where individuals may take different actions than might be the most beneficial for the team as a whole.
.
You can only take this assignment if you have the book Discovering t.docxshericehewat
You can only take this assignment if you have the book Discovering the Humanities. This homework needs to be done by reading Chapter Nine. It needs to be a minimum of 150 to 200 words. It needs citations and referances.
Western art and architecture has influenced and been influenced by cultures in India, China, and Japan.
Part I:
Using examples provided from this unit's reading, discuss how the artistic culture in either India, China, or Japan (select one) exhibits influence from Western cultures. Discuss, too, the reciprocal connection, specifically explaining how India, China, or Japan influenced Western art and architecture.
Part II:
Add to your post by discussing the similarities and differences between art from your selected culture (India, China, or Japan) and ancient Greek sculpture. Use examples and images to support your ideas.
.
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Similar to Four challenges face the nursing workforce of today and tomorrow .docx
The Impact of Immigrant Workforce in the Senior Care Economy 2.docxlillie234567
The Impact of Immigrant Workforce in the Senior Care Economy 2
The Impact of Immigrant Workforce in the Senior Care Economy 15
The Impact of Immigrant Workforce in the Senior Care Economy
Dominique Elmadi
Bay Atlantic University
ECON 505
Bintou Lingani
December 2, 2022
Table of Contents
ABSTRACT 3
INTRODUCTION 4
LITERATURE REVIEW 6
CONCLUSION 14
REFERENCES 15
ABSTRACT
This paper presents the challenges and opportunities of the senior care economy. The demographic trends in the United States show an aging nation. The last two decades have seen the country grow continuously older, resulting in a growing elderly care economy which translates in the creation of a great number of jobs, now and in the future, for senior housing and care options. Home health care workers are estimated to be the third fastest growing occupation.
At the same time, a shortage of paid caregivers has led immigrants to play an important role, both in nursing homes as in-home care, filling the gap. This paper focuses on 3 states where one-fourth of these older Americans live: California, Florida, and Texas, analyzing the trends in senior care, the options available, the costs and the contribution of the immigrants to the labor force.
By 2025, the in-home health care industry is expected to generate $225 billion in revenue and employ close to 3.5 million workers; therefore, the growth of the industry is good news for the economy. The industry provides jobs for a wide range of workers, including nurses, home health aides, as well as individual care aides. The shortage for low and middle skilled home health caregivers is a challenge which also entails an opportunity to provide such services, while promoting economic development and job creation and could be addressed, among other initiatives, by immigration pilot programs for caregivers.
INTRODUCTION
Many studies concur that “In the US, the number of people aged 85 and up will more than double to 14.4 million by the year 2040” (ACL,2020). This means that there will be more demand for senior care in the upcoming years and it is important to navigate about the economic options available for them, while at the same time analysing the impact of these options on the economy. According to several studies, the trends imply that there will be a rising need for senior housing and care options for seniors who need some level of care. However, the future is not all bright. Growing workforce shortages and the resulting increasing cost of labor are leading concerns for the industry, which relies on people to provide services and care at the bedside. The worker shortage will be one of the biggest difficulties in this industry segment.
Since the 1990s, the number of immigrants in the United States has grown dramatically. Immigrants make up a significant share of the U.S. workforce, and their impact is especially evident in the senior care economy. .
- Healthcare spending in the US is concentrated among a small portion of the population and must be reduced to control costs. Chronic conditions are a major driver of spending and will continue growing.
- There is an explosion of healthcare data from a variety of sources, but most of this data is unstructured and difficult for computers to interpret. Leveraging this data through analytics could provide insights to improve care and reduce costs.
- Continuous care that extends beyond traditional clinical settings will be needed to effectively manage chronic conditions, which account for most US healthcare costs and 157 million Americans by 2020. Big and small data analytics that incorporate lifestyle, behavioral and socioeconomic factors may help with continuous care and population health management.
Elderly falls are a significant issue in healthcare facilities. Several factors contribute to increased falls among elderly patients, such as long hospital stays which cause patients to collapse while waiting for care, and poorly designed facility layouts with staircases but no elevators. A proposed solution is to implement bed alarms to alert staff when patients attempt to exit beds, which may help decrease fall rates among elderly patients aged 65 and older during 30-day hospital stays compared to not using bed alarms. Falls among the elderly are a major health issue that result in injuries, increased healthcare costs, and even death.
Controlling Future Health Care Costs Sep2011ri27525
The document discusses rising healthcare costs in the United States and potential drivers of future costs. It notes that healthcare spending is projected to grow significantly by 2020 and be a large portion of the country's GDP. Three main drivers of costs are expected to be hospital services, prescription drugs, and physician/clinical services. Additionally, new medical technologies and treatments contribute to higher costs. However, the biggest factor may be increasing rates of diseases like obesity, diabetes and heart disease among younger populations due to worsening lifestyle and risk factors. This could negate gains from medical advances and result in higher overall disease burden and healthcare expenditures than currently projected. Emphasis is placed on promoting healthy behaviors to curb unnecessary costs and improve wellness.
Paper 3 healthcare status in chittagong city revised 28 janMohammad Haider
The document discusses the healthcare status and challenges faced by urban poor populations in Chittagong City, Bangladesh. It finds that overall healthcare access is moderate to very poor, especially in Sandwip Colony, due to a lack of public healthcare services and facilities like community hospitals and clinics. Establishing more accessible community healthcare facilities that provide free treatment and specialist doctors could help address issues around maternal, child, and general healthcare access for the urban poor. Further policy reforms and structural improvements are still needed to strengthen urban poor populations' access to essential healthcare services in Chittagong City.
Chapter Five Older People and Long-Term Care Issues of Access.docxmccormicknadine86
Chapter Five
Older People and Long-Term Care: Issues of Access
1
2
Why the new interest in long-term care?
The Baby Boomers are adding to the growth in the population over 65.
There is increasing fear of dependency on long-term care.
Adult children of the elderly having to find care for their parents.
Healthcare reform promises great changes that are not well understood.
3
3
The Growing Population Needing Care
The need for ADL and IADL assistance continues to grow.
Table 8-1 presents the broad range of services needed by the disabled.
Most of the population needing long-term care do not live in nursing homes.
Many factors contribute to the inability to predict the exact number needing services in the future.
4
4
The Growing Population Needing Care
Future populations may be better educated which is associated with lower levels of disability.
Ethnic composition suggests a greater need for care and government support.
Boomers will bring greater numbers of people needing services.
The number of those over 75 will greatly increase.
5
5
The Growing Population Needing Care
Disability rates will increase among those who are not in nursing homes.
The most common disability is physical.
In addition, the nursing home population is expected to have profound increases until it triples by 2030.
The number of younger persons with disability has also increased.
6
6
Issues of Access
The current system is far from ideal.
There is not an adequate supply particularly for the poor.
The system itself continues to be so fragmented that many are not aware of what is offered.
Financing is an underlying problem.
7
7
The Costs of Care
Expenses for this care are sizable and will increase in the future.
Private insurance only pays for a small percentage of the care.
Medicaid pays for over 85% of nursing home care.
8
8
The Costs of Care
Annual costs of nursing home care can average $58,000 per year and may exceed $100,000. For many, the costs of this care is just not affordable.
With the addition of the Baby Boomers, costs will most certainly increase in the future.
The effects of reform are not currently known.
9
9
The Care-giving Role of Families
About 74% of dependent community-based elders receive care from family members.
The majority of caregivers are women.
The number and willingness of family caregivers may decline as the Boomers become in need for assistance.
10
10
The Role of Private Insurance
Private insurance for long-term care is a relatively new product.
Improvements in coverage are being made, but only an estimated 20% of the population will use it.
CCRCs and LCAHs hold promise for the future.
11
11
The Role of Medicaid
Medicaid is changing under PPACA to include more eligible adults who will receive benchmark coverage.
Medicaid is used for those elders who meet certain criteria.
Medicaid does not pay for the full range of services including home-based care.
Some states are using a waiver to offe ...
Chapter Five Older People and Long-Term Care Issues of Access.docxtiffanyd4
Chapter Five
Older People and Long-Term Care: Issues of Access
1
2
Why the new interest in long-term care?
The Baby Boomers are adding to the growth in the population over 65.
There is increasing fear of dependency on long-term care.
Adult children of the elderly having to find care for their parents.
Healthcare reform promises great changes that are not well understood.
3
3
The Growing Population Needing Care
The need for ADL and IADL assistance continues to grow.
Table 8-1 presents the broad range of services needed by the disabled.
Most of the population needing long-term care do not live in nursing homes.
Many factors contribute to the inability to predict the exact number needing services in the future.
4
4
The Growing Population Needing Care
Future populations may be better educated which is associated with lower levels of disability.
Ethnic composition suggests a greater need for care and government support.
Boomers will bring greater numbers of people needing services.
The number of those over 75 will greatly increase.
5
5
The Growing Population Needing Care
Disability rates will increase among those who are not in nursing homes.
The most common disability is physical.
In addition, the nursing home population is expected to have profound increases until it triples by 2030.
The number of younger persons with disability has also increased.
6
6
Issues of Access
The current system is far from ideal.
There is not an adequate supply particularly for the poor.
The system itself continues to be so fragmented that many are not aware of what is offered.
Financing is an underlying problem.
7
7
The Costs of Care
Expenses for this care are sizable and will increase in the future.
Private insurance only pays for a small percentage of the care.
Medicaid pays for over 85% of nursing home care.
8
8
The Costs of Care
Annual costs of nursing home care can average $58,000 per year and may exceed $100,000. For many, the costs of this care is just not affordable.
With the addition of the Baby Boomers, costs will most certainly increase in the future.
The effects of reform are not currently known.
9
9
The Care-giving Role of Families
About 74% of dependent community-based elders receive care from family members.
The majority of caregivers are women.
The number and willingness of family caregivers may decline as the Boomers become in need for assistance.
10
10
The Role of Private Insurance
Private insurance for long-term care is a relatively new product.
Improvements in coverage are being made, but only an estimated 20% of the population will use it.
CCRCs and LCAHs hold promise for the future.
11
11
The Role of Medicaid
Medicaid is changing under PPACA to include more eligible adults who will receive benchmark coverage.
Medicaid is used for those elders who meet certain criteria.
Medicaid does not pay for the full range of services including home-based care.
Some states are using a waiver to offe.
Running head MODULE 1- ASSIGNMENT 1MODULE 1-ASSIGNMENT .docxjeanettehully
Running head: MODULE 1- ASSIGNMENT
1
MODULE 1-ASSIGNMENT
17
Module 1 – 3 Golden Age Hospital
DeMario J. Stackhouse
MHA – 599
Dr. Tina Evans
Trident University International
Background
Currently, the Mission Viejo municipality has a larger population of approximately 500,000 people according to the latest census of 2012. The total population comprises of 48.5% males and 51.5 % female. The county has two main healthcare facilities that provide services to the community of radius of approximately 10-miles. The Mission Hospital Regional Foundation Centre acts as a communal ship due to its functions. Besides, the mission health Centre is prominent to partner with other facilities such as CHOC Children’s (Burgess, Shaw & Kellas, 2011). The two healthcare facilities provide services to a total of nine municipalities at Viejo. These municipalities are San Juan Capistrano, Aliso Viejo, Laguna Niguel, Lake Forest, Laguna Hills, Laguna Woods, Mission Viejo, Ladera, and Rancho Santa Margarita. The county has communities and homes which comprises of the aging population and retired persons of fifty-five years and above.
Common senior medical situations
The makeup of the Golden Age Hospital in the Mission Viejo and its surroundings is useful because it provides quality healthcare services to infected people and the old. Many common health situations affect the old age in the municipality. These most common health conditions include heart attack conditions, lungs problems, and coronary diseases, which has been reported in places like Aliso Viejo and Laguna Hills (Collins, Connor, Mott & Hickey, 2015). Currently, dealing with these common healthcare conditions is challenging because there are no enough health facilities that can provide all needed services to the public. In most cases, senior medical situations need special attention which should be addressed with more care. Therefore, there is need for an extra wing at the Golden Age Hospital that should be specifically responsible to handle senior medical conditions only.
Major Medical Institutions
The senior healthcare institution in the municipality is the two hospitals located in Viejo that primarily provide acute healthcare services and respite healthcare services to the elderly. These healthcare services are susceptible; thus, it can allow caregivers to attend to other daily routines.
Market Research and Segmentation
Targeting and location of Golden Age Hospital
According to the current situation in the city, there is a need for more wing of the facility to prove healthcare services to the aging population that requires more attention. The development and modernization of more extensions in the facility will help to provide supplementary services to the two existing hospitals to deliver excellence healthcare services to old people. Statistically, in the nine counties, around 17.5 % of the total population is fifty-five years of age assuming the average age is 77 years (Ha ...
The macro trends in healthcare and the associated careershivani rana
This document discusses emerging macro trends in the US healthcare system and their impact on future healthcare jobs. It identifies trends like changes in the economy, demographics, lifestyles, technology and government policies. It notes that healthcare accounts for 18% of the US economy and that between 2010-2020 there will be over 5 million new healthcare jobs. It explores how trends like an aging population, increased chronic diseases, technology and policies like the Affordable Care Act are changing the system. Various career opportunities that may emerge like health economists, home healthcare workers, public health educators and health IT analysts are also outlined.
This document discusses the challenges that the elderly face in accessing affordable and adequate healthcare. As the elderly population increases in size, more will require long-term care which is very expensive. Many elderly live on fixed incomes from social security and have to choose between basic needs like food and medication due to rising healthcare costs. The limited coverage of Medicare often leaves elderly shouldering thousands of dollars in medical bills. Improving preventative care and increasing the number of geriatricians could help alleviate costs and ensure the needs of the growing elderly population are met in the future.
The Workforce of the Future - Ben Frasier.pdfBenFrasier
As a nation, we are faced with a critical health care worker shortage that needs both immediate and long-term solutions. Everyone is affected by healthcare: as citizens whose health and that of our loved ones is affected by how well our healthcare system is functioning; as healthcare staff who are facing increasing levels of burnout and lack of motivation to work within a broken system; as healthcare administrators whose job it is to optimize resources to ensure that patients receive comprehensive and equitable care and that healthcare workers receive the support they need to thrive in a safe working environment; to legislators whose job it is to create practices and policies that allow the healthcare system to achieve these goals.
Similar to Four challenges face the nursing workforce of today and tomorrow .docx (11)
You have been asked to explain the differences between certain categ.docxshericehewat
You have been asked to explain the differences between certain categories of crimes. For each of the following categories of crime, provide a general definition of the category of crime and give at least two detailed examples of specific crimes that fall into each category:
Crimes against persons
Crimes against property
Crimes of public morality
White-collar crime
Cyber crime
Then for the following scenarios, discuss the categories of crimes involved in each scenario and explain the specific criminal charges that you would apply to each scenario. You can utilize the Library, Internet and other resources to research the criminal statutes of a state of your choice in order to help you determine which criminal charges should be applied:
David S. was running around a public park without his clothes on, singing and shouting loudly, at 3 in the morning. Police arrived after neighbors called to complain. They saw David S. tipping over a garbage can and when they shouted for him to stop, he threw the garbage can into a car, breaking one of its side windows. The police arrested David S, His blood alcohol level was twice the legal limit.
Gary M. was arrested by the FBI when he showed up at a local mall to meet a "14 year old girl" for a date, which he arranged over the Internet. He didn't know that the "14 year old girl" was actually a 35-year old male FBI agent.
Elaine R. was an accountant working for a large corporation. She had been falsifying the accounting records and sending some of the corporate funds to her own bank accounts in an offshore bank. The corporation found out what she had been doing and reported her to the police.
Please submit your assignment.
.
You have been asked to help secure the information system and users .docxshericehewat
You have been asked to help secure the information system and users against hacking attempts. Complete the following:
Take this opportunity to describe the 4 different approaches and techniques a hacker would use to steal the organization's data.
For each approach, discuss what methods can be used to circumvent the attack, prevent it, or minimize the disruption caused by the event.
Include 2–3 pages of material covering the 3 discussion areas in Section 5 of your Key Assignment document (including the completed previous 4 sections).
social engineering,dumpster diving,identify theft,cyberterrorist
.
You have been asked to participate in a local radio program to add.docxshericehewat
You have been asked to participate in a local radio program to discuss the role of corrections in the community. The audience will debate whether the focus should be on rehabilitating offenders, punishing offenders, or isolating chronic offenders. You must decide which role should be the focus of the community's corrections policy and prepare to explain your viewpoint on the role of corrections by anticipating questions from callers and relating corrections issues to the topic you are researching.
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You have been appointed as a system analyst in the IT department of .docxshericehewat
You have been appointed as a system analyst in the IT department of a selected university in Malaysia. You are responsible to develop an online admission system for the university. For this reason, you have to do an analysis and design to model the online system that could be developed later. Identify the requirements for the system and produce a software requirement specification (SRS) to document all the details.
.
You choose one and I will upload the materials for u.Choose 1 of.docxshericehewat
You choose one and I will upload the materials for u.
Choose 1 of the following 3 questions, and answer it in a paper of no more than 1000 words. Submit that paper by
November 4
at midnight PST in the appropriate IICS515 Moodle dropbox.
4. Monday October 27 lecture
Themes: Global Media Governance and Regulation; The Internet and Digital Media
Readings: Chapter 5, “The Medium: Global Technologies and Organizations,” and Chapter 6, “The Internet”
In this lecture, we discussed the definition and history of communication rights as one element or dimension of communication policy, and used it to bring to life a subject—policy—that sometimes seems abstract and technical in nature.
In doing so, we noted the evolution from a “negative” rights view of communication rights, as expressed in Article 19 of the United Nations Universal Declaration of Human Rights in 1948, to the more “positive” definition of communication rights explained in the lecture content derived from the work of Marc Raboy (and Jeremy Shtern).
Remember that “negative” does not mean “bad” here nor “positive” good. “Negative” and “positive” rights—which are ways of thinking about all human rights, not just communication rights—are instead ways of characterizing the orientation of rights toward individuals and society. Negative rights are defined in terms of freedom
from
things, and positive rights in terms of freedom
to
have or do certain things. Both negative and positive rights derive their legitimacy from fundamental and universal consideration of what it means to be human and to be treat people as human beings.
In our case study at the end of the lecture, we then discussed how a “positive” approach to communication rights could help us better understand and perhaps act against cyberbullying.
In your paper, and in your own words, define “communication rights,” and then briefly explain the evolution from the negative to the positive rights approach to communication rights.
Once you have done that, and with reference to the cyberbullying pamphlet from the Canadian government attached to your lecture notes, demonstrate how a “positive” rights approach to communication rights can help us better understand and prevent cyberbullying. In other words, what are the limitations of approaching cyberbullying from a “negative” rights perspective, and what does a “positive” approach to communication rights do to help us understand and perhaps act against cyberbullying?
Cyberbullying is a problem in international communication that affects many, especially vulnerable teenagers, as illustrated in the case of the late Amanda Todd (from British Columbia).
You do not need to use the McPhail chapter here, as it is not directly relevant to this question. Rather, draw on the lecture notes and the podcast as your sources here.
5. Wednesday October 29 lecture
Themes: Global Media Case Study in Media and the Arab World; Orientalism
Readings: Said, Edward (1978)..
You are Incident Commander and principal planner for the DRNC even.docxshericehewat
You are Incident Commander and
principal planner for the DRNC event. As you commence the planning process, consider the two fundamental types of error committed by policy makers in their reliance on intelligence reports to formulate policy. What would you do to minimize these errors from occurring and adversely affecting your policy decisions?
Min 500 words, In text references, APA format
.
You DecideCryptographic Tunneling and the OSI ModelWrite a p.docxshericehewat
You Decide
Cryptographic Tunneling and the OSI Model
Write a paper consisting of 500-1,000 words (double-spaced) on the security effects of cryptographic tunneling based on an understanding of the OSI (Open Systems Interconnect) model (Review the OSI Simulation in the Week 3 Lecture).
Provide input on the type of cryptographic tunneling protocols (e.g., L2TP, IPSEC, SSL, etc.) that may be used, the layer(s) of the OSI at which each operates, and also recommend how they may be implemented. Cryptographic tunneling is inherent in building any common virtual private network (VPN).
.
You are working as a behavioral health specialist in a neurological .docxshericehewat
You are working as a behavioral health specialist in a neurological research center and are responsible for participant education. There are three participants to choose from: Stephanie has experienced a stroke; Jamie has experienced an amputation; and Robert has experienced a traumatic brain injury. Choose one participant to work with.
We are chosing Robert and his traumatic brain injury
Prepare
a 1,000- to 1,200-word paper that explains the functions and limitations of neural plasticity in the participant's recovery process.
Include
two to three peer-reviewed sources.
.
You are to write up a reflection (longer than 2 pages) that discusse.docxshericehewat
You are to write up a reflection (longer than 2 pages) that discusses what happened in the prisoner's dilemma activity we did in class on Monday, April 20. Some points to cover include why you took the action you took, what you thought others were going to do and why, and what actually happened. And what implications this has for situations in the work place where individuals may take different actions than might be the most beneficial for the team as a whole.
.
You can only take this assignment if you have the book Discovering t.docxshericehewat
You can only take this assignment if you have the book Discovering the Humanities. This homework needs to be done by reading Chapter Nine. It needs to be a minimum of 150 to 200 words. It needs citations and referances.
Western art and architecture has influenced and been influenced by cultures in India, China, and Japan.
Part I:
Using examples provided from this unit's reading, discuss how the artistic culture in either India, China, or Japan (select one) exhibits influence from Western cultures. Discuss, too, the reciprocal connection, specifically explaining how India, China, or Japan influenced Western art and architecture.
Part II:
Add to your post by discussing the similarities and differences between art from your selected culture (India, China, or Japan) and ancient Greek sculpture. Use examples and images to support your ideas.
.
You are to interview a woman 50 and older and write up the interview.docxshericehewat
You are to interview a woman 50 and older and write up the interview
in a 5 page MLA paper. You ask questions intended to elicit information about her life
and how it relates to the history of women in the late 20th century. Your paper
should be normal margins, 10-12 pt. font, typed and double-spaced. It should
include the approximate age of your interviewee—it does not have to include her
name.
EXAMPLE QUESTIONS ..........
What’s your first, most vivid memory? Going to my grandma and grandpa’s farm and making grandma walk me out to the outhouse for fear of a mean bannie rooster would peck me to death. He was afraid of grandma.
What was the apartment or house like that you grew up in? How many bedrooms did it have? Bathrooms? I lived with my mother and father mostly in a house in the city that had 2 bedrooms, 1 bathroom. I had to share a room with my older brother that was upstairs.
What was your bedroom like? Very simple. It had 2 beds made of feathers, a desk with a lamp and one dresser for our clothes. Dallas (my brother got the bottom 2 and I got the top 2)
Can you describe the neighborhood you grew up in? Not really. Every chance I got I went to grandma and grandpas and spent time with them. They lived deep in the country. I had one friend out there that lived about 3 miles away on the next farm. His name was Carl.
Tell me about your parents. Where were they born? When were they born? What memories do you have of them? Both parents were born in Richmond, IN. Memories include more of my mother than my father. He was a drunk that stayed out all the time. He only came home when he was ready to pass out or to beat us.
Who was more strict: your mother or your father? Do you have a vivid memory of something you did that you were disciplined for? Since mom was the main one around I would say that she was more strict. I remember one instance when I was about 16 and mom had kicked me out of the house because she was forced to work with dad being gone all the time and I was telling her that I no longer wanted to take care of my little brother because I felt like I was his mother rather than her and that I didn’t want to do anymore of the house work. It was her house she should have to clean it. She kicked me out. I was sitting on the porch crying and dad came home (sober for once) and sat on the porch with me, got me calmed down and offered to give me a ride to grandma and grandpa’s.
Did your parents have a good marriage? No they had a horrible marriage.
How did your family earn money? How did your family compare to others in the neighborhood – richer,
poorer, the same? My family earned money from my mother working in a diner. Dad worked in a mill but we rarely saw his money. We did alright but I would say that we were on the poorer end of society.
What kinds of things did your family spend money on? The necessities and that was it.
How many brothers and sisters do you have? When were they born? What memories do yo.
You are to complete TWO essays and answer the following questions. .docxshericehewat
You are to complete TWO essays and answer the following questions. Here are your questions:
1) How has the information provided in this class changed or reinforced your perspective on an issue(S). Please provide details.
2) What do you believe is the biggest challenge facing our nation and why? Be specific and detailed. What can be done to address this challenge? Be realistic and detailed in your responses.
750 - 800 words each essay
no plagiarism
.
You are the vice president of a human resources department and Susan.docxshericehewat
The vice president of HR wants to conduct a performance evaluation of Susan, who has worked as an executive assistant for one year. While Susan completes assignments efficiently and is well-liked, the vice president wants her to be more proactive in taking on additional responsibilities through professional development opportunities. The performance evaluation will provide feedback on Susan's performance, set goals for the future, and determine compensation. It will address areas like professional development, job duties, communication, work relationships, and recommendations for pay.
You are the purchasing manager of a company that has relationships w.docxshericehewat
You are the purchasing manager of a company that has relationships with many different suppliers. All information about orders, shipments, etc. is still manually exchanged. You have discussed incorporating Internet technologies to help manage the supply chain.
In 1-2 pages, summarize the advantages of using Internet technologies versus traditional methods in supply chain management.
.
You are to briefly describe how the Bible is related to the topics c.docxshericehewat
You are to briefly describe how the Bible is related to the topics covered in the course. An integration of the Bible must be explicitly shown, in relation to a course topic, in order to receive points. In addition, at least two other outside scholarly sources (the text may count as one) should be used to substantiate the group’s position.
.
You are the manager of an accounting department and would like to hi.docxshericehewat
The accounting department manager wants to hire a managerial accountant to focus on internal accounting. However, the CEO is not convinced such a position is needed. A 2-page memo should explain that an internal accounting system tracks financial transactions within a company, provides timely financial reports for management decision making, and ensures compliance with internal controls and procedures.
You are the new chief financial officer (CFO) hired by a company. .docxshericehewat
You are the new chief financial officer (CFO) hired by a company. The chief executive officer (CEO) indicates that in the past, there was little rhyme or reason for the prior CFO to approve or disapprove of large capital projects or investments that various managers proposed. You mentioned to the CEO that there are three primary methods of capital budgeting, and they are as follows:
Simple payback method
Net present value method
Internal rate of return (IRR) method
Discuss the following topics on the Group Discussion Board and write a group paper between 700–850 words. Assign topics to be written by each group member and compile it all together before submitting your group paper:
A company's cost of capital and how it is calculated
What the marginal cost of capital is and how it differs from the weighted average cost of capital
.
You are the manager of a team of six proposal-writing professionals..docxshericehewat
You are the manager of a team of six proposal-writing professionals. You are tasked with completing one 50 page formal proposal as well as a 1-2 page summary advocating funding for a new sports arena. Your supervisor, a member of the senior leadership team, wants to know how you plan to successfully accomplish the assignment. Prepare a PowerPoint Presentation to your supervisor that conveys the following information:
As manager, how will you organize the work to prepare a proposal?
What tasks will each professional be assigned and why?
What three or four communication tools will you propose be used to effectively articulate the proposal and why? (For example, formal paper-based, PowerPoint Presentation, blog, Twitter, Facebook, LinkedIn, etc.)
.
Level 3 NCEA - NZ: A Nation In the Making 1872 - 1900 SML.pptHenry Hollis
The History of NZ 1870-1900.
Making of a Nation.
From the NZ Wars to Liberals,
Richard Seddon, George Grey,
Social Laboratory, New Zealand,
Confiscations, Kotahitanga, Kingitanga, Parliament, Suffrage, Repudiation, Economic Change, Agriculture, Gold Mining, Timber, Flax, Sheep, Dairying,
Leveraging Generative AI to Drive Nonprofit InnovationTechSoup
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Gender and Mental Health - Counselling and Family Therapy Applications and In...PsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
How Barcodes Can Be Leveraged Within Odoo 17Celine George
In this presentation, we will explore how barcodes can be leveraged within Odoo 17 to streamline our manufacturing processes. We will cover the configuration steps, how to utilize barcodes in different manufacturing scenarios, and the overall benefits of implementing this technology.
Elevate Your Nonprofit's Online Presence_ A Guide to Effective SEO Strategies...TechSoup
Whether you're new to SEO or looking to refine your existing strategies, this webinar will provide you with actionable insights and practical tips to elevate your nonprofit's online presence.
Andreas Schleicher presents PISA 2022 Volume III - Creative Thinking - 18 Jun...EduSkills OECD
Andreas Schleicher, Director of Education and Skills at the OECD presents at the launch of PISA 2022 Volume III - Creative Minds, Creative Schools on 18 June 2024.
This presentation was provided by Rebecca Benner, Ph.D., of the American Society of Anesthesiologists, for the second session of NISO's 2024 Training Series "DEIA in the Scholarly Landscape." Session Two: 'Expanding Pathways to Publishing Careers,' was held June 13, 2024.
🔥🔥🔥🔥🔥🔥🔥🔥🔥
إضغ بين إيديكم من أقوى الملازم التي صممتها
ملزمة تشريح الجهاز الهيكلي (نظري 3)
💀💀💀💀💀💀💀💀💀💀
تتميز هذهِ الملزمة بعِدة مُميزات :
1- مُترجمة ترجمة تُناسب جميع المستويات
2- تحتوي على 78 رسم توضيحي لكل كلمة موجودة بالملزمة (لكل كلمة !!!!)
#فهم_ماكو_درخ
3- دقة الكتابة والصور عالية جداً جداً جداً
4- هُنالك بعض المعلومات تم توضيحها بشكل تفصيلي جداً (تُعتبر لدى الطالب أو الطالبة بإنها معلومات مُبهمة ومع ذلك تم توضيح هذهِ المعلومات المُبهمة بشكل تفصيلي جداً
5- الملزمة تشرح نفسها ب نفسها بس تكلك تعال اقراني
6- تحتوي الملزمة في اول سلايد على خارطة تتضمن جميع تفرُعات معلومات الجهاز الهيكلي المذكورة في هذهِ الملزمة
واخيراً هذهِ الملزمة حلالٌ عليكم وإتمنى منكم إن تدعولي بالخير والصحة والعافية فقط
كل التوفيق زملائي وزميلاتي ، زميلكم محمد الذهبي 💊💊
🔥🔥🔥🔥🔥🔥🔥🔥🔥
SWOT analysis in the project Keeping the Memory @live.pptx
Four challenges face the nursing workforce of today and tomorrow .docx
1. Four challenges face the nursing workforce of today and
tomorrow: the aging of the baby boom generation, the shortage
and uneven distribution of physicians, the accelerating rate of
registered nurse retirements, and the uncertainty of health care
reform. This article describes these major trends and examines
their implications for nursing. The article also describes how
nurses can meet these complex and interrelated challenges and
continue to thrive in an ever-changing environment.
· Previous article in issue
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Keywords
Nursing workforce
physician shortage
registered nurse retirements
Over the first 15 years of the 21st century, the size, education,
and age of the nursing workforce changed considerably. The
annual number of nursing graduates increased rapidly. The
growth of registered nurses (RNs) prepared with bachelor’s
degrees exceeded those prepared with an associate’s degree
starting in 2011, and the number of RNs who have obtained a
graduate degree (master’s, PhD, or doctorate in nursing
practice) increased fourfold. Moreover, the size of the
workforce increased by approximately 1 million RNs, with
employment growth occurring in hospital and nonhospital
settings. Since 2000, the number of employed RNs older than
age 50 years increased by 600,000, and these older RNs
currently account for 30% of RNs working in hospital settings
and 40% of RNs working in nonhospital settings (Buerhaus,
Skinner, Staiger, & Auerbach, In press).
These changes in the RN workforce occurred alongside other
forces. The new millennium began with a national shortage of
more than 100,000 RNs that lasted until 2003, a brief but sharp
economic recession in 2001, and the development and spread of
the quality and safety movement. The Great Recession in 2007
2. to 2009 was followed by a slow and prolonged recovery, the
implementation of health reforms created by the 2010 Patient
Protection and Affordable Care Act (ACA), and the release of
the National Academies Institute of Medicine Report, The
Future of Nursing: Leading Change, Advancing Health (Institute
of Medicine, 2010).
The increasing educational preparation of RNs, the growth in
the size of the nursing workforce, and the ability to overcome
nursing shortages, recessions, and health reform implementation
establishes a strong foundation that can sustain the nursing
profession as it faces new and unprecedented challenges that lie
ahead. This article discusses four challenges that RNs
throughout the country will face during the next 20 years. They
include the aging of the nation’s baby boom generation,
physician shortages, the retirement of RNs, and a new era of
health reform implementation.
These challenges will undoubtedly affect nursing regulation,
particularly those rules concerned with patient care safety in
acute and non–acute care settings, use of technology, access to
care, scopes of practice for both nurse practitioners (NPs) and
RNs, and accreditation of nursing education programs.
Regulators will need to be alert for new regulations that may be
needed or current regulations that may need to be examined and
updated to help nurses successfully respond to each of these
challenges.
Aging of the Baby Boom Generation
An estimated 76 million people were born during the baby boom
from 1946 to 1964, far more than any generation born before
them (Colby & Ortman, 2014). By 2030, all baby boomers will
be aged 70 years and older, and the number of U.S. seniors will
be 55% greater than that in 2015 (Kirch & Petelle, 2017). The
U.S. population aged 85 years and older will double from 6.3
million in 2015 to nearly 13 million by 2035 (See Figure 1), and
the number of U.S. residents aged 100 years will triple between
today and 2045 (U.S. Census Bureau, 2014).
3. 1. Download : Download high-res image (161KB)
2. Download : Download full-size image
Figure 1. Projections of Male, Female, and Total Number of the
U.S. Population Aged 85 Years and Older, 2015–2060
Source:U.S. Census Bureau (2014).
Currently, 54 million people are enrolled in Medicare, which
provides health insurance coverage to U.S. citizens aged 65
years and older, people with end-stage renal failure, and people
with certain disabilities (Centers for Medicare and Medicaid
Services [CMS], 2017). As baby boomers age, Medicare
enrollment is projected to grow to 80 million in 2030 (CMS,
2016) and lead to a substantial increase in demand for health
care. Because the demand for RNs is closely related to the
factors that drive the demand for health care, as the Medicare
population increases, so too will the demand for RNs.
The large numbers of aging baby boomers will also increase the
intensity and complexity of the nursing care required. Because
of advancements in medicine, more active lifestyles, and lower
rates of smoking, emphysema, and myocardial infarction, baby
boomers are predicted to have longer life expectancies than
previous generations and therefore will use more health care
services financed by Medicare (King, Matheson, Chirina,
Shankar, & Broman-Fulks, 2013).
Alhough baby boomers may be living longer, the prevalence of
chronic diseases among them is increasing. By 2030, 40% of
baby boomers are expected to have diabetes, 43% are expected
to have heart disease, and 25% are expected to have cancer.
Additionally, the percentage of Medicare beneficiaries with
three or more chronic conditions is predicted to increase from
26% in 2010 to 40% in 2030 (Goldman & Gaudette, 2015).
Chronic disease management will stimulate an increase in the
demand for health care providers, the complexity of treatment
regimens, the use of prescription medications (with consequent
untoward adverse effects), the potential for conflicting medical
advice, and the risks of duplicative tests, hospitalizations, and
emergency visits (Centers for Disease Control and Prevention,
4. 2013).
Approximately 11% of adults aged older than 65 years and 32%
aged older than 85 years have Alzheimer disease (Alzheimer’s
Association, 2016). Degenerative and debilitating diseases will
require long-term care and challenge families, professional
caregivers, and public resources. In the United States, the old-
age dependency ratio (number of people aged 65 years and older
per 100 people aged 20 to 64 years) will increase from 21 in
2010 to more than 30 by 2030 (Ortman, Velkoff, & Hogan,
2014), increasing pressures on health care providers and family
caregivers.
Aging baby boomers are also expected to affect the geography
of retirement. In 2010, states with the highest proportion of
their population aged older than 65 years were Florida (17%),
West Virginia (16%), Maine (16%), and Pennsylvania (15%)
(West, Cole, Goodkind, & He, 2014). In 2014, 32% of women
and 18% of men aged older than 65 years lived alone (Stepler,
2016). If baby boomers follow the pattern of past generations,
the rural and small-town population of 55- to 75-year-olds will
increase to 14 million by 2020. Much of this growth is reflected
by “aging in place,” in which older people have remained in
rural communities, while younger people have left for urban
areas (Baernholdt, Yan, Hinton, Rose, & Mattos, 2012).
However, those living in rural areas have access to fewer health
and social resources than those in urban areas, and they have
higher rates of poverty, unemployment, substance abuse, and
depression. Older people living in rural areas often face a
double jeopardy. In addition to the increased risk of age-
associated mental health problems and cognitive degenerative
diseases, those living in rural areas are more likely to
experience social isolation and inadequate or no access
to mental health services (Administration on Aging, 2011).
The increased number of older people, the complexity of their
health conditions, their geographic location, and their need for
social services and family involvement will pose many
challenges for nurses and health care delivery organizations in
5. the coming years. Not only will the demand for nurses increase,
but also the intensity and types of nursing care required will
rise.
Physician Shortages
The American Association of Medical Colleges estimates a
shortage of between 40,800 and 104,900 physicians by 2030
driven by decreasing working hours, retirement, and increasing
demand, particularly from aging baby boomers (Kirch and
Petelle, 2017, Association of American Medical Colleges,
2017). Separately, the Health Resources and Services
Administration (HRSA) projects a shortage of 24,000 primary
care physicians by 2025, mainly because of the aging of the
population and the overall population growth (HRSA, 2016).
However, not all agree that physician shortages exist. For
example, Gudbranson, Glickman, & Emanuel (2017) argue that
with improvements in the organization of health care, gains in
administrative efficiency, and technologic advances
in telemedicine and communication, the size of the physician
workforce is more than adequate to meet current and future
demands of the U.S. population.
Despite discrepancies regarding the estimates on the size,
timing, and existence of primary care and specialty physician
shortages, little disagreement exists regarding the uneven
geographic distribution of physicians (Gudbranson, Glickman,
& Emanuel, 2017). Rural areas average 68 primary care
physicians per 100,000 residents; urban areas average 80 per
100,000 (Champlin, 2013). Residents of rural areas are already
reporting long wait times and difficulties accessing a physician
(Kirch & Petelle, 2017). On the eve of the ACA’s 2014 health
insurance expansions, nearly 60 million people had inadequate
access to primary care, and the HRSA reported 5,900 health
professional shortage areas in the United States (Graves et al.,
2016).
Current and projected shortages of primary care and specialty
care physicians as well as the persistent uneven geographic
distribution mean that the nursing workforce will be
6. increasingly called on to provide some care that would
otherwise be provided by physicians (DesRoches, Clarke,
Perloff, O’Reilly-Jacob, & Buerhaus, In press).
Retirement of Registered Nurses
Beginning in the early 1970s, career-oriented and primarily
female baby boomers embraced the nursing profession in
unprecedented numbers following large increases in health care
spending resulting from the introduction of Medicare and
Medicaid (Buerhaus, Auerbach, & Staiger, 2017). By 1990,
baby boomer RNs numbered nearly 1 million and accounted for
about two-thirds of the RN workforce (Buerhaus, Staiger, &
Auerbach, 2000). As these RNs aged over the next two decades,
they accumulated substantial knowledge and clinical
experience. The number of boomer RNs peaked at 1.26 million
in 2008 and, after a brief delay in the early part of the current
decade (likely associated with the Great Recession), the baby
boomer RN cohort began retiring in large numbers (Auerbach,
Buerhaus, & Staiger, 2014). Since 2012, roughly 60,000 RNs
have exited the workforce each year, and by the end of the
decade, more than 70,000 RNs will be retiring annually (Staiger
et al., 2012, Auerbach et al., 2015). In 2020, baby boomer RNs
will number 660,000, roughly half their 2008 peak.
The retirement of 1 million RNs between now and 2030 means
the years of nursing experience and knowledge they have
accumulated will be lost to the nursing workforce as these RNs
exit from the workforce. The authors estimate that in 2015, the
nursing workforce lost 1.7 million experience-years (the number
of retiring RNs multiplied by the years of experience for each
RN), double the number in 2005 (See Figure 2). This trend will
continue to accelerate as the largest groups of baby boomer RNs
reach their middle to late 60s. The departure of such a large
cohort of experienced RNs means that patient care settings and
other organizations that depend on RNs will face a significant
loss of nursing knowledge and expertise that will be felt for
many years to come.
7. 1. Download : Download high-res image (321KB)
2. Download : Download full-size image
Figure 2. Years of Experience Lost to the RN Workforce, 1980–
2030a
Health Care Reform
The 2016 elections gave Republicans control over the White
House and Congress and, as promised, they initiated efforts to
repeal and replace the ACA. As of this writing, they have not
been able to do so, and the main goals of the ACA remain:
improving the efficiency of health care delivery systems,
expanding insurance coverage, increasing the number of certain
health care professionals, emphasizing health education
and disease prevention, and replacing fee-for-service payment
with a value-based system. Determining the direct impact of
these reforms on the nursing workforce is difficult, but RN
employment in both hospital and nonhospital settings has
continued to grow over the past several years (Buerhaus,
Skinner, Staiger, & Auerbach, In press).
However, the new administration and Congress now seek to
scale back and either modify or reform the ACA in several
ways, including eliminating personal and employer mandates to
purchase health insurance, converting Medicaid to a block grant
program, promoting health savings accounts, emphasizing
greater competition among insurers, and allowing states more
flexibility in determining what constitutes essential health
benefits and coverage of pre-existing conditions (Antos &
Capretta, 2017). Recent Congressional Budget Office estimates
suggest that these provisions would lead to large reductions in
the number of people with health insurance. If the
Congressional Budget Office estimates are reasonably accurate,
the demand for health care would fall toward pre-ACA levels,
and hospitals would once again contend with a larger portion of
uncompensated care. Moreover, how an increasing portion of
uninsured hospital patients will affect nurse employment is
unclear, but greater financial pressure on hospitals could lead to
lower RN wages and hospital closures.
8. Meeting the Challenges
Each of these challenges is formidable and will significantly
affect the RN workforce. What is more, these challenges will
occur simultaneously and interact with each other, making the
next 15 years perhaps the most important time in the nursing
profession’s history.
Aging Baby Boomers
Given the large number of baby boomers with multiple chronic
diseases, the nursing profession should realize that its clinical
workforce will be unable to provide all the care required. After
all, nursing education undergraduate and graduate programs
offer little focused content on geriatrics, and such content has
never been popular with nursing students. Thus, nurses should
not count on the education system to meet this challenge.
Instead, nurses should form partnerships with others—social
workers, pharmacists, communityhealth departments, primary
care and other physicians, community health workers,
churches, home health care agencies, long-term care facilities,
and emerging health care delivery systems—to both understand
the scope of need in their communities and to determine how
resources can best be organized to provide a more coordinated
and efficient system of care delivery. Such partnerships can
involve community housing planners; schools of engineering,
business, and architecture; developers of wearable digital
sensors; and others who can contribute to modifying physical
environments, developing business ventures, and enabling
digital devices to ease the burdens on aging boomers and make
better use of professional and family caregivers.
Nurses in policy positions can urge state legislatures to
recognize the health care implications of aging baby boomers
and to find nonpartisan public policy strategies that can help
nurses and others improve the care of the nation’s aging society.
Similarly, nurses can develop interprofessional models of care
that go beyond physical care to provide mental and behavioral
health support, especially for patients with Alzheimer disease
and other cognitive degeneration conditions. Nurses, by
9. themselves, are unlikely to be able to provide all the needed
care, but they can lead the development of new care models and
interpforessional and interdisciplinary teamwork as well as
increase their influence in shaping private and public policies
and removing barriers to appropriate care delivery.
Shortages of Physicians
Although the magnitude of physician shortages is uncertain,
little doubt exists about their effect. They will impact nurses
providing primary or specialty care, particularly in rural areas
and for vulnerable populations—women, low-income people,
the uninsured, people who do not speak English as a first
language, people with disabilities, people who are dually
eligible for Medicare and Medicaid, and Native Americans and
African Americans (DesRoches, Clarke, Perloff, O’Reilly-
Jacobs, & Buerhaus, In press). The expected increase in demand
for primary care and the uncertainties associated with payment
and delivery reforms have invigorated policymakers to address
how to ensure the primary care workforce can respond to the
health needs of all U.S. individuals.
Efforts aimed at removing restrictive state-level scope-of-
practice laws and regulations governing NPs should continue.
Additionally, regulations promulgated at the local level (namely
by hospitals and insurers affecting NP hospital admitting
privleges reimbursement, etc.) can also constrain NPs’ scope,
often more directly, even in states that do not impose state-level
restrictions, will need to be carefully examined. Growing
evidence on the cost, quality, consumer satisfaction, and other
contributions of primary care NPs is stimulating policymakers
and influential health organizations to increase the number of
NPs and to expand their scopes of practice (Donelan et al.,
2013, DesRoches et al., 2013, Buerhaus et al., 2015, Perloff et
al., 2016). However, rather than viewing the lifting of scope-of-
practice restrictions as a fight between nurses and physicians,
NP leaders could structure their public policy arguments around
the opportunity (and evidence) that NPs can increase access to
care, especially to aging and medically complex baby boomers
10. and people living in rural areas (which should appeal to
Democrats), and reduce costs and increase consumer choice
(which should appeal to Republicans).
Furthermore, NP leaders need to recognize that solutions
addressing the implications of physician shortages and the
growing demand for care of older adults must acknowledge the
complex relationship between physicians and NPs. Beyond
differences in perspective (cure versus holism), education,
training, and the ways their roles have been shaped by health
care delivery organizations over decades, the roles and
expectations of both physicians and NPs are changing. Payment
incentives are evolving, and health delivery systems are
beginning to emphasize population health and implementation
of care delivery models that address social determinants of
health. In this environment, improving the capacity of the health
care workforce can be aided by nursing leaders adopting a more
inclusive perspective and working with physicians and other
stakeholders to jointly determine questions such as who can best
provide needed services and whether changes in payment and
other policy changes are needed to improve the delivery and
coordination of care. Ultimately, NP leaders should envision a
relationship with physicians that allows for the evolution of
roles and practices that make sense to both NPs and physicians,
respect each other’s strengths, and ultimately lead to a
reconfiguration of the workforce that is more responsive to the
health needs of a changing society (Buerhaus, DesRoches,
Dittus, & Donelan, 2015).
Growing concern about the adequacy of the primary care system
has stimulated efforts to find new ways to reconfigure primary
care delivery systems. This concern is best described in the
recent Josiah Macy Jr. Foundation report, Registered Nurses:
Partners in Transforming Primary Care (2017). The report
makes clear the futility of continuing to use RNs in limited
ways and offers recommendations aimed at expanding the
number of RNs and their roles in primary care, increasing
primary care content and clinical experience in undergraduate
11. nursing education, and offering other strategies to expand the
productive capacity of RNs providing primary care. In the
future, nursing education accreditors may need to consider
regulatory incentives to increase the inclusion of primary care
content into the curriculum.
Accelerating Rate of RN Retirements
The replacement of retiring RNs will not occur uniformly.
Health care delivery organizations in some regions of the
country will face faster RN retirements and slower replacements
(especially the New England and Pacific regions) than
organizations in other regions (the Southern and Central
regions) (Buerhaus et al., 2017, Auerbach et al., 2017).
Consequently, some organizations will experience bursts in RN
retirements that may result in temporary nursing shortages and
disruptions in care delivery. How can health care delivery
organizations overcome the loss of so much nursing knowledge,
wisdom, and expertise?
Health care administrators, state and federal policy makers, and
quality review organizations must recognize that the retirement
of a large number of RNs has only begun. It will intensify over
the coming years, and the loss of RNs with decades of
experience will create multiple risks. Foremost, the quality of
patient care could decrease as new, less experienced RNs
replace RNs with decades of experience. This statement does
not intimate that RNs with fewer years of nursing experience
are less qualified to provide high-quality nursing care. Rather,
it simply acknowledges that the longer an RN is in the
workforce, the more likely he or she is to have an increased
ability to effectively manage all types of clinical and
organizational challenges.
Experienced RNs are likely to be more adept at identifying
complications and unexpected changes in patient conditions
sooner and respond appropriately. They are also more likely to
know how to manipulate the organization’s culture to get things
done, make clinical assignments that better match the
knowledge and skills of nurses with the needs of the patient,
12. serve as role models and mentors, and deal effectively with
physicians, administrators, and others to ensure the well-being
of patients and families. All these attributes matter greatly in
providing a consistent, predictable, and safe patient
environment.
Hospital chief nursing executives, hospital patient care unit
managers, and human resource officers should take four actions
to anticipate and prevent the negative consequences that could
result as RN retirements accelerate.
First, information on an organization’s nursing workforce must
be gathered to ascertain when and how many RNs are expected
to retire and identify the nursing units, departments, and patient
populations that will be affected. Sharing this information with
physicians and other clinicians who will be affected and seeking
their involvement will be critical to mitigating potential harmful
consequences.
Next, hospital leaders should prioritize working with
department and unit leaders to engage soon-to-be retiring RNs
to learn what can be done to delay their retirement—for
example, decreasing work hours and the number of workdays,
modifying their responsibilities, improving the ergonomic
environment to minimize injuries, or revising organizational
policies and clinical conditions that hinder and dissatisfy
nurses. Similarly, older, more experienced RNs could be offered
opportunities to fill new roles in community engagement,
patient navigation, or education and prevention.
Organizations also should encourage the creation of programs
that bring older and younger RNs together to identify the
knowledge and skills needed by rising RNs that can be imparted
by older, more experienced RNs.
Finally, organizations should review and strengthen succession
planning to ensure that retiring nursing managers are replaced
by RNs well prepared to assume management of clinical and
administrative operations on patient-care units. Future RN
leaders could be identified and partnered with soon-to-be
retiring RNs managers and participate in formal programs in
13. management and leadership development, team building,
communications, budgeting, program development, and other
leadership roles.
Effects of Health Care Reform
Although the future of the ACA is uncertain, the provisions that
aim to increase the efficiency of health care systems and move
away from a fee-for-service system toward value-based
purchasing could be advantageous to the nursing workforce. The
spread of accountable care organizations, medical and health
care homes, and bundling payments means that systems will
want to employ the clinicians most productive at achieving the
best outcomes at lowest cost. For example, in a fee-for-service
environment, much of the work that RNs do in care
management, care transitions, and patient self-management in
their home is not directly billable and, therefore, is a cost to the
organization, and the care is underemphasized. In a value-based
environment in which provider organizations are more likely to
face financial incentives to be accountable for the quality and
total cost of care, the same care management activities become
advantageous to the organization’s bottom line, assuming they
help the organization avoid costly care episodes, such as
hospitalizations, readmissions, and unnecessary use of
emergency departments. RNs are already working in expanded
roles in Medicare accountable care organizations, including
direct provision of services and in care management and
coordination roles (Pittman & Forrest, 2015). When health care
organizations are at risk for the total health spending of their
attributed patients, their concerns can extend to addressing
social determinants of health and focusing on population
factors, which can enhance the roles of RNs, particularly those
with expertise in public health, care coordination, and
partnership building to improve health care.
Conclusion
Although the four challenges facing the nursing workforce are
daunting, they offer nurses unprecedented opportunities to
shape health care delivery systems and increase nurses’
14. influence everywhere along the care delivery continuum. Taking
advantage of the opportunities created by these challenges will
require leadership from all areas of nursing—practice,
administration and management, education, research, policy,
and unions. Nurses in each of these areas need to see
themselves as leaders. According to Bohmer (2013), leaders
anticipate challenges, see the big picture, motivate others to
focus on the right opportunities, and create conditions that help
achieve common goals. Perhaps the most important step moving
forward is for all RNs to see themselves as leaders and
spearhead efforts to address the challenges that will face the
nursing workforce in the years ahead.
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